George Giglioli was an Italian, born in Naples. His father was Director of the faculty of Agriculture and Professor of Agricultural Chemistry at the Royal University of Pisa; that was where Giglioli graduated from in 1921 as a Doctor of Medicine. In 1922 he obtained a Diploma in Tropical Medicine and Hygiene from London and in 1925 a Diploma in Dermatology and Venereology from Paris. In 1932 he got a Diploma of the Superior School of Malariology; while in 1933 he was admitted to membership of the Royal College of Physicians, London, as well as becoming honourary lecturer in Tropical Pathology at hi alma mater, the Royal University of Pisa. However, it is his phenomenal achievement in British Guiana, which will endure in the annals of tropical medicine.

In May 1966, on the occasion of Guyana’s independence, the Guyana Graphic attributed the eradication of the dreaded malarial disease almost exclusively to Dr. George Giglioli. They observed:
The era of Guyana’s growing pains is pockmarked with incidents, none of the least significant of which has been the battle against the scourge of malaria. And in this battle one man’s name stands out boldly – Dr. George Giglioli, fames malariology, whose dedicated service in the cause of ridding Guyana of this dreaded scourge, is a story of single minded purpose and unflagging determination. In the course of this battle, (he) has helped Guyana’s transformation from one of the world’s foremost fever-ravaged countries to the place where the death-dealing disease was first checked, then beaten back until today, victory over malaria has become one of the glorious achievements in the history of Guyana’s progress against disease and death. Today Guyana can boast of freedom from malaria, a freedom won largely through the unrelenting campaign of Dr. Giglioli.
The Graphic’s designation of the malarial experience as a ‘scourge’ was no exaggeration. In 1943-44 the percentage of school children with enlarged spleens was astounding. Malaria had had such a devastating effect on population growth that between the 1931 and 1946 censuses, while the drier, malaria-free Corentyne Coast recorded a population increase of 384 per 1,000 and the partially malaria-free West Coast Berbice 249 per1,000, it was a paltry 87 per 1,000 on East Coast Demerara, and 113 on the East and West Bank Demerara. On the Essequibo Coast the population actually declined by 142 per 1,000. This translates to a meagre natural increment of 36 per 1,000 between 1921 and 1931, and 186 per 1,000 between 1950, the natural increment, overnight, was a comparatively prolific 192 per 1,000.
On the sugar plantations, in a population of about 75,000, hospital admissions during the malaria epidemic of 1938 was over 13,000, with 240 deaths directly attributed to the disease. In 1944, over 10,000 cases were admitted to estate hospitals; 200 died. With the eradication campaign launched after 1945, less than 800 were admitted in 1948, with under 30 deaths; by 1950 under 200 cases were admitted to estate hospitals, with less than 10 deaths.
Yet, as late as 1939, the Director of Medical Services of British Guiana argued that malaria was so endemic to the colony that it was futile to contemplate its eradication. It was axiomatic that the ‘scourge’ which stifled the imagination, nullified effort, and killed was a ‘sisyphean’ task: ‘elimination is an utter impossibility’.
Since the late 1920s, Dr. Giglioli’s passion for researching the cause of malaria in British Guiana had led him to isolate the Anopheles darling as the sole vector. Moreover, he was well on his way to identifying the sources of its vulnerability, its potential for self-destruction. In June 1939 a Malaria Research Unit, headed by Dr. Giglioli, was established with support from the Rockerfeller Foundation, the Sugar Producers’ Association and the government. This extraordinary man was on the verge of possibly the most significant achievement in the social history of Guyana.
For 10 years, 1922 to 1932, Giglioli was Chief Medical officer at Mackenzie, Upper Demerara River. His major contribution, in malariology, was still to be established. In 1933 Giglioli joined Plantation Blairmont as medical adviser. This estate, at the mouth of the Berbice River, had a fairly high rate of malaria infection; but under its progressive head, Sir Edward Davson, and its imaginative manager, Guy Eccles, Blairmont had become a reforming estate, already trying to sweeten the bitter legacy of sugar.
It was Blairmont’s susceptibility to malaria which had led to the inspired appointment of Giglioli as their medical adviser. He had already done useful research on the Upper Demerara River in the 1920s; this was published as a book in 1930, Malarial Nephritis, which won the Davson Centenary Gold Medal in 1932, the year before he joined Davson at Blairmont.
Giglioli’s excellent research at Blairmount, between 1933 and 1937, was pursued with equal vigour at Booker, which he joined as Estate Medical Officer, in the latter year. In 1939 he was seconded to the government5 as Director of the Malaria Research Unit. By then he had published several ground-breaking essays on Anopheles darling and identified its cardinal behavioural patterns, its feeding and resting routines. By the late 1930s the colonial inertia on malaria was lifting. Workers’ militancy after 1934-35 and the low productivity of workers with chronic malaria were eroding the complacency, along with other factors.
In 1942 Giglioli was named Honorary Government Malariologist and in 1945 he became Medical Adviser to the S.P.A., a post he held until his death. Indeed, Giglioli’s research into A. darlingi, establishing that it was the sole vector of malarial infection in British Guiana, the assessment of its breeding habits and the astounding eradication of the dreaded disease in the colony, between 1946 and 1948, constitute an epic in tropical medicine. It was an achievement with revolutionary potential economically, socially and politically, at the end of the 1940s.
Between 1922 and 1932, when he was the Chief Medical Officer of the Demerara Bauxite Co. at Machenzie, Upper Demerara River, he established that A. darlingi could not survive in the excessively acidic, brown water of the Demerara River and the surrounding forest creeks and swamps. When, however, this water was contaminated by the bauxite washing process, leading to precipitation of the brown organic matter the water carried in suspension, thus reducing its acidity, A. darlingi was able to breed. This was the start of his journey on the tortuous road to its demise. Between 1933 and 1937, on the Davson’s Estate on the Berbice estuary – Blairmont (West Bank), Bath (West Coast) and Providence (East Bank) – Giglioli advanced his work, limiting the breeding and distribution of the anopheles to the pivotal question of water reaction. This was the environment which enabled him to isolate A. darlingi as the sole vector of the disease, rampant on most of the coastland of British Guiana.
In 1938-39 those findings were published locally, in four articles. He arrived at four principal conclusions: (i) that A. darlingi was the only carrier of malaria of importance in British Guiana; (ii) that it ‘breeds selectively in large bodies of water which are clear and slightly acid or neutral in reaction; it does not breed in waters with a marked acid reaction’; (iii) A. darlingi does not breed in water of high salinity or brackish water, very common on the Corentyne Coast, in Berbice; (iv) originally a forest mosquito, it likes a humid climate; it does not survive on the windswept, drier coast front-lands of the Corentyne.
On the basis of these crucial findings he was able to recommend to the sugar producers in 1937, when he joined Booker, that the depredations of A. darlingi could be tempered if ‘sheltered yards, situated within the cane cultivation, were condemned to be gradually eliminated’. He advised that all new residential areas be located on the ‘open front-lands, where salt soils, wind-borne sea spray and constant winds offer naturally unfavourable water and atmospheric environment for both the breeding and survival of A. darlingi.’
Giglioli attributed its virulence to the empoldered, man-made environment of the British Guiana coastland. Ironically, it was the reclamation, the humanising of this environment, which had made it vulnerable to A. darlingi. He argued that malaria was virtually nonexistent on the Corentyne Coast, apart from the occasional epidemic in years of excessive rainfall, because much of its front-lands were still in a primitive state, unreclaimed, with constant incursions by sea water and the consequent high salinity of the land. This gave rise to a sort of scrubland, hard grasses, not trees, thus exposing the coast to high winds; this was antagonistic to the propagation of A. darlingi.
Giglioli contended that the highly acidic, organic soils of the ‘pegasse’ area immediately inland from the coastland clay, was well as the forested sand reefs, interspersed on its margins, were not conducive to the dreaded malarial vector. So both the sea in front and the ‘pegasse’ lands and sand reefs behind, were inimical to the propagation of A. darlingi. They tended to predominate in the less acidic interior regions of red loams and lateritic soils.
The cultivated coastland, the planation zone, with its myriad drains and ditches, irrigation canals, flood-fallowed cane fields, rice fields, ponds and borrow pits, provided an ideal habitat for A. darlingi. These ubiquitous reservoirs of non-acidic water were a haven for this species – a point dramatized by the malaria-free Corentyne Coast’s sudden susceptibility to malaria, in years of heavy rainfall, when the water on the saline front-lands become diluted, as was the encroaching acidic water from the ‘pegasse’ back lands.
Giglioli calculated that on every square mile of cane cultivated (10-acre field) there were 16 miles of irrigation canals, 4.5 miles of drainage sideline canals and 45 miles of four feet drains. This complex hydrological environment, in conjunction with the extension of the area under wet-rice culture since the First World War, made coastal British Guyana especially vulnerable to A. darlingi. By the start of the Second World War, Giglioli had unearthed most of the key characteristics of this species, including its peculiar feeding patterns.
At the end of his series of articles on malaria, in 1938-39, Giglioli had concluded that ‘certain weaknesses’ in the biology of A. darlingi ‘may be exploited to its detriment’. Though confident that malaria could be ‘successfully controlled’, he was circumspect about its eradication. His achievements a decade later, by 1948, had exceeded his most optimistic prognostication.
As Giglioli observed, it was Davson’s imaginative approach to industrial relations, even before the 1930s, which had made his research possible. The higher incidence of the disease at Blairmont gave urgency to the task. Giglioli remarked that it was here that ‘great advances’ were made in ‘unravelling’ the old problem of the transmission of malaria. But he also conducted surveys and treatment campaigns on hookworm on Davson estates. In April 1934 the infection rate was 73.4 percent; by December 1935 it has been reduced to a mere 6.2 per cent. Giglioli tackled another common problem, megalocytic anaemia of pregnancy. He observed :’(It was) a very common and disabling disease in East Indians causing a high maternal, foetal and neo-natal mortality, was identified and its complex causes were elucidated; very effective therapeutic and preventive measures were successfully introduced.’
The health, of the predominantly Indian resident workers at Blairmount were dire. In 1934, 1,075 of its resident population of 1,926 had to be admitted to hospital at least once that year – 55 per cent. That constituted 1,392 admissions, entailing a loss to the estate of 13,388 hospital man-days in 1934 alone. In short, this amounted to 36.5 inpatients per day, with each patient spending 9.5 days in hospital. Besides, 1185 cases were treated as outpatients and 40,656 minor treatments were administered at the estate’s dispensary.
On the sugar estates of British Guiana, in 1944, just before the start of the anti-malaria campaign, infant mortality per 1000 live births was 176. This declined progressively to 109, 106, 91, and 82 between 1945 and 1948. It is irrefutable that malaria was at the crux of the stagnant population on the estates. Indeed, it was the foundation of the static Indian population in the colony before the end of the 1940s. For them in particular, more susceptible to the ravages of malaria than African people, the results were dismal. As the Immigration Agent general observed in 1922, of the 238,969 Indians taken to the colony as indentured labourers between 1838 and 1917, 69,803 had returned to India, leaving a balance of 169,166. However, the census of 1921 recorded 44,228 fewer Indians in British Guiana – 124,938.
With the eradication of malaria, a revolution took place in demographic patterns among Indians after 1948. The implications of this demographic revolution for the social, economic and political evolution of the colony were astounding. Even when taken in conjunction with broader international and imperial developments after the Second World War, the eradication of malaria – Giglioli’s monumental achievement – still represents the most important achievement in the country in the twentieth century.
It is nearly 40 years since this great man died, yet no major biography of him exists. He deserves a work on the scale of the book I did on Jock Campbell. This short book by Denis Williams, written shortly after Giglioli’s death, is all that we have. I hope, therefore, that its republication may inspire someone to do a full study of a true revolutionary in the medical and social history of Guyana.