The Revenge of the Malaria Mosquito

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“No Good Deed Goes Unpunished”

                  - Franklin Pierce Adams

Reducing the global incidence of malaria is one of the great historical triumphs of public health. Malaria has not completely disappeared as a disease. There were 228 million cases of malaria globally in 2018. However, the incidence of malaria has been significantly reduced from its historical highs. In the early stages of the fight against malaria, quinine was made widely available. There were public health campaigns to eliminate breeding spots for mosquitoes. Insecticides were widely used to reduce the mosquito population. Pharmaceutical research has discovered antimalarial drugs that are substantially more effective than quinine. Malaria used to be prevalent in every region of the globe except the Arctic and Antarctic. Malaria has been nearly eliminated from North American and Europe. It has been dramatically reduced in the rest of the world.

    

Normally, the elimination of a major disease is a good thing.

    

It was a mixed blessing in Thailand and Malaya.

    

How can the elimination of a disease that leads to fevered miserable death have a downside?

    

Southeast Asia historically had been a land of “freedom and plenty”.

    

The freedom and plenty are in quote marks for a reason.

    

Where governments ruled, government could be savage. War was commonplace. Taxation was confiscatory. Slavery was common. In Thailand, nobles maintained the right of claiming any young girl that suited their fancy. Punishments were horrific. Trials were generally trials by ordeal. Executions were long and torture-filled and horrific.

    

And if the kings did not bother you, there were still the pirates. Pirates routinely raided the coastline. Taking slaves was common. Stealing food supplies was common. Killing merchants for their goods was common.

    

Economic development levels were low. India, China and Indonesia were far richer than Thailand and Malaya. Ubiquitous thick jungles impeded land transportation. Pirates impeded sea transportation. Some trade was still possible despite all of this. Some merchants got rich. But Thailand and Malaysia were backwaters compared to most of their neighbors.

    

So, in what ways were Thailand and Malaya lands of freedom and plenty?

    

Population was sparse. Land was plentiful. People could have access to as much land as they liked.

    

Most ancient Southeast Asian rulers did not even worry about registering or controlling land. All they cared about was controlling people. Labor was scarce. Peasants were scarce. Farmers were scarce. Tradespeople were scarce. Soldiers were scarce. Jungle was all over the place. Anyone could grow anything they liked in whatever jungle they could find because there was so much jungle everywhere.

    

So how did peasants deal with kings they did not like? They ran into the forest. How did workers deal with employers they did not like? They ran into the forest. How did soldiers deal with officers they did not like? They ran into the forest.

    

Anyone who was unhappy could get rid of any problem by migrating fifty or one hundred or two hundred miles – finding a tropical paradise similar to the tropical paradise which had just been left. Runaways settled in new unoccupied land and continued living life on their own terms.

    

Forest living was comfortable living. One did not have access to the vast material wealth of a Chinese emperor or the storehouses of a successful Kolkata merchant. But the forest yielded vast amounts of natural fruits and vegetables, fish in the streams and animals that could be trapped or hunted. Agriculture was slash and burn. One had to work very hard for two days to a week chopping down all the trees and natural growths in a patch the size of a small bedroom. But after that, one simply set all of the chopped vegetation on fire, let it burn into ash, and one had a rich bed of fertile soil on which one could grow anything one liked. In return for about a week of hard work, peasants had a low maintenance garden that would provide most of the staples they would need for the next three to five years. That was a relatively easy lifestyle.

    

General labor scarcity meant that wages in whatever cities existed were high. Chinese and Indians migrated to Thailand and Malaya to get wages to quadruple or even dectuple what they could get in their home country. If urban living became too oppressive, retiring into the countryside for a life of tropical ease was a realistic possibility.

    

One consequence of such a small number of people and such a large amount of forest is that lots of people were able to completely avoid being governed at all. The mountainous regions in the East of Thailand and Burma the North of Cambodia, and the West of Vietnam and Laos were almost completely stateless. People lived in small self-governing villages. If one did not like a decision one’s neighbors made, one could simply pick up and move to a place with better neighbors or no neighbors.

    

The same conditions applied nearly everywhere on the island of Borneo. The coasts had rajahs and various local despots. A few days walk inland would get rid of your government problem once and for all.

    

What ended this regime of plentiful resources and personal liberty?

    

Population growth.

    

Population in Southeast Asia increased exponentially throughout the nineteenth century. It positively exploded in the twentieth century – notably after World War II.

    

As occurred in the rest of the world, death rates fell dramatically during modernization. Birth rates fell too – but much more slowly with a significant lag. The new combination of low death rates and high birth rates led to dramatic population growth.

    

What happened when Thailand and Malaysia had to deal with a population bomb?

    

First of all, labor was no longer scarce. Since labor was not scarce, wages ceased to be high. There were increasing problems of urban poverty and squalor.

    

Secondly, there was no longer plenty of land to absorb surplus population. Migrants continued to pour into the countryside. (In fact, pouring into the countryside became increasingly easy as governments build roads and highways that extended into the backlands.) But there was now less and less vacant property that one could move into within these backlands.

    

It did not help that the same governments that built all of those access roads had development projects planned for the territories they opened up. It also did not help that royalty, military figures and highly placed civilian administrators and elected politicians all had personal plans for that land. Huge estates were being created to support whatever export agriculture was lucrative at the moment. Those huge estates were not open to individual migrants seeking a hut and a slash-and-burn garden. In fact, those estates would not be even remotely hospitable to a slash-and-burn-oriented migrant; the newly opened land would be immediately deforested to allow for the creation of new plantations.

   

Even more land would be destroyed by dams built to provide hydroelectric power to the regions burgeoning cities.

   

But the population boom transformed Thailand and Malaya from labor scarce land rich countries to labor surplus land poor countries. The struggles over increasingly scarce land led to fully mobilized conflicts between, on one side, developers, the state and military interests – and on the other side, traditional residents of forested regions – who now had everything to lose and few opportunities for further migration. Pitched battles led to political mobilizations. These struggles represent some (but not all) of the political polarization in Thailand that led to the “the Yellows” (the conservative pro-Bangkok faction) fighting “the Reds” (the leftist pro-mountain rural faction.)

    

So the declining death rates of the twentieth century had surprisingly adverse consequences on the quality of life.

    

What caused death rates to decline?

    

In the European historical demographic experience, death rates declined as a function of improvements in food supply. The food supply increased due to

a. Increases in land supply coming from drainage of swamps and marginal land,

b. improved plowing techniques,

c. improved transportation allowing for commercial markets to develop in foodstuffs.

All of these eliminated the crop failures and famines that had been a demographic fact of life in Europe before the nineteenth century.

    

Thailand and Malaya already had perfectly adequate food supplies. What produced their decline in death rates was increased control over malaria. Better anti-malaria drugs, more spraying of insecticides in swampy areas, more use of mosquito netting and better hospitals, and medical care overall, all helped to reduce the incidence of malaria deaths in Southeast Asia. (These deaths were reduced, but not eliminated. Malaria still kills people in the tropical regions of the world.)

    

Reducing the number of malaria mosquitoes reduced the amount of human suffering associated with disease.

    

Increasing the number of people increased the amount of suffering associated with poverty, warfare and social conflict.

    

The Franklin Pierce Adam quote “No Good Deed Goes Unpunished” is signally apt.

    

What is the solution to this problem?

    

Birth control. Lots of birth control. 

    

But even with aggressive fertility control, world population is expected to double in the next fifty years.

    

The amount of arable habitable land on the planet is not expected to double in the next fifty years.

    

There is going to be more poverty. There are going to be more land conflicts. There are going to be more people migrating because the place they lived can no longer support the larger population it is expected to carry.

     

The effects of population growth are savage – even in a world where economic growth can cover for some of the needs.

    

We need to reduce global mortality. We need to keep people from dying. Neither old diseases like malaria or new diseases like COVID are good things to have.

    

But mortality reduction is not cost free.

    

With the saving of life comes global responsibility.

    

We must all work to see that the increased number of people our planet will have to support will have food to eat, a place to live and a way to survive.

    

Currently we are not doing that.

    

Expect a lot of hungry miserable displaced masses.

For More Information

 

The statistics on the contemporary incidence of malaria come from Leo Braack. April 24, 2020. “Good News About Malaria Elimination in Southeast Asia”. Globe: Lines of Thought Across Southeast Asia. https://southeastasiaglobe.com/southeast-asia-malaria-elimination/

For general discussions of the social histories of Thailand and Malaya, see Phongpaichit, Pasuk and Chris Baker. 2002. Thailand: Economy and Politics. New York, Oxford. Ouyyanont, Porphant. 2017. Regional Economic History of Thailand. Singapore, Yusof Ishak Institute. Mackay, Colin Robert.  2013. History of Phuket and the Surrounding Region. Bangkok, White Lotus Gomez, Edmund Terence and K. S. Jomo 1997. Malaysia' Political Economy: Politics, Patronage and Profits. New York, Cambridge. In general, Thai governance was far bloodier than was Malayan governance.

On the free populations of the uplands of Southeast Asia, see the many books of James Scott, a political scientist at Yale. A particularly good choice is his 2009 Art of NOT Being Governed: Anarchist History of Upland Southeast Asia. New Haven, Yale.

For discussions of population growth and mortality trends in Thailand and Malaya, see Smith, T. E. 1952. Population Growth in Malaya: Analysis of Recent Trends. London, Royal Institute of International Affairs and Cochrane. S. H. 1978. Population of Thailand: Its Growth and Welfare. Background Working Paper # 2 of 8 Prepared for the Thailand Basic Economic Report. Washington, World Bank.

On European mortality decline, see Livi-Bacci, Massimo. 1991. Population and Nutrition: Essay in European Demographic History. New York, Cambridge.

The internet has many data resources on world population trends. See Population Bulletins https://www.prb.org/collections/population-bulletins/ for all sorts of useful demographic analyses.