The history of sleeping sickness
Sleeping sickness in ancient human societies
The risk of trypanosome outbreaks during the early African civilisations is of course difficult to judge. It must have been relatively low for a number of reasons: firstly Africa as a whole was thinly populated and the risk of the disease spreading over such widely dispersed population should have been low. Secondly, people had the good habit of maintaining large areas around the villages clear of vegetation thus providing protection against wild predator animals, enemy tribes and slave raids. Unintentionally, as a side benefit, this served as a barrier against tsetse invading their village. Thirdly, tribes and kingdoms were isolated from each other by densely grown areas the so called sanitary barrier or “Grenzwildnisse”. Thus avoiding spread from one community to another. Moreover trial and error made people abandon their villages and from then onwards avoid such sites by collective memory over generations. Another important fact which reduced their exposure was that practically everywhere there was an abundance of game for tsetse to feed on.
Naturally people in the endemic areas knew sleeping sickness for its conspicuous late stage symptoms such as mental derangements and emaciation. Apparently people recognised the somnolence and visibly enlarged neck glands. Old vernacular names have been retraced indicating "sleepiness" or "nut-disease". They also knew about risky sites as shown by names like "river" or "fishers" disease. Local healers carried out (and still do so) excision of swollen posterior neck glands not only for patients but also as a means of preventing the disease. In certain tribes all the young men were operated systematically to "prevent impotence”. Also herbal treatments and ritual treatment were practised against the disease.
West African kingdoms such as Benin, Ghana, Mali and Songhai were closely linked with the Arab world via the numerous trans-saharan trade routes. From these contacts originate the first written record on sleeping sickness by the historian Ibn Khaldun who reported the death of King Diata II, sultan of Mali in 1373 who suffered from lethargy, “... a disease that frequently befalls the inhabitants...". Should there have been any large scale outbreak in those days the news would certainly have filtered through in Arab literature.