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.