Crawford Kilian is not on enough readers' lists. He pays the rent as a Canadian writer whose H5N1 blog I have read for several years. In addition to being blogmaster for the gold standard tracking Avian Flu worldwide, he has several published books and is a contributing editor of The Tyee, an online site for all matters British Columbian, including blogs (something like herding cats). This morning's post should be a must-read for a much wider audience than it will receive. I'm copying it here with the intention of bringing wider attention to it at least to a few local sources here in the Atlanta area. This is an important message that many of ys have been thinking, talking, writing and complaining about for years. Perhaps in the wake of the latest flu flap the message can get a little traction. I hope so.
"Dead, your Majesty."
Via the Jakarta Post, which isn't saying much about bird flu these days: Africa scrambles to prevent arrival of swine flu. Excerpt:
Swine flu has killed 26 people in Mexico and two people in the United States. Although the number of deaths is low, there are fears that if the virus spreads, it could mutate into a more dangerous form and that there could be a second, more lethal wave.
And yet, as global attention focuses on swine flu - which has infected more than 1,600 people in more than 20 countries - thousands of Africans die unseen and unnoticed every day of preventable and treatable diseases.
"Why isn't there such an emergency mobilization against diarrheal diseases which kill 2.5 million children a year?" said David Sanders, professor of public health at the University of the Western Cape.
"Maybe it (swine fever) is a huge threat but it does seem to have triggered an overly hysterical response," he said Tuesday of the global mobilization.
"One can't help but wonder if there isn't a North-South divide expressing itself here," said Sanders, one of South Africa's top public health experts.
The burden of ill health in Africa is crippling. Nearly 3,000 children die each day of malaria, often for lack of a simple bed net. More than 1,900 people have died and 56,000 people have been sickened since January in a meningitis epidemic that has swept Nigeria, Niger and Chad but gained little international attention.
The chaotic health system in Nigeria has prompted concern about whether authorities in Africa's most populous nation would be able to trace or control swine flu cases.
Zimbabwe struggled to cope with easily treatable cholera, resulting in an epidemic that killed more than 4,000 people and sickened 80,000 - in an ominous sign of what might happen in the event of the swine flu virus taking hold.
The continent's richest nation, South Africa, is also beset by health problems, with an estimated 1,000 people dying each day from HIV/AIDS and even more become newly infected with the virus.
In the worst-hit South Africa urban sprawls, tuberculosis has reached four times the level classified as an emergency by the World Health Organization.
This is a topic often discussed in Flublogia, and our attitude is, admittedly, inconsistent. That's a kind word for "hypocritical."
Most of us are comfortably settled in rich industrial countries where problems like TB and AIDS are rarely in the news. Zimbabwe, like our own homeless, is a deplorable problem...but not our problem. We'd prefer to focus, via high-speed internet connections, on a conjectural disaster instead of the many real disasters killing people somewhere else.
If a thousand people died in the US tomorrow from swine flu, the country would go beyond a mere war footing. Three hundred million people would turn all their efforts to preventing death #1001, while ignoring routine deaths from cancer, heart disease, auto accidents, and gunshots.
Is it a North-South problem? Maybe a black-white problem? That's probably part of it. As La Rochefoucauld cynically observed 300 years ago, "We always find the strength to bear the misfortunes of others." If the others aren't our colour, or religion, or class, or nationality, their misfortunes are very bearable indeed.
But it may also be, in part, a cultural or even psychological problem. Dr. Philip Alcabes, in his recent book Dread, points out the difference in the way we respond to "new" diseases and whatever is endemic: Endemic is just the way things are, but when a new disease turns up, someone's to blame for it...usually the victims.
So the Chinese and some Americans blame the Mexicans for it. The Mexicans blame industrial pig farms for it. If H1N1 had broken out first in Canada, we'd be catching flak for our slovenly hygiene and socialist healthcare system.
A wiser response would be to consider why we think we can protect ourselves by attacking others, and to ask whether such a response may even expose us to greater danger.
If it's all the fault of someone's else's lousy hygiene or corporate greed or simple nationality, we excuse ourselves from thinking about the social and cultural conditions that we're comfortable with—even if they set us up for being the next fatality.
Charles Dickens understood this a century and a half ago in his great novel Bleak House. He didn't know about the germ theory, but he knew that the rich could not insulate themselves from the diseases of the poor. When Jo, the ignorant street-sweeper, dies of smallpox that will reach to the top of Victorian society, Dickens damns his readers for it—including us:
Dead, your Majesty. Dead, my lords and gentlemen. Dead, Right Reverends and Wrong Reverends of every order. Dead, men and women, born with Heavenly compassion in your hearts. And dying thus around us every day.
Faced with a potential pandemic, we are already shrugging it off as a "false alarm," but it's actually an undeserved dress rehearsal. A minor new virus has tested us and found us (mostly) wanting. We've done some things right, and many things wrong. But we seem to be escaping with just a bad scare.
If we learn from our mistakes, and act wisely, we'll be ready for the next attack. If we laugh at H1N1, in the next attack our children, like Jo, will be dying around us every day...not just from some exotic influenza, but from TB, HIV/AIDS, and all the wretched endemic diseases that we still take for granted.