We Have Met the Enemy, and He is Us

Opinion, by Jack Woodall

RIO DE JANEIRO, BRAZIL – Thus spoke not Zarathustra, but Pogo, the philosophical possum of the Okeefenokee swamp in Walt Kelley’s classic cartoons. The evidence is all around us that we carry within us the seeds of our own destruction.

In 2002, a malicious rumor about polio vaccine causing sterilization of Muslim women circulated in Northern Nigeria and vaccination was halted. The infection has now spread back to 14 countries from which, at great effort and expense, it had been eradicated.

Look at another crippling disease, tuberculosis. Cure requires daily doses of antibiotics for a number of weeks. But in countries where people have to travel far from home to receive health care, as soon as they start to feel better they head for home, not yet cured, carrying back with them bacteria which have survived the treatment so far and are now resistant, to be spread again in their community.

Look also at HIV/Aids. Educated people know how it is spread and what to do about it, but nevertheless get carried away in the heat of passion and ignore precautions. As a wise friend of mine likes to say, “Hormones will always trump neurons.”

Drug-addicted HIV-infected prostitutes in western Europe know full well that they can infect their clients, but they have an expensive habit to feed, which over-rides all other considerations. A Swiss teenager who was told her drug-addicted boyfriend was HIV positive said “I know he loves me and would never do anything to hurt me.” In the face of such emotional responses, what chance do precautions have of succeeding?

Some scientists have convinced themselves that Aids is not caused by HIV, and worse, have succeeded in convincing politically powerful figures, setting back Aids control programs for years, as in the case of South Africa.

Dengue is on the rise in Brazil right now, and Rio will not be spared. Cuba has shown – twice – that dengue can be eradicated by a drastic reduction of mosquito breeding, in spite of repeated reintroductions of the mosquito by trading vessels. Cuba has been free of dengue for almost 20 years at a time, but as the iron rule of the regime has weakened, people have stopped cleaning up their environment and they now have dengue every year, just like us.

Behold a paradox. People everywhere tend to either not believe a word their government says, or take it with very large pinches of salt. Yet they are happy to turn over the responsibility of disease control to the government without collaborating themselves in prevention.

When the government announces that dengue is coming, and cannot be fought without help from the community itself, who cares? Let the authorities argue over whether mosquitoes are a municipal, state or federal responsibility — householders in Rio don’t lift a finger to help.

As long as human nature continues to let laissez-faire rule, we are on the wide straight road to our own destruction. A favorite saying around town is “Ilegal – e daí?” ( illegal – so what?). When it comes to dengue, it seems that the attitude is “Dengue – e daí?” (Dengue – so what?) then we get upset when somebody we know dies from it.

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Jack Woodall PhD was a visiting biomedical research professor at the Federal University of Rio de Janeiro (UFRJ) before he retired, and is now Editor of the Rio English language monthly The Umbrella and Associate Editor of ProMED, the only free online source of professionally commentated news of outbreaks of infectious disease worldwide.