PIG TO HUMAN: THE WORM-SEED CYCLE

         The pig tapeworm, is a parasitic invertebrate without a mouth, body cavity, digestive tract or anal opening. A gutless flatworm, the parasite must absorb food directly through its body covering. Each mature segment contains male and female sexual organs and an excretory opening. A full-grown seven meter tapeworm is a segmented chain with a communal lateral nerve cord. The sexually immature head segment, called a scolex, has specialized suckers for attaching to the human intestinal wall. The middle segments are sexually functional and the end segments are mere egg sacks. Eggs are either released in the human bowel or egg sacks are excreted whole into the environment.
         Pigs start the intermediate host cycle when they swallow tapeworm eggs. Adult worms do not develop in the pig. Instead the hatched egg works its way through the intestinal wall and enters a vein. The embryo then travels the blood stream until it lodges in the pigs muscle. Nested in muscle tissues the small worm develops into its bladder-like form known as the cysticercus. These cysts eventually become the worm-head, but develop no further until a human eats the infected pork. The scolex pops out, attaches to the human intestine and grows its full seven meters of communal segments. Humans are the only host for sexually mature pig tapeworms.

Seven Meters of Death

         Unfortunately for humans, not only are they the sole host to mature T. solium, they can also act as intermediate hosts as well. When pigs and humans eat eggs of the pig tapeworm, bladder-like cysticerci can develop from embryos, causing the disease of cysticercosis. The larval stage of T. solium, Cysticercus cellulosae, invades human skin tissues, the brain, eyes, muscles, heart, liver and lungs (Tjahjadi et al 1978:279). Humans infected by seven meter pig tapeworms rarely experience discomfort, but when they harbor cysticerci it is physically devastating (Desowitz 1981:39).
         If infection with the larval stage leads to cerebral cysticercosis it has severe and sometimes fatal results. Central nervous system involvement unpredictably ranges from general malaise to epilepsy and death. Infection of the eye most often occurs in the vitreous body and the subretina (World Health organization 1976:67,70). Inflammatory reaction to the cysts in the brain is a veritable 2-5 year time bomb leading to epilepsy and psychosis.

West Papua's First Worm Epidemic

         There had never been reports of human taeniasis or of cysticercosis in humans or pigs anywhere on the island of New Guinea. Nor was the absence of pig tapeworms the result of insufficient or uninformed search (Gajdusek 1977:83). Then in 1972 two Indonesian physicians examined feces of 170 Ekari people. They were admitted to Enarotali hospital located in the Paniai Lakes highlands of West Papua. Physicians discovered that 9% of the patients had tapeworm eggs (Tumada and Margono 1973:371). Between 1973-1976 there were 157 patients with severe burns admitted to the hospital (Subianto, Tumada and Margono 1978).
         Three quarters of the patients were classified as having third and fourth degree burns and 17 underwent amputations. Epileptic seizures before or during hospitalization were present in 64 males and 27 females. Most of the patients were unconscious at the time of accidentally burning in the household fire. Nearly half displayed detectable or visible cysticerci.
         The brain is the most common site where cysts lodge in humans besides tissues just under the skin and muscles. Autopsies confirmed that cysticerci located in the cortical layer of the brain caused the epileptic fits (Tjahjadi et al 1978:282). The horrendous extent of the cysticercosis epidemic becomes obvious in the following case studies (see Tjahjadi et al 1978:Figs.1-3; Gajdusek 1977:Figs.6-9): Tjahjadi et al (1978:280) report of one "35 year old male . . . admitted to the hospital for severe burns on his left foot. He had a past history of fits of four months duration. One night while sleeping on front of an open fire, a child saw that the patient's foot was on the fire and pulled it away. The patient was unconscious and had no memory of the accident on waking up a few hours later. A below knee operation had to be performed but the man died 18 hours after the operation. An autopsy was performed and there were multiple and scattered cystic nodules involving all lobes of both cerebral hemispheres of the brain. Over 20 cysticerci were found throughout the brain, the majority in the cortical layer (Tjahjadi et al 1978:281).

         Subianto et al (1978:276-277) report that:

         A boy, 7 years old, was admitted with fainting spells and convulsions for three months. The convulsions started from the right hand spreading over the whole body. After a convulsion, he fell unconscious. One night his father witnessed his son lying with part of his head and upper arm in the hot ashes of the fire. the boy was still unconscious when the father pulled him out of the fire.
         Upon examination the face and the upper right arm were covered with third degree burns. On the second day of hospitalization, the boy expelled segments of a tapeworm. Two complete adult worms were recovered from the stool after treatment with atabrine. The worms were identified as Taenia solium. Palpable or visible cysts were not detected.
         Epileptic seizures were observed during hospitalization, especially when the usual dose of phenobarbital (50 mg t.d.d.) was decreased. One year later after discharge he was readmitted with burns on both feet.

         Over 2000 Ekari people near the Enarotali hospital were surveyed by Subianto and Tumada in 1973. Eighty-seven (4.2%) had developed cysticercosis and 8% had developed intestinal taeniasis infection. Between 1975-1977 cysticercosis and taeniasis increased and spread, with intestinal infection up to 20% (Gajdusek 1977:87). However, fecal samples demonstrate a low sensitivity for the parasite. In one African study only 6% of the stools showed taeniasis. Autopsies indicated over 60% of the population were infected (Desowitz 1981:40). By 1978, serological tests confirmed that at least 25% of adults and children were infected with cysticercosis (Desowitz 1981:41). Undoubtedly, the majority of the Ekari people are infected.
         Who are the people the Indonesian physicians and the international parasitological consultants call the Ekari? Why were they the first to suffer the ravages of worm infections and how did they become infected? The Ekari are a Fourth World people who call themselves the Me. Anthropologists (Pospisil 1978) and southern neighbors of the Me people call them the Kapauku. Their north eastern neighbors call them the Ekari. The Me people, who number around 65,000, speak a Papuan language of the Trans-New Guinea phylum (Voorhoeve 1982). Their homeland is the Paniai Lakes region that forms a large highland basin 1500 meters above sea level. Paniai Lakes is the western-most of four densely settled highland basins. Also in West Papua is the Baliem Valley. The Wahgi and Asaro Valleys are in Papua New Guinea.
         The Me are labeled by the Indonesians, the physicians, the consultants and even the anthropologists as primitives from the Stone Age. By regarding the Me as living fossils it is easier to judge them as being so disgustingly uncivilized that they must personally bear primary responsibility for their own epidemic. The Javanese governor remarked to the consultant Desowitz, "You know, they are not like you and me. They are very primitive, and it is extremely difficult to change their customs even for their better health" (Desowitz 1978:45).
         This comment typifies the disdainful disregard the Indonesian state has for the Me. It shows too how they justify their aggressive advancing civilization policy. This thinking forms the rationale for eradicating superstitions and primitiveness from Me life (Pospisil 1978:110). The Indonesian physicians regard the primitive huts of the Me as partly responsible for the rampant epileptic seizures and worm infection (Subianto, Tumada and Margono 1978:275). Gajdusek (1977:84), the first international consultant to visit the Me, called them Stone Age Highland Melanesians with a pig- breeding culture. Desowitz (1981:41), the second international consultant to visit the Me, somehow found enough humour in Ekari Stone Age toilet habits. He flippantly title his book New Guinea Tapeworms and Jewish Grandmothers in commemoration of the devastating epidemic. His insensitivity towards the Me and their pigs can be appallingly ethnocentric:

         Unfortunately, the traditional Ekari barbecue doesn't allow for thorough cooking. The Ekari throw the dead pig on the fire just long enough to warm it up. One reason for this haste is that, except at the big feasts, an Ekari wants the pig he slaughters to be all his. Neighbors are not customarily invited to dinner. The Ekari kills his pig secretly - or as secretly as a pig can be butchered - in the dead of night, following the kill with a quick turn on the fire. A fast-food meal takes place in stealth and gloom.

         This and other customs have not endeared the Ekari to anthropologists, who have described them as greedy and avaricious, and as "primitive capitalists."
         Pospisil (1978:vii,3) admits his only interest in the Me was their primitive law and isolation. He wanted to be in "an untouched Stone-Age Papuan society and to study its primitive political institutions in action." Pospisil's view of the Me as natives and primitive capitalists belongs to 19th century thinking. Analytically his views are very much at variance with other socioeconomic studies of pig exchange systems in the Highlands (Brown 1978). Although Pospisil finds the Me to be extremely individualistic, in all fairness he does not describe them as greedy and avaricious.
         Pospisil's exhaustive analysis of pigs in Me economic and ritual life does not support the Desowitz version of secretly gorging undercooked pork. Successful pig breeding is the most important source of man's wealth and prestige. Pig trading in juwo, the pig feast, tapa, the pig fund-raising ceremony and dedomai, the pig market, is necessary. These activities are essential to achieving the political leader status of big man (Pospisil 1978:11). The Me display their wealth through the channels of conspicuous generosity. Stingy, greedy big men have been known to be executed (Pospisil 1978:31).
         Putu duwai naago, the birth ceremony so drearily maligned by Desowitz, is actually and occasion of conspicuous generosity. It is a time to distribute free food (Pospisil 1978:31). Desowitz (1981:44) throws up his hands in dismay at what he sees as the abysmal cultural gap between civilization and the Me. A big man said "you tell us not to eat the infected pig, to be careful, to cook it long. How can this be done? If a child is born at night, we must sacrifice a pig immediately. There is not time to look and see if it has seeds. The pig must be killed and eaten at once." The father gives the birth ceremony in honor of his newly born child. The ceremony includes pork prepared in a dopo cooking mound steamed together with fern leaves, vegetables and sweet potatoes (Pospisil 1978:65). Guests receive portions of pork prepared in this fashion.
         Pigs have been in New Guinea for at least 5,000 years. In the big Highlands basins intensive agriculture has supported competitive big man pig exchange systems for over 2,000 years (Golson 1982). Pigs are an ancient, integral part of Melanesian culture and identity. The military has been exploiting the intimate human-pig cultural association for its counter- insurgency potential in its war with West Papua.

"A Gift" of Biological Warfare for West Papua

         According to the World Health Organization (WHO) (1976:67), taeniasis-cysticercosis is increasing in many countries. This, says WHO is due to "intensification of animal production, development of meat industries in several developing countries." The health organization also says that an increase in world meat and live animal trade, large-scale inter-country migration of agricultural and other workers are important factors. The camping explosion in some countries with an "increase of promiscuous defecation, other breakdowns of sanitary conditions, [and] sewerage farming" are also WHO reasons for the spread of tapeworm infections. In live animal trade and large- scale intercountry migration the World Health Organization foreshadows the purposeful policies of Indonesia toward West Papua. However, what the devastating diseased pork in West Papua really suggests is that the World Health Organization must add the intentional use of animal-to-human infection as a deadly form of biological warfare to their list of transmission conditions.
         Years after the outbreak of worm infections among the Me, Enarotali hospital physicians published their findings in the internationally circulated Tropical and Geographical Medicine Journal. They declared that the "cause of the increasing number of taeniasis solium and cysticercosis in the area could not be established. The origin of the pigs in the Paniai district could not be traced since pigs have been in the area for a long time" (Subianto, Tumada and Margono 2978:278). This claim was clearly covering up their earlier admission in the obscure Bulletin of Health Studies in Indonesia. Here they reported that transmission to the Me was restricted to a single importation of one batch of infected pigs from Bali in 1971 (Gunawan, Subianto and Tumada 1976).
         Gajdusek (1977:84) points out that it was the Me "who first noted the appearance in the pig flesh of strange cysts, which they had never seen before." He noted that the Me "brought this to the attention of the doctors, missionaries and administrators. They themselves had associated this infection with the introduction of new pigs, a gift from the Indonesian government in Java, since they had first seen the cysts in the flesh of new pigs and such cysts had appeared later in their own pigs." A Me big man stated in Desowitz (1981:44):"We are not blind. We can see the seeds that give us illness in the pig flesh."
         Desowitz's (1981:41) reconstruction of historical events indicates that the tapeworm rode the "anti-colonial wave; the vehicles of transport were men and pigs." The anti-colonial wave is Indonesian state expansion into the Fourth World nations of West Papua which started in 1963. It was then that the Dutch reluctantly pulled out leaving West Papuans to decide their political future in an Act of Free Choice to be held in 1969. Indonesia outlawed social movements for autonomy in West Papua in the years leading up to what is better described as the Act of No Free Choice. The United Nations peace keeping force withdrew in 1963. As they did, over 15,000 Indonesian troops were stationed in West Papua and land disputes immediately took place. Military officers seized Papuan land and resources for themselves and for transmigrants from Java (Osborne 1985:34). Politicized intellectuals and indigenous peoples linked to form the Organisasi Papua Merdeka (OPM), the Free Papua Movement. Founders of the Organisasi Papua Merdeka were Afak people and many received training from the Dutch for the Papuan Volunteer Corps. They fought the first OPM armed resistance movement in 1965 and sustained the struggle for two years (Osborne 1985:35).
         In 1969 1,025 indigenous community leaders were chosen by the Jakarta government to represent some one million West Papuans in the Act of Free Choice. President Suharto personally intervened to declare that any West Papuan who opposed being retained in the Indonesian state would be guilty of treason (Osborne 1985:41). The first major OPM armed struggle against the Act of Free Choice took place at Enarotali and: was launched by the defection of 85 well-armed Papuan policemen to the OPM. Encouraged by such action from within Indonesian ranks, local villagers laid siege to the Enarotali airstrip and four others, digging holes in the runways to prevent landings. On April 29, shots were fired at an aircraft carrying Irian's military chief, Sarwo Edhie, wounding a police inspector who was with the general. Local moral was boosted by raising the Morning Star flag and declaring the area liberated from Indonesian rule. When Papuans seized a Catholic mission radio they broadcast an appeal to army headquarters at Nabire asking Indonesia to withdraw its troops and allow the people to choose their own future. According to a press statement by the Irian governor, Franz Kaisiepo, the revolt had the support of all the leaders of the 30,000 people in the region. The statement said, forthrightly, that tribes which had been enemies for years were united in their hostility to the Indonesians (Osborne 1985:42).          The Indonesian army responded to OPM armed resistance with machine-gun strafing from aircraft. They flew in paratroopers which forced over 14,000 Me from their villages and into the bush as refugees (Osborne 1985:42). A few months later in July another major confrontation took place in the Paniai Lakes region. Thousands of other Me people abandoned their villages while women made food gardens in the remote portions of their mountain homeland. The Me warriors attacked Indonesian patrols on many fronts (Osborne 1985:47). The sham election had gone down by August, 1969. Indonesia's government then announced West Papua was officially the province of Irian and solely within Indonesia. In Australia, Labor MP Charles Jones, later a minister in the Whitlam government, complained, "nobody seems concerned that there should be independence for coloured people from other coloured people" (Osborne 1985:49).
         It is not difficult to see why the Me people were singled out as recipients of worm infested pigs. By West Papuan standards, they were densely settled around the Paniai Lakes. Thousands had taken up sustained armed resistance against incorporation into Indonesia and their homeland was a prime locality for Javanese transmigrants. Desowitz (1981:41) is decisive about tapeworm trafficking when he writes that the Me:

were uncertain, to say the least, about the change in regime, and during the plebiscite, of shortly thereafter, the Indonesians sent troops to Enarotali. Some of the soldiers came from Bali. Indonesia's President Suharto softened the military action by sending a gift of pigs. The pigs, too, came from Bali, the area in which pig rearing is largely concentrated, since Bali is Hindu and the rest of Indonesia is mostly Muslim. Whatever the political and social advantages of the gift, the medical result was an unforeseen tragedy.