The Moses of Malaria: Nicolaas H. Swellengrebel (1885–1970) Abroad and at Home (review)

This book is a labor of love and learning and reveals in great detail how Nicolaas H. Swellengrebel contributed to our knowledge of malaria. For those who consider themselves malariologists of the twentieth or twenty-first centuries, it is a window into the life and thinking of an outstanding personality who unraveled many of the intricacies of malaria, the disease, its epidemiology, and control. It reveals how much was discovered by Swellengrebel in the early decades of the twentieth century and provides an admonition not to reinvent the wheel, but to build and expand our knowledge on the shoulders of such pioneers.

Nicolaas Swellengrebel was born in 1885 to an upper-class family in Amsterdam. His early interest in biology took him through high school and into university in spite of the warning by Hugo de Vries, one of his professors, that few jobs for biologists existed. His interest was in cytology of bacteria and whether or not they were nucleate. He showed that spirochetes were not bacteria and described the genus Boriellia after Dr. Borrel, with whom he worked at the Institut Pasteur in Paris in 1907. His development was influenced by famous bacteriologists and microbiologists, such as Pasteur and Koch, but his bent towards biology encountered issues with the medical hierarchy, few of whom had a biological background.

His initial public health work started with plague that was epidemic in Holland as well in the Dutch colonies in the East Indies. It was in the East Indies that he met Schuffner, the famous German malariologist, and set up a long and productive collaboration and friendship. It was this association that also involved him in the problems of malaria and fostered his understanding of its epidemiology and the importance of a detailed understanding of entomology in its transmission.

Swellengrebel was accompanied by his wife, Meta, on his second stint to the East Indies. Together they visited various outposts and stations examining the malaria situation and stressed the importance of identifying those species that were consistently infected with oocysts, thus differentiating between vectors and nonvectors. This phase of his work included much collaboration with Schuffner among other experts, plying the work of epidemiology, entomology and species sanitation (control of mosquito breeding sites). It was an important and informative period of his life. The book covers in detail much of this work and shows the level of sophistication reached by Swellengrebel as a malariologist.

The Swellengrebels returned to Holland in 1919 after the end of the Great War to deal with a major outbreak of tertian malaria in North Holland. His experience from the East Indies enabled him to devise a selective approach to reduce the scourge, a public health problem that stretched across Europe and western Asia. One of the major contributions of this book is to reveal and remind us of the enormous and extensive problem caused by malaria in Europe after that war. It details the work of the League of Nations Panel of Experts (League of Nations Malaria Commission) in dealing with the upsurge of malaria throughout Europe as well as the United States. In the first of several missions, the Commission, which included Swellengrebel, traveled for several months throughout Europe, and details of the extent of the problem are well illustrated through Swellengrebel’s letters to his wife.

Swellengrebel was involved in numerous tours and international visits concerning malaria; he and his British colleague S. P. James visited the United States in 1927 to report on the malaria situation and its control, spending several months visiting the malaria-afflicted states mainly in the South.

The book shows the development of Swellengrebel’s increasing status as an international expert and advisor and the overall respect accorded him. He was impressed by different patterns of disease he observed, particularly in the spleen rates seen in children and adults in the African continent compared with the situation in the...