Health Epidemics and Structural Causes

“Can the Mosquito Speak” is a study of the structural factors that led to the malarial outbreak that spread from Sudan and along the Nile Valley from 1942-1944. This health epidemic was compounded by man-made environmental changes; dam construction across the Nile River, use of synthetic chemicals, and political unrest. “Dams, blood-borne parasites, synthetic chemicals, mechanized war, and man-made famine coincided and interacted. It is not surprising to see disease brought by environmental transformation, industrial chemistry shaped by military needs or war accompanied by famine.” (Mitchell p.22). These factors interacted to produce an environment vulnerable to the spread of disease. The dam construction led to water shortages and lack of irrigation which decimated crop production throughout the Nile Valley. Synthetic chemicals were employed to combat the mosquitoes. The wartime movement of people to and from foreign places may also have facilitated the transportation and spread of the disease carrying mosquito. Together, these factors contributed to the aggressive transmission of malaria within communities and across vast distances.

Diarrheal disease is also affected by compounded structural factors. Poverty, access to clean drinking water, nutritional education, and access to treatment are some of the most important proximate issues of the global diarrheal disease problem.  Diarrheal disease is treatable; however, solutions such as oral rehydration and plumpy’nut only treat the symptoms and not the underlying issues. Diarrheal disease is a health epidemic specific to developing countries where poverty and lack of access to clean water are often the primary contributors to diarrheal disease. Like the malarial outbreak, optimal treatment must not only address the observable symptoms but, most importantly, must effectively identify and address the ultimate structural and underlying factors.


This article further discusses “disease of poverty” and the especially high risk of mortality for infants and children.






One thought on “Health Epidemics and Structural Causes

  1. Both malaria and diarrheal disease are hugely disabling and lethal epidemics when left untreated, and the fact is that most factors magnifying the effect of these outbreaks are very tied in to political divides, government structures, and the man-made structural violence that perpetuates poverty and thus the diseases themselves. Your comments on Mitchell’s book chapter are totally right; while so many humanitarian groups all over the world have attempted to make huge advances in treating and preventing malaria and diarrheal disease as afflictions due to pathogens alone, it is really easy to lose track of the structures in society that have enabled these pathogens to become to widespread and virulent. As an additional comment, this plumpy nut baby is really darn cute.

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