And while some polio transmission continues in Nigeria, Pakistan and Afghanistan, it’s arguably not the West that should be most concerned about this, but countries that border these three nations and face the greatest risk of new outbreaks of disease in their regions.
Are you really that stupid that you don’t understand what we are saying? It’s not just people who listen to the Taliban who can get sick, if something like polio spreads to the rest of the world no one will have any resistance, many people aren’t even vaccinated for it these days. Then an almost-eradicated disease could become a real health threat again.
I didn’t read that as her agreeing with the sentiment. She’s just saying that that IS the sentiment in large areas of the former Third World. Her agreeing or disagreeing with it doesn’t make it suddenly stop being so.
Sounds like agreement to me, partially (and poorly) disguised as Just Asking Questions. And this viewpoint completely ignores the role of religious extremism, ignorance and xenophobia in local resistance to immunization efforts.
ed anger, insults are not permitted in General Questions. No warning issued, but don’t do this again.
Moderator Note
solosam, we also don’t need this kind of rhetoric in GQ. It’s obvious that supporters of the Taliban are not the only victims. Please limit yourself to factual responses. No warning issued.
I don’t know about Nigeria, but in other African countries, yes, it’s a fact: a LOT of people see Western medicine as a last resort. And of course that turns into a vicious circle: you see the hospital as the last resort, so you only bring your relative into the hospital when you’ve tried everything else, by which time it’s way too late for the hospital to save him, so he dies, and you’re more convinced than ever that Western medicine is at best useless and at worst actively destructive.
And of course it’s a fact that in Third World conditions, medicine isn’t going to have the same success rate as it does in a well-funded, up-to-date, pristine First World hospital. Acknowledging that doesn’t mean that I think Western medicine is evil (???); just that I think it works better when you’re able to put all of its principles into practice.
But what exactly do statements like “essential medicines may be hard to find” or “doctors often have limited and outdated medical training” have to do with Islamic (or at least fundamentalist Islamic) hostility towards immunization, which obviously has been successful in Third World nations (when vaccination programs are allowed to proceed without workers being murdered)?
Not speaking for even sven here - I could have her point totally wrong - but I think she was saying that less effective Western medicine = less faith in Western medicine = more wariness of any form of Western medicine, including vaccines.
I’d add that, if you have fundamentalists who are reflexively hostile to and/or wary of anything Western, then a context where Western medicine isn’t able to function at full effectiveness is going to give them traction with non-fundamentalists. ‘Remember how the hospital said your aunt needed medicine X, and she took it and died? Now the same hospital is telling you your kid needs this shot. Are you seriously going to trust them with your kid, after they killed your aunt?’
“Western medicine is a lot more of a crapshoot [in third world countries as opposed to first world], and most families are likely to know someone who has been noticeably harmed by it. It’s often seen as something of a last resort, when nothing else is working.”
Don’t be disingenuous. even sven is not sitting there thinking, hey maybe there is something to this shaman stuff and you know it.
Traditional cures, even if they’re just placebos, may seem to work better in many cases, if only because they have much more mild effects, so you’re less likely to have dangerous side effects.
A personal example: this summer, I had a minor ear infection that was treated with antibiotics, had an intense allergic reaction to the antibiotics that wrecked my immune system (temporarily), was hospitalized and isolated, given more (different) antibiotics because they didn’t know what it was at first and I had almost no immune system to fight a possible infection, eventually picked up a hospital-acquired infection (you know, one of the nasty ones that’s resistant to many antibiotics) that took me another two months and two different courses of antibiotics to fix. All told, I had months of fallout illness and recovery from something that probably would have gone away on its own if I’d just stayed in bed a few days and drunk some tea.
Now, that hasn’t turned me against evidence-based medicine, but it has made me a lot more cautious and aware of the limits of medicine. Someone else might have reached the opposite conclusion. And what if they’d only had the very first antibiotic available, the one that I had an allergic reaction to, and none of the follow-up care? They’d go away thinking that western medicine sometimes makes you much sicker. Their traditional remedies probably don’t do that.
This stuff happens (I could tell my own, less horrific story).
Still, I’ve never had the reaction that “We$tern medicine didn’t work, so now it’s time to turn to quackery and I’ll throw boiling oil on the Visiting Nurse if she shows up at my door.” We have people like that in the U.S., even if they didn’t get such inspiration from the Koran/Bible/Talmud/My Religion’s Creepy Story Book.
So we essentially handed them (some “them” or other; a large group of people at least some of whom are likely to have unkind feelings towards the West) a potent biological weapon.
I think the argument here is that I didn’t say “Yeah…Islams is teh evils! It’s because they are dumb and bad!”
I genuinely believe that, like most of the people I know, most people are not crazy or stupid. If you put some thought into, most people have essentially rational motivations, although this can look unintuitive from the outside.
In this case, I think the leaders are looking for the credibility boost that comes with becoming an internationally reknown baddie. Rather than being run of the mill small-town power players, they’ve found a way to actually really piss off some of the most powerful people in the world. Pissing off the West is a great way to get the allegiance of the multitudes of unemployed, vaguely angry, disaffected young men in the area. Young people in Nigeria today often face limited prospects, and young men (the demographic most likely to get restless) don’t really have a clear picture as to why, which makes them ripe pickings for anyone who can make a convincing argument that they can give these young men a bit of power against the huge forces that affect their lives.
And we are talking about politics on a fairly local scale here. Most of these leaders don’t actually aspire to international prominence, but would like to become an important person- or way or another- in their community. A lot of the anti-West bluster isn’t actually about the West, but about appealing to people on the local level. It’s a lot like the right wingers who will go on and on about illegal immigrants despite living in a region without a large immigrant population.
On the ground, among mothers and the like, the anti-vacination works because people have had bad experiences with Western medicine, often do not have access to the good that can come from it, and are justifiably suspicious of medical interventions that they don’t understand and honestly don’t have many good ways to understand. When you don’t have much in the way of schools, libraries, or even television, you actually have no way to know that the nice foreign lady trying to inject your kids can be trusted. If you know that previously CIA agents had used that guise, and that HIV had been spread in your area due to injections, it’s not that wacky to be hesitant. It’s a pretty reasonable thing to do with the information you have.
And do remember that whole polio is a horrific and rare disease in our minds, and it is one of the few things that would cause the rare and tragic event of a child death. In rural Nigeria, I’d guess around 1 in 5 kids dies before their fifth birthday, and polio is barely a factor in that. It’s a tiny blip on the radar in people’s minds. So there is probably some confusion and resentment as to why we are so concerned with this little random disease, when people’s kids are dropping dead from other diseases left and right. We see vaccination as the main way to prevent childhood disease, but in rural Africa it can be perceived as hardly making a dent.
When I was in Cameroon, I once went to the doctor’s office in my village for a simple case of malaria, and the doctor started pulling me towards another room. I asked what was going on, and they informed me that I had a tumor and they would need to operate. I, of course, said there was no way in hell they were going to remove a “tumor” they had apparently just found in our WWI style hospital. That was the right choice, right? You would do the same thing, wouldn’t you? Well, so did the Cameroonians. Likewise, I would have at least a few questions before I put my arm out in a village-based vaccination campaign. Wouldn’t you?
I don’t understand this. Polio was a problem in Pakistan even before the Taliban put a stop to vaccination campaigns.
If the Taliban wanted to use to use polio victims as a vector for biological warfare, they could do so regardless of what the CIA did or did not do. We haven’t “given” them anything they did not already have.
But…Islam is evil, dumb, and bad. Among its laundry list of flaws, it prevents people from getting vaccinations. The CIA isn’t responsible for killing doctors in Pakistan; the Taliban is, and ONLY the Taliban is. Let’s not play this game of “Well, what were they supposed to do, not shoot vaccine workers? Huh?”
Moreover, ‘we’ haven’t done a damn thing to stop polio vaccinations. The Taliban has. That’s on them, not us.
Can you see how “I find your most fundamental beliefs to be evil, dumb, and bad. Now, could you kindly hand me your two year old so I can give her an injection.” might not play out particularly well in practice?
Islam does not prevent anyone from getting vaccinations. People choose not to get their children vaccinated because they are taking the advice of local religious authorities who have figured out that being anti-vaccination is a handy talking point that plays well into local anxieties and experiences. But this certainly is not anything particular to Islamic texts. Anti-vaccination movements, in particular, have a long history of being an easy sell among everyone from social progressive to conservative Christians. I’d imagine that a combination of anxieties about being responsible for a small child, the uncomfortable invasiveness of injections, and the non-intuitive mechanism of vaccination makes them an easy target for fear, and organizations and political leaders have long known that fear is one of the best ways to create loyalty. This has been going on since vaccinations were first produced, and has found fertile ground in what are the poorest and least educated parts of the world.
Again, not surprising. Why do you trust vaccines? I promise you, it is not because you are a superior human being. It is because you took biology in high school from a credible school system, and you learned the fundamentals of how it works. It is because you were vaccinated as a child, as were your parents and maybe your grandparents, and you’ve seen it in practice for decades with no ill effects. It is because you’ve consistently received effective, high-quality care from Western medicine throughout your life, and you and your community have evidence that it is trustworthy. It is because our health care system ensures our doctors are rigorously trained and held to the highest of professional standards. It is because our government oversees vaccine production and quality controls, and enforces consequences when something goes wrong. At every level, we have developed trust and understanding in our doctors, so when they say we have to give our kids an injection, we tend to believe them.
Your average farmer in northern Nigeria has none of these things. His education is probably sporadic and inconsistent, making it difficult to go beyond the most absolute basics of things like biology. He is probably among the first generation or so to have access to vaccination, and he has not seen the results. He has not received consistently good care from Western doctors. If he has seen care at all, it’s probably been very basic and has not been able to save his family members from common diseases such as malaria. The doctors he sees are likely to not be well trained and may regularly violate professional standards. The government can’t be trusted to oversee a highway, much less vaccine production, and if something goes wrong (which it has in the past, such as with HIV contaminated needles being reused) he knows that there will be no recourse. There is no trust, no understanding, and no “rational” reason to believe what that nice public health worker is telling him.
The issue with doctors in Pakistan was that we had CIA employees posing as public health workers to gather intelligence. People generally are really uncomfortable with foreign intelligence officers from somewhat hostile countries doing surveillance on them. You, for example, would probably be upset if your meter maid was an Iranian spy. So when this all came out, people naturally became pissed off and skeptical of public health workers, potentially setting work back decades as that trust is rebuilt.
Let’s say you have found yourself in a Northern Nigerian small town, with the roads washed out and the phone lines down for the next couple weeks. You develop a worrying but not immediately deadly symptom- let’s say it is moderate watery diarrhea with occasional blood in it. You walk down to Ye Average Nigerian Pharmacy and talk to the pharmacist, who you don’t know from Adam. You ask him for the drug you want (which should be effective), and he leads you to a shelf with six bottles:
A: A legitimate looking box that says it is the correct medicine, and has Chinese writing along one side.
B: A legitimate looking box of French-made medicine (was that smuggled in from Cameroon?) that is six months out of date and appears to have been opened previously
C: Another bottle of the French made medicine with a box that tries to look similar, but has slightly off colors and a couple of misspellings
D: A box of the right medicine that is in a language you’ve never seen before and claims to have been produced in Bahrain
E: A box of legitimate looking British-made medicine that is for some other drug that you’ve never heard of, which the pharmacist insists is just as good
F: A blister pack of otherwise unmarked pills, that look like the right pills, but who knows? They are being sold at half price.
Other than the unmarked pills, all of the boxes cost 20% of your cash on hand. Outside of the pharmacy, there is a street stall selling suspiciously similar medicines for a fraction of the price. You have a neighbor whose son was rendered blind by inappropriate medicine. There are persistent rumors of random powders, including household cleaners and pesticides, being sold as counterfeit medicine. Before the trip, your doctor warned you to never, ever buy medicine from street stalls.
Now let’s say the city mayor decides that counterfeit medicine is his big platform, and he’s hanging up posters and giving speeches everywhere about how evil China is for selling the fake stuff. Your city just happens to have a Chinese agricultural outpost on land the mayor would like to use for his new city hall. The small Chinese crew is not particularly well liked in town, probably out of simple xenophobia. You remember reading a few articles a while back about counterfeit Chinese medicine…something about it leading to drug-resistance malaria or something.
What do you do?
In this case (which is fairly common), I’d guess you wouldn’t trust any of them. Evidence-based medicine is great and all, but when you have no way to know what medicine is real and what is counterfeit, you are going to be very extra-careful of what you are putting in your body, because it could be literally anything. It could be counterfeit, it could be the wrong medicine, it could be a sugar pill or it could be something actively poisonous. If you decided to just wait it out and hope, that wouldn’t really be an ignorant, dumb, or anti-evidence-based-medicine choice. And just like you would be very careful, so would people who live there.
The mayor’s rantings may or may not really affect your choice, but if you are asked why you don’t buy pills, you might mention fears of Chinese-made counterfeit drugs.
Anyway, the point here is that in the poorest parts of this planet, the medical choices are not between “happy, clean, sterile western medicine” and “dirty, evil, fuck-the-ifidels whatever,” but rather a set of confusing, untrustworthy, even somewhat random options that you have no reason to trust either way.
Even sven, thank you for participating. I’d reply to all your messages, but I’m not sure I fully grasp what point you’re trying to make. I understand that poor, underdeveloped places may have difficulty trusting vaccinations. Are there any poor underdeveloped non-Islamic communities that actively resist polio vaccination? (which, btw, is generally orally administered in most developing countries) If not, and Islamic communities have a particular reason to be wary of the vaccine (The rumour I’ve heard is that vaccines are a plot to make muslims infertile, and it predates by many years the US using a doctor as a spy), then where did that come from? Do you have any information on that?
It seems to me that the heart of the problem is cultural rather than religious. According to this, 97% of all polio cases are in Afghanistan, Pakistan and Nigeria. There are plenty of other Muslim countries out there where polio isn’t a problem.
Also (on a very quick Google), British Muslim kids don’t have a lowervaccine uptake ratethan British non-Muslim kids: higher uptake for pertussis, on a par with controls for other vaccines. So when you remove the cultural factors, Islam in itself isn’t preventing vaccination.
To me, that implies that saying that the problem is caused by Bad Evil Islam is like saying that deaths from snake-handling are caused by Bad Evil Christianity. It may well be true, but it’s very far from the whole truth. The problems are actually caused by a specific, localised, culturally shaped version of the religion - and it’s simplistic, naive and counterproductive to discount the cultural factors.
What some posters are unwilling to acknowledge is that Islam-based hostility to immunization was occurring long before the misbegotten plan to track down bin Laden via DNA harvested during vaccinations.
The idea that the Taliban and “local religious authorities” are basing their opposition to immunization entirely on deliberate plans to turn people against the West strikes me as simplistic, to say the least…just like the idea that the Taliban destroyed ancient works of art to piss off the West. People who make these arguments are giving far too much credit to their own countries’ influence, and far too little to generalized religious hatred, xenophobic paranoia and just plain evil.
“…most people have essentially rational motivations”
This is what I’d term the “most people” fallacy. Most people are reasonable, most cops are honest, most corporate officers have the interest of their communities at heart, most lawyers believe in justice (alright, I’m starting to get carried away), etc. etc.
It’s not what “most” people are or do that counts - it’s how most people respond to the destructive or dishonest influences in their group. If they go along with bad decisions made by a loud minority, it does not matter how good “most” are at heart.
There are certainly non-Islamic religious sects that preach against vaccination (though I’m unaware of any that go around murdering public health workers offering free life-saving medical interventions). Major figures in those religions have spoken out in support of immunization (for instance, the Vatican has damped down attempts to cripple vaccination via the charge that cell cultures used in vaccine production were originally derived from legal abortions). What Islam needs are powerful and influential figures in the faith coming out in support of vaccination both regionally and locally. And I haven’t seen that happening on anywhere the level needed to counter the murderous antivax craziness promoted and carried out by the Taliban.
