Tree bug

BMJ 1998; 317 doi: (Published 15 August 1998) Cite this as: BMJ 1998;317:456

Letter from South Africa

  1. CH Vaughan Williams, principal medical officer
  1. Ingwavuma, South Africa

    There are two common conditions that affect doctors who work at Mosvold Hospital. One is tick bite fever. Almost every new doctor is confidently diagnosed as a sufferer sooner or later. We do not have the serology for confirmation. It is, however, of note how often it is diagnosed among medical staff and how rarely in patients. Most patients have to make do with less distinguished illnesses such as flu and perhaps an infected insect bite. There are a lot of ticks around. There are also a lot of mosquitoes; not to mention the 80 000 described insect species and 3000 species of spider and the thousands of undescribed bugs of various kinds, many of which are not averse to giving you a nasty nip if they have the chance. Colds are also common, although less often diagnosed among medical staff.

    The other affliction that seems to affect a substantial number of staff, particularly if they remain exposed to the bush long enough, is tree bug. I admit to being a sufferer of this condition. It starts by wondering about the strange palm tree outside your house. Eventually you discover that it is a cycad, a plant that is more or less the same as when the dinosaurs were around. You ask a Zulu what the tree with dazzling red flowers against the dry August bush is, and are disappointed by the lack of an answer. After a while you learn that it is a coral tree. Then you wonder why some large local trees seem so oddly twisted, and it turns out that they are strangler figs; and so it goes on.

    South Africa has 16 times as many tree species as the whole of northern Europe. The garden of a previously tree bugged doctor has a fine botanical collection and his efforts have many patients sitting under them on a hot day. A teacher in Ingwavuma has tree bug so badly that when he goes to a game park he can hardly see the rhinos, so absorbed is he by what they are eating. Then come some less pleasant discoveries. Australian gum trees have been stuck all over southern Africa, not only in vast plantations but apparently as some marker of civilisation in a really quite bizarrely unimaginative way. You learn that South Africa has less than 1% of its original forest remaining. It seems that disrespect for African people was paralleled with disrespect for African vegetation. One exception is the baobab tree. On the drive north to Zimbabwe it seems that whereas all the other plants made way for the road, the road has been routed around the huge baobabs.

    The tide against indigenous plants does now seem to be turning, although it will take time to reverse decades of ruthless exotic planting. Richard's Bay and Durban now have an indigenous tree policy. Newly planted saplings are usually mahoganies, fever trees, giant leafed figs, wild bananas, or wild date palms, rather than the jacarandas and flamboyants. Once there were few books to be found on the subject, whereas now there is quite a choice.

    We welcome articles of up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake,or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to.

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