"The Wisdom of Whores"

Elizabeth Pisani’s The Wisdom of Whores is an unsettling glimpse into a world full of “hookers”, “junkies”, “gays” and “trannys”, where the vilest of them all are the silk suited, air-plane hopping, number punching, self righteous research consultants and their mother organizations that have capitalized on the booming “AIDS Industry”, pocketing much of the funding for their invaluable services of not coming up with accurate data, of not curbing the rates of newer infections and of not being able to provide care for the already infected. She lays out the harsh facts about organized mal-practice and mis-information like a “butcher with satin gloves on”.

The eternal shortage of funding for AIDS is in most part due to the bottomless pockets of those involved in working towards its alleviation. The reality is that even a portion of all that wasted money is sufficient to make a critical change and provide care for the needy. The tragedy is that AIDS has become too profitable for anyone, apart from the infected and a few others, to really want to eradicate. The same principles of profit that deny Universal Health Care, equal land ownership, etc. are responsible for the ineffective and down right indifference towards complete alleviation of AIDS.

I could not resist contemplating on the “AIDS scene” of Nepal while reading The Wisdom of Whores. Like most third world countries, Nepal too has an army of International Non-Government Organizations (INGOs) like the UN, WHO, ILO, etc. that seem to have set up permanent base in the context of battling AIDS. Many of my friends who have recently graduated with degrees in Development Studies, Social Work and Sociology try to get into these organizations. For them, it is a place to be compensated for their hard earned degrees, and at the same time feel legitimate for contributing to society. That fine line between Public and Academic Sociology exists within other disciplines as well. Do we use our knowledge for sheer academic and theoretical purposes or do we act upon what we know, even if it means less compensation and a lot more effort? It is no wonder most people choose the easiest way to go about things. In today’s world we’re all economists who carefully weigh our opportunity costs before making any decisions. Same goes with our professions. We choose whichever one is the most beneficial to us, rather than to our cause. There are only a few people like Pisani who make unpopular choices of sticking to their cause by transcending personal benefits. It was really interesting for me to see a vivid and concrete example of Academic Vs. Public Sociology, in Pisani’s transition from one to the other.

Another aspect of the book that really struck me was how we as professionals so often take data as mere statistics. We forget that the statistic actually represents a person. I agree that it helps us remain value free and emotionally detached but at what cost? We fail to acknowledge that lifeless statistic as a human in a unique social circumstance. In doing so, we ignore the different realities of people in specific space and time contexts. Pisani uses Faud to illustrate this point very effectively. While Faud would be seen as nothing more than a statistic according to conventional data analysis, in reality he is a complicated being with a number of behavioral patterns that can be labeled or not, according to the culture he hails from. He considers himself a straight man that has an active sex life with his “decent” girlfriend who is a prostitute, gives blow jobs to other men strictly for monetary reasons, while occasionally getting a blow job from a ‘wari’ (transgender person) to reinforce his masculinity. Strictly as a statistic, Faud would appear to have a unidimensional character with linear relationships with other statistics. However, Faud as an individual is a multidimensional character that has reciprocal relationships with his prostitute girlfriend and the other people he has sexual relationships with. Pisani points out that using people as just statistics contributes to the inaccuracy of a study because it fails to take into consideration a variety of factors that are essential to our proper understanding of whats really going on. The networks of human relationships cannot be studied through only numbers, we need to study the choices, behavioral patterns, likes/dislikes, etc. of people. The task might be too monumental to have a thorough study of every individual but at least we can vary our research according to cultural and recurring trends in specific areas.

Indonesia like most other Asian countries is in a transition towards modernization while still retaining many of its traditional value and belief systems. On the one hand it strives towards numerous modern aspirations such as Freedom in Sexuality and Expression while on the other it still treats these topics as Taboo. Because of the dialectical nature of this transitory phase it is extremely difficult to introduce new preventive strategies such as “abstinence” and condom use to effectively curb the spread of HIV infections. Traditional sentiments towards sex remain deeply rooted in the minds of its people. In itself that is not a bad thing. However these sentiments developed over a period of time during which the risk of contracting HIV was absent. In the present context, that risk is astronomically high. Thus, the necessity to “tweak” traditional sentiments towards sex in order to grapple with the imminent dangers of HIV infections is very crucial. The most effective way to do this is through education and creating awareness. As Pisani observed at Rawa Malang, a major red-light area near Jakarta, medical stores advertised a galaxy of “sexual enhancement” drugs but “not a condom to be seen”. In the absence of awareness, even free condom distribution will be met with indifference and remain ineffective.

Before we come to the conclusion that “Sex Education” therefore should be included into the school curricula and that would promote “safer sex” practices which would then lead to a decrease in newer HIV infections and thus inhibit its spread, we need to consider who are most susceptible to HIV in the society. Usually, its those who don’t go to school or cant afford to go to school. Since trying to provide equal access to education for all is tackling another “Social Problem”, we will leave it as it is for now. However, identifying the interests and general haunts of these “at risk” uneducated groups allows us to infuse messages of awareness into things they are most likely to come across in their daily routines. For example, going to the cinema is a major recreational activity for most underprivileged people, especially in Third World Countries due to the fact that many of them do not have TVs at home. Hence, if messages emphasizing on what AIDS is, its effects, the risks of having unprotected sex, and the importance of condom use are shown to the audiences before a movie starts it would get through to a large number of people. If that would be too taboo, then incorporating messages about AIDS or basing the storyline around someone infected with AIDS in the movie itself would be highly effective too. Other methods through which awareness can be spread could be Billboard Signs, Posters, Health Workshops in specific areas and street theatres.

While Religion can play a great role in promoting abstinence, it is difficult to rely on in a country like Indonesia that has multitude of ethnic and religious groups. However, if all the leaders of the major religions of that country got together and decided to incorporate awareness activities in their Churches, Mosques and Temples, then I think it’d be highly effective. Unfortunately, religious intolerance and violence remain pervasive, and putting to much “faith” in religion to solve these social problems might deem too optimistic. The struggle is not really to create a perfect world; it already is perfect in its essence and place in the universe. The struggle is to promote wellbeing to its inhabitants. And unless that becomes our genuine collective priority, our “calling”; well-being will be limited, and like all limited things with high demand it will come with a very expensive price tag. The solution is really a very simple one: we all need to work together for each other’s well being because in doing so we will be guaranteeing our own.

All in all, this is an extremely insightful book not just into the world of AIDS but also into the role of the scholar. The eternal debate between Academic and Public Sociology reverberates throughout this book like a giant Chinese gong. Statistic or human? Profit or well-being? Academic or Public?

Mass Hysteria?

My study is based on the information I gathered from a leading Nepali newspaper called the Kathmandu Post. It revolves around an article dating back to the 1^st. of August 2003, titled, “Mystery Disease claims 150; around 4000 affected”. The newspaper published two other follow-ups on this story on the 11^th. of August; where it mentioned 50 more deaths, and the 8^th. of September, where it claimed that the authorities had concluded that the deaths and ailments were a result of mass hysteria. However, no evidence or explanation on how they had reached that prognosis was given.

The disease suddenly made it’s first appearance in a remote village in the far western region of Nepal. Most of the people infected were school children. It is explained that the afflicted person would develop flu like symptoms such as fever, head-aches, loss of appetite, joint aches, etc. that would in severe cases lead to death. Local medical authorities were not able to come up with a plausible diagnosis. Even an investigative team sent from the capital, Kathmandu, were baffled by the unexplainable ailment and hence dubbed it mass hysteria. This elusive disease had claimed more than 200 peoples lives and had affected more than 5000 people by the 8^th. of September 2003 when it disappeared as mysteriously as it had appeared. In the absence of any other definite explanation, people seemed to accept the ‘mass hysteria’ hypothesis and it was soon pushed to the back of everyone’s mind.

As I went through every issue of the daily newspaper spanning an entire month, I could not help but notice some other occurrences that seemed to run parallel to the surfacing of this ‘mystery disease’. They were:

1. The country was going through a full-fledged civil war. The rebel groups used the forests as a hideout and would often travel through villages to get somewhere else. These traveling rebels probably brought with them germs and diseases from their shabby barracks in the Jungle and passed them down to the villagers through even minimal contact. The rebels were known to have stayed overnight at people’s houses on some instances.

2. Massive flooding was taking place in other parts of the country due to heavy monsoon rainfall. Seventy five percent of Nepal’s terrain is hilly or mountainous. Because of the heavy rainfall landslides in nearby areas were destroying houses and killing people. At the same time due to poor drainage systems and crisis control skills, numerous pools of stagnant water were forming, leading to a rise in number of mosquitoes. A number of malaria cases were reported. At the same time the flooding and landslides led to the destruction of sanitation facilities. In the absence of clean drinking water an alarming outbreak of cholera and typhoid occurred killing thousands in these affected areas.

3. The government was incapable of providing the essential aid to these disaster struck areas for a number of reasons. First and foremost was the countries extreme topography. The winding roads over hills and mountains will slow down any aid worker. Airstrips are completely absent in some areas due inadequate space for runways. The only way to get there would be to either walk or by helicopter. With only a few helicopters at the government’s disposal and a war going on at the same time, the priorities the government took are pretty evident. Further more, even a properly organized group was not sent to the village to pry into the ‘mystery disease’ incident. A handful of people whose professional backgrounds are still not known were sent and they concluded that it was mass hysteria and no further investigation took place. When questioned why the kids were more susceptible to the hysteria than adults, they replied that since children’s minds were more imaginative they were more likely to fall prey to hysteria. I was appalled by the fact that they did not even entertain the idea that schoolchildren come in contact with more people and hence it could have been a result of some sort of communicable disease. Another reason the government could not provide sufficient relief efforts was because of its sheer unwillingness to do so. Corrupt officials who would go to any lengths to make money plagued the government in those days. Some may have even made money off of what was allocated for the disaster victims.

4. Last but not least, we did not have people questioning what we were being told. There are plenty of educated people and active youths who usually swarm to common themed issues like helping out orphanages, women’s rights, etc. It is not my intention to imply that these are any less important. However, when a mysterious disease wipes out more than 200 people and affects 5000 I would expect more questions from people who know better, myself included. I remember hearing about it at that time as well. I was intrigued by the fact that hysteria could lead to so many fatalities but apart from that I did nothing; I didn’t know any better.

In conclusion I would like to accentuate on the fact that medicine, as a social institution is not isolated from other crucial elements of society such as education, good governance, technological progress, environment, transportation facilities, journalism, etc. The overall coordination and communication between the above-mentioned elements, is crucial in enabling us to draw effective and truthful conclusions. In the absence of such conditions we see the cacophonic distortion of information leading us to answers that are far from the truth. Thus, medicine as a science alone, cannot progress without the support and consistency of numerous other social factors. Just as a vehicle needs all four wheels turning in the same direction to move forward, medicine too needs all its social tributaries pointing in the same direction to succeed.