Maraña: War and Disease in the Jungles of Colombia, Lina Pinto-García, 2025, University of Chicago Press
Leishmaniasis might be considered one of nature’s egalitarians, existing to humble humans in their endless conflicts by making no distinctions between warring parties.
This potentially deadly disease, as Lina Pinto-García and other scholars have pointed out, is associated with war—sometimes referred to as the “guerrilla disease” but incorrectly so, as it inevitably affects both sides in asymmetrical warfare with a vengeful equality.
We might even characterise leishmaniasis as a democratic disease—but that would do a great injustice to those denied treatment for this potential killer, who are invariably the weaker parties and civilian victims in conflict. It is, therefore, perhaps more appropriate to think of leishmaniasis as a disease of imperialism.
Thus, in a recent example of this very human vector, Israeli soldiers doing their worst in Gaza have been infected through bites by the sandfly that carries the parasitic leishmania protozoan responsible for this sickness.
The fact that the disease has not been identified among the plague of dangerous skin conditions suffered by the long-suffering Palestinian population themselves almost certainly tells us much about its imperial preference: data about whether it is present in Gaza has simply not been collected, according to the WHO, even though Médecins Sans Frontières (MSF) fears it is there, given the appalling conditions in which Gazans are forced to survive.
While Pinto-García applies her focus on the relationship between leishmaniasis and conflict to the long civil war in Colombia, the Latin American context allows one to draw clear parallels with that of the Middle East: a US-backed neo-colonial military endeavour to erase resistance in terrain that is the sandfly’s natural habitat.
Indeed, notes Pinto-García, categories of imperialism have been routinely deployed in the science of this disease. She writes that it has “been historically named according to spatial and imperial references. Even today, in several parts of the world, cutaneous leishmaniasis is known by names that perpetuate and give primacy to colonial imaginaries … Reminiscent of imperialism and the colonial origins of leishmaniasis as a biomedical category, scientists still use the New/Old World terminology to highlight epidemiological differences between the two world hemispheres.”
Pinto-García’s book focuses on the relationship between the disease and Colombia’s conflict, an entanglement that she refers to using a word often employed to describe the country’s jungle—maraña—that has been exacerbated by decades of military deployments.
She states clearly that the relationship between war and leishmaniasis in Colombia cannot be disassociated from broader connections between these two phenomena in other places.
The author explores both how the disease has spread as a result of conflict but, far more importantly, how conflict has shaped its treatment.
By its very nature, the Colombian war has funnelled soldiers, guerrillas, paramilitaries, victims of kidnapping, victims of forced displacement, and coca growers and harvesters into the country’s forests and, consequently, exposed them to leishmaniasis. In turn, the constant movement of these groups across, into and out of the jungle has spread the disease.
Pinto-García records how in Colombia, state management of leishmaniasis “starts and ends” with Glucantime—the standard drug used to treat it in most Latin American countries—yet non-military populations have faced multiple state barriers to accessing this medicine.
She writes: “More perturbingly, this book shows that Glucantime is officially delivered through a complex control scheme that, relying on regulations, institutions, discourses, expertise, and knowledges, serves to manage populations and produce therapeutic distinctions between state allies (Army soldiers) and state enemies (guerrilla members and civilians with uncertain affiliations) in the context of the armed conflict.”
In short, the Colombian state has “weaponised” Glucantime and this has been made possible, the author suggests, by the “pharmaceuticalisation of war”, a process alluding to both the penetration of pharmaceutical products into the conduct of warfare, and the adaptation of the war apparatus to fit the therapeutic regime based on Glucantime.
There are multiple victims of this medicinal hierarchy, and not just the guerrillas excluded from the treatment regime. Given the high toxicity of Glucantime, its preferential application has had a disproportionate toll upon the footsoldiers of the Colombian Army.
However, it is the terrifying reality of militarised prescription that has created such perverse and socially violent outcomes, such as the lazy association as a result made by the Colombian security forces of victims of this disease with their enemies.
Pinto-García describes leishmaniasis-related stigma and discrimination generated by visible sores or scars which has resulted in marginalisation, exclusion and violence not only against guerrillas but also of civilians affected by the disease who have no connection with them.
This is only possible in a context in which the war being waged by the state—particularly at its most deadly under Álvaro Uribe (2002–10)—takes on the character of a neo-colonial, civilisational conflict in which violence is directed by the imperial proxies not just against opposing forces but against anyone not aligned with the status quo.
In this relentless terror against its own people, the state has developed entirely arbitrary means of identifying its enemies, with the author citing as one example the bizarre association between guerrillas and the use of rubber, as opposed to leather, boots.
She writes: “Leishmaniasis has played a similar role in the Colombian conflict as rubber boots have. Although the disease and the marks it leaves on the body are not specific to members of guerrilla organizations, for many, leishmaniasis is a guerrilla illness. As such, this disease bears a double stigma in war-ridden Colombia. It involves not only the fleshy and visible body marks that characterise the disease but also the social stigma that establishes a perverse association with demonised guerrilla groups.”
With wisdom, Pinto-García thereby notes that a realistic assessment of the fragile peace that now prevails in Colombia involves reaching a deep understanding of the ubiquitous nature of war and how it has penetrated every sociocultural pore of society.
Leishmaniasis has been part of that violent, unforgiving and inescapable story and—if understood as a metaphor for the all-pervasive pathology of war—can reinforce the recognition that achieving a meaningful peace ultimately requires far more than just addressing the determinants and outcomes of conflict.
The author writes: “What this disease tells us about the conflict in Colombia is that war spreads everywhere; that violence invokes and engages unanticipated actors and mechanisms; and that to overcome the armed conflict and achieve peace, it is not enough to address only the obvious expressions and consequences of war.
“Instead, achieving peace requires delving into war’s thick layers, which are deeply rooted in ordinary life and intertwined in human and more-than-human worlds.”
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Categories: Colombia, South America