Weekends are usually quiet in Flublogia. Viruses and bacteria don't knock off work, but many of those who report them do. (We retirees know that work ends only when life does.) So instead of blogging news of fresh disasters, some thoughts on what we might learn from the old ones.
Late Thursday night I got the email from Sonny Krishnan about the sixth Cambodian H5N1 case (and fifth death) of the new year. When I woke up Friday morning, nine Nigerian polio-vaccination workers were dead. In the course of that day I also posted about the return of B2B H5N1 to Tay Ninh in Vietnam and an 18-year high in measles cases in the UK.
I saw a pattern in these reports, and I've been thinking about it while doing chores around the house and walking the dog. If you see an error in my thinking, please let me know.
Cambodians have been dying (in small numbers) of H5N1 since 2005. Even more Vietnamese have died of it since 2003. Vaccination has saved millions of children from what I experienced in the fall of 1948, aged 7, when I caught polio. Measles is another disease routinely dealt with by vaccination, like pertussis, mumps, and rubella. So why the hell are people still catching and dying from these diseases?
That is, how have so many human beings grown to adulthood in the 20th and 21st century while remaining ignorant about such diseases and the means of preventing them?
Vietnam has been losing people to H5N1 for a decade. Never mind the idyllic images of remote villages that time forgot; even the most backward duck farmer in the Mekong Delta isn't far from a mobile phone, and his political masters are online like the rest of us. Cambodia is online too. The United Kingdom is not part of the Third World—after all, Jenner gave us vaccination—but it's still dealing with serious levels of measles.
I could go on: The US and Canadian nurses who won't get a flu shot, the now-endless stream of Haitian cholera patients, the adolescent morons smoking outside every high school in North America.
If cholera could reach the remotest village in Haiti long before any NGO could, why doesn't the message move just as fast?
That question has been bugging me for years, while I post news stories endlessly explaining what cholera is and how to cook chicken thoroughly. So Cambodian parents are still unaware that letting the kids play in chickenshit is not good? And American parents think routine vaccinations will make their kids autistic? What is going on here?
The only conclusion I can draw is that a vast gap exists between the rulers and the ruled, and not just in the Third World. We in Flublogia are not the rulers but their servants, and therefore aware of mysteries like the germ theory of disease. The ruled may live in Javanese villages or Colorado suburbs, but on their calendars it is now and always 1513. To them, the rulers and their rules are just another annoyance, like mosquitos.
The Nigerian gunmen on their motorcycles were doing in their 16th-century way what their victims were trying to do in their 21st-century way: Get rid of a threat. They had some vague idea of a better way to live that would involve an absence of the threat, so motorcycles and AK-47s—products of a science and technology far beyond them—were their vaccine. Damn their stupid souls, they thought they were doing their fellow-Nigerians a favour.
Science and technology also informed the world of the killings, and of the little girl who died of H5N1 in Kantha Bopha Hospital last Thursday. We communicate using means undreamed of even half a lifetime ago, spreading information and knowledge instantly. But like ignorant terrorists on motorcycles, some of us also use science and technology to promote anti-science, to reassure those still living in the 16th century that they're right to do so.
So we're on one side of a vast cultural and psychological gap. What we say must sound strange and alarming to those on the other side, just as 21st-century English would sound to 16th-century Londoners: They would catch a word here and there, but it would still be alien gibberish. And probably immoral.
I notice that many news reports include criticism of the victims' communities, where it's fine to let the kids play with the chickens and help in the slaughtering. WHO's rapid response teams are conducting a "public health education campaign" in Cambodia to teach them otherwise, and that seems eminently sensible. But it doesn't seem to work.
That, I suspect, is because we may speak the communities' language but we are not of those communities. So we're not trusted, and often deservedly: The ruled usually have bad experiences with their rulers, and have little reason to trust them. But the culture of the community is old and reliable and doesn't require learning a lot of newfangled ideas or behaving in some crazy new way.
As much as we have learned about the structure of the influenza virus and the behaviour of the human immune system, we are still deeply ignorant about the people we are trying to protect: the Haitian mother under her tarpaulin, the Balinese farmer, the African truck driver, the vaccine-averse Canadian nurse. Until we can really know and understand them, and respect them as they are in their endless 16th century, we will never find the words that will make a difference to them.
And I will always have new outbreaks to post about.