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The Maldives form the central part of an underwater mountain range in the center of the Indian Ocean, creating a crossroads for seafaring, migration, trade, and warfare. Because of this remote yet strategic location, the Maldives became either a disastrous hurdle, a convenient stopover, or a promising stepping stone in the Indian Ocean—and a favorable residence for a small, self-contained, ocean-foraging and seafaring people. The Maldives are among the few central and western Indian Ocean islands that were already populated, long before the colonial period. The archipelago is presumed to have been settled some 2,500 years ago. Dravidian, Sinhalese Buddhist, and Arab Muslim influences formed the unique cultural identity of the preindustrial Dhivehin (Maldivians). Throughout the historic eras, the crossroads position of the Maldives becomes conspicuous at particular junctures. Three commodities exported by the Dhivehin were of particular significance in the global economy and positioned the islands at various historical crossroads: coco-de-mer, coir, and cowries. Ptolemy’s Geography provides the earliest western reference to the archipelago. Ibn Battuta, who served as the royal judge, is a renowned representative of the Arab trade and Muslim religious networks that had a lasting effect on the shape of the island kingdom. The most comprehensive accounts of the colonial era are provided by the shipwrecked François Pyrard, from the early 17th century, and by H. C. P Bell, between 1879 and 1922. The Maldives have ethnic and linguistic ties to Sri Lanka (Ceylon) and were politically and economically closely connected to this neighbor. In 1887 the archipelago officially became a British protectorate, gaining its independence in 1965. The eradication of major diseases paved the way for the advent of the tourism industry in the 1970s. Since the late 1990s, the molecular approach to population movements in the Indian Ocean has provided new insights into the cultural admixtures that contribute to the genetic mosaic of the Dhivehin.

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When the first hominins and their successors migrated north from Africa into Eurasia, they created a new, interlinked disease environment. They brought some diseases, such as malaria, with them from Africa, and newly encountered others, such as plague, in Eurasia. Regional changes in climate played a role in human health, not simply due to their influence in determining the success of year-to-year harvests and grazing lands, but also because periods of warming or severe and sudden cooling shifted the interactions between humans and the flora and fauna that made up their environment. Exchanges of disease between the two continents would continue up through the medieval era. Whereas vast distances and low population density likely shielded Eurasian populations from frequent epidemic outbreaks up through the Neolithic period, by the beginning of the common era, with its vastly intensified trade networks, Eurasia would begin to see a new phenomenon: pandemics, including the Justinianic Plague and the Black Death, the largest mortality events in human history. The diseases of medieval Eurasia are still among the world’s leading infectious killers and causes of debilitating morbidity. Because they have all persisted to the present day (with the exception of smallpox), modern science plays an important role in their historical reconstruction.