missionaries offered no formal clinic or hospital to their Ssese parishioners and medical resources for acute crisis were limited.51 Anglican missionaries sent people with complicated or persistent illness to the CMS hospital at Mengo, near Kampala, and would request that a doctor visit the islands when necessary.52 The Ssese CMS missionaries, in comparison to those on the Buganda mainland, did not prioritize medical work in their evangelizing and did not establish sites of formal, regular medical treatment. The structure and nature of the CMS Ssese mission may have hindered it from serving as a resource for healing or medicine, regardless of missionaries’ training or goals. Its early years saw frequent turnover of personnel due to illness, and necessary staff itinerations between posts on large islands and dispersed daughter churches meant that the men who led the mission were often away as much as they were at home. Missionaries’ engagement with their readers did sometimes involve matters of health and illness, however, and was especially focused on women missionaries, women readers, and their children.53
By contrast, the White Fathers on the Sseses actively integrated medical treatment into their mission life and, over time, increased their capacity to do so, dispensing remedies and offering care in hospitals and hospices. By 1895, the White Fathers mission at Bumangi included a school and a small hospital with a few dozen beds, serving an estimated population of fifteen thousand on Bugala Island.54 Priests regularly cared for a few dozen people in the hospital, assisted by local catechists.55 Of note for responses to widespread illness, and ultimately for epidemic sleeping sickness, was the White Fathers’ ready provision of medicines to their Ssese and Ganda charges. They dispensed a variety of available remedies, many typical for the era: a variety of purgatives and emetics, drugs presumed to affect the circulation, and drugs to relieve pain. Priests treated one another, and sometimes African patients, with calomel (mercury chloride) as a purgative, saltpeter (potassium nitrate) for rheumatism, “calaya” for hematuria (blood in the urine) or blackwater fever, citric acid to calm vomiting, and brandy.56 They administered quinine for a wide variety of complaints, including but not limited to diverse manifestations of fever, and also dispensed laudanum. Some of these remedies were also given to their catechists and nearby families.57 For the illness called kaumpuli (which they equated with bubonic plague), in the 1890s, for instance, priests gave their Ganda patients, variously, aloe as an emetic, “acide phénique” (phenol, carbolic acid), quinine, and cantharides, an ancient treatment for edema that could be used to produce blisters on the skin.58 In the main, the White Fathers mission and hospital, despite some staff turnover, gained a strong foothold as a hub for healing, utilized regularly by catechists and their relations as well as by nearby communities more broadly in times of intensifying crisis such as outbreaks of widespread illness.59
Missions on the Sseses, as elsewhere, functioned as points of exchange and distribution of valued goods alongside and sometimes overlapping with medical interventions.60 On the Ssese Islands on the whole, and Bugala Island foremost, Christian missions provided an important precedent for colonial interventions and institutions focused later on addressing epidemic sleeping sickness. The missions would later offer tropical medicine researchers a springboard to launch their work: social connections would facilitate relationships within which experimental treatment and control measures were arranged and make available the physical spaces within which these measures would play out. In parallel to these material and social resources were experiential points of reference for dealing with widespread or disseminated instances of sickness and death. Chief among the causes of those was kaumpuli.
KAUMPULI: INTELLECTUAL WORLDS AND STRATEGIES OF AMELIORATING MISFORTUNE
Experiences of illness, particularly of what appear to be epidemics that sickened and killed many, surface in diverse sources created around Lake Victoria in the late nineteenth and early twentieth century: early colonial reports, missionary letters and diaries, accounts of the occasional traveler making his way through the region, and oral histories and traditions. One of those causes of illness and misfortune, kaumpuli, illustrates how historic Ganda ideas about illness and strategies for mitigating or avoiding it were connected to practices of doing so in the late nineteenth century. Outbreaks of widespread illnesses could and did move into and out of the framing of kaumpuli—it was not a universally applicable etiology. But kaumpuli provided a coherent, meaningful, and capacious means of understanding sudden and serious illness in Buganda by the late nineteenth century. Moreover, kaumpuli could catalyze mobilities and reorientations to domestic spaces and evinces the kinds of intellectual and pragmatic resources available for people faced with outbreaks of illness. Discussions of kaumpuli and cholera in missionary texts from the 1880s and 1890s open up space to consider central elements in Ganda nosologies as well as strategies of seeking treatment and healing in the late nineteenth century. Focusing on illness categorized as kaumpuli in the period between roughly 1880 and 1905 underscores the flexibility and expansiveness of Ganda etiologies and nosologies and discourses of illness and causation. It also proves a complex, multilayered problem that is good to think with. Considering kaumpuli allows us to apprehend the simultaneity of intellectual work in different but intersecting systems, situating Ganda ideas of illness and wellness within an era of widespread social, political, and epidemiological change, while also exploring the mutability of European biomedical models in the same era.
By the late nineteenth century, two specific balubaale were associated with certain kinds of illness and death that struck Ganda populations. The minor lubaale (Ndaula/Ndahura) Kawali was associated with irruptions on the skin, while the better-known Kaumpuli, a deity born of ancient transgression and misfortune, brought “plague” into people’s lives.61 While Kawali seems to have been associated with a particular type of illness—one which caused raised bumps or lesions on the skin—the lubaale Kaumpuli could have diverse impacts on human health. Important for epidemics to come was how his power registered in widespread illness in Ganda communities, striking people with disease and driving them from their homes.62
Between the 1880s and early 1900s, illnesses causing wasting, vomiting, and/or diarrhea fit into the etiology of kaumpuli, as did illness causing fever, pain in the chest, inflammation in the armpits, groin, and glands.63 These categorizations, gleaned from mission diaries and contemporary ethnographies, varied over time. In the 1880s, for example, missionaries equated kaumpuli with cholera, based on conversations with their African interlocutors and observations of a few sick people, suggesting that signs of Kaumpuli’s power could involve weakness or rapid wasting, diarrhea, and vomiting, as well as fever and changes to skin tone or appearance (e.g., bluish or darkened lips, sunken eyes). More often than not, its end was death.64 While contemporary definitions provide an extensive terminology covering pain in the belly, vomiting, and diarrhea, among others, the symptoms missionaries recorded at the time as signs of cholera had no specific Luganda gloss, other than an association with kaumpuli, underscoring both the novelty and severity of this way of ailing.65 In the early 1890s, another missionary clearly equated kaumpuli with an illness vaguely defined as “plague,” describing it as “a disease attended generally with swelling of the glands, and pain in the chest,” and noting further that “it is very prevalent after the rains.”66 By the late 1890s, however, Europeans around Lake Victoria firmly understood kaumpuli to be bubonic plague (Fr., peste bubonique), a disease characterized by dramatic swelling of glands in the armpits and groin (buboes), fever, weakness, blackening or suppuration of the skin around the buboes, and death. This particular iteration of plague, well known in European history, had by the late 1890s also become associated with an identifiable germ.67 Kaumpuli, therefore, could align with the presence of Yersinia pestis in the body. But within another few years, further diversity was fitted into kaumpuli. In 1902 to 1903, an itinerant British scientist reported that Ssese islanders named as kaumpuli an illness associated with fever, swelling of the face and areas of the neck, swelling of the glands, wasting, sleepiness, and death. Severe diarrheal disease also remained an aspect of other cases of kaumpuli simultaneously.68 In each situation, missionaries or scientists used the Ganda word kaumpuli to describe specific, widespread illness around them, both reporting the presence of epidemic disease and disseminating a “local” name for it.
