Reading Malaria Literature

There is a passage in Karen Blixen’s 1937 memoir, Out of Africa, that illustrates a vital task for contemporary work in literature and medicine: namely, to elucidate the ways literature was central to the constitution of modern medical discourse concerning Africa, producing a corpus on the continent that should be read with a supple mode of attention drawn from advances in humanistic as well as clinical and social analysis.

Blixen—a Danish baroness, former settler, and known writer of fiction—opened her memoir by situating her farm among the Ngong Hills of Kenya, in a continent many of her readers in Europe thought inhospitable, if not also uninhabitable. A primary objective of her opening page was to make apparent to readers the conditions of possibility for European life in Africa. She achieved the intended effect by delineating a space carved out for settlement. “The Equator,” she wrote, “runs across these highlands, a hundred miles to the North, and the farm lay at an altitude of over six thousand feet.”¹ The land’s height and geographical position combined to create a remarkably lean landscape, with “no fat on it and no luxuriance anywhere,” for it was “Africa distilled up through six thousand feet, like the strong and refined essence of a continent.”² The wide views provided an additional sense of greatness, freedom, and unequalled nobility. They produced a “heroic and romantic air” so palpable it became a defining quality of her tenure: “The chief feature of the landscape, and of your life in it, was the air. Looking back on a sojourn in the African highlands, you are struck by your feeling of having lived for a time up in the air. . . . Up in this high air you breathed easily, drawing in a vital assurance and lightness of heart. In the highlands you woke up in the morning and thought: Here I am, where I ought to be.”³

To read Blixen now, in light of scholarship often grouped under postcolonial studies, is to pay still necessary attention to the ways literature and colonialism reproduce twentieth-century conceptions of African space.⁴ We may begin, for instance, with Blixen’s you and I. They serve as classic pronouns for the perennial reader and writer of colonialist literature, pronouns that permit a specifying mode of intertextual resonance, asking present as well as past audiences to imagine being placed on a highland in Africa.⁵ The pronouns thus connect Blixen’s memoir to several histories of literary production concerning the continent, histories that repeatedly conjure what Mary Louise Pratt has called a “rhetoric of presence,” a set of relations between land, exploration, and settlement on the one hand, and the aesthetics of narration and representation on the other, relations that manifest in scenes of travel and eventual if temporary habitation, where the author may, at least initially, adopt the posture of surveyor for under-discovered land.⁶ Readers from different periods and settings are thus pulled into a familiar set of relations, made to participate in the reconstitution of rhetoric that has for some time colonized textually; and this colonial presence recurs even when gender makes for a point of early feminist critique. It is there in Mary Kingsley’s late nineteenth-century attempts to craft an ironic form for traveling while British and female in West Africa. It is also here in Out of Africa’s opening pages—though Blixen’s own use of pronouns locates her at the margins of a now actively civilizing society, at a place that is no longer scene for arrival, no longer setting for exploration, but an increasingly cultivated outpost, one that wishes to become as integral to Europe (in its politics, economy, and circulating readership) as it was previously distanced with respect to its land and culture.⁷ The contradictions inherent in reading colonialist literature are thus amplified. They are only deepened by Blixen’s coupled aims: to recount a set of sympathetic relationships with native Africans and to situate these relations within settler reproductions of European society in Nairobi, founded on notions of social and economic difference, and on land coopted...