Below, a guest post by Priscilla Wald, the author of the book Contagious (Duke University Press, 2008), a history of how the narratives of epidemics and global pandemics obscure the real cause of such health problems. This essay originally appeared as an op-ed in the Herald Sun (www.HeraldSun.com.)
Panic sells newspapers. It keeps our televisions on. It is exhilarating in its way. Even addictive. And it has consequences. People, places and behaviors are stigmatized. Panic affects economies. Travelers cancel trips to Mexico, California and New York. Movies, concerts and sports events are postponed.
In the midst of a threat of pandemic, the media do not remind us of the national health insurance crisis or of the lack of access to health care that is truly a global disaster. Mid-crisis, the problem of global poverty seems too large to address or even comprehend. We have more immediate concerns.
Yet, the threat of a pandemic is precisely the moment for such reminders — that access to health care should not be a luxury, but a basic human right and a priority, at home and abroad.
As I have found in my research for a book about how the mainstream media tell the stories of communicable disease outbreaks, pandemics are fueled by poverty more than any other factor. That's not to say that quarantine and vaccine are not very important in responding to a pandemic, but we should not lose focus on the fact that nothing will go further to contain the spread of disease than a healthy population with access to health care.
The outbreak story is a familiar one, seen in fiction, film and the news.
It goes like this: a new microbe surfaces, and people begin to get sick.
The illness is mysterious and doesn't respond to treatment. Some people die. Then the illness begins to spread. Quickly. Microbes know no boundaries. The world is shrinking. No one is more than a plane ride away from "Ground Zero" of the pandemic.
Then, medical experts race to identify the microbe. They prescribe treatments. They work to make a vaccine. They advise hand washing and avoidance of crowds. Images of people in surgical masks mark the danger.
Those are the actions that we can take as we wait for the experts, the quarantines, the vaccines and Tamiflu to solve the problem.
In the telling of the outbreak story, the media present the pandemic as solely a medical problem. But it is a social problem as well. Poverty and inadequate health care are the most effective vectors for the spread of disease. Malnourished people are more likely to get sick; overcrowded living quarters are a microbe's haven.
The eradication of extreme poverty and hunger is the first of the U.N. Millennium Development Goals. The World Bank estimates the number of people in developing countries living in extreme poverty in 2005 to be 1.4 billion. The United Nations believes the goal of cutting in half the number of people living on less than one dollar per day is reachable by 2015.
Current World Bank estimates put the cost of a worst-case pandemic as high as $3 trillion. More staggering are the estimated costs in human lives, which would exceed 70 million deaths during the course of the pandemic.
Those lives are, of course, not measurable in economic terms, but there is little doubt that a devastating economic crisis would follow any worst-case scenario.
To be fair to the media, some journalists work hard to inform the public without fueling panic. Their reports on the pandemic mention poverty and lack of access to health care as factors that explain why the illness is worse in some places than others. However, these are almost never flagged as the factors that explain the pandemic itself.
The problems of poverty and inadequate health care are overwhelming.
There's nothing we can do. So we wait for the experts. And we wash our hands.
I am grateful for the experts. And I wash my hands. But I also marvel at the lack of discussion of health-care spending, especially when facing the threat of a pandemic.
There is no better time than a moment of heightened awareness and fear to be mindful of the social causes and consequences of pandemics, and of the responsibility that belongs to all of us to work to address them. As human beings, we cannot afford to wait for the experts. The media has a responsibility to remind us of that fact.
In an introduction to Wald’s essay, Cathy Davidson writes: "Priscilla Wald's work reminds us that the reason the humanities are so important is that they encourage us to take a take a giant step back from present crises in order to see them in larger cultural perspectives . . . so that we can see not the muddled, murky outline of present overreaction but understand a pattern of such overreaction as it recurs, and then recurs again, with the individual cases different (Typhoid Mary, HIV, SARS, Avian Flu, etc.), . . . The persistent problem is the unequal distribution of wealth and the unequal distribution of health (not just health care but good health) that is the real epidemic. The recurrence of the "outbreak narrative," in Wald's terms, is the intermittent tug of the impoverished at the hem of the privileged. But, as she so eloquently concludes in her thoughtful and provocative book, the real problem of "contagion" is not that we might get sick but that poverty is a sickness that, most of the time, middle-class first world peoples are not only immune to but also inoculated against.”
The fact that the flu is taking so many lives in Mexico confirms Wald’s thesis. Poor living conditions, malnutrition, and the stress associated with poverty make poor Mexicans more vulnerable than middle-class Americans. At the moment, at least, our stronger immune systems are protecting us. Though if the flu spreads into our poorest neighborhoods, we could expect that it would claim many more victims. And what do we do then, build walls around our ghettos?
The Ecologist reminds us that the living conditions that U.S. companies have helped create for Mexico’s swine also goes a long way toward explaining the origins of the disease: “The Ecologist’s position on the current swine flu outbreak is much as it was when the first reports of avian influenza surfaced in 2006 . Until government and public health officials look at the entire picture of the aetiology of the disease they will not be able to contain this outbreak, or prevent similar, future outbreaks.
“It is disappointing that, so far, very little of the press coverage has focused on the role of factory farming in the genesis of this virus. Animals kept in industrial conditions, crowded into small pens next to each other, fed unnatural diets, and kept ‘healthy’ with a regime of veterinary drugs, will have greatly weakened immune systems and will effectively act as living Petri dishes in which this virus and others may combine and recombine to become unique strains that, in theory, can also be uniquely virulent.”
CBS News correspondent Hari Sreenivasan, also points to the massive industrial hog farms that have sprung up in Mexico
The farms’ owners deny being the source and say they're cooperating with health officials. But Sreenivassn notes that just last year the nonprofit Pew Charitable Trusts warned that hog farms could become breeding grounds for new strains of the flu.
"The warm conditions and the close proximity of animals being able to pass viruses back and forth and to the human workers," said Bob Martin of the Pew Environmental Group. "It's a situation ripe for the development of a novel virus."