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This is a book that is difficult to categorise. It is a unique book that is a strange mixture of the histories of the author's own family, the colonial service and most intriguingly of all of tropical medicine. For the author is the descendant of three generations of doctors who would come to specialise in tropical medicine - indeed if anything helped create and define the discipline itself. This was achieved largely thanks to the opportunities provided by the British Empire whose colonies stretched in and out of tropical latitudes and whose soldiers, sailors and servants were afflicted by the deadly tropical diseases that lurked within the deceptively paradisical looking environments.
To say this is a discursive book is something of an understatement - and this is largely due to the incredibly varied careers of the characters described. To say they lived and worked in a bewilderingly diverse set of locations is an understatement. It is something of a paradox to consider how easy travel is in the 21st Century compared to previous centuries and yet how in the heyday of Empire families could and did move thousands of miles to live in some of the most remote locations for years on end with little or no contact with home for long periods of time. There was little bureaucracy in empire and indeed until 1914 there were not even passports. As the ability to move around the world sped up, the dead hand of bureaucracy slowed us all down it seems. This family history also shows via the Bahr branch of the family that this freedom of movement was not limited to within the Empire itself as one branch of the family travels from Germany to Russia to Liverpool in a quest for economic opportunity and security. Before planes, ports often had intimate connections with one another despite their distance which promoted trade, commerce and a flow of personnel moving hither and thither.
If there is a towering individual in this book then it has to be that of the author's great grandfather Patrick Manson. He would come to be regarded as the Father of Tropical Medicine after discovering that Filariasis (which causes elephantiasis) in humans was transmitted by mosquito. This was actually far more consequential than just isolating one particular parasitic disease's origin. He was the first person to prove that pathogen's could be transmitted by a blood feeding arthropod like the mosquito. This insight unleashed a wave of research into other insect borne pathogens and ultimately recognised the role of mosquitoes in carrying other tropical diseases like Yellow Fever and the widespread malaria which afflicted so many people around the world. It is interesting that for such an important imperial figure much of his early career was outside the technical Empire but in the exotic location of China as a doctor for the Chinese Imperial Maritime Customs Service. This was one of those unusual 19th Century institutions that was far more influential than its title might suggest. It was run by the remarkable Sir Robert Hart who was able to increase income for the Qing dynasty through clamping down on corruption and modernising the service. It was no mere collector of customs dues despite the name. It also had responsibility for navigation of the rivers, map making, constructing harbours, policing the waterways, charting the weather and tracking and limiting the spread of disease from ships and boats travelling to and within China. Indeed they even conducted research into these diseases likely to afflict the workforce and traders. This is where Patrick Manson comes into the equation.
His early years in the Treaty Port of Amoy are particularly fascinating as he was one of the earliest wave of Europeans arriving into a culture vastly different to anything they had ever known. Despite being a product of his time, Patrick does come across very much as someone who deeply respects and likes the Chinese culture that he has been immersed within. Of course being a doctor with so little support he soon had to become a jack of all trades in dealing with anything and everything thrown at him. And not just physical injuries, this was the era of deadly diseases like cholera and elephantiasis. Fortunately, Patrick was able to bring Western technology and manufacturing to his aid in research with the microscope being a particularly invaluable tool. Indeed it helped him analyse the blood of some of his infected house staff like his gardener Hin Lo. It was analysing his gardener's blood and the blood of mosquitoes that had fed on him that allowed him to prove that the mosquito was the vector of transmission of Filariasis. Quite an impressive feat for a young doctor still in his 30s and miles from anywhere and with incredibly slow means of communication. This was not to be his only breakthrough either, he also worked on Bilharzia and Sparganosis but perhaps his most impressive contribution was his collaboration with Sir Ronald Ross that undoubtedly helped Ross make the connection between mosquitoes and malaria. Sadly Ross did not go on to credit his mentor for the advice and help given to him - much to his own diminishment.
Patrick would later move to Hong Kong where he set up a dairy in an attempt to improve the milk supply to the growing colony and became the founder of the Hong Kong College of Medicine for Chinese where one of his students was to be Sun Yat-Sen who would later become the first President of the Republic of China. It is interesting to consider just what role these Western education establishments played as a catalyst for impatient modernising radicals like Sun Yat-Sen? Indeed later when in London Patrick would help rescue Sun Yat-Sen from the clutches of the Chinese legation when he had been detained within it. How history may have played out differently had Patrick not called on the Prime Minister Lord Salisbury to intervene to have him freed?
On returning to London he began an association with the Colonial Office which would be taken up by the next two generations of his family. But perhaps most important was his role in setting up The London School of Hygiene & Tropical Medicine. It is easy to see the connection between the Colonial Office and tropical medicine as the Empire added swathes of Equatorial Africa and Pacific Islands to its already impressively large Empire in the last years of Queen Victoria's reign. It should be said that even without a Nobel Peace Prize the honours and prestige from the establishment did arrive late in life and hence the all important title of 'Father of Tropical Medicine'.
Now the book starts to take some very interesting and unexpected turns as the author traces her cosmopolitan family's movements across the globe. The next chapter is actually about Robert Thurburn who was the father of Henrietta Isabella Thurbun who married Patrick. Robert also had a fascinating life within Britain's informal Empire namely in the Egypt of Muhammad Ali Pasha. This largely revolved around commerce through the company of Brigg's and Co. which before the Suez Canal was dug held the contract to convey passengers overland from the Mediterranean to Red Sea and vice versa which was proving an ever more important part of imperial communications. Just like the Chinese Imperial Maritime Customs Service, Briggs and Co. was another commercial entity that had huge influence and prestige in Britain's Informal Empire. Muhammad Ali Pasha was a forceful character with which Britain vied for influence over amongst other European powers but also sometimes came into conflict with as his power seemed to challenge that of the Ottomans whose vassal he was supposed to have been. However his dynamism and ambition meant that the British ended up aligning against him which would ultimately weaken British commercial opportunities in Egypt at least for a generation or two. The Thurburns would be something of an economic casualty as a result of this change in support. It was not until Disraeli triumphantly and unexpectedly bought a share in the Suez Canal Company that British interest returns to anything like the influence it had been in the heyday of Briggs and Co.
The book then takes another unexpected leap to the Baltic to establish the story of the Hanseatic Blessig and Bahr families linking Germany to Imperial Russia and from there to Liverpool as international commerce provided another infusion into the author's family tree. In this case it was the young medical student Philip Bahr who the descendant of these Baltic traders who married Patrick's daughter Edith Manson who was a nurse at the London Hospital where Philip was training. Together they would start the second generation of tropical medical researchers in the family.
Within a very short period of time the two newly-weds travelled to the other side of the world to take up a post in Fiji. Patrick had suggested that Fiji might make the perfect location to discover new filaraie and also to investigate the causes of dysentery. In what must have seemed even more basic conditions than his father-in-law had experienced in China, young Philip found a filarial worm of his own new to Fiji which caused lymphatic filariasis. The young couple had to endure the tropical typhoons that afflict the Pacific Islands and ended up in very remote locations indeed for what was already an incredibly remote colony. Philip found some consolation in his interest of ornithology which could hardly find a better venue to indulge it. He was to find other well connected ornithologists in the future which allowed him to make unexpected connections and friendships. Notwithstanding this solo hobby, far from Colonial servants lording it over the local population we learn of the plight of poor Dr Prideaux the resident medical officer on a leper colony in Fiji. Commenting that the pay was poor, the accommodation substandard but the responsibilities huge.; wee get glimpses of colonial servants like Dr Prideaux who really are selflessly helping people in the most remote locations imaginable.
Philip spends World War One in the Middle East desperately trying to help the British and Imperial Forces fight off the dangers of various tropical diseases like malaria and cholera. He would find himself serving in Palestine and Egypt and came into contact with General Allenby himself who was concerned to keep his soldiers as healthy as possible in the otherwise appalling conditions of the Middle Eastern climate and environment. After the war he would lecture at the London School of Hygiene and Tropical Medicine and was instrumental in editing the bible of Tropical Diseases namely: Manson's Tropical Diseases. Indeed on the back of this service to Tropical Disease Sir Patrick Manson asked if Philip would change his name to Manson-Bahr in a touching show of respect in both directions.
As if it is hard to keep the geography straight, the story now goes via the African Continent as the next generation of Manson-Bahrs - Clinton - meets his wife in East Africa whilst serving with the Colonial Medical Service. Clinton was originally despatched to Tanganyika before war broke out. The author explains just how much responsibility these colonial officers had but also how committed they would become to their posts learning obscure languages and the customs of people that most people did not know even existed. They became invested in the communities they were charged with caring for and administering. It could also be terribly isolating with young men being left alone and miles from support. It appears that Clinton was very happy to take on these responsibilities but sadly we learn that his brother would also end up in East Africa under the duress of war breaking out but ended up committing lonely suicide in the back of beyond. Clinton would serve in the Royal Army Medical Corps as East Africa came to be in the Front Line with Italy declaring war on Britain in 1940. In 1943 he was to marry a young Scottish lady; Joan McInnes. Joan had had a hard life already losing both her parents and her sister to Spanish Flu in the aftermath of World War One. Moved pillar to post amongst relatives she travelled to South Africa to live and work with an aunt of hers. Travelling to and from South Africa was done by steam liner and she appears to have struck up a relationship with a girlfriend who had family in Nairobi and fortune took an unexpected turn. Again we get a nuanced picture of a colonial Kenya that had many layers of complexity for those who lived there. Some thrived in the ideal climate but sometimes at the expense of others. It was no bed of roses though and war brought new opportunities and risks. In this climate Joan and Clinton were to find one another.
After the war finished, Clinton was to follow somewhat in his parent's footsteps as they travelled to Fiji for five years working with the Colonial Medical Service once more. It is at this stage that the author herself makes her first appearance in earnest. The colony had developed rapidly since Philip had been sent there a generation earlier. It helped that doctors were near the top of the colonial hierarchy and held a relatively privileged position. The author explains though that somehow the Fijians themselves seemed to be able to stand outside this colonial hierarchy being almost completely oblivious to it. They had their own hierarchy to adhere to and did not feel beholden to anyone else's. This privileged position for the Manson-Bahrs did manifest itself when her mother became seriously sick when the children are taken to Government House to be cared for there whilst Clinton attended to his sick wife. This was the pinnacle of the colonial structure in any colony.
We do see the technology of transportation evolve as ships give way to seaplanes and later long distance aircraft linking the colonies far faster than ships ever could. After Fiji the family returns to East Africa in the midst of the Mau Mau rebellion. The author later learns that there is a Mau Mau armourer living next door to them who prosaically had taught her how best to deal with the problem of soldier ants. There then comes the paradox of what to do about education. It had long been the decorum for children to spend their young years with their families but then when secondary school age they would be sent to a boarding school for their education and to be able to take all the formal examinations appropriately. This of course would create the dilemma for the mother to either stay with her husband or stay with the children in Britain. She could not do both. It appears that the boarding school options in Britain did not go down well with these particular colonial children who were more accustomed to the freedom and climate of a colonial lifestyle. Eventually the unhappy author returns to Africa for her education but the era of Empire is coming to an end as independence beckons. The consequences of independence for Belgian Congo focuses minds in neighbouring colonies like Kenya. There is an interesting insight when the author explains that her mother was horrified at her husband's suggestion that some African students of his come over to the house for dinner. The father is used to working with educated Africans but the mother who had not been educated to a high standard felt intimidated: "The Empire had given her status as a white memsahib and she protected it fiercely." It shows that professional familiarity could break down barriers but those isolated and at home might be slower to embrace change and ideas of equality.
The author's life still has twists to take as she spends some time being educated in Switzerland and then follows her father as he becomes professor of clinical tropical medicine at Tulane University in Lousiana. A logical next step for a family steeped in tropical medicine and with a tropical empire to work within rapidly receding. It is a fascinating time politically as the Vietnam War is raging and the author experiences and witnesses racism on a scale unlike anything she had seen in the British colonies. This was overt racism and travelled in both directions. The attitudes of the Deep South provide a telling contrast to the dying days of Imperial Britain.
As I said at the beginning this is a difficult book to characterise and explain, it is a hold on to your journey across time and space. It is great to see family photographs provide imagery to the wonderful cast of characters described. The book could really benefit from a family tree as it can be quite hard to keep the various strands of the family together as we travel the world in their company. In essence though this is a book that tells the story of a vanished world of colonial opportunity and intellectual curiosity coming together in a symbiotic relationship over multiple generations. This book provides something of a counter narrative to the idea of a wholly exploitative Empire. The people described in this book are invariably trying to improve the condition of the people they are working for and on behalf of. They want to treat the sick. They want to know what is causing so many people to get sick. They want to cure disease. They want to make the world a better place. The author pays tribute to three generations of her own family that all helped in their own way to create the branch of medicine we now know as 'Tropical Medicine'.
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