global health

Pass the Olive Oil, Please

I want to thank Caitlyn Ark for this wonderful blog post, which she wrote based on her experience doing a study-abroad class this summer.

Pass the Olive Oil, Please
The Healthy Diet of a Social Mediterranean, Caitlyn Ark

As I was leaning off the side of our very large, but only slightly crowded, ferry, I watched the gentle crashing of the startlingly wine blue waters below me. Wine deep, wine rich, I thought to myself, which something that the Ancient Greeks, who sailed these same waters, originally coined, intertwining food with the natural landscapes from which they come from.[1] The day was warm, but the kind of warm that drifted down from the bright Mediterranean sun to eventually settle on my shoulders like a soft shawl. I found myself at the bow of our boat, searching for the small nip of the wind to kick up my hair and offer a slight reprieve from the warm air. The Mediterranean is an oligotrophic sea, meaning it is very low in nutrients, so I was surprised to note that I could see schools of small fish darting around socially near the top of the water, playing a marine version of follow-the-leader. …

Diet and Global Health

What is the single most important factor in shaping global health in the developed world? Interestingly, it does not appear to be access to the most technologically sophisticated medical technology. In the chapter on health in our textbook, I start by saying: “Chile, Costa Rica, Cyprus, Guadalupe, Hong Kong, Israel, Malta, Martinique, Singapore, and the United Arab Emirates are a diverse set of nations and territories. Yet they all have one fact in common: their citizens live longer than those of the United States, as do the citizens of many developed countries (Smallman and Brown, 2015, p. 236). Lee Miller and Weilu have an article titled “These are the World’s healthiest nations” in Bloomberg (February 24, 2019) which looks at global health statistics. The methodology looked at a number of factors -not only life expectancy- to rank countries. The top five countries were Spain, Italy, Iceland, Japan and Switzerland. There are many such rankings, and each one has methodological questions or choices. But all such national rankings of health can leave you questioning what you think you know, particularly about the role of diet in health. …

Measles and conspiracy theories

An outbreak of measles in Clark county Washington has led to at least 36 confirmed cases, and quite possibly a dozen more. A recent Oregonian newspaper article by Molly Harbarger had the title “Vancouver-area measles outbreak costs county $187,000 so far.” While we now view measles as a childhood disease, some historians have suggested that it could have caused the Antonine plague that devastated ancient Rome (165-180 AD). Globally, in 1985 nearly 1.2 million people died from measles annually (see slide 3), and many more patients suffered from pneumonia or were left with damaged hearing. Of course, measles is easily preventable with a regularly administered vaccination. This vaccination not only protects the person who receives it, but also babies too young to receive the vaccine, or patients with weakened immune systems, such as people receiving chemotherapy or living with HIV/AIDS.

The outbreak in Clark county was entirely preventable. Too few people had received the vaccination for herd immunity to work. It’s a sign of a larger problem, which is people’s refusal to vaccinate their children against diseases such as Whooping Cough, which is making a come-back in the United States. Public health authorities suggest that one of major factors driving these outbreaks are the conspiracy theories regarding vaccines spread through social media, YouTube and the internet. Interestingly, outbreaks of these vaccine-preventable diseases are no longer primarily happening amongst the poor and marginalized, but rather amongst the educated and privileged. …

Wet Markets and Avian Influenza

Map of Hong Kong by Shawn Smallman, Apple pencil in Procreate

This week I had an article published: “Wet Markets and Avian Influenza: Public Policy Decisions in Hong Kong.” Because the Journal of International and Global Studies is open source, you can read the article by clicking on the link above if you are interested. You can also read the abstract here:

After the emergence of H5N1 avian influenza in 1997 Hong Kong implemented a sophisticated system to regulate live poultry markets. While this system is well designed and thorough, it also has limitations. The rise of H7N9 avian influenza (which is typically acquired through contact with poultry, including in live markets) makes this an appropriate time to revisit the ethical and practical issues related to this trade. Based on data from field observations of live markets in Hong Kong, and interviews with experts in the field, this paper recommends that the government of Hong Kong create a committee to examine the pros and cons of ending live poultry markets in this Special Administrative Region.

Shawn Smallman, 2018

The 1918 Flu Pandemic

“Virus” by ddpavumba at freedigitalphotos.net

The 1918 influenza pandemic was the disease outbreak that took the greatest toll in the twentieth century. Globally, perhaps between fifty and a hundred million people died. There are a wealth of wonderful books on the topic. I particularly recommend both Alfred Crosby, America’s Forgotten Pandemic and John Barry, The Great Influenza. Eileen Pettigrew’s Silent Enemy is an excellent popular account of Canada’s experience of the pandemic.

Years ago I was visiting a graveyard in Portland, Oregon. There were three graves next to each other, a man, a woman, and a child, who had all died within a few days of each other in November, 1918, almost certainly from the flu. It’s hard to imagine now what that lived experience must have been like. So many families have stories of ancestors who fought in World War One and survived, only to die on their way home.

My own grandfather was traveling in the Peace River country of northern Alberta at the time. He had decided that he was bored on the farm in southern Ontario. He and a friend had set out on an adventure to travel to the Yukon. Then his friend came down with the flu that fall in 1918. Although they never did make it to the Yukon, my grandfather helped to get his friend Frank home, where -as far as I know- he had a long and happy life. Of course, this was only one insignificant moment in the global disaster that impacted families from India to Australia, and took tens of millions of lives.

There is a fascinating new podcast series on this outbreak, which is well-researched and thoughtfully presented: Going Viral: the Mother of All Pandemics. The presenters have deep historical knowledge, and have invested an immense amount of time in preparing this engaging work. I enjoyed their trip to the former battlefields of France to try to track down the pandemic’s origin with Dr. John Oxford. One would think that there wasn’t much new left to say on this topic. Yet in their search for the true origins of the pandemic they look at provocative thinking and current debates, such as Mark Osborne Humphries’ idea that perhaps the pandemic actually began in China. They are also engaging speakers; one can imagine listening to them as a student, and being captured by their lecture style. You can find the podcast on iTunes and similar venues. Given the proliferation of H7N9, the diversification of influenza clades, and the fact that we still don’t have a universal influenza vaccine, this history remains sadly relevant. Highly Recommended. If you are interested to learn about more recent debates, you can also read my own work on influenza and pre-pandemic vaccines as well as conspiracy theories. Both of these articles are publicly available for free. You can also find more freely available articles on influenza here.

Shawn Smallman, 2018.

 

Fighting Conspiracy Theories

“Witness Howard Brennan sitting in the identical spot across from the Texas School Book Depository four months after the assassination. Circle “A” indicates where he saw Oswald fire a rifle at the motorcade.” By Howard Leslie Brennan [Public domain], via Wikimedia Commons. Caption text from Wikimedia Commons also.
Apart from Murray in Stranger Things, and the Lone Gunmen in the X-files, most conspiracy theorists don’t have secret knowledge that the majority of humanity is unable to accept. Instead, people turn to conspiracy theories when they feel disempowered and desperate. Conspiracy theories thrive during times of crisis, such as a pandemic, or a profound political crisis. They also emerge at times when trust in government is low. I’ve done work (with my wonderful colleague Leopoldo Rodriguez) on a conspiracy theory in Argentina that focused on the death of government prosecutor Alberto Nisman. In the Argentine case, these conspiracy theories absorbed the news and attention of an entire nation. But during the 2009 influenza pandemic, conspiracy theories became truly global, as people told these narratives from Mexico to Europe. I studied this phenomenon in an article that is open access:

Shawn Smallman, “Whom Do You Trust? Doubt and Conspiracy Theories in the 2009 Influenza Pandemic” Journal of International and Global Studies, Vol. 6, No. 2: pp. 1-24. While its helpful to document instances of conspiracy theories, it’s more important to understand how to combat them when they can cause damage, particularly in the field of global health. How do health authorities fight conspiracy theories about vaccination, which are not only making it more difficult to eradicate polio, but also costing health workers their lives?

Book Review of Diniz’s Zika

Diniz, D., & Grosklaus Whitty, Diane R. (2017). Zika : From the Brazilian backlands to global threat. London: Zed Books.

This brief book is built upon extensive ethnographic fieldwork with mothers, doctors and scientists during Brazil’s Zika outbreak. The translation from Portuguese by Diane Grosklaus Whitty is masterful. Translation is always hard, and I have read too many books by Brazilian authors that suffered from overly formal wording, or endless run-on sentences. On a very small scale I understand this challenge from translating quotes in my first two books, for which I could easily spend an hour for a single statement. Of course, a developed narrative -with multiple voices-  is an exceptional challenge.  Diniz was very fortunate with her or the press’s choice for a translator. The prose is clear, energetic and yet still carries the feel and beauty of Portuguese. …

Conspiracy Theories and Zika

Conspiracy theories have long fascinated me. I’ve published (with my colleague Leopoldo Rodriguez) on the death of Alberto Nisman in Argentina, and the conspiracy theories that tragedy spawned. I’ve also written about the conspiracy theories that circulated regarding the 2009 H1N1 influenza epidemic. More recently, I’ve been doing research on the Zika epidemic. I’ve just published an article, “Conspiracy Theories and the Zika epidemic,” which you can view in the open-access Journal of International and Global Studies. …

Canadian doctors

In case you have ever wondered if Canada’s culture is truly different, you might want to read Amy Wang’s article in the Washington Post, “Hundreds of Canadian doctors demand lower salaries.” While most people who read the article comment on the fact that Canadian doctors are willing to give up part of their salaries to help others, I think that the picture it paints of an overstrained health care system is equally important. Free health care is a core Canadian value, but it’s also important to receive that care in a timely fashion, from caregivers who are treated well.  The article describes a disturbing Facebook video by an exhausted nurse, who has been pushed past the limit. Still, it’s hard not to finish the article without a smile on your face.

Shawn Smallman, 2018.

Influenza Humans Commons

Colorized transmission electron micrograph of Avian influenza A H5N1 viruses. By Photo Credit: Cynthia Goldsmith Content Providers: CDC/ Courtesy of Cynthia Goldsmith; Jacqueline Katz; Sherif R. Zaki [Public domain], via Wikimedia Commons
The Influenza Humans Commons is a collection of open-access articles on influenza, which is a great resource both for research and for course materials. You can find my own article, “Whom Do You Trust? Doubt And Conspiracy Theories In The 2009 Influenza Pandemic,” at this site, where it was recently among the top ten downloads. This is the paper’s abstract:

The 2009 pandemic of H1N1 influenza led people around the globe to create narratives about the epidemic defined by the question of trust; these narratives ranged from true conspiracy theories to simply accounts in which mistrust and betrayal formed a motif. In particular, most of these narratives reflected a fear of capitalism and globalization, although in specific regions, other issues—such as religion—played a more central role. These stories were not unique to the H1N1 pandemic but rather have appeared with every contemporary outbreak of infectious disease. This paper will examine conspiracy theories and moral panics related to the H1N1 pandemic in different world regions to explore how the disease became associated with economic and social systems in these accounts.

Shawn Smallman, 2018

Privacy & Cookies: This site uses cookies. See our Privacy Policy for details. By continuing to use this website, you agree to their use. If you do not consent, click here to opt out of Google Analytics.