ad-free
Channel / Source:
TEDx Talks
Published: 2016-03-28
Source: https://www.youtube.com/watch?v=DR8GOoE91Lk
mmhm %HESITATION so about a year ago I found myself homeless I wasn't so much that I didn't have a place to live but I was actually kicked out of my own apartment you see I was returning from Sierra Leone from my second stint as a physician in Imola treatment unit I received an email from my apartment building telling me to quarantine elsewhere no the look taken
aback rate I have not been exposed to Ebola I don't have the insect I'm not symptomatic in anyway but this is November two thousand fourteen if you remember here in the U. S. about a potential a boa outreach here was really high and if you talk to one of public health professionals they would have said the chances of getting a ball in the U. S. is
one in thirteen point three million but you know certain policies went on to play in one of them was the fact that anyone who is returning from West Africa had to go through one of five airports if you remember and my return actually coincided with the first two weeks of that policy being put into place and I remember being quickly identified the minute I came into
the customs all I was taken to an empty room in the back and asked to sit on a plastic chair those demarcated with plastic tape about ten feet away there's a customs officer and he's asking me all the routine questions have you been to West Africa yes I have have you been in an area where it all is active yes I have have you taken care
of the bullet patients yes I have C. put his pen down and then he looks at me and he says no one has said yes self yeah so many gets out he wants another ten feet picks up the receiver and he says yes Sir the doctor said yes what happens next any quickly after that the CDC personnel came and with full personal protective equipment kind of
like the type you see here and mind you this is after I spent twelve hours among hundreds of other airline centers so they go through their own questions you know and the CDC nurse %HESITATION band wants to take my temperature but they can't find a disposable thermometer so I offered to use mine you know been using it for the last few weeks she looks at me
with his incredulous look inside yep we're not gonna let you use your thermometer darn there goes my plan I've been tearing this toy thermometer with me this whole time just in case this would happen sneak back in the country I you know what I was relatively lucky you talked a lot of my colleagues who were returning responders from West Africa they actually faced a lot more
stigma some of them were refused entry back into their states some actually had their kids disinvited from birthday parties I heard one story when someone was accosted in public by their neighbor long after their quarantine was over and accused of being malicious and irresponsible actually many of them lost their jobs those they were traveling nurses in such and at that statement wasn't limited to those of
us that actually were returning from West Africa university of Nebraska Medical Center one of the hospitals I was assigned as a receiving center for patients who are Americans who are returning with little effort must Africa received daily death threats when they were taking care of their patients nurses at Bellevue who took care of Craig Spencer one of the MSF American doctors returned from Guinea and developed
a bola they refuse service in restaurants and beauty parlors and some of them lost their moonlighting jobs I think for all of us what took us a back was the fact that here we where you know we thought we were trying to help the communities the very same communities that we had now become pariahs in it is as if I had spent weeks battling this virus
and all of a sudden I was a bio hazard and because I was a bio hazard I would become an untrustworthy human being it wasn't the policies that took me aback he was actually the fear and the distrust those pointed at me and I couldn't help but think if this is how we were treated how're Ebola patients communicable disease of the stigma actually have a very
long history every epidemic seems to create its own set of pariahs and even the policies that we use to help limit the spread of epidemics such as isolating somebody who has the disease quarantining somebody who has been exposed to the disease have undue social costs it's not so much the policies but it's the social judgment that we assign to those that those policies are pointed at
and stigma in some ways by one definition is the recognition of a distinguishing mark and the subsequent evaluation of the person who carries and usually that mark is given to see a a group of people or an area that's already deemed undesirable but I can't help but wonder what people think differently about Ebola virus disease is the epidemic had occurred in Iowa and not west African
think of all the time and it doesn't have to be the black death right doesn't have to be bonded played think about the time your child got headlights remember the reaction of the other parents and the teachers right it's as if the other ring was instant the minute your child was recognized as the carrier flights and you and your child may recover from the headlights incident
but for those who actually have severe infectious diseases statement can be devastating I had the good fortune %HESITATION in the spring of last year of working with a lot of the bullets the visors who had wanted to go back and work in noble achievement units to advocate for patients and at the end of the day after all our training and we would get into a circle
and they would tell their stories and the most common theme in all their stories was one of bravery survival but also of de humanization they felt that they had stopped being a human being and were treated as a virus long before they entered a bullet treatment units they became nothing that cannot be touched that thing that must be put away nothing that's coming to get us
and that's not the first time I've actually heard that sentiment because sure Tina who is the executive director of aids action and a lifelong HIV positive advocate I heard one speaker he said it's as if the virus took over not just my body but also my identity isn't it interesting what we do right we de humanize the human and we create a sentient being out of
the virus state likely also have please a huge role in hampering the very efforts of stopping the epidemic that we're scared of during this particular epidemic of Ebola commercials airlines and shippers stop flying to West Africa and for those of us on the ground that minute we start running out of physical and human resources to battle this epidemic many times it sigma actually causes people from
coming forward who has the disease and it continues the strain of and the chain of transmission within the communities and in particular reason why it's important to talk about stigma emerging pathogens is because we're starting to see emerging pathogens with a lot more frequency we discover human infections that are new to us every year or year and a which means that this is a result of
overpopulation of natural degradation of climate change but it also means that we as a civilization need to strike a balance between being safe and shooting ourselves in the foot when it comes to battling his pandemics how do we do that education education is one of the major ways that you could potentially decrease stick life you can tell people what the real risks are %HESITATION of of
the transmission you could do that and come loose as as in the novel the plate he says the evil that is in the world almost always comes ignorance but the difficulty in talking about emerging pathogens is that by their very nature they're emerging right there at the horizon of our knowledge so there's a certain amount of uncertainty the trouble is how do you convince the public
to listen to your policies when you're at the same time you're telling them you don't know everything about this dog and scientific uncertainty in general is a difficult concept to communicate for scientists scientific uncertainty in statistical variation is part of the natural way of getting to know the world it's like getting the major themes of on Monday and then moving forward ever so slowly to learn
about the pressure you would think though of the world as a big jar of multi colored marbles and you want to know what was inside that jar you put your hand take out a set of marbles and you have some idea of what's in there but the more times you put your hand and more places you put your hand and we'll give you a better idea
but the only way to be a hundred percent sure about what's in that jar you took out every single marble and that's just not possible in natural phenomena for the public scientific uncertainty represents cacophony if there is uncertainty that means anything is possible and that's actually not the truth that little bit of uncertainty it we have about emerging pathogens actually rests on this mountain of scientific
knowledge we already have about the way bacterias and viruses work so we can get better at talking about uncertainty but part of the problem is also how risk is perceived influenza kills fifty thousand people in the U. S. every year there were eighteen measles outbreaks in twenty two states while label epidemic was going on so why is it that the public was assessed no one in
thirteen point three million chance well it's partly about how we are as human beings and receiving risks we obsess about something that's new in our horizon rather than risks that we've already meet as our background noise Russell actually very obsessed with risks that are popularized risk that are brought to our attention a lot more than risk that again are not brought to our attention the media
doesn't talk about it so the media plays a huge role in the way that we perceive new risks in our communities you don't just once I'd like to have measles be described as the ISIS of biological agents right then there's this beyond education beyond advocacy nimby not in my backyard in some ways public health is about public morality because public health is not just doctors and
nurses it's actually all of our influence on whether we make positive or negative decisions and if that's the case how do you improve public morality one way is to promote practical wisdom this is a chicken performing able a triage not an example of practical is to but that is not what Barry Schwartz the psychologist meant when he said practical wisdom he suggests that by expecting the
lowest common denominator of behavior from everyone and then providing incentives for positive behavior we actually take away from our drive to do the right thing we take away from our virtue and one way to promote practical wisdom without taking away our drive to do the right thing celebrate moral exemplar this is easily the French Easter is the head nurse the Kenema hospital where I worked in
August of two thousand fourteen eastern I worked shoulder to shoulder and one of the darkest months of this epidemic he was there in March two thousand fourteen when the first patient with Ebola arrived Kenema and he's seen over five hundred able of patients national healthcare workers have faced some of the worst stigma of any of us some of them are driven out of their homes and
villages were forced to stay on the grounds of the whole treatment units so they avoid any insignia that identified them as a bull workers the day in and day out they would go in month after month to risk their lives and when they left they had any signs of their heroes and so remember asking French one day why he does what he does and he said
because this is my community because these are my people because these are human beings and I mean that's a good way to remove stigma by re humanizing the person who has the disease because after all when inside I went into that Abel achieving unit every day we can see the virus we sought real complete human beings those are their own life trajectories with their own family
