I would ask the reader to pause for a moment and ponder the statistics. Statistics are mere numbers; they need to be translated into human experience. What would a 90 percent mortality rate mean to the survivors and their society? The Black Death in Europe at its worst carried off 30 to 60 percent of the population. That was devastating enough. But the mortality rate wasn’t high enough to destroy European civilization. A 90 percent mortality rate is high enough: It does not just kill people; it annihilates societies; it destroys languages, religions, histories, and cultures. It chokes off the transmission of knowledge from one generation to the next. The survivors are deprived of that vital human connection to their past; they are robbed of their stories, their music and dance, their spiritual practices and beliefs—they are stripped of their very identity.
The overall mortality rate in this wave of epidemics was indeed about 90 percent. To put that statistic into personal terms, make a list of the nineteen people closest to you: All but one will die. (This of course counts you also as a survivor.) Think what it would be like for you, as it was for the author of the Cakchiquel manuscript, to watch all these people die—your children, parents, grandparents, brothers and sisters, your friends, your community leaders and spiritual authorities. What would it do to you to see them perish in the most agonizing, humiliating, and terrifying ways possible? Imagine the breakdown of every pillar of your society; imagine the wasteland left behind, the towns and cities abandoned, the fields overgrown, the houses and streets strewn with the unburied dead; imagine the wealth rendered worthless, the stench, the flies, the scavenging animals, the loneliness and silence. Enlarge this scenario beyond towns and cities; enlarge it beyond kingdoms and civilizations; enlarge it beyond even continents—until it embraces half the planet. This inferno of contagion destroyed thousands of societies and millions of people, from Alaska to Tierra del Fuego, from California to New England, from the Amazon rainforest to the tundra of Hudson Bay. It is what destroyed T1, the City of the Jaguar, and the ancient people of Mosquitia.
This is the sort of thing that writers of postapocalyptic fiction put themselves to imagining, the stuff of our greatest news-cycle nightmares—but this very real Armageddon lies beyond reach of the darkest Hollywood movie fantasies. It was the greatest catastrophe ever to befall the human species.
Should sixteenth-and seventeenth-century Europeans be blamed? If one can blame the dead at all, they are answerable. The Spanish, English, and others contributed mightily to the death toll through cruelty, slavery, rape, abuse, starvation, war, and genocide. Europeans killed many native people directly without the assistance of disease. In some instances, they intentionally used disease as a biological weapon by, for example, giving Indians smallpox-infected blankets. And millions more Indians died of disease who might have survived, had European brutality not left them weakened and susceptible.
It is tempting to argue that if Europeans hadn’t arrived in the New World, these deadly pandemics would not have happened. But the meeting of the Old World and the New was inevitable. If Europeans hadn’t carried disease to the New World, Asians or Africans would have; or New World mariners would have eventually reached the Old. No matter what, disaster would have ensued. This was a monstrous geographic accident waiting to happen. This was a time bomb that had been ticking for fifteen thousand years—counting down to that fateful moment when a ship with sick passengers finally set sail across the wide ocean.
This is in no way an apologia for genocide. Still, the catastrophe was largely a natural event, a mindless biological imperative, a vast migration of dumb pathogens from one side of the planet to the other.
There is much irony in the story of our own disease. The strain of leishmaniasis that befell us is a rare example of a New World disease attacking (mostly) Old World people. While I obviously don’t believe in curses, there is an inescapable sense of commination in the fact that a New World city destroyed by Old World disease wreaked havoc on its Old World rediscoverers with a New World disease. But this irony misses the modern lesson: This was a Third World disease attacking First World people. The world is now divided into Third and First, not Old and New. Pathogens once confined to the Third World are now making deadly inroads into the First. This is the future trajectory of disease on planet Earth. Pathogens have no boundaries; they are the ultimate travelers; they go wherever there’s human fuel. We First Worlders have become far too complacent in the idea that disease, especially NTDs, can be quarantined to the Third World, and that we can live safely in our communities supposedly gated against pathogens, ignoring the suffering of the poor and sick in faraway lands.
The HIV medical crisis has already pushed leishmaniasis into new areas of the globe, especially southern Europe. HIV vastly increases the destructive power of leish and vice versa. A leishmania/HIV coinfection is a terrible combination, considered to be a “new” disease all of its own, almost impossible to treat and usually fatal. HIV and leishmania become locked in a vicious cycle of mutual reinforcement. If a person with leishmaniasis gets HIV, the leish accelerates the onset of full-blown AIDS while blocking the effectiveness of anti-HIV drugs. The reverse is also true: A person with HIV who lives where there’s leishmaniasis is a hundred to a thousand times more likely than a healthy person to get the disease, due to a weakened immune system. People suffering from a leish/HIV coinfection are so teeming with the parasite that they become super-hosts, potent reservoirs accelerating its spread. And visceral leish, like HIV, has been shown to be transmitted by dirty needles among IV drug users; two studies in the late nineties found leish parasites on some 50 percent of dirty needles discarded by drug users in Madrid at two different locations several years apart. Sixty-eight percent of all visceral leishmaniasis cases in Spain were among IV drug users.