“The years teach much that the days never knew” (Unknown source)
It has been puzzling why the architect of the start of the first successful national malaria-eradication campaign anywhere in the world, Dr I Kligler, should have been forgotten, and his work, until recently, almost unknown.
But the things in this world that tend to be memorable are single dramatic events, or a single moment in time. Teachers are rarely remembered. Education is not a single dramatic event, and can usually only be appreciated over a period of time when, with hindsight, we are able to see Education’s value.
So when Dr Kligler died in 1944, his principal contribution, namely the priority he gave to education in his malaria-elimination campaign, was not fully appreciated, and at his death, there seemed little of his anti-malaria work that could then be considered as huge or memorable. There was nothing unique in his methods of control (which methods were based on sound principles), but his approach to education when dealing with malaria elimination was unique.
His methods worked, and Palestine/Israel is now free of malaria. His methods were not reliant on vaccines, drugs or mosquito bednets, and possibly because of that, there doesn’t seem to be anything dramatic about his work. Sadly, many reading this will patronise and pay lip service to the points raised, but it must be remembered Kligler’s method worked, and which cannot be said of many other methods that have been attempted over the last 90 years. It is important to consider what is done (and also what is not done) today and which would possibly have upset Kligler had he have still been around and seen such things.
a. Kligler was bad at delegating, and he tended to supervise things himself. So he omitted writing very much about this. He was a Zionist who had come to live in Palestine in 1920. He would never have countenanced any outside agency or organisation coming in to supervise or manage the works – these had to all be dealt with by people who lived there, not by people who would ‘helicopter in and then helicopter out’ (as Bill Jobin once described).
b. In 1922, Kligler agreed with the British Mandate’s Health Dept. “….. only by placing all antimalarial work under the control of an organised Government Dept. that country-wide success can be obtained in dealing with a disease like malaria”. There seem so many different independent organisations conducting their own projects, and it seems unfortunate they cannot submit to one authority in order to coordinate their efforts.
c. Kligler stressed again and again that the educational aspect of the malaria elimination work was certainly as important, if not more so, as any other. Indeed, when he first began the work, approximately 13-14% of his budget was earmarked for education, to try to get the population interested and involved, and prepared to co-operate with the anti-malaria works and their maintenance. (One knows there is something wrong today when seeing pictures of people misusing mosquito bednets as fishing nets, or as chicken coops. ) This first step in malaria elimination, namely the initial interest and involvement of the population, perhaps may be seen as one of the keys to success. The situation today may be seen at www.eradication-of-malaria.com/smokers.html and which site is entitled ‘An Acceptance, a Fatalism, an Inevitability of Malaria’.
d. The practical aspects, and the emphasis of the education which Kligler introduced may be seen at http://www.eradication-of-malaria.com/cooperation.html . This involved cooperation of Arabs and Jews which was shown to be very successful.
e. For those attempting malaria elimination where there are social and even violent disturbances, perhaps Kligler’s example may fortify and encourage, and show how effective were his methods. See http://www.eradication-of-malaria.com/difficulties.html .
Because the world, and the anti-malaria community, tend to go looking for a silver-bullet, a quick fix, an immediate solution for all, it is also important to remember that malaria is a local problem, and that a successful attack on a mosquito breeding site is possible only after a careful study of the local conditions combined with systematic experiments with the method or methods most likely to give the desired results. But the principle of involving the cooperation of the population still remains and applies everywhere, not just locally.