Palestine 100 years ago, Hans Christian Anderson’s tale of ‘The Emperor’s New Clothes’, malaria elimination and today’s failure of engagement with the community

A century ago, Dr. I. Kligler, a Jewish Zionist in Palestine, initiated the first start anywhere in the world of a successful national malaria elimination campaign. It is little realised today that Palestine back then was drenched in malaria, rendering it uninhabitable in many areas, leaving it a country almost empty. Kligler recognised in his quest for malaria elimination firstly the need to demonstrate that malaria elimination was in fact possible. Secondly, he noted that the old colonial attitudes which then prevailed around the world towards subject populations also existed in Palestine. He realised that to be effective in educating anyone to assist with malaria elimination in such a colonial environment, that person would need to be educated, and such education had to be conducted with ‘dignity and respect’. Such an attitude is something that was (and still is in many places) sadly missing within former colonies. Kligler knew the Zionist dream of a Jewish homeland in Palestine would in all probability be an impossibility unless malaria could be defeated there. He accordingly set out to initially demonstrate on a very small scale what could be achieved by way of malaria control. With dignity and respect, he engaged with all the inhabitants, both Arabs and Jews, sometimes even individually if necessary, to educate about the disease and to explain why his anti-malarial works were necessary, thereby enlisting the inhabitants effective assistance in these works. The result was enthusiastic co-operation by the inhabitants for over twenty years which was eventually rewarded with malaria elimination. Unfortunately, the example shown by Kligler is little known to the rest of the world today, and unless communities suffering from the disease learn from such examples, the task of malaria elimination elsewhere around the world will continue to be fraught with great difficulty, and more than likely to result in failure.