The Trouble with Malaria in Africa

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Jim Webb, Colby professor and expert on historical epidemiology

 

By Timothy Gillis

PORTLAND, ME – The Center for Global Humanities hosted a seminar Monday at the University of New England, Portland Campus. James L. A. Webb, Jr. spoke on “The Trouble with Malaria in Africa.”

Beyond the obvious trouble with a deadly disease, Webb argued that one of the greatest challenges to health officials was a medical irony: concerted efforts of combining drugs for the affected population with insecticides aimed at malaria-carrying mosquitoes were extremely successful. But the disease has never been fully eradicated.

The Bill and Melinda Gates Foundation helped fund a malaria eradication program (later renamed a malaria “elimination” program, with “subtle distinctions” in the new word’s difference), Webb said.

The program made great strides against malaria, with dramatically improved statistics in each of the first few years. Drugs and insecticides combined to eradicate 50, 80, 90, 95 percent of transmissions. “But you could not fully eradicate it,” Webb said.

While he admired their efforts, Webb said the Gates Foundation “embarked on malaria elimination with an enthusiasm not tempered by knowledge of past campaigns,” adding that the foundation’s announcement of their goal was met with the science community’s collective jaw dropping.

“It’s not that hard to lower the percent of transmissions, but you can’t get to zero,” Webb said, the realization of which can be a deterrent to donors.

Webb said those getting into the malaria elimination business would do well to study historical epidemiology, which is not a political history or a social history. “It’s a history of infection and interventions… a study of the patterns of disease,” he said.

Malaria was, at one time, the World Health Organization’s #1 killer, the reason for its formation. By the 1960’s, there was little disease but it was never fully eradicated. Rebound malaria decimated West Africa in 1965 until it began to be controlled in the 1980’s.

“When you turn your back on it, it springs back,” he said, reminding the audience that malaria was wiped out in the United States as recently as the 1840’s.

“They used to have epidemics in Sebago,” he said.

Speaking at a university known for its strengths in the health sciences, Webb called for historical epidemiology to be added to the curriculum of med schools across the country. “The findings are cautionary… and the failure (of malaria control specialists) constitutes a significant public health risk,” he said.

Webb said the government wants a cure for malaria, to be able to put troops in Africa and not worry about disease, but that’s a “white perspective on malaria.”

Someone who had braved the evening’s falling snow to attend the lecture asked Webb to speak about vaccines for malaria. He said there have been some successes, but the challenge was that vaccines had to be “stage-specific” when targeting treatment, at several stages of the life cycle of the virus.

An official at the World Health Organization recently told Webb that “50 years from now, we’ll still be five years from a vaccine.”

Another questioner wondered about the role of poverty in the disease. Webb said there was no doubt that access to clean water, better housing, and electricity all made for a much-improved defense against disease.

“Having electricity, and a fan is far more effective than netting,” Webb said.

Someone asked why malaria seemed to be most apparent in Africa. Webb said 70 different mosquitoes transmitted the disease, but not all of them did it effectively.

“Many mosquitoes don’t care where they get their blood meal, from a cat, from a cow. But (African mosquitoes) are highly specialized, they have a preference for human blood.”

Webb was introduced as a pioneer in the field of historical epidemiology. His work integrates approaches from the biological sciences and the social sciences to produce perspectives that are useful to historians, practitioners, and planners in the field of global public health. He is the founding editor of two book series at the Ohio University Press: “Perspectives on Global Health” and the “Series in Ecology and History.”  He is currently writing a book on the history of malarial infections and interventions in tropical Africa.

He said one of the ironies of malaria control was the case of chloraquine, a drug that worked better than all the international interventions. It sold very cheap in local shops – for a penny or two a dose – and was an easy profit for the storeowners, he said.

But like other drugs, the effects were less impressive over time, once humans built up immunity to it.

The best way to understand the history of African pharmacopeia, he said, was to realize that their plant-based treatment reduces toxicity levels leading to general health. That method runs counter to the West’s use of drug-based treatment, focused on a specific ill.

A final question dealt with counterfeit drugs, with money being made off the sale of useless treatments for the disease.

Webb reaction was to say, “As a species, we’re pretty unethical.” What disturbed him about reports of counterfeit drug sales was that “the packaging is identical,” between fake and real drugs, “which suggests the factories have two shifts – one that makes real drugs, the other makes fake ones.”

Sports writer switch-hits to fiction

By Timothy Gillis

A baseball writer for ESPN has returned to his true love: creating fiction. Author Josh Pahigian, who teaches writing composition at the University of New England, made his name by traveling from ballpark to ballpark, covering America’s pastime.

But now, he says, he is getting back to his creative roots.

“I wrote the ‘Ultimate Baseball Road Trip’ in 2004, with my grad school buddy, Kevin O’Connell,” Pahigian said. “That got some national media attention. Kevin and I were on ESPN for an appearance and both started writing for ESPN out of that. It launched me as a baseball writer and, as much as I like that, it’s not my real passion.”

Pahigian, who has seven baseball-related books to his credit, loved the start he got as a sports scribe, but it did kind of pigeonhole him as a writer.

“There was a temptation to keep writing baseball books,” he said, “because of the money and response, but it was moving me away from what I saw myself as – a fiction writer.Writing fiction again was very freeing for me. Writing the type of non-fiction I was writing was rooted in a pretty straight-forward account of the facts – baseball guides and history books – which focused on ‘what was,’ with a little bit of my opinion. Writing fiction gave me a chance to use the creative side a lot more. It’s been invigorating for me, a pleasure.”

Pahigian also teaches in the Low residency, a Master of Fine Arts program in Creative Writing at Western Connecticut State University in Danbury, Ct., working with students one week each semester. His teaching schedule allows him time to hone in on Old Orchard Beach, where he worked at one time for the recreation department. OOB is the site of his debut novel, “Strangers on the Beach,” a fast-paced whodunit set with the familiar backdrop of the OOB Pier, the summertime tourists, and the Brunswick, where one of the main characters hides out.

Pahigian said he enjoyed revisiting his old OOB haunts, both literally and in his writing, but the entire process took quite a while to come to him.

“From the time I had the idea for it, it took about a year writing it, then another year finding a publisher, then another year for it to come out,” he said. “My wife, Heather, andI spent a lot of time at the Beach. We were married on Pine Point Beach, about a mile up from Old Orchard, in 2002, right in front of the Lighthouse Inn.”

Now living in Buxton, Pahigian says he had a lot of fun writing about a place that healways enjoyed going to.

“Strangers on the Beach” tells the story of Ferdinand Sevigny, “a bold and brash billionaire whose failed stunt to sail blindfolded across the Atlantic lands him in Old Orchard, triggering a series of events that redefines him and all those people caught up inthe mysteries that surround him,” according to a press release on the novel. The book has been tapped as an “Indie Sleeper Title to Watch” by Publisher’s Weekly, the release said.

The novel has several good plot twists, perhaps surprising for a writer’s first foray, but Pahigian employs a few classic tricks, as well as some original red herrings. Most of the chapters are quite short, and work like a series of Dan Brown or Michael Crichton cliff-hangers, providing quick-paced reading and cinematic qualities. The narrative perspective is always what’s called “limited third-person,” wherein the storyteller is not one of the characters but some voice removed from the action. The “limited” nature of the perspective means that the narrator does not know all (as an omniscient narrator does), and Pahigian uses this curtailed view to his advantage. Chapters usually shift from one to another over-the-shoulder points-of-view, and the reader is kept curious but only partially informed.

“I tried to limit myself to whatever would be apparent to that character,” he said.

Billy, a local kid who gets caught up with the billionaire’s escapades, is first seen under the pier, lamenting his troubled life with a morally loose mother. He encounters someonewhom he (and the reader) thinks must be the billionaire, but that’s not so.

Ernie, a local cop, seems destined for a long, important role in the mystery, but that assumption also proves false.

“When I started, I expected him to be in the book all along,” Pahigian said, “but there was a danger of him taking over. When I decided to kill him, I went back and added some foreshadowing.”

The author said Old Orchard seemed like a natural locale for his mystery.

“The town has a history of devastating fires and floods,” he said. The fire in the novel is based on several such blazes, but not on any specific one.

“I guess I took something that was historic of the town, and tweaked it to build the story, for Sevigny’s stay at the Brunswick,” he said.

Pahigian said the main character might not be the same person as the protagonist.

“None of it is possible without Sevigny,” he said. “He’s the locus of the story, but – from a writing standpoint – Billy and Marisol were more interesting to create.” Marisol is Sevigny’s love interest.

Another character, Sally, collects objects on the beach and becomes an unwitting witness.

“She’s not based on a specific person, but my wife and I go to the beach a ton, and I’ve seen people who walk around and collect things,” said Pahigian, who plans on writing more fiction now.

“I’m working on another novel, also set predominantly in Old Orchard. It’s not a sequel or a prequel – different characters but the same setting that inspired me,” he said.

The next novel is also a murder mystery, part of it set in 1927 when a plane is lost at sea. The pilot is assumed lost with it, but the plane, in fact, has landed at Old Orchard Beach, and the tourist town becomes a perfect backdrop once again.

Josh Pahigian will be reading from “Strangers on the Beach,” and talking fiction, in general, at the following places: On Wednesday, January 30, at 6:30 p.m. at McArthur Public Library in Biddeford; on Thursday, February 7, at 7 p.m. at North Gorham Public Library; and on Saturday, February 9, at 2 p.m. at Thomas Memorial Library in Cape Elizabeth.

Angel Flight Connects Patients with Pilots

By Timothy Gillis

When Dr. Jeremy Morton retired from active surgery fifteen years ago, he was looking for a way to combine his background in the medical field with his love for flying. The Portland surgeon had flown air ambulances during the Vietnam War, and later started a heart surgery clinic in Presque Isle, so he’d already set a pretty high standard of expectation for himself.

“I heard about Air Lifeline, did some flights with them for a couple of years,” he said. “Angel Flight took over and, it all became one organization.”

Morton, who has lived in Portland since 1971, got his training in Houston and was a surgeon in Vietnam. He has made around 120 flights for the company, which connects patients in need with pilots willing to donate their time and fuel for free.

Morton flies a Cessna 182, and says there’s a big need for people coming down from Aroostock county to go to Boston, while a few go to New York.

“That represents the greatest need,” he said. “Generally the people are of limited means, and it’s an enormous distance to travel. The majority are people with cancer or kids with orthopedic problems. They need to go on a regular basis. A lot of patients, for example, go to Dana Farber for chemo, and have to go a couple times a week. People are ambulatory, but not always feeling well.”

A trip from the County to Boston could take more than seven hours each way, and the burden on the patients is not only a financial one.

“It’s a pretty onerous chore for them to make several trips like that,” said Morton, who alters his cockpit demeanor based on each patient. “Some are very chatty; some don’t say much. Some want to talk about their medical problems; some don’t. I don’t identify myself as a physician unless they ask.”

Morton, who got his pilot’s license in 1978, said he had done a fair amount of medical flying in the past, but he’s not now flying now as a doctor.

“I ran a clinic in Presque Isle and Bangor before Bangor started a heart surgery program, so I would fly up to the clinics in the morning,” he said. “Especially in Presque Isle, it’s hard for patients I saw in Portland to come back after their surgery.”

Over the years, Morton has seen all kinds of patients. “I had some little kids that were going to the Shriners’ Hospital,” he said. “I had a fellow one time that I flew out of Boston and after a while his wife asked what I did. I told her ‘surgery.’ Her husband piped up from out back and said ‘what’d you say your name was?'” Apparently, Morton had operated on him eighteen years earlier.

“We had some flight trouble, bad weather,” Morton recalls. “He said, ‘I hope this is another one of your successful operations.'”

The chance to donate the time it takes for these flights, as well as the fuel and wear-and-tear costs on his plane, is worth every minute.

“It’s very rewarding. It’s a skill I have that I can put to use, and the opportunity to do that’s very gratifying,” said Morton, who is a consultant at the Maine Medical Center and is on the hospital’s institutional review board.

Morton was quick to share the credit, however, and he thinks that, far too often, the press reports only on the pilot angle.

“We get a lot of cooperation from a lot of people, including the folks at Logan. We have a special arrangement for Angel Flights. They let us land there for nothing,” he said. “We already have enough costs to concern us with (e.g. fuel) so Logan is very supportive.” Other companies help out. Phillips 66 gives them a dollar off per gallon of fuel. Morton uses 15 gallons an hour, and about 75 gallons for a typical trip from Presque Isle to Boston. He credits such companies as these for making his volunteerism more affordable. “They have a sense of wanting to support the program,” he said. “I’m a little surprised other companies haven’t followed suit.”

Keith D’Entremont, head of corporate development and community outreach at Angel Flight Northeast, has been with them for three years. His father, Roger D’Entremont, a retired TWA captain, does all the pilot approval for the company, which was started by Larry Camerlin in 1996. Roger has been around for all of those 16 years, first as a pilot, and now in charge of orientation, making sure pilots have met certain minimums, (hours of flight time) to make sure patients are safe.

They have more than 60,000 flights in their history, to 189 different health care facilities in 33 states, roughly ten million miles of transportation. They also have a virtually spotless record for safety. One flight did go down. The pilot and two passengers died in 2008, crashing in Easton, Massachusetts, on a flight from New York. “Since that crash, we’ve increased our qualifications,” Keith said. “Aviation, by its nature, is a risky business.” He’s flown, but not for Angel Flight, saying he’s not near the hours required, 500 or more depending on the type of license.

In the Maine area last year, Angel Flight provided almost 1,600 flights. “In total, we provide an average of 95 flights a week,” Keith said. “So we ‘re pretty busy.”

Pilots provide time, fuel, and the aircraft. Angel Flight NE acts as go-between for patients and their social workers and pilots who will fly them.

“They’ll call us with a need, we see how we can help,” Keith said. “We do our best not to turn down anybody.”

Coleen DiCesare, who was diagnosed with leukemia in August of last year, is one of those thousands of people assisted by Angel Flight NE and Dr. Morton on two occasions. She lives in Holden, Maine, near Brewer.

“In the beginning, after I was able to come home from Boston for a month, I was able to fly to Boston once a week for an appointment,” said DiCesare, who still travels to the Hub once a month. She said that, in addition to Dr. morton, she has met a lot of different pilots, and they have “all been absolutely wonderful. I had one bumpy flight, just one of those things that happens sometimes.” DiCesare, who recently turned 65, had never flown in her life until she flew with Angel Flight. Desire the novelty and the foreign feel of being airborne, she raves about her transportation.

“Oh my goodness, I try to call them two weeks before my flight,” she said.

“‘Earth Angels'” on the ground pick me up in a car, take me to airport. It has been a tremendous blessing to me and my family because there were times in the winter when I couldn’t always fly. We had to drive down. It’s a lot of money and a long ways. But for the last three or four months, I’ve only flown on Angel Flight. Without them financially, I don’t know what I would have done. It would have been a tremendous burden.

Mental illness in young becomes an emergency

Medical co-authors see more children in ER

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By Timothy Gillis

 

As a desperate last resort, more young people with mental illness are showing up in emergency rooms, according to a new book called “Suicide by Security Blanket,” by Laura M. Prager, MD, and Abigail L. Donovan, MD.

That alarming trend holds true in the emergency room at Massachusetts General Hospital, where the two authors work. While the state of Maine has not seen a similarly dramatic increase, the Maine Medical Center has its hands full each day, employs round-the-clock psychiatrists, and uses several area agencies for inpatient pediatric psychiatric care. Despite some general claims of “poor parenting these days,” that is not the focus of the book, nor their authors’ main concern.

“Parenting has always been difficult,” said Prager. “Now, there are fewer and fewer community resources. Parents have nowhere to turn. Kids end up in emergency rooms for all sorts of reasons.”

The result of these ER visits is sometimes worse than the intended cure, with young kids often re-traumatized, simply by what they come to see in such a setting. “Imagine being a six-year-old, in a major metropolitan emergency room,” Prager said. Donovan agrees that the problem has an identifiable cause.

“What we’ve seen over the past several years is that there have been massive cuts for kids and adults for chronic mental illness. There are still a few community-based services left, but these don’t have the availability and depth of services to help kids who need help,” Donovan said. “Kids fall through enormously large cracks and end up in the ER.”

Maine is fortunate, for now, and local hospitals have avenues for assistance. But any given day, with a struggling economy and stressed family relationships, that luck could change.

“Overall, I think Maine is better off than some states when it comes to psychiatric services for children with the caveat that no mental health system is ‘perfect,'” said Nathan W. Mick, MD FACEP. An assistant professor at Tufts University School of Medicine, Mick is director of both Pediatric Emergency Medicine and Clinical Operations at Maine Medical Center.

“We have not seen a dramatic increase in pediatric psychiatric Emergency Department visits at Maine Medical Center, though we continue to care for children with mental health emergencies on an almost daily basis,” Mick said. “We’re fortunate to have access to board-certified psychiatrists and child psychiatrists 24 hours a day in the ED at MMC if needed.” When necessary, MMC can refer patients to an outside agency for help.

“We have three facilities for inpatient pediatric psychiatric care (St. Mary’s, Acadia, and Spring Harbor) and Sweetser helps us with ‘crisis response’ in the Emergency Department for pediatric patients,” Mick said. “We see a variety of mental health conditions in children including anxiety, depression, obsessive-compulsive disorder, and behavioral outbursts. Some of these psychiatric emergencies occur in the school setting and we can be asked if a child is ‘safe to return to the school’ which is an assessment we take very seriously.”

The book by Prager and Donovan is full of composites of characters the doctors have encountered during their years in the ER.

“We use the salient features,” said Prager. “There’s more universal relevance than you might expect.”

The book is from The Praeger Series on Contemporary Health and Living. Other titles in the series are how-to books or ones offering medical advice, Donovan explained. “We weren’t really doing any of those things, (but trying to) create some affective resonance to give emotions behind the data.”

“There’s no algorithm,” Prager said about diagnosing the cause of mental illness. “What we’re trying to point out is that taking the time to explore all the aspects of what happened yields the best result.”

“The devil is in the details,” Donovan said. “What Laura taught me is that there is no detail too difficult to explore.”

The book is a collection of vignettes, each involving a pseudonymous child with a mental illness who, for different reasons, ends up in an emergency room.

One chapter tells of a child with writing on her legs that seems too intricate and ill-placed to have been done by her. Doctors need to interpret whether or not the child might be in danger, and must decide whether or not to report. Another chapter tells of a threatening drawing a child did in school, and doctors must work with school officials to determine whether the child might be a danger to others. Other examples include the child who sees things, one who won’t move for fear of infection, and one who is so active she becomes a threat to hospital workers and has to be restrained.

Prager, who has run the child psychiatric emergency service at Mass. General for more than a decade, said these stories are all too familiar.

“I’ve had a book in my mind for many years,” she said. “Most important is I’m simply appalled with how we manage kids with psychiatric damage. Very distressing situations that bring kids to the ER finally prompted me to affect some change in the system. Kids with psychiatric illness are just as ill, yet even in our own ER, we don’t have adequate resources to treat them. I want this door to be open. This is a secret territory. I want the public to know what really happens.”

Donovan, who was a resident at MGH in 2008 and then joined the staff, is newer to the medical field than Prager, but she agrees that their local experience is suggestive of national trouble.

“In the grand scheme of ER, we are very lucky,” Donovan said. “We have a well-run and large hospital. Imagine what the conditions are like (for hospitals) that don’t have the staffing and resources that we have.”

The doctors each have an interest in writing, and they shared that enthusiasm as they created the book. “We would each start writing different chapters, trading back and forth,” said Prager, who has been writing short stories since an undergraduate. Currently, she is assistant editor for the Journal of the American Academy of Child and Adolescent Psychiatry. She has another book in the works, but wouldn’t say what it is about.

Donovan has written articles in journals, but this book is the “first journey into a piece that’s less for the academic community” and more for readers from all backgrounds, really anyone with children.

Most of the chapters tell sad tales of struggling kids, often with well-intended parents who are lost for a remedy. One story does end on a happy note, however, as a child is reunited with his beloved telescope. He still contacts MGH’s ER every New Year’s Eve to thank them for helping him. He cites their patient understanding as seminal in helping him recover. It’s a patience for which not all hospital ER’s have the time or services, a dearth often caused by public perceptions and fiscal policy.

“There’s a stigma associated with it,” Donovan said. “A lack of understanding exacerbated by socioeconomic situation, but it’s not limited to that: rich kids can have mental issues, too. Kids suffer in silence for a long time until the straw breaks. There’s so much shame that goes with mental illness.”

Peaks Island Writer Tells South African Tale

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By Timothy Gillis

Peaks Island and South Africa might seem like they are worlds apart, but a new book, “White Dog Fell from the Sky,” by Eleanor Morse, brings the far-away culture close to home.

Morse lives on Peaks Island and teaches a course in sudden fiction there. She has traveled extensively in Africa, living in Botswana for almost four years. But it was on Peaks Island that she created her new novel’s main character, Isaac Muthethe, a medical student who flees South Africa after one of his friends is murdered.

“There are 10 or 12 people sitting around a living room,” Morse said of her sudden fiction class. “I wasn’t sure where the first chapter came from. I found it leafing through a notebook, so Isaac was born on Peak’s Island. I felt responsible to tell his story.”

This is Morse’s third book, after “Chopin’s Garden” and “An Unexpected Forest,” but the first “big press book.”

“I was really lucky. I have a wonderful agent in New York, Jane Gelfman. Her first pick for editor was Kathryn Court, president of Penguin,” Morse said.

“The main thing she was interested in was tightening the narrative line in the middle of the book. It was a real ‘listening-to-each-other’ process.”

Gelfman and Court read drafts of the work eventually, but Morse said that, for more than two decades, her first reader has been Kate Kennedy, director of the Southern Maine Writing Project.

“She’s a close friend, and we’ve been each other’s first readers for years,” Morse said.

The novel is a heart-wrenching tale of a struggle too-often forgotten – apartheid South Africa and the brutality of its racist laws.

“White Dog Fell from the Sky” tells the story of Isaac, the medical student come gardener, Alice Mendelssohn, whose gardens he tends, and Ian Henry, the specialist in San rock paintings with whom Alice falls in love. But the strongest ties of love and mutual respect are bound between Alice and Isaac, in a melodic telling of unlikely harmony.

“Setswana is a beautiful language,” Morse said. “I wasn’t able to capture the music of the language, but I wanted the language there. It’s so much a part of the sights and sounds there.”

Morse used words and phrases from the foreign tongue, and then translated them for readers through smooth appositives. The result makes for a reading that is both exotic and immediate. And the story is one that, while set in another country, gives the reader a sense of immediacy and correlation.

“I left this country in 1972,” Morse said of her journey to Africa. “What happened was that a man who was to become my husband grew up in Botswana. His parents were congregational missionaries in the 1940’s. We met when he was in grad school and I was in college. He went back to Botswana. I finally decided to see if this man was in or out my life.”

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Eleanor Morse, author

Morse and Andrew Seager had two children – a son named Alan who was born in Gaborone, Botswana in 1973, and a daughter named Catherine, who was born in Blue Hill, Maine, in 1980.

“We were engaged by transatlantic cable, and then returned there (Botswana) for almost four years,” Morse said.

At the time, Gaborone, the new capital of Botswana, had been carved out of the bush, she said. Right after the country gained independence from England, Seager went back to run the first national elections. Shortly after that, in Botswana, there was a discovery of diamonds and copper nickel that put the country on a strong economic base. “There was no army to siphon off funds,” Morse said. “So money went into education and healthcare.”

Her experience there stayed with her, and now she has turned that into a compelling novel of love, loss, and redemption.

Regarding the creation of her characters, Morse said “Alice came to me when I was beginning another book, kind of a book that had to do with the Vietnam war, and people who returned from the war. Like some books, it didn’t really take off, so I had the seed of Alice in my head.”

She said she couldn’t really tell where they third character came from. “I don’t plan on a book the way some people do,” she said. “Ian came about in a slightly less visceral way. I was very interested in Bushmen painting, while in Botswana. There was a lot of antagonism between ranchers and the people who live traditional lifestyles. I started doing research in Bushmen painting, and that’s really where Ian came from. From the very start, he was the kind of guy who was a rapscallion. I wanted him to be a part of the wilderness that he loved. That made him not always fit for human society.”

Morse admitted that Ian’s character is less sympathetic that the other two, and she also concedes that a white American woman telling a black South African’s story might yield come criticism.

“I was very sensitive in telling the story,” she said. “Alice’s first voice was first-person. But I felt the book would suffer disunity if her voice was first person and Isaac’s was third. But it felt arrogant being a white woman telling a black man’s story in first person, so they both became third-person characters.”

Morse said she wanted to tell the story of that time and place, and most importantly, didn’t want the black people in the book to come across as victims.

“Isaac, in my mind, has a lot of courage and intelligence and dignity,” she said.

Morse uses a combination of actual African sayings and some of her own beliefs. She says she plans to return to Botswana with the son who was born there someday.

Her book contains powerful images – a sunken garden that Isaac tries to build for Alice, and the White Dog of the title.

“I lived in India for six months,” Morse said, where she met a dog like White Dog named Blondie. “It was one of the most cheerful animals I met in my life, and belonged to a Tibetan man who was learning to be a Thankga painter. He pretty much ignored her, but she was loyal to him, and I loved her loyalty and hopefulness. I didn’t set out to make White Dog a symbol, and was worried a little bit that White Dog was white and might be taken for something else, but White Dog is herself. If a symbol for anything, it’s a symbol of loyalty and persistence.”

White Dog has been brought to life, in a way, by MECA student Gaella Materne. She worked with Morse to create a papier mache version of the book’s title character, on display in the window at Longfellow Books.

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Gaella Materne, artist

Materne, who is in the last year of a Bachelor of Fine Arts degree, said it was the first time she has been involved in something like this.

“I thought it was a fantastic opportunity,” she said. “When you’re a senior, you want to get your name out there as much as possible.”

Her plans for next year? “I’ll probably just go ahead and do what I love, and see where it brings me. I’m crossing my fingers a little bit. That’s the trick: like Eleanor, do what you love. She loves writing and she’s good at it.”