The weekly group-based program “Paths: from loneliness to participation” was conducted face-to-face over 15 sessions by nurses, social workers and volunteers in primary care in Catalonia (Spain) to alleviate loneliness among older people by promoting peer support and participation in community assets. We aimed at exploring participants’ experiences of loneliness and participation prior to the program and its perceived benefits. The qualitative design was descriptive-interpretative. Data were collected through three focus groups and 41 interviews applying a semistructured topic guide involving 26 older participants, six professionals and nine volunteers. Participant-observation of all sessions involved the 38 older people who started the program. A thematic content analysis was applied. Older persons with diverse profiles of loneliness and participation explained different degrees of decrease in loneliness, an increase in participation in local community assets, companionship, peer support and friendship, and an empowerment process. Successful cases reported improvements in mental wellbeing and recovering the sense that life was worth living. Loneliness persisted among some widowed participants and vulnerabilities hampered some benefits. Participants, professionals and volunteers reported different degrees of success in older people to alleviate loneliness by enhancing social relationships and activities through complex processes interrelated with health and socioeconomic factors. Loneliness is defined as a negative feeling due to the perception that the social needs of the person are not corresponded, neither in quantity nor in quality, by the social relationships that the person has . In the At a personal level, several risk factors related with sociodemographic characteristics and health status are associated with loneliness: being female, living alone, limited education, small social network, low self-efficacy, poor self-rated health, depression and recent bereavement (often due to widowhood) ,7. GeogrCertain intervention characteristics are related to a higher efficiency at reducing loneliness, such as theory-driven interventions ,19,20. HRegarding intervention effectiveness, a systematic review on interventions based on social capital targeting older people showed few and diverse trials assessing the impact on loneliness and they were generally ineffective . HoweverIn Spain, the program “Paths: from loneliness to participation” was designed, conducted and evaluated to alleviate loneliness among older people attending primary health care . The intIn summary, despite a diversity of programs in place around the world and isolated successful results, evidence and detailed understanding on whether and how programs decrease loneliness is lacking, as well as how the characteristics of the target population influence the impact. Likewise, while previous literature clearly suggests health beneficial effects of social capital, less is known about social capital interventions and how social capital can be built for health promoting purposes. Qualitative evaluation of interventions to explore participants and professionals’ perspective on the experiences and perceived benefits is a complementary approach to the quantitative evaluation of objective impacts that can help understand the processes and interpret the effects of the programs.Therefore, this paper reports the qualitative evaluation of the program “Paths: from loneliness to participation” aimed at exploring participants’ experiences of loneliness and social participation prior to the program; and describing its perceived benefits on loneliness, social participation, and support and health according to participants’ experience, volunteers and professionals’ observations.The study was conducted adhering to the rigor and quality criteria for qualitative research: description of context, of participants and of the research process, methodological adequacy, triangulation of data and reflexivity of the research team . MoreoveThroughout the paper, “participants” refers to older people participating in the program and “informants” comprises all agents involved: participants, volunteers, and professionals.Following a constructivist research paradigm, a qualitative study with a phenomenological approach was chosen, in order to explore the lived experiences of the involved agents applying a descriptive-interpretative design.The perceived benefits of the program were identified among participants according to their experiences and then triangulated with the perceptions of volunteers and health and social care professionals and with the researchers’ observations.This research applies the social capital theory adapted to ageing by Nyqvist and Forsman .The “Paths: from loneliness to participation” program is theory-driven and was designed around the mentioned operationalization of the social capital theory applied to ageing with the goal to alleviate loneliness among older people by promoting peer support and participation in local community assets ,30,34. IOne intervention group was conducted in a semirural area , and two in an urban area, Barcelona: one in a low socioeconomic level neighborhood (zone B) and one in a medium level one (zone C). Settings were selected by convenience to evaluate the viability of the intervention in different contexts.The study population reached through the focus groups and interviews comprised 26 older people who participated in the program, nine older volunteers and six health and social care professionals. All 38 participants  who started the program were involved in the participant-observation. Participants of the program were invited in person to the interviews and focus groups by the researcher (LCP) to take part in this qualitative study and agreed to participate. All volunteers and professionals directly involved in the program were invited to participate. The characteristics of all 38 participants have been previously described in detail.  Table 1 We intended to interview all 26 participants who finished the program out of 38 older people who started, but only 23 were available. None of the participants were excluded for any other reason. Moreover, one participant who had dropped out of each intervention group was selected taking into account their gender and the heterogeneous reasons for leaving the program: two women, one of whom dropped out to care for a family member and the other had an injurious fall, and one man who started a social activity. Furthermore, nine older volunteers who accompanied the three intervention groups were interviewed. One man and one woman initially involved as volunteers were not available. All six professionals involved as facilitators or observers were interviewed.Focus groups and interviews were semistructured and followed a topic guide with open-end questions. The topic guide had been previously planned and prepared based on a review of the literature and the objectives of the study. The guide included adaptation according to the type of informant and had been agreed by the research team . Interviews and focus groups were conducted at the end of the intervention, in June–July 2012. Twenty-six older people were interviewed twice: in the focus groups conducted in their natural group during the last session of the program, and in an individual interview, in order to gain more personal information about their situation prior to the program, the process carried out and the perceived benefits.Interviews with participants were partly conducted at participants’ homes and partly in a local senior club. Focus groups and interviews with professionals and volunteers were conducted in each primary health care center. Interviews lasted approximately one hour and focus groups around 1.5 h.Moreover, participant-observation was conducted in all 15 sessions of the program in the three zones by one or two members of the research team. Field notes included any positive and negative information on the implementation of the intervention and the attitudes and reactions of participants, volunteers and professionals along the sessions. Notes were rigorously collected differentiating observed facts from subjective interpretations. A total of 58 field notes from observations were taken. All techniques were conducted by two female researchers , both with experience in ageing research. As a consequence of the observation period, researchers established a rapport with participants during the 4.5 months. Participants were aware of the researchers’ involvement in the program.All conversational techniques were digitally recorded and transcribed . A thematic content analysis was conducted. The analysis involved a triangulation of techniques, researchers, and informants. Two female researchers  independently analyzed the transcripts. DRA is an expert on qualitative research and was not involved in the program. The analysis was conducted according to following steps: (1) formulation of pre-analytical intuitions after successive readings of the transcriptions and the notes from documentary techniques; (2) creation of an initial analytical framework and text codification; (3) creation of categories by grouping the codes according to the analogy criterion based on predefined themes  and new emerging elements from the discourses, with a continuous cross-checking between the categorization and the source of the data that combined a deductive and inductive approach; (4) analysis of each category and relationship with the others; (5) elaboration of the new text with the main results.The loneliness model, the theories of behavior change, such as the social cognitive theory and the stages of change of the trans-theoretical model, and the three ageing crises were used to interpret the findings once data had been coded and categorized.The results were structured to build an explanatory framework of the processes that participants underwent during the program, their perceived benefits and the main influencing factors. The results and the framework were discussed with the entire research team and verified with the corpus when needed. Informants verified results by providing their feedback on preliminary results. Informative richness for a deeper understanding of the phenomenon studied around the program was achieved according to the study aims and research questions. Data saturation was reached at the end of the analysis in the main categories for women, since participants were not contributing with new information.The ethics committees from IDIAP Jordi Gol and Universitat Autònoma de Barcelona approved the protocol (Ref number 1403). The informants participated voluntarily after signing informed consent forms. Anonymity, confidentiality and protection of stored data were guaranteed. No financial or material compensation was offered to informants.As recommended in the Standards for Reporting Qualitative Research  the resuTwo profiles of participants were identified regarding previous experiences of participation. The first profile was composed of participants with no previous experience of formal participation. They were women with a low educational level and mainly widowed. Their life had been focused on family and house care, and caring had been a barrier for participation. They shared trajectories of disempowerment, lack of courage to participate alone and renouncing to make decisions that they considered would be unfaithful towards others. Some women had no friends, had participated in social activities only with their husbands and stopped participating when they passed away. Some of them had no previous knowledge on community assets, or had prejudices, especially about senior clubs.“He didn’t want to go, because I sometimes said “let’s go and see”. We live beside the senior club… (…) but I didn’t have the strength to say “if you don’t come, then I’ll go on my own””. Participant 5, Woman, 78 years old, Zone C.The second profile had previous experience of social participation. They were mainly single, divorced or widowed, including the only widower. Widows who had participated together with their husbands in community assets had ended participation when their husbands passed away. Those who had participated on their own had conducted activities for other people , with others  or to help others  and it had been a source of mental wellbeing. They had stopped mainly due to age-related health problems , economic problems, or translocation. Stopping them had contributed to their loneliness. Nevertheless, some participants reported having found ways of coping with limitations to maintain some informal activities, like overcoming pain to go for a walk.“For a long time I used to go there every day (to a center for disabled children) … look at my knee, I’ve needed an operation for 18 years but I decided not to have it, and I can’t feed them from sitting, because sometimes you have to hold their head and I can’t.” Participant 1, Woman, 83 years old, Zone C.Three main profiles of participants were identified regarding experiences of loneliness. In the first profile, participants expressed their loneliness as a consequence of widowhood. Their husbands’ absence had left a void that was impossible to fill and finding a new partner was disregarded to avoid being a “servant” again or because their husband was irreplaceable. They were living alone, suffered from loneliness mainly at home and coped with it by talking with their deceased husband, going out for a walk or having a pet.“I’m missing the most important thing, I’m missing my husband.” Participant 29, Woman, 78 years old, Zone B.In contrast, a recently widowed man who dropped out had joined the program to find a new partner.Many of them had cared for family members and started to feel lonely after or while caring. They explained feeling lonely despite the support perceived and received from their family and neighbors. In some cases, widows suffered depressive symptoms and anxiety or had a pharmacologically treated depression. Nevertheless, it is to be mentioned that a minority of them expressed widowhood as a relief from a constrictive marriage.The second profile comprised some long-term widowed, divorced or single participants who expressed that they were solitary. They expressed having a fear of relating with others, a lack of social relationships and that they received pressure from their family to interact more.“I’ve done it (joining the program) mainly because I had a problem relating with others, isn’t that right?” Participant, N. 18, Woman, 65 years old, Zone A.In the third profile, participants were suffering from loneliness in company. They had moved to live with their children due to health problems, or their children and grandchildren had moved to live with them due to economic problems. Older women expressed missing having their own space and a lack of communication with their children, who had little time for them.“My daughter and I have a good relationship, but I can’t have any conversations with her… She takes care of me if I am ill … but I can’t tell her stories about older people; they are very tedious, because she has no time. It’s true, she works long hours and has no time. She would like to listen to me and so on, but she says “Ah Mum, not today, I have no time, maybe on Sunday…”. “Participant 28, woman, 71 years old, Zone B.In addition, providing economic support to their children was a strong source of worry that intensified their loneliness.“And now I’m turning 74 years old. I thought than when I was old, I would have my retirement prepared, I thought I could live my life a bit. But I see it is the other way round, that now I have to be there for the others, instead of them being there for me; I am the one who has to be there for everyone.” Participant 2, Woman, 73 years old, Zone C.Professionals and volunteers observed changes in participants that they attributed to the intervention. The benefits were more intensive among those participants who adhered more, suggesting a dose–response effect.Professionals and participants expressed that the program was especially successful at promoting mutual support. Living in the same area gave them a feeling of familiarity, and participants often met each other on the street, and sometimes walked back to their homes together.According to participants, the group provided companionship, a feeling of social integration and sense of belonging to the group. The group was perceived as a space of attention, respect and affection to give and receive emotional support. When a participant suffered an injurious fall, was in low mood or had a new illness, support relationships could be observed.Many participants were part of a group for the first time and for some participants, the group was the only place they had to socialize.Participants discovered that peer relationships, as opposed to relationships within the family, provided a way of communicating shared worries and interests by sharing a similar age.“We are the same age, you can talk about the same things… youth, depending on the topic… you talk but…, I don’t know, youth is very different. (…) For me, the company of one or the other is different. With the group companions there …, I don’t know, maybe it’s another freedom, another thing because since we all speak about the same thing, pretty much, about what happens to us and about what we do not have…” Participant 29, Woman, 78 years old, Zone B.Participants identified others as a model to follow or, on the contrary, as a model to avoid, evoking positive changes.Some participants became friends and started visiting and calling each other. While some people were previously aware of missing having friends, others made friends for the first time.“(...) because I don’t tend to go out with friends here and there. But now it’s different, since I’ve been coming here (…) Look, I get on very well with Maria, she’s a lovely and good woman and we get on great together. For her it’s the same; she says “I’ve found a shoe for my foot, because I don’t trust anybody but you”.” Participant 37, Woman, 77 years old, Zone B.In some cases, new friends generated subgroups that integrated other participants, including those who were more socially isolated. In other cases, friendships were closed, and some participants felt excluded.“... and they seem to have become very united to go out on walks together (…), but I go by and they are sitting there and never say “do you want to come with us”, so I go home....” Participant 2, Woman, 74 years old, Zone C.The group comprised different profiles regarding educational levels, age-related disability and health problems, which unified but also divided the group. Some participants expressed having felt united and treated without differences. In some cases, participants and volunteers developed support relationships with more vulnerable participants, moved by compassion. Telephone contact was especially relevant between participants with mobility limitations or living apart, and also for volunteers to support participants.“The one I see who needs to cheer up is Margalida, she is very down... (...) For me it’s no effort because it’s something I’ve done all my life, listen to people and be at their side and support them. Let them tell you things, especially that… I’ll go and see her this week, because she called me the other day and I went to her house and now I want her to come to my house”. Volunteer 2, Woman, 77 years old, Zone A.However, those participants with mobility limitations and hearing impairment were at higher risk of not establishing friendships and dropping out, thus losing the opportunity to benefit of the program at any level.The few participants with a higher educational level expressed not sharing interests with the rest. For them, feeling valued and helpful for more vulnerable participants was key to remain in the program. In one group, there was a conflict with one participant. She felt more skillful and was jealous of those who participated more in the group.“You can see that she doesn’t stop talking, she always wants to speak… and from the first day there has been a conflict, and everybody saw there was a conflict. Even Jose said he didn’t feel comfortable because of her. And of course, this has restricted the dynamic a bit, hasn’t it? It hasn’t been easy…” Social care professional 1, Woman, Zone C.Most of the participants reported that their loneliness decreased after the program by feeling accompanied by peers and professionals, and thanks to the bonds established and to having become aware of and engaged in local activities of their interest. While some people said they no longer felt lonely because of new friendships, others continued to suffer from loneliness, but with less intensity. The awareness that loneliness was a common matter helped them to cope with it by realizing they were not alone in their loneliness.“I don’t feel lonely, now I have friends”. Participant 28, Woman, 71 years old, Zone B.“Like bread and butter: loneliness is easier to digest when in company”. Participant 4, Woman, 78 years old, Zone C.Some participants expressed a transitory benefit on loneliness. For them, home was the space of loneliness, while the group and the street were relational spaces. Likewise, some participants said that the improvement would vanish once the group finished. Nevertheless, thinking and talking about the program with others also helped them to feel less lonely.“I am happy to join the group, but then, when I get back home, I fall apart, I need to be on the street with someone… at home, alone, is bad…” Participant 35, Woman, 81 years old, Zone B.Some widows who attributed loneliness to widowhood reported no decrease in loneliness after the program. Accordingly, in these cases the main effect desired of the intervention was not achieved. However, these participants reported other benefits such as an increase in social relationships, well-being and empowerment.“Since my loneliness is due to missing my husband, it cannot be replaced, at the moment, or ever.” Participant 13, Woman, 75 years old, Zone A.According to all types of informants, the program was generally successful at helping participants to discover and sometimes engage in local activities.Visiting community assets allowed participants to get a sense of what was available and to remove prejudices. Moreover, some people returned to community resources where they used to go with their husbands.“The satisfaction of seeing things I had never seen before, although you imagine them, you’ve seen them on TV, but being there inside, you see it, you touch it, it is a big satisfaction…” Participant 5, Woman, 78 years old, Zone C.The visits included testing local activities and triggered participation in a wide range of activities. Some participants started participating in activities immediately and others started later during the program. They became engaged in activities that suited their interests, abilities or worries . Belonging to the group facilitated becoming engaged with other peers. Thus, new friends easily did new activities together, accompanying each other and reinforcing their friendship.“Carme and Teresa meet up to go to the cinema, since they live near each other, and Carme does not like going out on the street on her own at night. They meet up to see the film that the parish puts on in the cinema and has been recommended to them, but it’s not a planned activity; it’s an extra outing.” Field note, researcher LCP, referring to participants 10 and 13, Women, 75 and 80 years old, Zone A.Other participants made specific plans to start activities the following year and some exclusively connected with their wish to participate. For some participants, socializing was very important but participating in activities was not. Some participants, especially those who had been caregivers over the past years, discovered the value of doing activities with other people.“Everything we did there was new to me. Everything…” Participant 12, Woman, 79 years old, Zone ALow self-confidence and low communication ability, often related with low education, limited the benefits on participation to the extent of feeling they were not up to join community assets.“She tells me she’s odd and that she thinks everything is very nice and would like to get involved but she doesn’t feel capable because she is silly, she doesn’t express herself well, she talks poorly...” Field note, researcher LCP, referring to the participant 30, Woman, 84 years old, Zone B.Participants, professionals, and volunteers agreed on the improvement in mental health. The program was seen as a strategy to prevent or alleviate depressive symptoms. Many participants took antidepressive drugs and/or tranquillizers and explained feeling better after the program. Some women expressed that the program was a salvation to them. One participant explained having solved her sleep problems.“For me, beforehand, I wasn’t able to go anywhere on my own. Now, I’ve changed! If I had to go for an X-ray, I had to be accompanied, and, since I have claustrophobia, in a lift and things like that… but now, I go alone wherever it may be, an X-ray, Sant Pau … I’m a different woman!” Participant 5, Woman, 78 years old, Zone C.According to the professionals, some participants were initially trapped in a loop linked to loneliness with an obsessive focus on illnesses and woes, but the intervention successfully broke it by connecting them with others, awakening the wish to remain connected and helping them to forget about their worries.Sharing their woes and coping strategies among peers during the sessions was generally relieving and helped them to deal with them, although specific people needed to feel their suffering was greater.“By participating, you don’t feel lonely, with everything you are experiencing.” Participant 18, Woman, 65 years old, Zone A.Specifically, sharing the way in which they talked with their deceased husbands to overcome loneliness helped them to feel better instead of “crazy”, as they said.In terms of positive mental health, participants reported an improved subjective well-being, becoming aware of worse circumstances and valuing their situation more. They reported being more understanding and empathic, and having more trust in other people; particularly those who were more closed and socially isolated. Others explained being more compassionate, respectful and having learned not to judge others. Likewise, they also reported feeling less worried and more able to deal with economic, family and health problems. Those living with family members expressed having learned to be more tolerant in cohabitation with other household members.An empowerment process was observed that contributed to alleviating their loneliness. According to the three groups of informants, the program contributed to the development of personal potential and autonomy to participate and to live their life as they wanted, with less dependency on their children. They had a feeling of strength and of power to decide.“My daughter wanted me to spend every Sunday with them, but I didn’t like it and I used to say: “but why do I have to be here every Sunday?” and she’d say “so that you’re not on your own” (…) And now, if one day I don’t want to go for lunch I say “today, I won’t come for lunch, don’t wait for me because I’ll be with Maria”, now it’s different.” Participant 37, Woman, 77 years old, Zone B.Participants attributed their empowerment to the attention and value received. Additionally, realizing they had helped peers was very satisfying and increased their self-esteem, since it gave value to their life experience. Accordingly, feeling useful and able instead of useless meant that their life was not ending and was worth living.“(With the program) you have another stimulus, you feel like living, you feel like someone needs you for something. You feel that you, life, or God or whatever, needs you for something. Do you know what that feels like?” Participant 29, Woman, 78 years old, Zone C.In particular, those participants with a life trajectory that was family-oriented, said that they reached a new sense of freedom in their lives. Those participants with severe physical conditions felt connected with their wish to live by becoming aware that others do care about them. They were aware of their own empowerment process and participants mutually reinforced each other. It was strange for them having lived until then without these satisfying aspects of life. However, participants did not see themselves able to lead the continuity of the group and wanted someone as a leader to tell them where to go.Empowerment was also enhanced by discovering new interests. Becoming engaged in local activities like physical activity and memory training especially promoted healthy ageing, but their physical activity also increased by starting to participate.The program had some benefits on self-care and healthy lifestyles. Participants were motivated to dress smartly, some of them rediscovering the desire to get dressed up after widowhood by identifying some participants as a model to follow.Two participants with hearing impairment felt motivated to wear the hearing aid that they had not used before because they wanted to feel connected to others in the group.Through the program, they became aware of the relevance of taking care of their own health, especially those who had cared for a spouse and whose own health and self-care had not been a priority before.Nevertheless, participants reported limited benefits on physical health, since many participants reported suffering from chronic conditions with aches that were difficult to alleviate.Some differences and communalities could be identified between the three zones considering their semirural and urban contexts and the different socioeconomic levels in the urban neighborhoods.As mentioned in “I say: so, you (meaning the husband who had died) were the one who wanted to live here , you go, you leave me alone and I remain here”. Participant 13, Woman, 75 years old, Zone A.Only in the urban context, participants mentioned that the program contributed to a less hostile neighborhood. In the semirural area, many of the participants knew each other before, but the previous dynamics greatly influenced future relationships that could be built. Otherwise, in both urban areas, it was uncommon that participants knew each other and in these few cases, a previous relationship facilitated developing supportive friendships. Community assets were also already known in the semirural area but not their full range of offers. Whereas in the urban areas, many participants expressed surprise when discovering the opportunities for participation that they had near their homes.Although the urban zones were different in terms of socioeconomic levels, observed processes and perceived impacts were more influenced by the socioeconomic characteristics of the participants than the contextual ones. Indeed, both zones were similar regarding some features that were relevant to enhance the effects of the program by promoting social interactions beyond the sessions. For instance, at that time, in both urban zones several community assets offered a diversity of activities and older people were present and relevant in the community life, e.g., participants easily met in their daily errands, sitting in benches or walking in pedestrian zones.The results of the qualitative evaluation of the program were convergent with the already published quantitative effects on loneliness, social support, and participation . HoweverOur results are consistent with research reflecting that handling loss is key in the attitude towards participation and social relationships . Our stuOur findings are consistent with the qualitative results of other programs in the same area like the Circle of Friends . In bothThe loneliness model could partly correspond to the type of loneliness observed by professionals prior to the program. The loneliness model proposes that chronic loneliness entails a cognitive bias consisting of a self-reinforcing loop associated with negative social expectations that cause social distance . In thisThe program helped participants to overcome, at least in part, the three ageing crises of autonomy, identity and belonging and consequently brought the feeling that life was worth living to participants and alleviated their loneliness . It helpThe role of modeling, and the reported increased self-efficacy are in line with social cognitive theory . MoreoveIn line with the salutogenic approach, benefits were mainly reported on well-being, the social aspects of health and positive mental health, and there was also a decrease in ill mental health .However, some participants did not report benefits from the program in certain spheres of their lives. Poor physical function and low socioeconomic level, especially when linked to low education, low self-confidence and low communication abilities, hindered engaging in the program and limited the process of change among participants. This is in line with previous research that shows that socioeconomic factors are key factors linking social relationships with health . NeverthLastly, the historical and cultural context seems to configure a generation of older women who had grown up assuming traditional roles of dependence on their husbands. Some of them remained powerless in widowhood, while others were relieved, and others managed widowhood well alone over time. In addition, the 2008–2009 financial crisis seems to have worsened the experience of the ageing process and enhanced loneliness by stressing family dynamics.The rapport built between researchers and participants during the program generated a trust that facilitated the observation of the sessions and sharing personal experiences in the interviews, although it might also have influenced their answers, consciously or unconsciously wanting to please researchers. Nevertheless, the assumptions we had as researchers regarding how and why the program should have reduced their loneliness were challenged from the first group session to the last interview.Among informants, men were rare, since women were a clear majority among participants and the only gender among volunteers, professionals and researchers. This fact has as consequences that the men’s discourse is underrepresented in the results. However, community-based programs targeting older people in Spain are frequently dominated by women . AccordiBenefits reported by older people at the end of the program were triangulated with those perceived by volunteers and professionals and with the observations of researchers during the process. Accordingly, the richness and complementarity of the information generated with the different techniques and the three types of informants are a strength of the study, since triangulation of informants and techniques is a criteria for rigor and quality in qualitative research to enhance trustworthiness and credibility of data analysis . NeverthQualitative findings are limited to the post-intervention timepoint with no further data on whether and how the perceived effects lasted and what was the trajectory of participants not experiencing certain effects. However, the quantitative evaluation was repeated at two years follow-up and significant long-term effects on loneliness, social participation and depressive symptoms were detected . MoreoveLastly, primary care professionals involved in the program were especially motivated to work on loneliness, and the implementation of the program might face barriers in primary health care contexts with a strong biomedical focus. Accordingly, caution is required before transferring these results to other settings. Nevertheless, similar community-based programs in different contexts, such as Circle of Friends, have shown their applicability.This program supports the WHO Active and Healthy Ageing policies and provides insight into how to enhance social networks and participation while ageing to enhance well-being.In addition, our findings should support current practices and policies of social prescribing programs, which link primary care patients with community resources with the aim of strengthening participation and social support, and promoting health, particularly mental health, and well-being .Nevertheless, the role of primary health care in loneliness interventions may differ according to the cultural context and the characteristics of the health and social care system and the available community resources . In any Regarding the intervention design, guaranteeing the continuity of the group remains a challenge, as well as an appropriate follow-up to enhance, if needed, participants’ engagement in the social activities in community assets. Strategies are needed to focus on those persons with social and health vulnerabilities and, consequently, at risk of dropping out or of being socially excluded during or after the program.Future research should include more qualitative evaluations of interventions for a better understanding of personal processes and perceived intervention benefits on loneliness and unintended effects, addressing its complexity, including context specificities .Programs addressing loneliness tend to reach and work well with certain profiles of people , while they might be missing some others . Indeed,Finally, with the expectation of an increasing number of vulnerable older people vaccinated against COVID-19 in Europe, research should guide post-pandemic times on how to rebuild social capital, especially in older people with aggravated loneliness during the pandemic.The qualitative evaluation of the Paths program has contributed to understanding the complex processes that are involved when promoting social capital in older people with low participation and loneliness. The intervention tried to promote social capital to make it a social resource available to all group members. Different degrees of success were observed among participants on their reported alleviation of loneliness, increase in social relationships and engagement in social activities. In the most successful cases, the program enabled their empowerment and enhanced processes of change. Those participants reported an improvement in mental well-being, experienced new freedoms and became reconnected with the sense that life was worth living. However, some widowed participants remained emotionally lonely and other participants were not interested in joining social activities. Moreover, vulnerabilities related to health, socioeconomic factors and age-related disability limited the adherence to the program and the perceived benefits of the intervention.These findings should support further designs, and the implementation and evaluation of interventions. The cultural context of the study is a familistic society with a primary health and social care system with a community-based approach in Catalonia, Spain. However, our results can inspire other programs that should be flexible to adapt intervention components to the specific contexts and to participants’ characteristics.Our results might guide post-pandemic programs on how to resume face-to-face social interactions and social activities among older people suffering from loneliness.


This article proposes a new line of enquiry in the history of animal conservation by suggesting that African wildlife protection was a form of public health in the early twentieth century. Through examining the activities of South African epidemiologists, politicians, bureaucrats, farmers, and zoologists in the 1920s and 1930s, the author argues that wildlife was integrated into epidemiological strategies and agricultural modes of production. Against the backdrop of a series of plague outbreaks, carnivora once deemed “vermin” were legally protected as sources of human health and agricultural wealth. As public health, food security, and carnivore populations were imbricated, the categorical boundaries between human and animal health also began to blur. Ultimately, this case suggests the need to bridge environmental and medical history and to broaden the history of environment and health beyond canonical figures such as Rachel Carson. Paying attention to colonial “peripheries” and African thought is critical in understanding the origins of twentieth-century environmentalism. In his opinion, without its abundance of birds, the earth would be reduced to a barren desert, and those destitute human survivors would be at the mercy of malarial mosquitos, blood-sucking flies, and plague-carrying rodents. In “waging incessant war on the insects which carry disease microbes to man and beast,” birds rendered humankind “a service which cannot be overestimated.”3Without birds, “the most beautiful and loveable of God’s creation,”4 Most recently, COVID-19 has brought the latter into unprecedented light. The degradation of nature in the relentless pursuit of economic growth, we are constantly reminded in articles and op-eds, has become a serious risk to human health. This is particularly the case in Africa, where past outbreaks of Ebola and fears of future undiscovered zoonotic diseases haunt the pens of conservationists and epidemiologists alike.5 In this current ecological Roughly one hundred years ago, the bird protection movement spread across the world in response to a perceived global decline in avian fauna. The chief culprits of this crisis were often thought to be farmers, who destroyed wilderness for large agricultural estates, and defended these from bird depredations with poisoned grain and shotgun shells. Today, the earth faces two strikingly similar crises: the global collapse of insect populations and the spillover of zoonotic diseases from animal to human populations as forests and jungles are cleared for agriculture.altered environments in order to render them “healthy” through sanitation, vector eradication, and public health policies.6 The counterpart to this historiography, which addresses environmental preservation and health, has received less attention, and has typically been associated with the thinking of North Americans such as Aldo Leopold.7 Biologists in the interwar period, as Gregg Mitman has argued, sometimes looked to Hippocrates and his ideas about health being “a state of equilibrium between the organism and its total environment.”8 Proponents of this thought worried that environmental alteration would upset equilibrium, and produce ill health in humans, animals, and the land itself. These ideas became particularly important in the post–World War II West, as environmentalism gained momentum in the wake of Rachel Carson’s Silent Spring.9 In wildlife management, Harriet Ritvo has argued that by the second half of the twentieth century, the “standard unit of management” become the “ecosystem rather than the species.” This led to the protection of carnivora, who were previously considered to be “blots on the landscape.”10 Yet wildlife management by ecosystem was not the first time wildlife managers broadened the scope of conservation beyond the species: from the 1910s in South Africa, the idea of a “balance of nature” was, in many cases, a key unit of management. Although this concept was considerably different to the ecosystem, its devotees nevertheless posited that each creature played a role in maintaining, or disrupting, nature’s equilibrium, and decisions about wildlife management needed to be made in a holistic framework. Most histories of environment, wildlife, and health in colonial circumstances have demonstrated how Europeans 11 While this was sometimes the case, not all farmers and biologists were convinced that farms should or could be separated from “natural” environments. The possibility that living wild animals might have been integrated into public health strategies as a source of human health remains largely unexplored, due to the presence of a well-studied state veterinary department that, according to Jane Carruthers, Shirley Brooks, and Karen Brown, was antagonistic to wildlife protection. Medical and veterinary scientists, these scholars argue, were opposed to wildlife protection on the grounds that wild animals were reservoirs of disease. For them, wildlife destruction was a means of maintaining livestock health.12In 1910s–30s South Africa, concern about environmental alteration threatening human health was growing and influenced public health strategies. Such concerns have received little attention in southern African environmental and medical history, which has focused primarily on the separation of humans and wildlife. This, the argument goes, was achieved by creating game reserves and exterminating animals on rural frontiers.white South African milieu. In the 1920s and 1930s, in attempt to control “veld rodent” vectors of plague in the countryside, Mitchell, in collaboration with FitzSimons and zoologist Austin Roberts, attempted to agitate the Union government to criminalize the killing of “useful” rodent-devouring birds of prey, wildcats, and mongooses and to teach farmers on the ground that these carnivora were not their “enemies” but their “friends.” Although their views were not entirely aligned, FitzSimons, Roberts, and Mitchell suggested that in a country transformed by mechanized agriculture and urbanization, birds of prey and terrestrial carnivora played a critical role in maintaining the “balance of nature” and preventing environmental and medical catastrophes.Through examining the attempts of employees and affiliates of the Union of South Africa’s Department of Public Health to control bubonic-plague-carrying rodents in the veld, this paper examines an unstudied approach to wildlife management that rested on the opposite assumption. For the first Secretary of Public Health, James Alexander Mitchell, and a series of zoologists and “rodent inspectors” with whom he worked, wild animals were not simply reservoirs of disease. Rather, numerous carnivora provided public health services to humankind in consuming plague-carrying rodents, and insect carriers of other diseases. The protection of such wildlife was fundamentally a matter of human health. Such ideas were not Mitchell’s own but were derived primarily from the propaganda publicized Such ideas were divisive and prompted a series of debates in parliament, periodicals, and correspondence over the degree to which birds of prey and terrestrial carnivora brought balance to nature and prevented outbreaks of plague. How nature’s balance should be maintained, the role humans should play in keeping animal populations in balance, and which wild animals could be considered agents of public health provoked a wide array of responses from individuals of diverse linguistic, professional, and racial backgrounds. Although publicists of wildlife protection as a measure of public health appear to have been primarily white, English-speaking, and urban, their publications and lectures drew supporters and critics from rural Anglophones, Afrikaners, and Africans alike. Despite such patchy reception, wildlife protection as a public health strategy nevertheless shaped the South African environmentalist movement. By the 1930s, in numerous parts of the country, all owls, several hawks and eagles, as well as wildcats, once considered “vermin,” became legally protected sources of public health. As human and predator population health and wealth were imbricated, so too did the categorical boundaries between human and animal roles in the economies of nature and agriculture begin to blur. While predators of numerous species were retheorized as farm laborers and public health workers, Roberts and Mitchell attempted to transform farmers into rodent predators in an extensive rodent-destruction campaign.13 This paper seeks to bridge these by suggesting a new avenue of historical enquiry in African history: wildlife protection not only as an ethical imperative, a form of national heritage, a means to preserve “the hunt,” or a strategy to create biological laboratories, but also as a form of public health.14Ultimately, this paper suggests a need to bring the history of natural history, medical history, and environmental history into conversation when thinking about the origins of twentieth-century environmentalism. As Sellers 15 Since 1914, outbreaks of bubonic plague, one of the most dreaded diseases in history, had been appearing in isolated, disconnected, and seemingly random locations across the Orange Free State, Cape, and Transvaal provinces. Confoundingly, these were areas in which “ordinary domestic rodents” that had ravaged Cape Town, Port Elizabeth, and Durban in 1900–1901 were few or absent, and no evidence of infection in wild veld rodents—who Mitchell suspected might be harboring the disease—was visible either.16In early 1920, James Alexander Mitchell, the first secretary of the Department of Public Health (formed in 1919), was baffled by what he later described as a “complete mystery.”17 According to Mitchell, the conflict was responsible for the importation of plague into the country: it had greatly increased the demand for “Hay, forage, 18 In 1910, the four colonies  unified, forming the Union of South Africa. This was an uneasy union, characterized by divisions and resentment, and further complicated by the patchwork nature of the state: the former colonies became provinces and retained considerable controls over legislation, including wildlife protection laws.19 The unification of the “white races” accelerated the exclusion of African people. In 1913, the Natives Land Act was passed, allocating just 7 percent of the land to the African-majority population.20 Much of this land was antithetical to agriculture and settlement, leading African National Congress founding president John Dube to protest that African reservations in Zululand were “full of” with malarial “fever and nagana.”21The reappearance of bubonic plague far into the interior of the country formed the latest in a series of medical and environmental ailments with which the newly created Department of Public Health had to contend. Mitchell had taken up his post in a period when South Africa was reeling from the ecological consequences of a series of profound political changes in the late nineteenth and early twentieth centuries, which shaped his understanding of public health. In 1902, the Boer War ended with the British annexation of two independent Boer republics.22 By the end of the century, this “model of scientific agronomy spread northwards” toward the Transvaal and Orange Free State governments.23 Advocates of “progressive” agriculture—self-styled “progressives”—were primarily English, but also included some Afrikaners and colonial-educated Africans.24 “Progressive” farmers mobilized the sciences to optimize food production and combat livestock diseases, soil erosion, and pests.25 They scorned or ignored many existing farming methods practiced by Africans and settlers alike and in particular the long-established migratory farming practice that William Beinart refers to as transhumance.26 Transhumant farmers had 27 “Progressives” dismissed transhumance as environmentally damaging and a source of the spread of disease.28 Instead of migrating to avoid environmental problems, and kraaling animals at night, they insisted that these should be tackled in situ by creating large enclosed farms supported by mechanization and irrigation schemes, fodder crops, monocultures, and a declaration of war on insects, rodents, parasites, and vermin.29Accompanying such political changes came environmental changes. Since the mid-nineteenth century, state officials in the Cape of Good Hope had attempted to implement “progressive” or “rational” agricultural techniques to optimize food production.30 and their project of “modernizing” agriculture accelerated in the late nineteenth to mid-twentieth centuries. The enclosure of farms was legislated in the Cape in 1883, and with the rapid expansion of livestock farming between 1905 and 1930, agriculture became an increasingly important source of state revenue.31 In the 1910s and 1920s, “inefficient” farming practices were blamed for drought and soil erosion and deemed in need of modernization.32 State interventions were imposed in African reserves, which were “insensitive to rural social relationships and often highly disruptive.”33 The enclosure and mechanization of agriculture across much of the countryside likewise created a class of “poor whites,” who lacked the capital to compete with mechanized farms.34 In the 1920s and 1930s, these “poor whites” were a key concern in both Union politics and eugenic societies. Whites living on rural frontiers, many worried, were racially degenerating on account of their exposure to a taxing climate, 35Progressives had a “disproportionate influence over state policy in certain spheres”36 The increasing visibility of pests produced anxieties for the new state. Swarms of locusts appeared to intensify, tearing down vegetation as they feasted.37 Disease was rampant and often a direct result of industrialization or large-scale agriculture. In 1918, the influenza pandemic decimated the country, reducing the mining workforce, the backbone of the economy, to 62 percent capacity.38 In the 1910s and 1920s, nagana, a livestock disease that caused progressive emaciation and death in cattle, appeared to be spreading with intensity.39 Malaria remained a serious problem in the subtropical Natal province and parts of the Transvaal.40 But of all of these maladies facing Mitchell and the Department of Public Health, bubonic 41 was perhaps the most terrifying and required urgent attention.42 Two outbreaks of plague on farms called Grootdraai (in February 1920) and Angra Pequina (in March 1920) near Bothaville in the Orange Free State provided the first opportunity for the Public Health Department to investigate. Austin Roberts, a zoologist affiliated with the Transvaal Museum, was commissioned to perform a seemingly simple job: find and destroy the rodents responsible.43 Roberts was a higher vertebrate zoologist who is today considered to be the most influential South African ornithologist and whose field guide to birds is still in print.The process of “modernizing” agriculture brought new vigor to a long-standing conflict between settlers and “vermin.” Between the 1890s and 1930s, under the direction of veterinarians and zoologists, quarantine zones between farms and the wilderness were created across the colonies/provinces in which vegetation and wildlife was eliminated, and “vermin” found trespassing on enclosed farms was continuously killed.44 Subsequent investigations by rodent catcher William Powell and a team of doctors and laborers confirmed his speculation: hundreds of infected gerbilles and multimammate mice were discovered on the farm.45 The results of such investigations were disturbing: thousands of rodents lay hidden under the soil, harboring a terrifying infection, and even for a zoologist with knowledge of their habits, these could be detected only by “almost microscopic examination of the ground.”46Roberts arrived in Bothaville on April 30, 1920, and swiftly commenced his studies at Angra Pequina. During his nearly three months of fieldwork on the farm, he battled to complete his task. Excavating the soil in search of burrows was exhausting work, and trapping was almost futile—carnivores devoured caught rodents while he slept. All he could offer was circumstantial evidence that rodents in the area such as the springhaas, gerbille, and multimammate mouse were reservoirs of the disease.47Throughout the 1920s, Powell conducted a series of rodent surveys across the Union to determine the prevalence of plague, and areas vulnerable to the disease on account of their veld rodent populations. 48 his experience was largely useless in the veld. Urban-plague-control policies in South Africa largely gravitated around attempts to exclude rats from areas of human occupation through retrofitting houses to render them rat proof, razing entire buildings to the ground and burning their contents, forcibly removing Africans and Asians from their homes on suspicion that these harbored rats or fleas, inspecting and fumigating rat-occupied premises, and strategically laying out poisons and traps.49 Such spatial strategies of urban rodent exclusion, however, could not be utilized in the vast expanse of the veld: although one could rat proof a farmer’s house, a field of maize was another matter. Perhaps fortuitously for Mitchell, zoologist Frederick FitzSimons, the ringleader of a group of aggressive bird protection publicists of South Africa, had already provided a strategy for excluding rodents from settler farms: the labor of wild birds. Although Powell had identified and roughly charted the distribution of the reservoirs, the origins of the outbreaks and the factors driving the spread of plague remained obscure. Why had this disease reappeared approximately twenty years after its apparent eradication far into the interior of the country, and not at its coastal epicenters of Cape Town, Port Elizabeth (now Gqeberha), and Durban? And how could one ever hope to control a zoonotic disease harbored by minute, superabundant rodents and their fleas across hundreds of kilometers of barren veld? Even though Mitchell was a veteran of plague control who had been involved in containing the 1900–1901 outbreak in Cape Town,Farmer’s Weekly. An Irish-born zoologist whose family settled in South Africa in 1877, FitzSimons is largely remembered for his antidote kit for South African snake venom and his endeavors to popularize natural history.50 His Port Elizabeth Museum was visited by approximately 100,000 to 150,000 people per year and was a lively center of natural history in the Cape Province.51 Seeking to attract audiences of white and “coloured”52 people from across the region, FitzSimons and his wife Henrietta FitzSimons regularly hosted evening lectures, invited schoolchildren to the museum, and conducted lecture tours across the Cape Province.53 FitzSimons was involved with municipal public health in Port Elizabeth and in the 1910s used his position to conduct a propaganda campaign against the housefly, which he saw as a vector of typhoid, influenza, and other infections.54 In the 1910s and 1920s, he also wrote a regular column on South African natural history in Farmer’s Weekly: an agricultural newspaper that was primarily directed at an English-speaking audience of “progressive farmers,” but nevertheless had both Afrikaans and African readers.55 These articles formed the nucleus of his four volumes on The Natural History of South Africa:Mammals (1919–20) and two volumes on The Natural History of South Africa: Birds (1923). In these articles, and in his museum, he hoped to nurture a love of nature among farmers and propagate the need to protect species threatened with extinction.56By the 1920s, FitzSimons was a household name in his local city of Port Elizabeth and among readers of the farming periodical Farmer’s Weekly, a series of monographs, lectures delivered across the country, and exhibited material in the Port Elizabeth Museum—FitzSimons prophesized a looming environmental apocalypse. Decades of persecution of South African wild birds, under an erroneous belief that they were pests, or simply sheer bloodlust, he argued, had upset the “balance of nature” and wrought environmental and medical chaos. Once in healthy equilibrium, balance had been tipped, resulting in biblical plagues of locusts, rodents, flies, as well as livestock and human diseases.57 In direct opposition to many veterinarians, FitzSimons argued that wildlife protection was not antithetical to the agrarian economy; rather, wildlife destruction was. Insects and rodents, in his opinion, were the chief cause of all South Africa’s medical and agricultural woes and “enemies” of humankind. Armies of locusts, rats, mosquitos, and caterpillars were locked in perpetual warfare with “man” and sought to drive “him” from “the face of the earth.”58 With fewer predators and an increased supply of food in the form of vast maize and mealie monocultures, this panoply of pests were breeding prolifically, devouring crops, and broadcasting plague, trypanosomiasis, malaria, bilharzia, and other diseases far and wide. Fortunately for humankind, these “enemies” were kept in check by powerful allies of humankind: wild birds.59In his written and oratory work of the 1920s—articles published in daily newspapers and 60 According to FitzSimons, far from being thanked by farmers for services rendered in pest control and public health, wild birds were instead slaughtered in enormous numbers.Seeking to appeal directly to capitalist farmers, FitzSimons framed this argument in terms of goods and services. Drawing upon the writings of British gentleman James Buckland, he argued that birds should be, quite 61 To exclude insect and rodent pests from their lands, they would need to accommodate birds. To do this, they could integrate bird labor into farming strategies by planting forests, creating reservoirs, and providing nesting boxes. If farmers experienced bird depredations, they could use nonviolent methods to scare them, such as rattles, scarecrows, and laborers patrolling orchards with dogs.62 FitzSimons presented these methods as a scientific approach that applied natural history to agriculture and offered an alternative to vernacular pest control. However, many of these techniques had already been in use by indigenous African peoples. For example, in the Transvaal, the Balobedu utilized various nonviolent (or less violent) technologies for scaring crop-eating birds.63 One, according to anthropologist Eileen Krige, involved killing a hawk or an owl, and putting it on a tree to act as a scarecrow.64 Another involved “tying string to sticks planted all over the field to which 65 Both strategies were presented by FitzSimons as his own in 1922.66Such actions were dangerous not only to the farming community but to citizens of the entire country. Instead of trying to exterminate birds and sever themselves from nature, FitzSimons thought a much safer strategy was for farmers to ally themselves with wild birds by engaging in bird “preservation and protection.”67 he argued that bird destruction was also hindering the racial “progress” of the country. Through exercising violent brain “lobes” shared with our simian ancestors, “bird slaying”68 farmers were allegedly “lower than an animal” and rapidly degenerating toward what he regarded as the lesser status of Africans.69 Playing into the ever-present discourse of “Black Peril” he dismissed Africans as cruel peoples who destroyed “immense numbers of birds,” to the benefit of vermin, and detriment of whites  expressed his support and erected a display in his museum detailing the economic utility of carnivora in controlling rodents.79 Although FitzSimons had argued that Africans were insufficiently “mentally evolved to be amenable to reason and persuasion in this matter,”80 other bird protectionists extended his initiative toward Africans farming in reserves. For example, in March 1922, lectures on “native agriculture” were offered at the South African Native College, likely by missionary Bernard Huss, in which birds were declared “our faithful friends.”81 In his courses delivered at “Marianhill Native Training College,”82 Huss likewise sought to teach African students that the bird was “a great friend of man.”83 Huss also publicized a series of articles in the quadrilingual English, isiXhosa, isiZulu, and Sesotho periodical Umteteli wa Bantu, a newspaper that had an extensive circulation in the reserves.84 Titled “Principles and Methods of Agriculture,” this series emphasized the need for farmers to preserve the “balance of nature.”85On the other end of the scale, numerous farmers praised his methods and experimented with protecting and fostering birds on their farms. Some reported great successes in reducing the prevalence of insects in their fields or rodents in their barns, and, perhaps wishing to distinguish themselves from FitzSimons’s depiction of the degenerating bird slayer, some attacked his detractors as selfish and antiscientific.86 Despite his critique of FitzSimons, in a 1922 letter to Mitchell, Roberts conceded that the plague problem was a result of “the disturbance of nature caused by the extermination of indigenous carnivora.”87 Mitchell agreed wholeheartedly, and in 1924 wrote to the Cape Provincial Secretary stating that “the whole question of the protection of bird life” should be “reviewed” in light of the “plague, locusts and other insect” problems.88 As evidence, he cited FitzSimons, Shortridge, and a letter he received from a farmer based in Westminster, Orange Free State, who claimed that his “trees and love of birds” were acting as a powerful defense against plague, since “all the chief plague areas are those where there is the least natural cover for birds of prey.”89Despite the controversy it aroused, FitzSimons’s narrative of ecological decline producing outbreaks of deadly diseases was timely and provided 90 This was a result of the “development of maize farming, the clearing of bush and cover, and the destruction of jackals, wild cats, mole-snakes, owls, and other natural enemies of rodents…”91 In his conception, plague within the veld was a symptom of a greater environmental illness and restoring balance to nature would bring the disease under control. For plague-carrying rodents to be excluded from spaces of settler agriculture, their predators had to be included on farms. In formulating a rural plague control strategy, Mitchell incorporated the “natural enemies” of rodents into his strategy as human allies. Not only hawks and owls, but also wildcats, and semiferal domestic cats, were deemed to be friends of the farmer, to be invited into settler spaces, and explicitly protected and 92 Once regarded as pests, Mitchell sought to transform these animals into agents of public health.In early 1925, Mitchell began intensely to push the cause of protecting rodent-devouring predators. In a circular to all local authorities of the Union of South Africa, he wrote that plague had been able to colonize most rural areas because “the balance of nature . . . has been seriously upset.”93 Repopulating the veld with carnivora would take time, and farmers needed to compensate for their destructive actions by assuming the functions that rodent predators once had in maintaining a healthy balance of nature. Once again, African methods of pest control seemed to provide a model for white rural health. From circulars sent to magistrates across the country, Mitchell learned that some African areas, in contrast to white agricultural areas, were free of plague. The Magistrate of Tabankulu, for example, argued that in his “entirely Native district,” “Like every other wild animal with four legs, the rat lives a precarious existence. . . . The little herd boys are out all day with dogs, always on the watch for rats which they kill and devour. The rats are kept well down by their natural enemies such as cats, hawks, owls, etc., of which there are a considerable number.”94 Here, Africans were depicted as “natural enemies” of rats with prolific rodent hunting skills, who had also managed to preserve cats, hawks, and owls. White settlers, by contrast, supposedly lacked the natural knowledge of rodents needed to seek and destroy them, and viewed their predators as “vermin.”95 To account for this alleged ignorance, Mitchell and Roberts initiated an “experiment in propaganda” in 1925–28.96 This comprised a series of English and Afrikaans lectures delivered by Roberts and FitzSimons in “Plague areas” in the Transvaal, Free State, and Cape; the distribution of pamphlets on the natural history of veld rodents; and the exhibition of English, Afrikaans, isiXhosa, isiZulu, and Sesotho propaganda posters juxtaposing images of death with gerbilles, multimam-mate mice, and springhaases.97 Roberts and FitzSimons were tasked with explaining to farmers that their own destructive impulses were to blame for plague, impressing upon them the need to foster the “natural enemies” 98 Both zoologists explicitly told their audiences that they were to blame for the problem. For Roberts, farmers had created an overabun-dance of rodent food and shot out large “and often useful” animals while neglecting their duties in controlling rodents.99 While Roberts aimed to promote cohesion among white farmers through attempting to appeal to a shared sense of guilt, FitzSimons sought to pit farmers against one another. Here, he continued to rely on a stereotype of bird slayers as “ignorant, brutal, thoughtless or superstitious” in contrast to the enlightened farmer who protected birds on his lands.100Humans, likewise, were integrated into Mitchell’s epidemiological strategy.101 In one, titled Rodents: Description, Habits, and Methods of Destruction, Powell argued that “jackals, all kinds of wild cats, owls, hawks, and mole snakes” had been “indiscriminately killed off” for years. This combined with the clearing of “bush and cover” in which such animals resided had “upset” the balance of nature.102 In addressing this, Powell argued that with exception of the despised jackal, these animals should be “protected and encouraged” on farms as far as possible.103 Unlike FitzSimons, Powell was in favor of a multispecies solution that combined poison, traps, rat proofing, fumigation, domestic cats, and wild birds to control rodents.104 Powell’s writings suggest that while birds and small carnivora would ordinarily maintain nature’s balance, the extraordinary situation produced by the modernization of agriculture meant that humans had to take on animal roles in the balance of nature and perform the functions owls, hawks, wildcats, and jackals once had. FitzSimons and Roberts’s lectures were complemented with a series of English and Afrikaans pamphlets on the natural history of veld rodents and methods of killing them, produced by William Powell. Such pamphlets were distributed to government rodent officers, who were tasked with identifying rodents, training farmers in rodent destruction, and distributing information on rodents to the public.105 Newspapers across the regions similarly suggest mixed success. The Albert Times, a paper based in Burghersdorp, a rural town within the plague-infected area, enthusiastically declared the lecture tours a great success.106 On the other end of the scale, The Friend, a Bloemfontein-based newspaper, declared that the Bloemfontein Town Hall  had been met with a “disgracefully poor audience” of mainly the converted—nurses and bureaucrats.107 The plague problem was covered extensively in Umteteli wa Bantu. On November 29, 1924, one reporter urged “Natives” to “join up” in the “war on rodents.” Among improving sanitation, keeping cats and dogs, and poisoning rats, the author advised that Africans “refrain from destroying birds and animals which prey on rodents” as doing so would “destroy” the “balance of nature.”108 Approximately a decade later, the same newspaper continued to publicize this advice: “preserve and foster natural enemies of rodents, such as wild cats, polecats, owls, hawks, and mole-snakes.”109 However, the extent to which this periodical was read by a Black agricultural audience remains largely unknown.110 This said, the case of renowned Zulu agriculturalist Robert Mazibuko does suggest that some African farmers were convinced by the campaign, or had already been attempting to preserve the balance of nature. Mazibuko, who studied agriculture under Bernard Huss in 1928, favored a holistic approach to farming that emphasized that “in nature everything is linked up or interconnected.” However, such ideas were not simply imparted upon him by Huss, but also learned “from our ancestors.” In an interview conducted in 1994, Mazibuko stated, “In African culture, the people always respected the land, the trees, the plants, the animals, birds and insects. For example, there sic] was allowed to kill—like owls, nkombose, ngete, eagles, vultures, storks and tickbirds. These birds were too useful to kill. You could not kill a secretary-bird either. It was important because it killed snakes.”111 Thus, it is possible that many of the same birds FitzSimons, Mitchell, Roberts, Huss, and others were imploring farmers to protect had already been under the ward of Mazibuko’s forefathers.From the traces that remain of farmers’ perspectives on wildlife protection as a form of public health, there is little evidence to suggest that the propaganda campaign was a success. In certain towns, Roberts noted that some farmers had already been converted to the cause of bird protection, and were fostering rat-devouring wild owls on their properties by providing nesting boxes. Others seemed completely uninterested in or apathetic to the idea.Farmer’s Weekly or its Afrikaans equivalent Landbou Weekblad, wildlife protection as a means of plague and rodent control received almost no attention. From a review of every issue of these two periodicals over the years 1925 to 1930, in thousands of articles, a mere forty-two were concerned with rats, and only eleven on plague.112 Of these, only three came from farmers. All others were produced by those involved in the experiment in propaganda.113In contrast to general newspapers, in farming periodicals produced primarily for white audiences such as 114 In 1923, Malmesbury Divisional Council likewise criminalized the killing of forty-eight species of birds, including owls and eagles.115 A year later, the Cape Province placed numerous birds of prey under provincial protection, including virtually all species of owl, two species of kestrel, and the Horsbrug’s Falcon.116 In the same year, King 117Ultimately, this mixed reception among various readers, writers, and lecture attendees did not prevent bird protectionists from making significant gains in national, provincial, and divisional legislature and regulations across the Union. Since 1922, various provincial and divisional councils had been passing ordinances and bylaws preventing the killing of birds. To name a few examples, in 1922, the Transvaal Province added insect and rodent-eating bustards, formerly on the Game List (which could be shot with license), to its list of “General Utility birds,” which were “entirely protected.”118 At its second reading on March 6, 1925, Close made it clear that the protection of birds was not only a matter of national pride, patriotism, and scientific importance, but one of public health. There “are many birds that have been shot out of this country,” Close argued, “birds whose natural food is the rodent of the country, and it is the rodents, as we know, that spread the plague.”119 The bill, he argued, was urgent and supported by “Prof. FitzSimons of Port Elizabeth” among others.120The return of bubonic plague, a disease associated with filth and primitivity that appeared to threaten the entire Union drew attention to the need for broadly applied legislature. In 1925, the first attempt to pass Union-wide laws for the protection of birds was made. In February, R. W. Close, an MP for Rondebosch, introduced the “Birds Export Prohibition Act,” which would criminalize the exportation of any bird outside of South Africa unless permission was obtained from the Minister of Agriculture.121 The “predatory wild birds known as raptores [sic]—to which belong the owls and hawks—,” he argued, “are great destroyers of rats and mice, but they have no protection under the law.”122 Acknowledging that these birds enjoyed partial protection across the Cape, he demanded that this be extended to the Transvaal and other provinces, and rigidly enforced, as this “balance of nature against rodents” was not something to be “interfered with.”123At this reading, the plague problem would already have been fresh on the attending politicians’ minds, having been discussed at length the previous day. In this discussion, H. B. Papenfus, a representative for Hospital, had argued that bird protection offered a remedy for plague. In a series of questions to D. F. Malan, the Minister of Public Health, Papenfus suggested that the Department of Public Health needed to impose “rigid protection” on birds of prey.124 Jan Kemp, the Minister of Agriculture, likewise offered his blessing to the bill, claiming that he had “already asked” various provincial administrations to stop “the reckless killing of birds” on the grounds that “we kill far too many birds and do not appreciate sufficiently their value and the good services they render in connection with the combating of diseases and otherwise.”125 Close’s bill subsequently passed without modification and came into force on May 2, 1925. By June 1925, wildlife protection as a strategy of public health gained further legitimacy. Likely a direct result of this discussion in parliament, along with FitzSimons, Roberts, and Mitchell’s concurrent propaganda campaign, “ordinances for the protection of natural enemies of rodents, especially birds of the owl and hawk families and wild cats” had been passed in all four provinces.126Close’s bill was uncontroversial and achieved almost uniform support from all constituencies. Even Dr. A. J. Stals, the member for Hopetown, claimed that as “a representative of farmers I want to give it my full of any kind across the Union.127 The plague problem was Close’s primary justification for this bill. At its second reading on January 29, Close argued that bird protection was a matter of concern to every citizen of South Africa due to the fact that veld rodents were “spreading in the most extraordinary fashion the dire disease of plague.”128 In a speech that could easily have been taken from one of FitzSimons’s publications, Close stated that “one of the best means of exterminating these potential pests of the veld”—through the protection of wild birds—was “given to us by nature.”129 However, it had to be enforced evenly across the Union, since if a farmer in “some locality” delighted in “shooting off the eagles, hawks, owls, and other wild birds,” this might “create danger in other localities, which will come back to them, their households and friends, in the shape of disease-carrying rodents.”130 Criminalizing bird destruction, he argued, would “do more to keep the danger of plague at bay than any amount of money spent by Government to reduce the means of conveying the plague when too late.”131Perhaps emboldened by the success of bird protection as a public health policy, a year later Close attempted to pass stronger legislation. On January 26, 1926, he read an extraordinary bill that would criminalize bird destruction 132 H. Oost, the member for Pretoria North, agreed and claimed that the “large majority of wild birds in our country are a pest that ought to be exterminated,”133 and that legislation for useful birds already existed in the Transvaal and Free State since 1841, Natal since 1896, and the Cape since 1899.134This bill, however, unlike its predecessor, provoked bile and vitriol in its debate, exposing a diversity of views on what the “balance of nature” was, and how best it should be maintained. Close was attacked by politicians representing agricultural communities who insisted that birds were, with few exceptions, pests. I. P. van Heerden, the member for Graaff-Reinet, argued that Close, a Rondebosch man, had no place to be lecturing farming communities on this matter.135 Owls, on the other hand, were singularly useful in rodent control and in need of protection.136 For R. B. Waterston of Brakpan, protecting birds might simply deepen the looming environmental catastrophe: if protected in order to “drive out one pest” (rodents or insects), birds of prey might become worse pests than “the one driven out, as they have found in Australia with the sparrows…”137 Major G. R. Richards of Weenen, similarly, posed a eugenic argument against the bill. Although he agreed that “if you destroy birds you interfere with the balance of nature,” there were also “a number of birds which, if they are overprotected cease to be fertile and gradually die out.”138 Citing evidence from his own experience of farming, he noted that protecting partridges on one of his farms had actually caused their population to decline, unlike on his neighbor’s farm, where the birds were offered no protection. This, his response suggested, was 139Other politicians were skeptical about a blanket ban and worried that this could actually exacerbate environmental and medical problems. For these men, human intervention in limiting and controlling animal populations was essential in the balance of nature, and humans had to keep raptor populations down or risk producing a plague worse than diseased rodents. P. W. van Niekerk of Waterberg, for example, argued that protecting hawks would be to the detriment of small birds, since for “every hawk that a farmer shoots” he will save “possibly, a thousand little birds.”140 Jan Kemp did not offer his blessing to the bill, unlike Close’s previous bill. In his view, the Union needed education rather than coercion. Children needed to learn “what birds are beneficial to the country,” and to love and protect these birds.141 Moreover, the bill was unnecessary: provincial administrations were empowered to pass bird protection laws and had already protected rodent and insect-killing birds in their localities. Kemp did not wish to appropriate their devolved powers.142Others criticized and ridiculed the bill on the grounds that it would turn nearly every child in the country into a criminal  or would criminalize Christmas since the “turkey was once a wild bird.”Natural History of South Africa and claiming that “there is in nature a balance, and we have to do our best to maintain that as far as we can” and that it would be a “very important step made to help, and, as far as possible maintain the balance of nature where we have had to do such things as the destruction of the jackal.”143 Sidestepping criticism, he argued that on grounds of the “sanitation, public health and interests of the community,” his bill needed to pass without modification.144Close attempted to defend his bill by reading extensive passages from FitzSimons’s 145 According to this conception of the balance of nature, the devolved powers of the provinces and divisional councils were actually critical in the quest of preventing plague and bringing balance. Local authorities knew their areas best and were already protecting those birds they deemed critical in controlling diseased rodents and insects. Further legislation was oppressive and unnecessary. As such, the bill failed to pass parliament, receiving thirty-five votes in favor, including from Deneys Reitz, the former Minister of Lands, and Jan Smuts, leader of the opposition. Fifty-eight voted against it, including D. F. Malan, the Minister of Public Health.146Close’s second bill hinged on the argument propagated by FitzSimons and his supporters that nature was fundamentally hospitable to white farmers, that virtually all birds maintained ecological stability, and that if the persecution of these animals stopped, they would bring balance to nature and plague would cease to be a problem. A blanket ban on killing these agricultural laborers and public health workers was therefore justified. Yet the parliamentary debate revealed that even though nobody was questioning the idea of a balance of nature, nor that certain bird species could serve as sources of free public health or agricultural labor, humans had to intervene in animal population dynamics to return balance to nature. For Close’s critics, the economies of nature and of agriculture were imbricated. While birds played a role in protecting human health and wealth, so too did humans need to safeguard the health and wealth 147 Mitchell was delighted with this and expressed his support for bird protection as a measure of public health and his sorrow that “Mr Close’s Bill for the protection of birds has been thrown out by the House of Assembly.”148 By 1931, he succeeded in persuading the Port Elizabeth, and Walmer municipalities to declare themselves bird sanctuaries in which “all wild birds are protected under the law.”149 This seemed a national trend, particularly in towns and cities, and in a survey of local laws conducted in 1933, Roberts found that “the policy of protection birds in the urban areas is favoured in the great 150 In a rapidly modernizing and politically changing country, a disease thought to be medieval had struck,151 and modernity itself seemed to be the root the problem. The unprecedented ability of humans to transform nature was rendering the veld a diseased landscape. In a decade of plague, as well as “Depression, drought and locust destruction,”152 an upset balance of nature seemed tangible, and restoring it became a means of promoting human health. In 1931, the Rand Daily Mail wrote that from “the economic point of view and from that of public health, the senseless and useless slaughter of most species of birds may be considered calamitous.”153Despite the failure of this bill, FitzSimons, Powell, and Mitchell continued to publicize propaganda, and further measures were taken to protect birdlife in numerous areas. The fact that local authorities were empowered to protect birds in their areas actually worked in their favor: by appealing directly to administrators and bureaucrats, they could circumvent parliament. In February, 1926, FitzSimons jubilantly announced that he had succeeded in prompting the Somerset East authorities to prohibit bird destruction in their area.154 More problematically, the existing legislation did not actually forbid farmers from capturing protected birds on their farms and selling them. The result of this loophole was that thousands of birds were being caught with bird lime and traded on the market. Deneys Reitz, now Minister of Agriculture, thought that this “cruel” trade, peddled primarily by children trapping indiscriminately in the Transvaal Bushveld, constituted the “main evil” driving bird decline in South Africa, and introduced a “Wild Birds Protection Bill” into parliament in 1934 to criminalize it.155 Several politicians representing agricultural areas were opposed to the bill on the grounds that farmers relied upon trapping and selling or removing birds from their lands to protect their crops and livestock. They argued that wild birds also constituted a “plague.”156 On the other end of the scale, bird protectionists argued it did not go far enough, and insisted that to protect the balance of nature, any kind needed to be prohibited as well.157 Some politicians, like FitzSimons, attempted to blame indigenous Africans for the problem, accusing them of roasting “thousands” of useful birds and eating them, and asserting the need for such legislature to be applied in Native Reserves.158 Despite criticism from both sides, Reitz’s bill passed parliament with few amendments, and came into force on April 13, 1934.159The evidence, however, suggests that bird protection laws were met with limited success. Both Close and Papenfus continuously pushed Kemp and Malan on matters of plague and bird protection and were horrified to learn that as of March 1927, permissions had been granted for as many as 20,781 birds to be exported, and not a single prosecution had been made under the Birds Export Prohibition Act.160 Humans living in rural environments needed to find ways of coexisting with birds and carnivora to prevent the resurgence of the Black Death, and the collapse of nature’s harmonious balance.Whether it was possible to enforce any of this legislation far into the rural interior of the country where plague continued to smolder is another matter. Nevertheless, the protection of carnivora in response to plague in the veld marks what is probably the first time a government public health institution officially framed wildlife protection as a strategy of disease control and a matter of human health. The terrifying prospect of bubonic plague creeping across the veld in bodies of gerbilles, multimammate mice, springhaases, and other rodents catalyzed a new understanding of public health in South Africa. The health of humankind needed to be viewed within a holistic network of human and animal population health, which could not easily be disentangled.161 Nevertheless, as late as 1941, officials in the public health department continued to advocate for the protection of birds of prey as a strategy of plague control and of obtaining free agricultural labor.162 To an extent such work continues to this day, as can be seen in the Ditsong National Museum of Natural History (As FitzSimons, Roberts, Mitchell, Close, and others proposed that wildlife protection was a means of preventing bubonic plague, they were partly articulating animal-protectionist views, and partly challenging a powerful state veterinary department that had argued the opposite. Their ideas shaped Mitchell’s policies, but less so his successors E. N. Thornton and E. H. Cluver. Thornton gradually turned away from Mitchell’s belief in an upset “balance of nature,” and in 1938, Cluver mobilized Charles  History .163 This article suggests that concerns about health may have played a role in the South African conservation movement and proposes a new line of enquiry in the history of interwar African wildlife protection. As this case demonstrates, wildlife protection was not only a matter of preventing extinctions, capitalizing on “waste lands,” and creating zoological laboratories, but in some cases was key to the maintenance of the health of nature, and the associated health of humanity. African wildlife protection in the 1920s and 1930s was also a public health strategy.Between 1920 and 1938, five national parks were created in South Africa, and public opinion toward protecting wildlife continued to grow.The imbrication of animal and human population health in this case study demonstrates that the relationship between wildlife and white farmers in the 1920s and 1930s was not always one of separation, enclosure, and extermination. As conventional understandings of pests were challenged by FitzSimons, Mitchell, Close, and others, bird protectionists blurred the boundaries between human and animal, natural and cultural. For these scientists, in charting the balance of nature, whether in periodicals and propaganda or in the field itself, birds became agricultural laborers and public health workers. At times, humans took on former animal roles in the balance of nature. Species across the human-animal divide needed to build their worlds in synchronicity to preserve the health of the population of South Africa. Reflecting upon environmentalist thought in the 1920s and 1930s seems important in our current ecological moment. In advocating for the protection of birdlife, FitzSimons, Mitchell, Close, and others framed nature itself as fundamentally hospitable to white South Africa, but under assault by the same social forces that were seen to threaten the fabric of white minority rule: alleged white degeneration and the agency of indigenous Africans. In this way, there was a tacit acceptance that nature itself was providing services to sustain white health and agriculture, and that birds played a key role in delivering these services. Wildlife was framed in simplistic, anthropocentric terms as worthy of protection on account of the services it provided to whites, and those seeking to interfere with such services were criminals in need of fine or imprisonment. As such, the articulation of wildlife protection as a policy of public health relied on vilifying human underclasses and despised animals and blaming them for environmental and medical problems. 164 Selective outrage directs blame toward those against whom many already harbor prejudices, while protecting their own and the interests of wealthy factory farmers driving habitat destruction and risking outbreaks of further zoonotic diseases.165 Simultaneously, the demonization of insects, so fundamental to FitzSimons’s project may have contributed to the global collapse in insect populations. Ecologists are now acutely aware that many insects, thought to be largely harmful in the early to mid-twentieth century, “provide critical services within ecosystems” and their declining population might result in “a catastrophic collapse of nature’s ecosystems.”166 As we approach myriad contemporary medical and ecological crises, it is urgent that we resist measures that FitzSimons might approve of: simplistic propaganda campaigns demonizing particular species and peoples. Histories of environment, health, and politics can help us avoid these pitfalls. This formula of framing wildlife protection as a service to the economy continues to inform certain sections of the African conservation movement to this day, whether through the discipline of ecosystem services identifying and calculating services rendered, or the creation of vast tourist spectacles of African fauna in game reserves. Many impoverished Africans continue to be demonized as “poachers,” and subsistence hunters trading bushmeat are sometimes blamed for outbreaks of zoonotic diseases.