Tuesday, October 14, 2014

Building and Tearing Down Walls

Tuesday, October 14, 2014

I encountered a barrier at the intersection of LaSalle and S. 9th Street as I made my way to the downtown YMCA this morning.  It strikes me as almost foolhardy to be doing so much roadwork when the first accumulating snowfall of the coming cold season is now quite possibly going to happen within the next thirty days.  This inconvenient barrier, news of the spread of Ebola in Africa and the approaching twenty-fifth anniversary of the fall of the Berlin Wall has left me pondering the theme of boundaries and barriers.

The Ebola virus has once again made news due to the death of a United Nations worker in Leipzig, Germany.  Ebola has now appeared in the nations of both of my parents’ origins.  At some point this morning I found myself wondering if Ebola could become the AIDS of the 2010s.

To carelessly over-generalize and draw an immediate parallel between AIDS and Ebola would be, well, careless.  The two viruses are transmitted in different ways.  HIV infection was originally mistakenly thought of as a disease typically found among injection drug users and sexual minorities such as gay men.  Its spread around the world and among people of varied socioeconomic, cultural, ethnic, gender and sexual orientation backgrounds effectively revealed many truths that some would rather not see.  Some of these truths are the following:
  • Illness does not necessarily make any distinction in whom is ultimately affected both directly and indirectly
  • We are all interconnected
  • Hysteria about potential transmission of illness can cause grave harm

Illness does not obey boundaries

People of many different backgrounds have died from the complications associated with AIDS in the three decades it has been present in the global population.  It does not matter if you are rich, poor, white, black, brown, male, female, gay, straight, lesbian, transgender, young, old, healthy or already ill.  HIV itself doesn’t distinguish between those who ultimately become infected.  Certain high risk behaviors typically associated with certain populations of people may place individuals at much higher risk of infection.    But each of us lives with risk on a daily basis.  This is a basic reality of life.

Though I was much too young to be personally at risk of HIV infection when HIV first appeared in the 1980s it has nonetheless impacted my life.  I have lost a few friends to HIV related complications.  And I have a larger subset of friends who live with HIV on a daily basis.

We are all interconnected

The appearance of Ebola in Dallas, Texas after a man departed Africa for Texas clearly shows how interconnected the entire planet has become.  We can now move people, goods and ideas around the planet in a minute fraction of the time we once did.  And with that speed has come enhanced risk.  I once traveled from Amsterdam to Hawaii in the course of a mere thirty-six hours.  When a person can reach anywhere on the planet in a matter of days you know the world has become an incredibly small place.

Fear of illness

Severe, pandemic illness has a way of inspiring both the best and worst of human behavior.  I can vividly recall seeing the Kalaupapa Peninsula of the Hawaiian island of Moloka’I some three years ago.  This peninsula became the site of a leper colony after leprosy found its way to Hawaii.  Even relatively isolated amidst the biggest ocean of the planet Hawaii was ultimately ‘discovered’ by the West.  And with that discovery came the introduction of foreign peoples, plants, animals…and illness.

Despite our amazing advances in technology, medicine and other disciplines I do not know that such advancement has fundamentally impacted human nature all that much.  The prospect of a pandemic has a way of drawing attention to our collective nature.  Fear of infection, illness and accidents, as well as disability, lost work and untimely death which can occur as a result, prompt both individuals and whole societies to engage in a wide variety of actions to reduce risk.  We wash our hands more often and with more attentiveness.  We may reduce risk of potential exposure by limiting our time in public places.  We stand up and walk away from those of us who cough just a little too much.  We quarantine the deeply ill.  And on the larger scale of whole nations we may enact measures such as travel bans and restrictions, screenings at major thresholds on our borders and so on.  And quarantine can ultimately prove extremely valuable.

One only need to google ‘AIDS hysteria’ to see that many, many people suffered in the 1980s as HIV continued to spread throughout the globe.  There were those who became infected with HIV.  And some of them went on to develop AIDS.  And then there were all the people who were somehow immediately connected to those who became HIV+ but never became positive themselves.  And then there was the much larger circle of the rest of the planet.  Regardless of where any one particular person fell within the web of our interconnectedness we were all somehow affected by the AIDS epidemic.  Some of us just might (still) not know this.

An April, 1986 article in the Chicago Tribune provides a concise summary of some of the most unfortunate consequences of the AIDS epidemic:

  • At one point at least half a surveyed population supported the idea of a quarantine of AIDS patients
  • Some people (15% noted in the article) even favored tattooing AIDS victims (this is reminiscent of labeling Jews in Nazi-era Germany as well as the life of Hester Prynne as told in The Scarlet Letter)
  • An increase in adverse actions on the part of some employers was noted.  This was due, in part, to a fear of transmission of AIDS in the workplace
  • Some health-care workers refused to provide care to those dying of AIDS
  • Even HIV+ children experienced discrimination.  Ryan White of Kokomo, Indiana is by far one of the best known examples.  Considering the ways in which HIV is in fact transmitted (through intimate sexual contact, sharing contaminated needles, receiving infected blood or blood products, from mother to fetus) discrimination perpetrated against children was an especially abhorrent manifestation of the fear of HIV and AIDS

More than thirty years has passed since the AIDS epidemic exploded into global awareness.  Thirty years ago this very month (October, 1984) bath houses in San Francisco were ordered closed by the city’s health department.  The next year, in April, 1985, the first international AIDS conference was held in Atlanta, Georgia.  It would be more than two years still later when President Ronald Reagan would finally acknowledge  AIDS in a speech.  A good timeline of significant events in the evolution of and response to the AIDS epidemic can be found on the NPR website here.  There was even a time when AIDS was noted to be the leading cause of death among American men aged 25 to 44!

How will the response to the Ebola epidemic unfold?  Will there be a measure of carelessness, bureaucratic dithering and prejudice equal to what was witnessed in the early years of the AIDS epidemic?  Only time will tell.  Every disease is unique in some respect.  But we are already witnessing the significant consequences of the spread of Ebola.  Certain basic cultural norms (such as an orientation towards physical contact) are being upended by the spread of the Ebola virus and the fear of the virus that spreads at the same time.  I think it is also a correct assertion to make that diseases common to those who exist at the margins of society are less likely to receive significant attention.  Put differently, those perceived to be of little value in a society will likely garner less attention than those who enjoy more power, more wealth and more access.

It was quite easy to meditate on the subjects of sickness and health as well as boundaries today.  I caught something of an autumn cold this past Sunday.  Being sick is a great way to be reminded of the gift of having a functional and strong immune system.  As I continue to rest and practice good self-care skills I am grateful to live in a country with a relatively decent public health infrastructure.  But there are no guarantees.  There are no walls that can ultimately withstand the passage of eternity.  And I think it only natural to ask: When we build a wall are we keeping out much of the bad or are we also keeping out a lot of the good?

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