A Reed Shaken by the Wind by Gavin Maxwell

marvelling that I had contracted none, but marvelling much more that Thesiger had survived four years of intimate contact.
    Dysentery is one of many diseases that are endemic; and in a marsh village, where the water comes right to the walls of the houses on every side, that drawn for drinking often contains recognisable fragments of human excrement besides a multiplicity of animal organisms so dense as to give the whole the appearance of a thick greenish soup. Yaws, a non-venereal relation of syphilis producing skin conditions of peculiar horror and high contagion, afflicts a great part of the population; ringworm or some allied skin affection may be expected in the heads of the greater number of children; hookworm spreads rapidly through the barefoot habit; andbilharzia is inescapable to the marshmen, who of necessity spend much of their time naked in the water. It is this last, perhaps, that might properly be described as the disease par excellence of the marshes, for no cure can prevent immediate reinfection. The bilharzia of the marshes is the parasite whose true name is Schistosoma haematobium, an organism about a centimetre long and a millimetre broad which ravages the pelvic region of its human hosts. In common with many other internal parasites it has an intermediate host, in this case the water snail, without whose total destruction the disease cannot be eliminated. At the stage of emergence from the snail the parasites are active burrowing organisms which penetrate the skin of a man and begin the next stage of their existence. An enormous number reach no fertile ground, as it were, and die, leaving weals and blotches where they do so, but the operation partakes of the stupendous profligacy of all generation; and, teeming like spermatozoa, a number pass through the lung capillaries to the heart and are thence distributed all over the body. The first symptom is the passing of blood in the urine, and this continues until at its height some thirty thousand eggs are being passed every day. These, in the marshes, return to the water, where they at once hatch into another active embryo stage which enters the water snail. It follows that the stagnant water surrounding a marsh village is densely teeming with the organisms of the post-snail stage, and it is impossible for any member of the community to avoid infection.
    The disease is very slow in progress, and one may play host to breeding bilharzia for years without more than mild discomfort if the infection is slight, but sooner or later all the pelvic organs may become affected and suffer severe pain and malfunction, besides secondary effects such as stones that form round the eggs in the bladder.
    That list is but a tiny fraction of the diseases to which the marshmen are subject, and it is small wonder that Thesiger,who for four years had performed seeming miracles among them, was besieged by an importunate multitude in every village that we visited. The number of patients would grow gradually from a nucleus of two or three in the household with which we were staying; word would go round that the medicine chest was open, and they would come in from every quarter of the village to press round him, sometimes in hundreds. To treat them all would have been impossible; no medicine chest that could be transported in a tarada would have lasted more than two or three villages; and many, especially milder cases or those whom Thesiger suspected of malingering in order to be in the swim, were turned away. From the first day these decided that I was a suitable intermediary; of less formidable aspect, perhaps, than Thesiger, and one whose heart could be softened to plead for them. I was soon surrounded with a crowd little less than that which milled round him, and no amount of repetition that I did not understand Arabic made any noticeable impression upon either their numbers or verbosity. Each displayed his suffering with a formal and unvarying ritual of pathos; my view became a