The His­tory of Health and Medi­cine Sem­inar series con­tin­ued today with a rather pro­voc­at­ive paper by Dr. Ann Her­ring and Sta­cey Lock­er­bie.herring.gif “The Com­ing Plague: Global panic, local reper­cus­sions and avian influ­enza,” con­tends that glob­al­iz­a­tion and spread of inform­a­tion has pre­ceded the poten­tial epi­demic with out­comes that alarm poten­tially unduly and have enorm­ous local eco­nomic and social impact.
Her­ring is well known for her work on the his­tory of infec­tious dis­ease and very spe­cific­ally on its impact on nat­ive pop­u­la­tions. Lock­er­bie work involves the trans­ition of aquacul­ture in cent­ral Viet­nam from local to a global com­mod­ity. Their work coin­cides as a res­ult of Lockerbie’s first-hand exper­i­ence in Viet­nam with the impact of poultry culls and the move­ment towards lar­ger state-controlled fact­ory oper­a­tions as the gov­ern­ment (over)reacted to the bird flu. This paper centres on the pro­cess of anchor­ing, where the under­stand­ing of a new dis­ease is linked and con­figured to past epi­dem­ics. In this case, from 2001, the Avian flu (a dis­ease first iden­ti­fied in the late nine­teenth cen­tury) has been anchored to the Span­ish Influ­enza of 1918. The res­ult of which has been global panic and extreme attempts to errad­ic­ate the poten­tial impact of the dis­eease with little or no under­satand­ing of its true vec­tors or study of the impact of the rem­ed­ies enacted.
The first part of the talk dealt with a lockerbie.giffac­tual explor­a­tion of the known imapct of the H5N1 virus look­ing at the spa­tial diemn­sions of the cur­rent out­break. As Her­ring iden­ti­fies, only 271 cases world­wide have been iden­ti­fied in human and of these only 160 have res­ul­ted in death. She ques­tions what has made this anchor to the 1918 influ­enza so per­vas­ive. There have been epi­dem­ics in the 1950s, 1960s and again the 1970s that more closely reflect the nature of the cur­rent dis­ease, but these seem to have been simply over­looked. Ques­tions raised after the talk sug­ges­ted that dis­ease may rep­res­ents another way that bor­ders can­not be secured…and thus in a secur­ity con­scious world, this is a mag­ni­fied threat — one par­tic­u­larly witty respond­ent sug­ges­ted the pic­ture of a ter­ror­ist armed with a chicken-bomb.

So, if the threat has been mag­ni­fied, what of the response to it? In this case, Lockerbie’s exper­i­ence in Viet­nam sug­gest that it has been simply enorm­ous, espe­cially at the local level. In a place where the con­sump­tion and avail­ab­il­ity of chicken forms part of cul­tural prac­tise, the mass cull­ing of flocks and the move to take the chicken out of back­yards and con­cen­trate in fact­ory sur­round­ings des­troys com­munity bonds and cul­tural links. The authors point to the Viet­namese state desire to be seen as tak­ing appro­pri­ate response to the threat has led to the elim­in­a­tion of live bird mar­kets and driven the adop­tion of super­mar­kets. Cul­tur­ally this has a huge impact as mar­kets had centred a local sys­tem of trust and com­mit­ment amongst vendors and buy­ers. More iron­ic­ally, by try­ing to gain bio­se­c­ur­ity, and shift poultry pro­duc­tion to safe and clean spaces, sci­ence is in fact driv­ing pro­duc­tion into the very sort of places in west­ern nations that strains mutate and erupt.

Thus those in the regions affected by H5N1 suf­fer doubly, both from the dis­ease itself as well as global con­dem­na­tion for cul­tural prac­tices that may not in fact be at the root of the threat.

Clearly, the poten­tial of the Avian Flu Epi­demic is dif­fer­ent because it is being con­figured in a more global fash­ion than things have been in the past. The real­ity is that we don’t know a lot about it. Cer­tain hypo­theses that have been raised and are really not based on study or under­stand­ing. So, what has made this hap­pen and who gives cre­dence to this fear mon­ger­ing? Her­ring asserts that the scary part it is its actu­ally ‘author­it­at­ive sci­ence’, and this has moved into fact and become unques­tioned dogma, des­pite any real evid­ence.