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Malaria, Poems

by Cameron Conaway

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Before traveling to Thailand in 2011, American poet Cameron Conaway viewed malaria as many Westerners do: a remote disease summed up by factoids:

It's borne by mosquitoes.

Half the world's population — 3.4 billion people — is at risk of catching it.

The disease claims 627,000 lives a year – that's one death every minute.

Conaway, 29, gives a human face to those figures in his new collection, Malaria, Poems. Each poem is paired with a related fact: "roughly one in ten children will suffer from neurological impairment after cerebral malaria" connects to a poem with this line:

Here / a girl of ten / confused / why her arms won't raise / when she's asked to raise them

Conaway started writing poetry in 2004, inspired by Lee Peterson, his poetry instructor at Penn State Altoona, who wrote about the Bosnian war. "She taught me that these literary tools weren't just for playing in the sandbox," says Conaway. "They could serve a social purpose."

He came to malaria in a roundabout way. Conaway's trip to Thailand was motivated by a desire to practice Mauy Thai kickboxing (he is a former mixed martial arts fighter and people sometimes call him "the warrior poet"). After he arrived in Bangkok, he met another poet hanging out there, Colin Cheney, who told him about the Wellcome Trust, a global charity that funds health research as well as projects on how culture affects health issues, such as with their features publication Mosaic. The Trust was soliciting applicants for its arts award, so Conaway attended one of the its conferences. There, he met Nick Day, the director of Bangkok's Mahidol Oxford Tropical Medicine Research Unit (MORU), one of the Trust's affiliates.

"I was impressed by Day's ability to talk about malaria and his research in ways that a normal human could understand. He did so with charisma and I really connected with him," says Conaway.

And Conaway learned that malaria has a poetic history. Sir Ronald Ross, who won a Nobel Prize in 1902 for identifying malaria parasites, often wrote poetry about the disease and his discovery:

With tears and toiling breath / I find thy cunning seeds / O million-murdering death.

With Day's suggestion, Conaway applied for the Trust's arts award and became MORU's first poet-in-residence. He spent seven months traveling to villages and vaccine research centers near Bangkok and in Bangladesh, gathering impressions for his work.

Malaria, Poems was published this month by Michigan State University Press. The poems touch on everything from counterfeit malaria medicines to stillbirths caused by the parasite to traveling bards who perform plays about malaria awareness. He also wrote poems that address social issues such as violence against women in Bangladesh and the lack of medical care in the region.

An excerpt from Malaria, Poems follows and describes Anopheles mosquitoes, which transmit the parasite between people.

SILENCE, ANOPHELES

You should have just asked the mosquito.
— 14th Dalai Lama

It's risky business needing
(blood)
from others
not for science or even more life
for hellos and goodbyes
and most substances between
but so your kids can exit
while entering and spread
their wings long
after yours dry and carry on
by wind not will.

It's risky business feeding on others,
but we all do
one way or another.

It's risky business needing
when you have nothing,
but life has you and lives
writhe inside you.

Risky to solo into the wild
aisles of forearm hair thicket
for a mad sip,
not quick enough
to snuff the wick of awareness
but too fast for savoring.

A mad sip that makes
you gotcha or gone
and may paint you and yours
and them — Plasmodium falciparum —
on the canvas you needed
to taste behind.

It's risky business needing
and then getting
and being too too
to know what to do —
too full and carrying
too many to fly.

It's risky business being
the silent messenger
of bad news when you don't know the bad news
is consuming you, too.

It's not risky business
being the blind black barrel
of pistol or proboscis,
but it is damn risky business being
the pointer or the pointed at.

It's risky business being
born without asking
for a beating heart.
Having and then needing to need
to want until next
or else
and sometimes still or else.

Risky when you're expected to deliver
babies and have no gods to guide
their walk on water
because you did it
long before they or him or her or it
never did.

Risky when you're born
on water and capricious cloudscapes
shape whether sun lets leaves
bleed their liquid shadow blankets
into marshes or mangrove swamps
or hoof prints or rice fields or kingdoms
of ditches.

It's risky business naming and being named
while skewered and viewed
under the skewed microscopic lens
of anthropocentrism
an (not) opheles (profit)
a goddess name, Anopheles,
that translates to mean useless
and sounds beautiful at first
then awful when its insides linger.
An(ophel)es, you are only 57% different, no,
you are 43% the same as me, no,
I am, no, we are 43% you, no, we all are
nearly, mostly.

It's risky business leaving
large clues —
a welt and then a dying child slobbering silver
under its mother's croon.

It's risky business being
when you don't
because you have two weeks
or less to do doing.

Risky business killing,
but it depends on who, where, when —
self-sufficient Malawi village in 2014
vs. the legend of Dante & Lord Byron.
Mae Sot or Maine, Rourkela or Leeds.

It's risky business killing
killers that always only want
their kind
of tropical retreat.

It's risky business being
small
profoundly —
the speck of black
sesame or apostrophe
blending in the expanse
of rye or papyrus
and taken
onto allergic tongues.

It's risky business sharing
your body with strangers —
uninvited multiplicities hijacking
what you have
because to them you are what you have.

Risky when all know
your 1 mile per hour,
your under 25 feet high for miles,
your 450 wingbeats per second.

Risky business being you
when some want not to fly
weeks with your wings
but walk days atop them.

Is it riskier business being content
and peacefully going extinct
or not being
content and forever brinking
in the bulbous ends of raindrops
that cling but fatten?

Like raindrops and us, Anopheles,
when you fatten, you fall.
History favors the fallen.

To drip
a long life
of falling
before the fall
or to live
a short life
oblivious to it all?

Risky that we exchange
counters — DNA mutations
that make some of us
sometimes
sort of
immune to each other's jabs
though hooks always slip through,
and we send each other stumbling,
always stumbling, always only stumbling.

Changing ourselves changes each other.
Each other is ourselves.

They tell us it's risky business doing
being,
but it is more risky being
doing.
Did you hear all that, Anopheles?
How about now?
We're asking. We're good at that.
Does all life listen
at the speed of its growing?
Are we listening too loudly
or too slowly to your silence?

"Human malaria is transmitted only by females of the genus Anopheles. Of the approximately 430 Anopheles species, only 30-40 transmit malaria" (Malaria, Mosquitoes, Centers for Disease Control and Prevention, 8 February 2010).

Excerpted from Malaria, Poems by Cameron Conaway. Copyright 2014 by Cameron Conaway. Excerpted by permission of Michigan State University Press. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Malaria

Poetry

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Jaeger stands in front of a remnant of the Berlin Wall. Behind him is a photo from Nov. 9, 1989, when he was the border guard who opened up the Bornholmer Street crossing, allowing East Germans to go to the west, the event that marked the fall of the wall. Soraya Sarhaddi Nelson/NPR hide caption

itoggle caption Soraya Sarhaddi Nelson/NPR

Jaeger stands in front of a remnant of the Berlin Wall. Behind him is a photo from Nov. 9, 1989, when he was the border guard who opened up the Bornholmer Street crossing, allowing East Germans to go to the west, the event that marked the fall of the wall.

Soraya Sarhaddi Nelson/NPR

To many Germans, Harald Jaeger is the man who opened the Berlin Wall.

It's a legacy that still makes the former East German border officer uncomfortable 25 years after he defied his superiors' orders and let thousands of East Berliners pour across his checkpoint into the West.

"I didn't open the Wall. The people who stood here, they did it," says the 71-year-old with a booming voice who was an East German lieutenant colonel in charge of passport control at Bornholmer Street. "Their will was so great there was no other alternative but to open the border."

Those people had come to his crossing at Bornholmer Street after hearing Politburo member Guenther Schabowski say – mistakenly as it turns out – at an evening news conference on Nov. 9, 1989, that East Germans would be allowed to cross into West Germany, effective immediately.

Schabowski was a member of the ruling Socialist Unity Party in East Germany who helped force East German leader Erich Honecker from power a month earlier because of mounting public pressure across the Soviet Bloc for reforms.

Jaeger recalls almost choking on his dinner when he heard Schabowski on his workplace cafeteria's TV set. He rushed to the office to get some clarification on what his border guards were supposed to do.

For East Berliners yearning to go to a part of their city that had been off limits for 28 years, Schabowski's meaning couldn't have been clearer. He was a member of the ruling party and what he said was law.

But for Jaeger, everything he learned as a communist who served his homeland in the army, border patrol and much-hated Ministry for State Security had been turned on its head.

The Berlin Wall was a "rampart against fascism," he recalls. "When it went up on the 13th of August, 1961, I cheered."

A Feeling Of Uncertainty

Twenty eight years later on Nov. 9, hours before the Berlin Wall came down, Jaeger felt confused.

He says between 10 and 20 people showed up at Bornholmer Street right after Schabowski's news conference. They kept their distance from the crossing, nervously waiting for a sign from the East German guards that it was all right to cross.

They didn't give any.

The crowd soon swelled to 10,000, with many of them shouting: "Open the gate!"

"I called Col. Ziegenhorn who was my boss at the time and he said: 'You are calling me because of this nonsense?'" Jaeger says, adding Ziegenhorn told him to send the people away. Jaeger says further calls to other government officials didn't help, either.

The Night The Berlin Wall Came Down

YouTube

(This video contains strong language in German.)

He insists East German border guards never had orders to shoot East Berliners illegally crossing into the West on that night or any other. But the official, Center for Contemporary History in Potsdam says 136 people were killed at the Berlin Wall during its existence, including people trying to escape, border guards and bystanders.

Jaeger claims lethal fire was permitted only if guards felt their lives were threatened.

During the quarter century he's worked at the Bornholmer Street crossing, his guards only fired one warning shot, Jaeger says. But on Nov. 9, he worried that if the crowd grew unruly, people would end up hurt, even if it wasn't from guns.

Cracking The Gate Open

To ease the tension, he was ordered to let some of the rowdier people through, but to stamp their passports in a way that rendered them invalid if they tried to return home.

Their departure only fired the crowd up more and pressure mounted on Jaeger from above and below to avert a riot. Despite orders from his higher ups not to let more people through, at 11:30 p.m.: "I ordered my guards to set aside all the controls, raise the barrier and allow all East Berliners to travel through," he says.

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It's an order Jaeger says he never would have given if Schabowski hadn't given the press conference four hours earlier.

He estimates more than 20,000 East Berliners on foot and by car crossed into the West at Bornholmer Street. Some curious West Berliners even entered the east.

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People crossing hugged and kissed the border guards and handed them bottles of sparkling wine, Jaeger recalls. Several wedding parties from East Berlin moved their celebrations across the border and a couple of brides even handed the guards their wedding bouquets.

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But Jaeger says he refused to leave East Berlin.

"I was on duty," he explains with a laugh. East German officers didn't get permission from their government to cross into the West until just before Christmas, he adds. Red tape involving his travel documents delayed the trip another month.

Making His Own Trip To The West

When he finally did go, Jaeger decided it had to be across his border crossing to the West Berlin neighborhood on the other side.

"I felt like I knew that place after hearing so often about it from people who constantly crossed here," he says. "So I wanted to see for myself what the area was like."

His first impressions of West Berlin weren't very positive, however. He was surprised, for example, to see Turkish immigrants living in conditions as poor as those of East Berlin.

But he also knew from West Germans who came across his border crossing that western goods were better than eastern ones and more readily available. Bananas, for example, were available in West Berlin during the cold winter months, but not in East Berlin, he says.

The West German government gave 100 marks (about $60) to East Germans who came to visit. Jaeger says he bought an air pump for his car tires and gave the rest of the money to his wife and daughter.

Reunification of East and West Germany in 1990 led to the dissolution of the East German border authority and Jaeger found himself unemployed at age 47. He tried his hand at a number of businesses, including selling newspapers, but he says the ventures never took off.

So he retired to a small town outside Berlin and spends his time giving interviews and traveling with his wife, Marga. He says they love to travel to countries they couldn't go to before 1989, including Turkey for their 50th wedding anniversary.

Jaeger says he has no regrets about what he did on the night of Nov. 9, 1989, nor was he punished by his East German superiors for doing it. He adds he is looking forward to the 25th anniversary activities this weekend.

The highlight, he says, will be a meeting with one of his heroes — Mikhail Gorbachev. The former Soviet leader has invited Jaeger to his Berlin hotel on Saturday.

Soraya Sarhaddi Nelson is NPR's Berlin correspondent. Follow her @sorayanelson.

Germany

Berlin Wall

In the latest vigilante attack based on an accusation of blasphemy, a young Christian couple in Pakistan was beaten by a mob and then incinerated at a brick factory.

There have been multiple cases in recent years in which Pakistanis are accused — often with little or no evidence — of committing blasphemy against Islam.

The police officer in charge of the investigation, Inspector Maqbool Ahmed, says he was told by local residents that the couple was still alive when they were shoved into a brick kiln.

By then, the husband and wife, Sajjad and Saima "Shama" Massih, were severely injured, having being beaten up by a crowd that set upon them when reports circulated alleging that they had defiled Islam's sacred book, the Quran.

According to Ahmed, more than 40 people have been arrested and are being questioned about the killings, which happened in a rural community in the province of Punjab, about 40 miles outside the city of Lahore.

The murders were described as "an act of sheer barbarism" by Joseph Francis, a prominent activist who campaigns on behalf of Pakistanis accused of blasphemy.

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Pakistani activists and members of the Christian minority light candles to protest the killing of a Christian couple who were burned alive after being accused of blasphemy. The protest took place in the capital Islamabad on Wednesday. Sohail Shahzad/EPA/Landov hide caption

itoggle caption Sohail Shahzad/EPA/Landov

Pakistani activists and members of the Christian minority light candles to protest the killing of a Christian couple who were burned alive after being accused of blasphemy. The protest took place in the capital Islamabad on Wednesday.

Sohail Shahzad/EPA/Landov

"We demand that the government sets up a judicial commission and thoroughly investigates the matter," says Francis. "It must bring the perpetrators to justice."

Reports from the area suggest that the allegations of blasphemy against the couple began to circulate after the husband, Sajjad Massih, had a financial dispute with his employers.

"Falsely accusing Christians of blasphemy has become a routine," says Francis, who heads Pakistan's Centre for Legal Aid Assistance and Settlement. "No false accuser has ever been punished. Such impunity has led to a surge of such incidents."

Punjab's chief minister has reportedly set up a three-member committee to investigate the murders. Police are under orders to beef up security in Christian neighborhoods in the province.

The killings come less than a month after an elderly, mentally ill British man, who is on death row in a Pakistani prison for committing blasphemy, was shot and injured by a guard.

The victims of such blasphemy-related vigilante attacks are often Pakistan's minority communities — including Christians, Hindus, and Ahmadis — although members of the mainstream Muslim majority have also been targeted.

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There was an international outcry in 2011 when the provincial governor of Punjab and Pakistan's federal minorities minister were assassinated, in separate incidents.

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Both men had calling for reforms in Pakistan's blasphemy laws, and spoke in support of Asia Bibi, the first woman in Pakistan sentenced to death for blasphemy.

Bibi is a Christian and a mother of five who has spent four years on death row after being accused of blaspheming during an argument with co-workers at a fruit farm. Her lawyers are currently preparing to appeal against her conviction before Pakistan's Supreme Court.

Pakistan's blasphemy laws are also a source of concern among human rights organizations and others. Activists say anyone who is accused can be arrested on flimsy evidence, and detained for years without bail.

They say the laws are increasingly exploited by people pursuing private vendettas over issues such as money, property, or politics.

The issue of blasphemy is so sensitive in Pakistan that most Pakistani politicians and officials prefer to avoid publicly discussing it because of the dangers involved. In May, a leading human rights lawyer was shot dead after agreeing to defend a Muslim university teacher accused of blasphemy.

Pakistan

If there's one thing college kids do best, it's thinking creatively. Often operating with limited resources and tight deadlines, they're used to coming up with ingenious solutions to life's everyday problems (usually on little sleep). So it's no surprise that experts are turning to students for help in battling one of this year's most pressing global health issues: the Ebola outbreak.

The U.S. Agency for International Development announced a $5 million Grand Challenge in October, signaling the urgency to develop better protective gear for health workers in West Africa. Recognizing that grads and undergrads are in the perfect position to come up with clever ideas, some of America's most prominent universities have organized their own design challenges and emergency hackathons to get students' brains churning.

Challenge accepted. Working between classes and into the night — even on Halloween — students have been hacking Ebola from every angle.

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Take, for example, how to improve the appearance of an Ebola protective suit. You might think aesthetics is the last thing innovators should worry about, but consider this: "For people in West Africa, when they look at somebody in full [protective] gear, it is pretty scary," says Dr. Harshad Sanghvi, vice president of innovations at Jhpiego, a global health nonprofit affiliated with Johns Hopkins University. "That's one of the reasons that people are afraid to come to the treatment centers."

Sanghvi helped organize a weekend hackathon two weeks ago at Hopkins in Baltimore, where a team of engineering students and textile experts are working on making the gowns look friendlier. Something as simple as adding name tags to the suits and developing a face protector that shows more of the face — to increase eye contact — can make a difference, he says.

At Columbia University, whose engineering and public health schools launched a two-week design challenge in early October, a team is tackling the same problem with a variety of colorfully patterned aprons that can be worn over anti-Ebola suits. Team member and engineering student Ramya Ahuja told the university's student newspaper that they studied traditional West African patterns to make their designs culturally appropriate.

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Students at Columbia University devised a spray bleach solution that first shows up as blue, then turns clear, so health workers can easily make sure they've disinfected everything. Courtesy of Columbia Engineering hide caption

itoggle caption Courtesy of Columbia Engineering

Students at Columbia University devised a spray bleach solution that first shows up as blue, then turns clear, so health workers can easily make sure they've disinfected everything.

Courtesy of Columbia Engineering

Another Columbia group thought of using color-changing bleach to help health workers confirm they've fully disinfected every part of their suits. Still another developed a lightweight cot that workers can use as a stretcher to transport patients and can double as a bed.

"[Students] think practical and they think outside the box," says Dr. Wafaa El-Sadr, an epidemiologist at Columbia's Mailman School of Public Health and one of the challenge's organizers. Students, she notes, aren't "encumbered by knowing the limitations."

While students don't have all the answers, they make up for it with "unbounded enthusiasm," says Aditya Brahmabhatt. A recent graduate of New York University's engineering school, the 24-year-old mechanical engineer organized an Ebola hackathon at his alma mater last weekend, which drew about 35 professional coders, data scientists and students.

"They were really excited to be given a chance," Brahmabhatt says. "People are looking for...these things where they can come and make a difference."

For a group of Kenyan students at Duke University, their ties to Africa were enough reason to get involved in their school's innovations challenge, which launched last week. "We recognize that this [Ebola outbreak] could happen in Kenya," says Dorothy Mangale, 27, a global health student. "So in the spirit of brotherhood or neighborliness, we decided that this was going to be an important issue for us."

Mangale's group includes global health, medical and computer science students. Together, they've come up with a mobile application with a "decision tree." The tree would help people figure out whether their symptoms warrant a visit to an Ebola clinic. It would also alert health workers to any suspected cases so they can send an ambulance as soon as possible.

For global health students learning about epidemics of the past, "It was hard for them to relate to what they were studying" in the classrooms, says Kyle Munn, the program coordinator for Duke's social entrepreneurship program, who helped organized the university's Ebola event. "So this gave them an opportunity to apply their learning to a current, real-world challenge."

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NYU's Brahmabhatt says he wants to see even more U.S. schools involved. "It's really sad to see that every university is not already doing this," he says. "Every university has computer scientists, data scientists, anthropologists and epidemiologists."

Coupled with the creative minds of passionate students, he says, this creates just the right balance of knowledge and skills for generating quick and innovative solutions. The most promising ideas resulting from the Ebola hackathons will either be entered into USAID's Grand Challenge or will be sent for field-testing and product development.

And those ideas don't necessarily have to come from a large event. Back in September at Emory University, one lecturer asked her introductory biology class to come up with a faster and cheaper way to test patients for Ebola. She intended for them to explain the science in an upcoming quiz for bonus points — but got a surprise when two students took her challenge to heart.

Freshmen Brian Goldstone and Rostam Zafari, both 18, came to her with an idea for cheap detection strips that can recognize the Ebola virus before the onset of symptoms. The duo, with the help of a few experts, created a Indiegogo campaign and raised more than $14,500 last month to put their strips to the test.

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