Papers on malaria: my life journey as a public health doctor in Tanzania

Zul Premji is a well-known malaria guru and his book covers his life story, which in short is a rags tale to a global malaria researcher. He dwells deep in a childhood world of family relationships and perhaps most of all for a scientist, those early days of self-discovery influence his personal folklore in ways that can hardly be categorized.

For him, the importance of brothers and sisters, teachers and youthful adventures is obvious, proof that science and life go hand in hand. To relate these realms, physical nature and the human world, and to notice their correspondences, is to gain insight into personal, social and political experiences.

In the tradition of a committed university professor, Premji wrote an episodic tale full of metaphors and broader lessons from a long career.

At each phase of his life, an important message is transmitted.

Premji was born in Iringa, Tanzania, to a somewhat poor and often on the move Ismaili family. First in Morogoro, then in Tanga, then on the outskirts of Mtwara, he attended a series of public schools: “I did well in my studies and I was active in sports, playing football, football. cricket and volleyball.

This comfortable and rather stable life came to an abrupt end sometimes in August 1967.


I received a telegram saying that my father had been hospitalized with a heart attack.

He rushed from Tanga to a small village in Mtwara, but rather than opening a duka to help the family financially, as his father and older brother wished, Premji knew he had to “continue his studies no matter what. ‘he is coming “.

Eventually, with the support of an academic sponsorship, he ended up at the Muhimbili Faculty of Medicine in Dar es Salaam.

There he studied medicine and later parasitology and began to build a reputation as a “malaria guru”.

As a specialist, Premji has participated in several influential studies. He led the Bagamoyo BedNet Project, a collaboration with Johns Hopkins University that analyzed the impact of insecticide-treated bednets.

And he helped develop a new diagnostic tool, known as the rapid diagnostic test, which is now being deployed globally for the diagnosis of malaria, particularly in sub-Saharan Africa.

“I am proud to have participated in this research,” he writes, “but my entrepreneurial skills are weak and I have failed to take advantage of the monetary aspect of this opportunity.” He later served as an advisor to the Tanzanian Ministry of Health in the “era of chloroquine resistance”. Despite Premji’s lack of entrepreneurial skills, his trajectory from the “vicious cycle of poverty” to corridors of influence reads like a tale of personal bravery.

Premji does not intend his account to be a comprehensive review of malaria research and development.

Beyond “The Five Riddles of Malaria,” a concise chapter that describes the disease, from its complex life cycle between humans and mosquitoes to the inability to predict its outcome in a given individual, the book deals more with of the traveling mind of a pathologist. Pensive articulations abound: a chapter on disease control policy is followed by an account of a pleasant trip to India; major career events are followed by topics such as “how to make medical school more interesting and less of a torture” and thoughts on aging.

“To grow old,” writes Premji, “is to move from passion to compassion.

These thematic leaps, changing directions, multiple faiths, put the work of science and the work of life on an equal footing.

Premji notes William Osler’s aphorism that “medicine is a science of uncertainty and an art of probability.”

He experienced this existential truth very early on and was “wary of attributing changing moments in my life … Too many influences swirl around us, and other secrets are seeping into it. unconscious ”.

Both inside and outside the lab, he believes, “instead of seeking certainty, we should constantly seek doubt about our beliefs, feelings, and futures.

Like Levi, who constructed his memoirs using the periodic table as a framework for interpretation, Premji observes through the prism of the empiricist, through a hermeneutics of doubt.

He traces the events of his life directly and with healthy skepticism, never rushing to over-define his experiences or make them into something they are not.

An entire chapter is devoted to his job as director of pathology at the Aga Khan University Hospital in Nairobi.

Unfortunately, his experience and observations as a professor at this private medical school were somewhat unsatisfactory and at times disappointing.

He writes clearly giving real examples of what is not so acceptable and suggests solutions for improvement.

Yet the reader cannot help but feel that Premji is holding something back.

Resistance to overly prescribed meaning, the fact of privileging concrete facts over story or belief, prevent the memory from finding a distinctive form, a logical common thread.

Some of his more interesting ideas, notably that malaria is a social disease that mainly targets the poor, are approached through anecdotes but are not fully articulated. Without thesis or ostentatious narrative arc, the material seems a little raw, in search of its organizing principle.

Zul Premji retired to Calgary in 2016, to help care for his grandchildren. “In time,” he wrote, “I hope I will return to Tanzania. Until then, he speaks with the authority of someone who has been successful.

With well-paced and pragmatic prose, Malaria Memoirs reads like an intimate conversation with a friend, someone who has lived a consecrated life full of accomplishments and is ready to share.

By Zul Premji

First published by Mawenzi House. Available in softcover and ebook

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