Esophageal Cancer in the Bantu of the
Transkei Associated With Mineral Deficiency
in Garden Plants 1. 2
J. W. BURRELL/ W. A. ROACH,' and A. SHADWELL/
Bantu Cancer Registry, Post Ollice Box 38, Butterworth,
Transkei, South Alrica
R.
SUMMARY-Inspections were made of 29 gardens on which Bantu with
esophageal cancer had largely subsisted for 15 to 30 years before their
deaths and 29 gardens in the middle of large tumor-free areas nearby.
The cancer gardens were less productive than the tumor-free gardens, showed
severer leaf signs which indicated molybdenum deAciency, and the leaves
of the maize had "withered end" only in these gardens. Molybdenum
treatment reduced the incidence of withered end to one quarter. This
remarkably close association between esophageal cancer and poor plant
production may point to a more direct cause and is being investigated.
Results of diagnostic leaf "injections" done in cancer gardens suggested that
deficiencies, not only of molybdenum but also of iron, copper, zinc, and
other trace elements, were widespread. The increase in crop after treatment
proved that molybdenum deAciency had reduced the metabolic efficiency
of beans (Phaseolus) and cucurbits to a small fraction of normal and had
rendered maize prone to aHack by two fungi known to be toxic to animals.
These deAciencies may lead to the formation of nitrosamines, some of which
cause cancer of the esophagus selectively in rats. A systematic preliminary
chemical screening of Bantu foods from cancer gardens for these and related
carcinogens will therefore be carried out. The Appendix describes the cultural habits of Bantu insofar as they may lead to the use of possibly carcinogenic foodstuffs. The staple foods cultivated are maize, pumpkins, beans,
and potatoes, and the women eke out a bare subsistence by consuming a
Received March 3, 1965.
This investigation was supported by U.S. Public Health
Service research grant CA-06565 from the National Cancer
Institute and by a grant from the Anna Fuller Foundation.
a Deceased. The late Dr. Burrell selected the 29 "cancer
gardens" and the 29 "tumor-free gardens" and took Dr.
Roach to all of them and Mr. Shadwell to the 11 of each
in the Butterworth district. He took no part in the agricultural work. Dr. Roach suggested the agricultural work
and planned and carried out most of it, though he did not
select the gardens. Mr. Shadwell cooperated in the agricultural work, made his intimate local knowledge available,
1
2
and used his great personal influence with the Bantu in
the Butterworth district to get their cooperation and good
will, without which the agricultural work would have been
impossible. He took no part in selecting the gardens.
4 I am most grateful to the Secretary for Agriculture of
the Republic of South Mrica and to Dr. M. H. Slabber,
qhief, Winter Rainfall Region, for leave of absence while
holding the post of Technical Adviser, so I could carry
out most of my part of the work described in this communication.
i Agricultural Officer, Butterworth, Transkei.
201
202
BURRELL, ROACH, AND SHADWELL
wide seasonal variety of weeds, e.g., dandelions (Taraxacum), milky
thistles (Sonchus), black nightshade (Solanum nigrum), many of which
are know n to be poisonous. Signs of malnutrition are common, and in the
frequent periods of food shortage the women may well be forced to make use
of more and more unsuitable (possibly carcinogenic) plants.-J Nat
Cancer Inst 36: 201-214, 1966
WITHIN THE MEMORY of elderly people
still living, grass grew to knee height over the
entire Transkei. The largest area that still has
this tall grass remains free of esophageal cancer.
The disease first became apparent in 1943 and has
since been increasing over the greater part of the
Transkei, i.e., areas that have lost their knee-high
grass and have become progressively less fertile (1).
Areas of low production are usually patchy, as is
the distribution of esophageal cancer (1, 2). For
these and other reasons, as many cancer and
tumor-free hut gardens as possible were visited to
determine whether there were any obvious differences. A map of Southern Africa (text-fig. 1)
is included for orientation.
As explained in the Appendix, most Transkeian
Bantu men spend much of their lives outside the
Transkei and may be subject to various cancerinitiating or cancer-promoting influences not
operative in the Transkei. Thus, all the men with
the disease in one area had worked in a particular
factory in a distant town (1, 2); a close association
was traced between the localized occurrence of the
disease in the East London Bantu location and the
illicit brewing of a "fortified" Bantu beer called
cidivici. It was prepared in discarded metal drums
after containing petroleum-asphalt, with a thick
residual coating of the probably carcinogenic contents on the inside; also, added to the brew were
carbide, liquid metal polish, etc., to give it an
additional "kick" (3). Further, many men changed
their jobs frequently and were suspicious when
questioned too closely about their past. The
present inquiry was therefore confined to persons
who, for at least 15 years prior to death, had not
traveled farther than to the nearest store or magistrate's office, only a few miles from their huts. It
was hoped that the causes of their cancers would'
be local. Most were women, who subsisted largely
on the produce of their hut gardens of up to an
acre in extent.
OBSERVATION OF GARDENS
Selections
Dr. Burrell mapped a study route that took a
zigzag course from one area of high incidence of
the disease, through an area in which the disease
was unknown, to the next area of high incidence
(1,2).
He used three criteria in the choice of cancer
gardens: (a) certainty of diagnosis in victims of
the disease, (b) maximum length of residence of
the deceased (never less than 15 years), and (c) proximity of other victims. The paramount importance
of (a) is obvious. Addition of criteria (b) and (c)
could increase the likelihood of finding some local
cause or causes of the disease; but it is unnecessary,
for the present purpose, to prove any statistical
significance to the clumping of cases. Though
areas of high incidence of the disease are well
known to local medical practitioners and are
obvious in the field and on the distribution map,
local politics makes publication of the map far too
potentially "explosive." All that need be stated
now is that it appeared logical, in the first instance,
to concentrate on areas where there was maximum
likelihood of finding the disease and compare them
with areas of minimum likelihood. To determine
the latter, maximum distance from a cancer case
seemed indicated. Bantu assistants were therefore
instructed to walk from one chosen cancer garden
to the next in as straight a line as possible and
note each garden en route. The middle garden
on the list so obtained was chosen for examination
as a tumor-free garden.
The selection of the gardens was made exclusively
by Dr. Burrell who, as far as can be ascertained,
never entered one of them. He had little or no
knowledge of agriculture and certainly none of
nutritional work on plants; also, until a few weeks
before his death he was highly skeptical of any
possible connection between the plant characterJOURNAL OF THE NATIONAL CANCER INSTITUTE
ESOPHAGEAL CANCER IN THE BANTU
\
i
f
SOUTHIIEST AFR I CA
\,
SOUTHERN RHODES IA
\,..
I
:
r-
W,;dhoek
,
\
I
203
I
BECHUAWILANO
I
I
I
I
o
I
50
t
TEXT-FIGURE 1.-Sketch map of Southern Africa showing the position of the Transkei
and (below) map ofthe Transkei on a larger scale.
Tracing from official map reproduced under Government Printer's Copyright Authority No.
3563 ot 7/21/65.
istics observed and the cause of cancer. It is difficult, therefore, to imagine that in the choice of
the gardens there could have been any conscious
or unconscious bias in respect to agricultural
characteristics.
The itinerary was arranged so 29 cancer and
29 tumor-free gardens could be visited alternately,
except that extra gardens were introduced as often
as possible to prevent the examiner from knowing
before entering whether it was a cancer or a tumorfree one.
The gardens are scattered over a distance of
more than 100 miles, including the districts of
VOL. 36, NO.2, FEBRUARY 1966
Umtata and Butterworth, and are representative of
those of practically the whole of the Transkei. The
two investigations, made as independently as possible, agreed perfectly and the data are summarized
in table 1.
Cancer Gardens Less Productive Than the
Tumor-Free
Three clear-cut differences were observed in
cultivated plants:
1. The 29 cancer gardens were obviously much
less productive than those that were tumorfree.
204
BURRELL, ROACH, AND SHADWELL
T ABLE I.-Observations on 29 cancer and 29 tumor-free
hut gardens
Fertility-No_ of gardens
rated:
High
Low
Molybdenum deficiency signs
seen in cucurbits rated:
Intense
Less intense
Molybdenum deficiency signs
seen in beans rated:
Intense
Less intense
"Withered end" sign seen in
maize plants
Cancer
Tumor-free
0
29
a more direct cause for the presence or absence of
esophageal cancer.
EXPERIMENTS ON PLANTS
29
0
29
0
0
29
29
0
0
29
29
0
2. Signs in leaves suggestive of molybdenum
deficiency, which were seen in all 58 gardens,
were more severe in each of the cancer
gardens than in the corresponding tumorfree ones. These were observed in pumpkin
plants and other cucurbits and beans (PhaseoIus) whose leaves show characteristic signs
when severely deficient in molybdenum.
3. Even more clear-cut was the difference in
maize. This was affected by "withered end"
in all 29 cancer gardens, but in none of the
29 tumor-free gardens. No reference to this
sign could be found in the literature.
(See footnote 6 for a brief description of the plant
characteristics listed above.)
These clear-cut differences seemed so remarkable
after they had been observed in about six pairs of
gardens that later comparisons were checked by
examination of neighboring gardens. Additional
gardens were always examined if the first one
visited did not contain the full range of crops:
maize, cucurbits, and beans. Thus, the abovedescribed differences were usually not between
single gardens, but between two groups, each of
up to four gardens. The gardens in each group
were well within a stone's throw of each other, but
the cancer group was usually at least a mile away
from the tumor-free ones.
Obviously, any connection between these agricultural differences and the presence or absence of
cancer is not likely to be direct, but it was only
remotely possible that anyone of the three results
were obtained by accident. They seemed worth
following up in the hope that they would point to
Although there is no causal connection between
any plant sign and a mineral deficiency in the
same sense that there is between the image on
an X-ray plate and the actual state of the organ
examined, plant signs are useful pointers to the
next step in an investigation. For example, those
just mentioned proved to be reliable indications
of severe molybdenum deficiency over a distance
of 400 miles in the western Cape (4). They
therefore merited following up. Moreover, such
a severe deficiency would usually be accompanied
by other deficiencies. It was decided therefore:
1. To test for molybdenum and other deficiencies
by plant injection methods.
2. To test for molybdenum deficiency by observation of the effect of seed treated with
sodium molybdate solution.
This work had to be done with the utmost
circumspection to avoid offending native etiquette,
customs, or taboos. Experimental planning, therefore, had to take second place and the inevitable
consequence was that many experiments were
lost. We hope the natives will eventually have
8 Fertility.-The difference in fertility between cancer
and tumor-free gardens was obvious at a glance when a
garden was entered. The height and size of the individUal
plant, color of the foliage (whether dark green or yellowish
green), leaf size and whether older leaves were scorched,
and the size and quality of the crop were assessed.
Molybdenum deficiency in (a) cucurbits.-The leaf of even an
intensely deficient cucurbit plant usually appears normal
until it is nearly full size. The lamina is first flat and then
cups upward. It becomes progressively more yellow;
later, there is a marginal scorch and the leaf is encircled
with a brown ring of dead tissue curving upward and
inward. Death of tissue progresses until the whole lamina
may be rolled upward and inward. Vines are sometimes
17 feet long, with only the terminal 3 feet bearing any
green leaf. Such plants bear no fruit. (b) Beans.-The
signs in the individual bean leaflet resemble those in the
cucurbit leaf.
"Withered end" in maiz;e plants.-Death of tissue progresses
from the tip of a leaf toward the base. Dead tissue is
separated, by a nearly straight line at right angles to the
midrib, from apparently healthy green tissue, with little or
no intervening yellowish-green area. Leaves become affected progressively from the base of the plant upward.
JOURNAL OF THE NATIONAL CANCER INSTITUTE
205
ESOPHAGEAL CANCER IN THE BANTU
sufficient confidence in us to allow future experiments to be more nearly under our own
control. Despite the limitations described, the
following indications of deficiencies were obtained.
cies. The lack of visible response of the two lots
of tobacco was not surprising because in both
gardens this luxury crop had been given a heavy
dressing of manure from the cattle kraals.
Preliminary Diagnosis of Mineral DeFiciencies by
Plant Injection
ConFirmation of Molybdenum Deficiency by Seed
Treatment
Plant injection is the rather inappropriate term
applied to methods for causing parts of plants,
ranging in size from a single interveinal area of
a leaf to a whole tree, to absorb liquid so that
its effect may be studied in comparison with that
of similar untreated parts (5).
Over 700 plant injections were made in cancer
gardens at 11 localities scattered throughout the
Butterworth district (approximately 35 X 15
miles). The whole range of soils in the district,
representing practically all those in the Transkei,
was covered.
In each set of injections, solutions of salts of
the elements molybdenum, copper, boron, zinc,
manganese, and iron were tested at least 5 times.
Eight sets were done on maize, 7 on beans, 6 on
pumpkins, and 3 on tobacco. Diagnoses were
made of 7, 4, 2, and 2, respectively.1
The results are shown diagrammatically in
text-figure 2.
These results suggested that the maize, beans,
and pumpkins growing in cancer gardens were
affected by a complex trace-element deficiency,
which justified the more difficult estimation of the
degree of severity of each of these apparent deficien-
Attempts were made in the 1962-63 season not
only to diagnose further the molybdenum deficiency but also to assess its severity, because the
latter can be used to measure the likelihood of
formation of abnormal products of metabolism.
This can best be done by estimation of the increase
in yield after curative treatment. Attention was
first given to molybdenum because such infinitesimal amounts are required by plants that deficiency of this element can be prevented, at least
partially, by merely wetting the seed with sodium
molybdate solution.
Arrangements were made to sow a strip of land
with treated seed for comparison with untreated
seed planted in strips on either side. This was
done by (a) a Bantu agricultural demonstrator,
who lived in the middle of a tumor-free area, and
§OEFINITE
E9RESPONSE
MAIZE
7 When one garden was visited for diagnosis of one set
of injections, all the treated leaves had been nipped off
neatly. On inquiry, the owner (a widow) said, "Sheep
broke in and ate them." "What! only the labeled ones
and no others?" Widow: "Yes, they ate only the labeled
leaves." Interpretation: "A widow, with no man to protect her, must be particularly careful to run no risk from
white man's powerful magic." The animals that broke
in and ate the 8 additional sets were not so selective.
PROBABLE
RESPONSE
BEANS
D
NO VISIBLE
RESPONSE
PUMPKINS
~
Ho
Fe
~
~
Cu
2n
Hn
~~
==
-
~
~
Ir--
TEXT-FIGURE 2.-Responses to diagnostic plant injection.
VOL.
36, NO.2, FEBRUARY 1966
TOBACCO
206
BURRELL, ROACH, AND SHADWELL
(b) a Bantu schoolmaster and his ex-schoolmistress
wife, who lived about 20 miles away in the middle
of a cancer area. These two experiments were
inspected when the maize had attained its full
height. In both localities:
The maize grown from treated seed was a
darker green than that from untreated seed.
The "treated" beans appeared to be growing
better and bore heavier crops than the
untreated.
The treated pumpkin plants were much better
in color, growth, size of crop, and freedom
from leaf scorch than the untreated.
There was much withered end in the cancer
area. Two independent counts revealed that
treatment had reduced the amount of withered
end to a quarter of that on the adjacent untreated
strips. Molybdenum deficiency, therefore, appeared to be a major factor in the cause of withered
end.
Unfortunately, due to special circumstances,
crops from both experiments were harvested a
few days before we could measure them. Both
the owners, however, were so pleased with the
crops grown from treated seed that they asked for
experiments the following season!
Measurement of Severity of Molybdenum
DeAciency
In the 1963-64 season, at the tumor-free locality,
maize and beans were sown together in the same
rows by the Bantu owner. Six procedures were
followed:
1) No treatment.
2) Seed was moistened with 2% sodium molybdate solution.
3) Seed was moistened with 4% sodium molybdate solution.
4) Complete fertilizer was applied to soil.
5) Seed was wetted with 2% sodium molybdate
solution and complete fertilizer applied to.
soil.
6) Seed was wetted with 4% sodium molybdate
solution and complete fertilizer applied to
soil.
When the maize was full grown, that treated with
the 4% solution had better leaf color and was 6
inches higher than the untreated, the 2% treated
being intermediate. The "2%" beans appeared to
bear twice the crop of the untreated and the "4%"
four times that of the untreated. Unfortunately,
these crops were harvested in error just before they
were to have been gathered and measured. The
maize was gathered row by row. Owing to hasty
ploughing and seeding, necessitated by inclement
weather, there were many long gaps in the rows
and, consequently, wide variability in yield from
row to row so that no reliance could be placed on
the yield figures.
However, one clear-cut difference was associated
with treatment: In unfertilized rows, with or without sodium molybdate, and in fertilized rows without sodium molybdate approximately 5 to 10%
of the cobs were heavily mildewed, whereas in the
fertilized rows with 2% sodium molybdate only
1% of the cobs were mildewed and none in the
rows receiving 4% sodium molybdate and artificial
fertilizer. Cobs from the latter rows were noticeably
brighter than the others.
At the cancer locality, artificial fertilization was
light but uniform. Only two procedures were
followed: 1) no treatment and 2) wetting seeds
with 2% sodium molybdate. The beans were
harvested and shelled row by row. The results
(omitting the guard rows) are shown in table 2.
All 4 "treated" rows yielded more heavily than
all 5 untreated rows. There was also an obvious
difference in quality. For some measure of this,
successive lots of 100 beans were counted and
TABLE 2.-Effect on yield of wetting bean seeds with
2% sodium molybdate solution
Yield of rows
Row No.
1
2
3
4
5
6
7
8
9
Average
Treated
2. 0
1.4
3.5
1.5
2.1
Untreated
0.4
O. 3
0.8
1.1
1.0
O. 7
JOURNAL OF THE NATIONAL CANCER INSTITUTE
ESOPHAGEAL CANCER IN THE BANTU
weighed. All 10 treated lots were heavier than all
10 untreated. The yield from the treated seed was
3 times that from the untreated, and the average
weight of 100 beans from the treated seed was 10
percent greater than that from the untreated.
There appeared to be at least 4 times the weight
of pumpkins on the treated plants than on the
untreated. They were all stolen, however, before
they could be harvested. The maize plants grown
from the treated seed were about 6 inches taller
than those from untreated seed, and the foliage from
the treated seed was darker than that from the
untreated. So much maize was stolen that no
comparative crop weights were obtained. No
withered end appeared in the 1963-64 season.
Conclusions
The following conclusions were drawn from the
work done on plants:
1. Results from plant injection suggest that maize,
pumpkins, and beans growing in cancer gardens
were affected by a complex trace-element
deficiency.
2. The fact that treating bean seed with sodium
molybdate solution led to a trebling of the crop
proved that molybdenum deficiency had reduced the metabolic efficiency of the untreated
plants to, at best, one third.
3. Observations on similar experiments made on
pumpkins suggested that the same conclusion
applied to them also.
4. Since treatment of maize with sodium molybdate solution reduced the amount of withered
end to a quarter, molybdenum deficiency is, at
least, a major factor in causing this condition.
5. The severe leaf damage suggestive of molybdenum deficiency seen in beans and cucurbits
in cancer gardens and the presence of withered
end only in these gardens indicate the high
probability of a more intense molybdenum deficiency in the cancer gardens than in the tumorfree.
GAP BETWEEN AGRICULTURAL FACTS
AND A KNOWN CARCINOGENIC
MECHANISM
It may be argued that the criticism made in a
recent editorial in the British Medical Journal, viz,
VOL. 36, NO.2, FEBRUARY 1966
207
"In fact there is a big gap between the suggestion
that the zinc/copper ratio in soils plays some part
in determining the incidence of cancer of the
stomach and any known carcinogenic mechanism
in which the ratio is likely to be 'important''' (6)
may also apply to the above facts. Brief consideration will, therefore, be given to two known consequences of these facts that may narrow this gap.
1) Direct Consequences of Poor Production of
Cancer Gardens
The Appendix describes the almost constant
struggle of the Transkeian Bantu woman to get
enough food on which to live. One obvious effect
of the poorer production of the cancer gardens,
compared with the tumor-free, hut gardens is that
the occupants of the cancer gardens depend more
on pumpkin vine tips and "edible" weeds than do
the occupants of tumor-free gardens. These plants
may be important in two ways (a) by providing
mechanical irritants, e.g., prickles from pumpkin
vine tips, milky thistles, etc., and phytoliths (7),
and (b) carcinogens (or cocarcinogens). A number
of the hundred wild plants used as food are known
to be poisonous, e.g., black nightshade (Solanum
nigrum) (8).
2) Consequences of Greater Intensity of Molybdenum and Other Mineral Deficiencies in Cancer
Gardens
Carcinogenic Fungi
Molybdenum deficiency rendered maize cobs
prone to fungal attack. Maize growing in cancer
gardens, being more intensely molybdenum-deficient than that in tumor-free gardens, is likely to
be more heavily infected.
Gibberella sp and Diplodia zeae have been identified by Dr. Davies and Mr. Petser of the College of
Agriculture, Stellenbosch. Both these fungi are
toxic to animals (9), and when only the germ end
of the grain is invaded, the attack is difficult to
detect. Infected maize is not only occasionally
used for making Kaffir beer, but some Bantu even
prefer the flavor imparted by the fungal infection.
Even a sophisticated Bantu agricultural demonstrator stated that he used such infected maize
when crops were bad. Aspergillus jlavus, known
208
BURRELL, ROACH, AND SHADWELL
to infect maize, is of interest in that one strain has
been proved carcinogenic (10). These facts seem
to justify a survey of fungi infecting maize and
other plants in Bantu gardens.
Mineral Deficiency Leads to Abnormal (Possibly Carcinogenic) Compounds
Another experiment, already reported, proved
that molybdenum deficiency reduced the crop and,
therefore, the metabolic efficiency of beans to, at
best, one third; the same is almost certainly true
for pumpkins. A metabolic block of this severity
most probably leads to abnormality of the organic
composition of the affected plants. Bradfield,
Flood, and Roach (11), using the half-leaf plant
injection and chromatographic methods, proved
that both iron and manganese deficiencies led to
abnormalities in leaf content in respect to numerous
compounds, including members of the amino acid
and phenolic fractions. Not only were there
compounds in the normal half of the leaf that
could not be detected in the deficient half, but
there were also compounds in the deficient half
that could not be detected in the normal half.
Nitrosamines Cause Esophageal Cancer Selectively in Rats
Druckrey and co-workers have shown that a
number of nitrosamines produced esophageal
cancer selectively in rats, whether administered by
mouth or injected; the tumors so produced resembled those occurring in human beings (12, 13).
These compounds include an amino acid with a
nitroso group (13).
Do Nitrosamines Occur in Bantu Food?
In a recent communication, Preussman, Daiber,
and Hengy made the following statements: "The
question should be examined whether N-nitroso
compounds are likely to be found in the human
environment. For example, a typical nitrosamine,
p-methyl nitrosoamino-benzaldehyde, has been
found and isolated from an eatable mushroom
(Clitocybe suaveolens).
Nitrosamines are easily
formed from secondary and even tertiary amines
and nitrous acid or nitrous gases" (14). Ther~
is no dearth of diamines in plants, and nitrous
gases are sometimes evolved from plant tissue.
Thus, evolution of these gases from chopped
herbage is a known danger in silage making and
many human deaths have been recorded. These
gases are evolved when plant material of various
kinds is macerated and allowed to stand; the
evolution is stronger when nitrate is added (15).
Nitrate may accumulate in plants in sufficient
quantity to be poisonous to animals (16). Molybdenum is essential for the reduction of nitrate in
all higher plants, and .nitrate accumulates in
molybdenum-deficient plants (17).
Workers do not yet agree on how nitrite is reduced to ammonia (18, 19), but one or more of the
elements, iron, copper, zinc, or manganese, is
reportedly involved. If so, a deficiency would lead
to an accumulation of nitrite and so to another
possibility of nitrosamine production; this would
be the more likely in the more intensely deficient
cancer gardens.
FIRST FIND THE CARCINOGEN(S)
Professor Druckrey and his team generously
demonstrated to us their unpublished, as well as
published (12), chemical methods for testing for
nitrosamines and certain other carcinogens. These
methods will be employed in a systematic examination of Bantu food and tobacco. Should any
carcinogens be found, they will be tested in experiments on animals.
Since the mineral nutrition experiments already
show promise of a considerable increase in food
production at small cost, they are justified apart
from their hoped-for contribution to the cancer
problem. 8 Should a carcinogen be found, these
experiments will provide material on which to test
the effect of mineral nutrition that hopefully will
lead to a means of preventing its formation.
S They are also winning the confidence and lulling the
suspicions of the Bantu-an essential part of the investigation, as the following facts will prove. When Dr. Burrell
refused to let W. A. R take a leaf sample, he issued the
warning: "Should cancer appear in the family, even such
friends as the headmaster and ex-schoolmistress might
become prey to tribal superstition." He told us of a past
Bantu patient of his. As a babe, he had been deposited
"on the doorstep" of a Roman Catholic Mission, where he
was reared, educated, and then sent to Rome for the 7-year
training for the priesthood. He returned to work for many
years among his fellow Bantu and eventually contracted
esophageal cancer. At the end, Dr. Burrell said, "Now I
must send for the priest to administer the last rites." The
Bantu Roman Catholic priest patient: "Yes, send for the
JOURNAL OF THE NATIONAL CANCER INSTITUTE
ESOPHAGEAL CANCER IN THE BANTU
priest to administer the last rites, but first promise me one
thing; promise me that you will have me buried in the gate
of the cattle kraal." [See reference (2), p. 504, footnote 11.]
It seems wiser, especially for an outsider, to be unnecessarily
meticulous 99 times than to be careless in the one respect
and so lose the confidence of the Bantu and jeopardize the
whole investigation.
At one of the local Bantu shows at which W. A. R. helped
judge so that he could be introduced as a (by implication
harmless) person "trying to grow three beans where one
grew before," the beans were exhibited for all to see. A
voice from the crowd: "Where were these beans grown?"
"On my land!" said the above-mentioned Bantu headmaster, rising to his full height and hitting his chest a
resounding blow. A week or so later, his ex-schoolmistress
VOL.
36, NO.2, FEBRUARY 1966
792--91Q-6~
209
wife regretted that she was not at the local Bantu agricultural
show. Had she been, she would have explained to the
people that we were doing good, not evil.
A recent occurrence illustrates another type of misconception to be avoided. W. A. R. treated seed for a few
European friends, one of whom gave some treated seed to a
Bantu workman. The latter was the only one to have a
crop in the recent drought, but it was all stolen. He took
his employer aside and said confidentially in a hushed voice:
"Won't you please ask the white witch who treated your
seed to treat mine next season so that the black bastards who
steal the cobs will get poisoned." To be suspected of being
a "specialist in evil" would engender fear rather than
friendly cooperation.