From the Microscope to the Telescope

The viewpoint of the chapters is similar to an optical device that begins as a microscope and ends as a telescope, going from the infinitesimal parasite to humans, communities, nations, and continents. The world of microbiology is an amazing universe continually being newly discovered. Chapter 1, Discovering Chagas’ Disease, reveals the medical history of this disease. Chapter 2, An Early Andean Disease, contains its history in the Andes. Chapter 3, Jampiris and Yachajs: Andean Ethnomedicine, looks at how Bolivian curanderos treat its symptoms. Chapter 4, The Crawling Epidemic: Epidemiology, deals with infestation by vinchucas, means of infection, and the extent of the epidemic. In Chapter 5, Cólico miserere: Enlarged Colon, and Chapter 6, Bertha: Mal de Corazon, one reads about the illness in its chronic stages of megacolon and heart disease. This is presented through the lives of people from two Bolivian families.

Reversing the microscope into a telescope to examine the environment relating to Chagas’ disease, Chapter 7, Cultural and Political Economy of Infested Houses, deals with the relationship of cultural and political‑economic factors in bringing into physical proximity parasites, vectors, and hosts.

What can be done to prevent Chagas’ disease is considered in the last chapters. Housing improvement projects are described in Chapter 8, Pachamama Snatched Her: Getting Involved, and Chapter 9, Sharing Ideas. Chapter 10, A Culture Context Model, presents a model for future health projects. The concluding chapter, Solutions, contains answers to punctuated approaches, economic causes, and environmental issues precipitating Chagas’ disease. Humans have created the social and environmental context for the spread of this debilitating disease, and it is to be hoped that they can be as successful in eliminating such diseases as they are in proliferating them.

This book includes appendices to learn more about biomedical aspects of Chagas’ disease. These appendices provide information in the forms of tables and charts concerning the vector species and hosts of T. cruzi in the Americas. It includes a discussion of the strains of T. cruzi, vaccine development, and an important section of the immune response, coauthored with the noted parasitologist Dr. George Stewart.

The perspective of Kiss of Death: Challenging Chagas’ Disease is to look at the relationship of many factors, almost as if one were looking at it from a galactic point of view, with the details of the puzzle examined in Bolivia, a small country with a small population (seven million people) and a high rate of Chagas’ disease, a variety of climatic and geographic featurestropical forests, high plateaus, and still higher mountainscontaining varied ethnic groups, social classes, and economic systems. Bolivia gives us the gift of the dervish in A Thousand and One Nights who claimed the power of seeing all the world at once, or that of Jorge Luis Borges’s Aleph, the diameter of which “was only two or three centimeters, but the whole of space was in it, without sacrifice of scale” (Borges 1977:625, Fernández‑Armesto 1995:19).

Reading about Chagas’ disease in Bolivia gives a perspective for understanding this disease throughout Latin America and for predicting what might happen in the United States and Europe, where it is spreading. Chagas’ disease is the space in which are encapsulated minutely infinite forces and from which we might get a broader perspective of the universe.