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But once he returns those two accounts to the original timeline – Freetown, late 2014 – the book goes back 500 years, to the origins of the transatlantic slave trade. For over 200 pages, Farmer goes into historian mode, and the book abandons much of its initial interest in disease and public health, instead turning to the many ways in which Guinea, Liberia, and Sierra Leone, their borders drawn by European lords, had been crippled by five centuries of what Farmer calls “the rapacious extraction – of rubber latex, wood, minerals, gold, diamonds and human movable property”.
This story is as powerful as it is tragic. Farmer takes the reader through many fascinating episodes: the first “back to Africa” movement in the 1800s which led to the founding of Freetown and the nation of Liberia itself; the age-old obsession with the Human Leopard Society, an underground network of shape-shifting Africans who allegedly practiced cannibalism and ritual murder; Harvey Firestone’s successful attempt to bypass the British monopoly on rubber that made Liberia the main supplier of latex to the United States. More revealing, it traces the origins of the ‘control over care’ ideology that emerged at the turn of the twentieth century, as European agents focused on disease containment – quarantines, segregationist building codes – rather than direct medical care, an approach that would govern much of the initial Ebola response.
As the timeline returns to the events covered in the early chapters of the book – Operation No Living Thing, Khan’s death, Farmer’s first encounter with the two brothers dying of Ebola in Monrovia – the facts recounted are, technically speaking , the same, but in the reader’s mind they have been transformed from isolated symptoms into a much deeper diagnosis, both by the intimate stories of Yabom and Ibrahim, and by the wide-angle view of the ravaged history of the region. The loop structure is not without flaws: several sequences are repeated almost verbatim, and a slightly stripped-down version of the historical interlude could have made the book even more powerful. But the overall effect is no less illuminating.
Read “Fevers, quarrels and diamonds” in the horribilis dose of 2020 inevitably raises the question of how the Ebola outbreak compares to the coronavirus pandemic. The farmer’s story from 2014-2015 contains obvious omens: Dr Anthony S. Fauci appears in a supporting role; a television personality named Donald J. Trump denounces President Barack Obama’s handling of the crisis on Twitter. But in a way, the lessons of 2014 are almost the reverse of what we experienced in 2020. The Ebola death toll, Farmer says, comes from the medical deserts of upper West Africa, d ‘a longstanding failure to invest in basic health infrastructure and supportive care. Covid-19, on the other hand, tells of how a disease managed to cause such destruction in what should have been a medical oasis: failure to control, not to cure.
Farmer begins the final section of “Fevers, Quarrels and Diamonds” with a quote apparently spoken by Louis Pasteur on his deathbed: “The microbe is nothing, the land is everything.” The microbe is nothing, the land is everything. If indeed Pasteur said the line, the reference to “terrain” was an allusion to the “terrain” of the human body, and the immune system in particular. But Farmer invokes it to point to a larger landscape, more political than biological: the violent conflict and material inequalities that inevitably play a role in determining whether a virus destroys human life or leaves it relatively unharmed. “It wasn’t,” Farmer writes, “a story of inevitable mortality resulting from ancient evolutionary forces. … It was the contingent story of a population made vulnerable. For this land – and the ravages of history that created it – Farmer has given us an invaluable map.
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