A nostalgic moment for me, the X-ray image came from a Zimbabwean man with Bantu haemo-siderosis. This is a condition in which a person ingests large quantities of iron. The excess dietary iron is deposited first in the skin giving the person a tanned colour. My patient complained that he had to stop drinking beer because his skin was getting too dark.
Bantu siderosis is caused by consuming large quantities of home-brewed beer made in ungalvanised steel barrels. The iron in the barrel oxidises and dissolves in the beer. The condition leads to liver cirrhosis, cancer of the liver, heart disease and diabetes. The condition was originally blamed entirely on beer brewed in rusty barrels, however genetics also plays a role in this disorder because it can also occur in non-beer drinkers, and of those that do, only some are affected. A genetic marker increases the risk of iron overload when excess iron is consumed.
Introduction of commercially brewed beer to rural areas in Zimbabwe in the 1960s dramatically reduced the incidence of the condition. It became illegal to brew beer at home.
However the law of unintended consequences came into play. In the villages people would brew beer as a communal event, often for the weekend, using maize meal, sorghum, and sometimes currants and raisins or marula fruit, and yeast. It was an important source of B group of Vitamins. The beer was consumed at home, and helped to bond families and the community. It played an important part in family ritual, healing ceremonies, and some would always be reserved for the spirits. Menfolk stayed close to home, money stayed in the group. After the beer was consumed any the highly nutritious sludge at the bottom of the barrel was given to the children to supplement their diet.
After introduction of commercial beer, the males would go out to the beer-halls, drink away from home. Money was lost to the community, there was a problem with public drunkenness, family dynamics were irretrievably altered, and an important source of nutrition for children in poor communities was lost.
One wonders whether the government would have done better to sell stainless steel or even plastic containers cheaply for the purpose than to ban home brewing, and one suspects commercial considerations had a hand in the decision.
In this self-portrait, along with the X-ray I have included an African sunset (Mana Pools on the Zambezi).