Modern Medicine in the Marshes

March 5, 2008

A few weeks back I wrote a post about The Shark God by Charles Montgomery. I praised this book for its unwillingness to get caught up in a search for a pristine version of the past. Wilfred Thesiger is a negative example of a writer who is explicitly looking for a culture uncontaminated by the modern world. He says as much in various places:

I had spent many years in exploration, but now there were no untouched places left to explore, at least in the countries that attracted me... What little I had seen of the Marshmen appealed to me. They were cheerful and friendly and I liked the look of them. Their way of life, as yet little affected by the outside world, was unique and the Marshes themselves were beautiful. Here, thank God, was no sign of the drab modernity which, in its uniform of second-hand European clothes, was spreading like a blight across the rest of Iraq. [60]

Thesiger writes a fascinating book.. invaluable for its portrait of life in the Iraqi marshes. But the underlying antipathy to the modern world works as a kind of second theme throughout.

What is so bad about the modern world? At one point Thesiger emerges from exploration of the marshes and finds himself in an outpost of modern Iraq.. the town of Kubaish along the Euphrates:

Behind a cement-faced esplanade, complete with lamp-posts, was ranged a row of ugly brick houses—the district office, a police post, a small dispensary, a school, a club house and the officials' quarters. Some were new but all contrived to look derelict... surrounded by tattered reed fences and a litter of broken bottles, rusty tins and pieces of newspaper, they merely looked as if the drains smelt. [102]

You get the idea: he doesn't like the way it looks. Nor is he any more comfortable with the obsequious social habits he experiences in places like this.

The people of the marshes live in a way that Thesiger finds admirable. They construct houses and large guest houses (mudhifs) out of qasab stalks from the marshes. Their skiffs (taradas) are constructed by traditional means. As a people they are self-sufficient, living off the marsh and what they can hunt or grow. Their social life is traditional and reflects centuries old practices and habits. Although Thesiger, writing in the 50s, does not have the vocabulary of modern ecology, he seems to be drawn to the sustainable lifestyle of the people with whom he has chosen to live.

In addition to feeling deep respect for these capable and adaptable people in the marshes, Thesiger looks with horror at the sicknesses and injuries that are commonplace:

They suffered from Trachoma, and other eye troubles, from scabies and piles, from stones, from intestinal worms of many varieties, from dysentery, both amoebic and bacillary, from bilharzia and from bajal, to name only a few of their complaints... Then there were the accidents. Some of the victims had been appallingly burned when their houses caught fire, and all too often small children upset pots of boiling water over themselves. Men were brought to me who had been gored by wild boars. [108-9]

He was no doctor, but dispensed as much medical help as he could. His meager medical skill was more helpful than the alternatives out there in the marshes.

I find it curious how medicine is an unquestioned good of the modern world.. or even disconnected from that world. In this case we find a critic of the modern world nevertheless absolutely certain about the need for medicine. Thesiger doesn't hesitates to treat those around him in need of help, but by introducing modern medicine he is doing just as much to disturb the traditional way of life of the marshes as t-shirts, tin cans, and light bulbs. I think we have to be very straightforward about this: traditional cultures are fascinating and complex, but they are filled with accidents and terrible physical complaints.. not to mention high infant mortality.

Lots of people, like Thesiger, bemoan the coming of the modern world to pristine places. But almost nobody is willing to criticize the presence of modern medicine in allowing more infants to live and lengthening lives. It would strike most as cruelty, in fact, to withhold this medical help. But medicine also should be seen as the lance point of the modern world.. and entrance into its economy. The fact that there appears to be no principled way of arguing against medicine points to the impossibility of actually siding with the traditional over the modern.

There are lots of times past that I admire—say Cairo at certain points during the medieval period. But if I were to say: "I wish that magnificent culture was still with us", I could well be thought cruel. Traditional social systems depend.. at their base.. on a certain level of infant mortality and poverty that we today find unacceptable. Our inability to contemplate this level of physical suffering makes us unable to imagine any alternative to the need for traditional cultures to merge with the modern world. What is not mentioned in this equation is that with a decline in infant mortality and a longer life expectancy comes more.. many more.. people. And this new population density has miseries and forms of poverty all its own.