Chapter 49: Disease Prevention and Control

Chapter 49: Disease Prevention and Control

December 7, 1866. East African Colony.

Great Lakes Region (Lake Victoria), Mwanza.

Today, the Great Lakes Region is the second most populous immigrant area in the East African colony, second only to the Upper Coastal Area. It lies right by Mwanza Bay on the Great Lake (Lake Victoria).

This region is rich in water resources, has fertile land, and enjoys a mild climate. The Great Lake (Victoria) is a basin lake and serves as the source of the Nile River. It lies within the East African Rift Valley, and currently, the East African colony controls the southern shore of the Great Lakes region, while other areas remain in the hands of the indigenous people.

The colony's first primitive fishing industry started here, using simple dugout canoes to fish in Lake Victoria as a meat supplement.

At present, the Great Lake (Victoria) has not suffered ecological damage from the introduction of farmed Nile perch, unlike in later times.

As a result, the freshwater fish in the lake remain diverse, and the unpolluted water makes them safe to eat.

The Great Lakes Region is among the wetter, rainier areas of Africa. The vastness of Lake Victoria has directly altered the local climate.

In sub-Saharan Africa, wet conditions are not necessarily a good thing. For example, in later times, Nigeria and Congo became hotbeds of tropical diseases.

In East Africa, insects—particularly mosquitoes—are extremely troublesome, especially since the equator runs through the center of Africa. Most of the continent maintains temperatures above 20°C all year round, providing an ideal environment for mosquito breeding.

Diseases like malaria, dengue fever, and many other infectious illnesses are transmitted to humans by mosquitoes.

In future history, East Africa would become one of the regions most heavily affected by malaria and similar diseases. Beyond low medical standards, the biggest issue is the rampant mosquito population.

In his previous life, Ernst worked in Tanzania. Despite good protective measures, the number of mosquitoes in Africa was overwhelming, and he contracted malaria twice.

That was already the 21st century. Ernst, a modern man armed with mosquito nets and coils, still fell victim. One can only imagine how terrifying Africa seems to Europeans in the current era.

To date, most European colonies in Africa are confined to narrow coastal plains; they dare not venture inland.

The Ottoman Empire holds the largest land area in Africa, mainly in North Africa and Ethiopia. Second is Portugal, with its colonies in Angola and Mozambique. Third is France, focused on limited land in North and West Africa. Lastly is Britain, with its Cape Colony. Other countries like Spain and the Netherlands are negligible.

Thus, Ernst's East African colony stands out—it is the first to penetrate deep into Africa's interior highlands.

Though the Portuguese colonies are also large, their administration is crude. They control local tribes by manipulating rival tribes, stirring conflict to benefit from the chaos.

While East Africa, like all colonies, has its dark side, Ernst treats it as his own home. Although the natives' interests are sacrificed, he facilitates future immigration, intending for long-term settlement.

In comparison, the Portuguese approach is essentially "draining the pond to catch the fish." Only due to the current global order can Portugal act with impunity. But after WWII, when African nations are encouraged by the US and USSR to seek independence, the Portuguese will be driven out by the locals.

That, of course, is history from a previous life. In this world, perhaps the East African colony will annex those lands. In any case, Ernst will not let go of Mozambique. "How can one sleep soundly when others are snoring beside your bed?"

The Portuguese have a track record. They once had designs on the Sultanate of Zanzibar but were soundly beaten.

They also entered Zimbabwe and Zambia in recent years but had to retreat after disease outbreaks among the locals.

Greedy as they are, the Portuguese will inevitably make a move on the East African colony. Ernst must stay vigilant. If the colony continues to develop smoothly, it will be the Portuguese worrying about their own colonies.

In East Africa, the year-round temperature exceeding 20°C encourages mosquito overpopulation and viral activity.

Disease remains the biggest threat to immigrant survival, so public health in the colony is a major priority.

Water sources near settlements are strictly managed, and polluting them is prohibited.

Shrubs, puddles, and other mosquito-breeding environments are cleared using fire or burial methods.

In large water bodies, fish that eat mosquito larvae are introduced to control the mosquito population.

Diseases like malaria in the East African colony are like a lottery—some unlucky immigrants get "drawn." Fortunately, quinine already exists in this era.

Ernst also introduced cinchona tree saplings from South America to cultivate in suitable East African areas, along with various Chinese herbs.

Western medicine remains somewhat speculative and immature. Bloodletting is still mainstream; in 1833, France imported over 40 million leeches.

Fortunately, more scholars are questioning and opposing traditional Western medical theories. Ernst is living in an era of transition from traditional Western medicine to modern medicine.

The 19th century marks a rapid rise of Western pharmaceuticals:

Merck (USA) – 1816Pfizer (USA) – 1849Novartis (Switzerland) – 1859Bayer (Germany) – 1863Glaxo (UK) – 1873SmithKline (UK) – 1875Abbott (USA) – 1888Roche (Switzerland) – 1896

Humanity entered the age of Western medicine.

Undeniably, some medical labs in Europe and America are now bursting with innovation that will, in decades to come, completely replace traditional medicine.

But this process is long—it will continue into the 20th century before the edifice of modern medicine is fully established.

Although cutting-edge medicine is advancing rapidly, most current clinical practice is still handled by traditional "old Western doctors."

These outdated practitioners still lack understanding of diseases, bacteria, and viruses. Surgery is done without anesthesia, bleeding, or disinfection protocols—so outrageous medical accidents are common.

Ernst dare not gamble with such doctors, so he prefers mature, low-side-effect remedies.

In addition to obtaining native herbal medicine from local Africans, Ernst also draws from traditional Chinese and Western medicines for reliable treatments.

For example, quinine and artemisinin are effective against malaria. Though Ernst is not a medical student and doesn't understand how to process these herbs, having the raw materials is better than having nothing.

If immigrants get malaria, they can at least boil these herbs into a decoction and drink it. It's not that he doesn't want to use extracted medicines, but the cost is too high. The colony is large and populous, with heavy expenses in all areas. Herbal cultivation costs little beyond labor.

Land is abundant; as long as the environment suits, you can plant as much as you want. Ordering medicine from Europe is far more expensive.

Currently, the most effective method of controlling infectious diseases in the East African colony is isolation. Once a case is found, it's immediately quarantined.

If their immunity gets them through it, they survive; if not, they die in pain.

Ernst has, of course, purchased some medicines. But due to transportation issues, most supplies are stored in the Upper Coastal Area closest to the seaport.

Inland colonies lag behind in material and medical supplies. Therefore, inland outposts must take greater initiative.

They organize immigrants for sanitation activities, manage waste and sewage disposal, destroy mosquito habitats, and grow mosquito-repellent plants (East Africa is a source of pyrethrum)...

This maximizes disease prevention. In today's world, East African colonists may lead the globe in hygiene awareness.

They might not even know what "hygiene" means, but they know their superiors forbid littering, eating unsafely, or relieving themselves anywhere...

These rules are strictly enforced by colonial administrators—violators are severely punished.

The administrators themselves might not be hygiene-conscious, but Ernst imposes his directives with righteous authority, claiming these are the conclusions of European experts.

Whether they believe him or not, once they follow his instructions, disease rates in the East African colony remain remarkably low.

Compared to other colonies, the difference is clear—even better than some more developed regions or countries, such as neighboring Mozambique or India in South Asia.

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