- Landscapes of Disease: Malaria in Modern Greece by Katerina Gardikas
Katerina Gardikas's Landscapes of Disease is filled with vignettes sure to intrigue many readers. Historians of malaria will enjoy the multifaceted view of a setting neglected in the existing literature. Historians primarily interested in modern Greece will appreciate this lens for understanding the new nation from its founding through the 1970s, when malaria was eliminated there. Much is here for those interested in public health and state development, as well. Some historians have explored the innovations that managed the upheaval of the industrial revolution and its many negative consequences for health by concentrating on the United Kingdom, the United States, and other now-rich countries. Others have focused on colonial and postcolonial contexts, emphasizing the role of medical and public health knowledge in exploitation and the ongoing influence of these patterns in international development. Within these narratives there has been limited scope for understanding how European and American ideas were variously interpreted, contested, absorbed, or rejected by a third group of nations—neither the colonizers nor the colonized, but the many newly formed states of the nineteenth and twentieth centuries. Gardikas fully embraces this potential in her central question (p. 12) of "how malaria interacted with the new social and economic realities that emerged in Greece after independence."
Gardikas examines malaria and the socioeconomic evolution of the new Greek state in four chapters. The first reviews malaria as an "ancient and global disease," starting with the origins of the malaria plasmodia 500–600 million years ago and detouring though sources that reveal the disease in antiquity and how it spread around the world in the medieval and early modern periods. This is followed by an overview of malaria control history. At times, this sweep seems too far from the book's main questions of malaria and the modern Greek state. This unfortunately crowds rich material discussing how Greek physicians and others came into contact with leading international figures of the malaria world, including Ronal Ross, [End Page 310] Giovanni Battista Grassi, and William Gorgas. Work in Greece by the League of Nations, the International Health Division of the Rockefeller Foundation, and the United Nations provides an excellent opportunity for situating the book's material in larger narratives of global malaria control, but many connections are left for the reader to make. Those not familiar with malaria historiography will have questions.
The second chapter on the fragmented geography of malaria brings a welcome focus on Greece and its new government, showing how it adopted responsibility for contagious disease and later turned to endemic diseases such as malaria. Gardikas then looks in detail at six different areas of Greece to explore how social and physical environments affected malaria. This material is rife with delightful nuggets that will resonate with scholars of post-WWII health and development, for example: The Greek government argued that draining swamps would protect health and advance agriculture in 1841; universal conscription policies in the 1880s helped spread malaria throughout the country; and there were many tensions between development and malaria. This last point is important, as Gardikas underscores in the third chapter ("Malaria in Peace and War") because malaria has been routinely and simplistically cited as an obstacle to development, but in fact many development activities actually lead to more malaria. For example, cash crop cultivation on the fertile plains increased malaria among farmers migrating from the hills, irrigation systems fostered greater crops and more mosquitoes at the same time, and digging clay for making bricks left pits of stagnant water, further increasing mosquito breeding grounds. This perspective on why citizens sometimes explicitly embraced increased malarial risk is augmented in the fourth chapter, "Patients, Doctors and Cures," which discusses how victims and caregivers understood malaria as both a personal and collective experience.
Amid the many intriguing details there are some shortcomings in this fine book. Perhaps the largest is that the analytic strategy is unclear. Almost all of...