Health Security Summer Reading

This summer, I read some great books about infectious diseases and the impacts they’ve had on culture, economics, politics, and, perhaps most importantly, the way people perceive and interact with the world. Tweet me suggestions for other good reads or books you’d like to see reviewed.

The Plague (Albert Camus)

“Ah, if only it had been an earthquake! A good bad shock, and there you are! You count the dead and the living, and that’s an end of it. But this here damned disease – even them who haven’t got it can’t think of anything else.” 

Though Albert Camus published The Plague in 1947, it remains exceptionally relevant even today. While intended primarily as an allegorical commentary on German militarism and moral responsibility, it also provides useful insights into disease dynamics. The novel, which details the spread of bubonic plague in Oran, Algeria and the reactions of its townspeople, is uncanny in its resemblance to recent responses to the Ebola outbreak in West Africa. During the course of the story, the characters experience confusion over the origin of the outbreak, panic about its rapid spread, despair over the lack of effective treatments, and rebel against a government-mandated quarantine intended to contain the plague within Oran’s walls.

While the details of the healthcare and public health responses to the plague are astonishingly accurate, what makes The Plague an especially satisfying read is the detail with which Camus illustrates the psychological and emotional tolls associated with battling deadly diseases. Most importantly, the novel avoids sensationalizing the disease in question, as many popular depictions of outbreaks are inclined to do. As such, The Plague is by far one of the best fictional accounts of an infectious disease epidemic I’ve come across.

 

The War Machine and Global Health (Edited by Merrill Singer & G. Derrick Hodge)

“Directly or indirectly, war touches the lives of most people on the planet, often with enduring and costly health consequences…Immediate casualties, in short, are only the beginning; war-related deaths and injuries are numerous and insidious and last far longer than active combat.”

The War Machine and Global Health is a stunning anthropological analysis of violent conflict and its impacts on population health. The book consists of numerous case studies examining the social, political, and economic drivers of conflict and draws out their associated health consequences, which, unsurprisingly, often persist long after the conflict in question dies down. These case studies explore among other issues, the decimation of Iraq’s healthcare infrastructure, the psychosocial health of child soldiers in Nepal, the forced migration of the Chagossian people, the Honduran government’s transgressions against its poorest citizens, and the challenges of achieving interoperability between US and Guatemalan military medical teams.

Recent acts of violence in places like Israel and Palestine, Nigeria, Pakistan, and Afghanistan underscore a disturbing trend: that the effects of violent conflict increasingly are spilling over into the civilian sector to an unprecedented degree. There is an urgent need for further scholarly analysis of this trend. Some researchers have already examined conflict as a public health problem, but The War Machine and Global Health does an especially impressive job of combining rigorous scholarship with anecdotes, interviews, and ethical analyses to paint a moving and comprehensive picture of what conflict does to people and their health.

 

Cherokee Medicine, Colonial Germs (Paul Kelton)

“I am much gratified at the good sense manifested by the Cherokee Indians. Who would have thought that vaccination would already have found its way into the wilds of America?”

Edward Jenner, 1802

The story of how British forces used smallpox-contaminated blankets to decimate Native American populations during the French and Indian War is an oft-cited example of early biological warfare. The story exemplifies the “virgin soil thesis,” or the idea that Native tribes’ primitive medical practices and lack of immunity were responsible for the disastrous impacts of smallpox among indigenous populations. In Cherokee Medicine, Colonial Germs, however, Paul Kelton delivers a meticulously researched rebuttal to the virgin soil thesis. Drawing from firsthand accounts, he argues that brutal treatment at the hands of colonizers was the main driving force behind Native American deaths, which in turn amplified the already deadly effects of smallpox. Focusing primarily on Cherokee populations, Kelton examines how commercial interests, cultural differences, and political tensions between colonists and tribes often gave rise to armed conflicts that were far more ruinous than any epidemic.

Of note, Kelton also acknowledges the agency of Cherokee tribes in responding to smallpox outbreaks and describes in detail the practice of Cherokee medicine. Though typically dismissed by colonists, Cherokee medicine was deeply rooted in extensive cosmological belief systems. Its practitioners embraced both quarantine strategies and inoculation as protective measures against smallpox. Cherokee Medicine, Colonial Germs is a valuable read for anyone interested in understanding the impacts of colonialism and disease from the perspective of indigenous populations, the challenges associated with conducting epidemiological analyses, and the roles of culture and politics in shaping the course of and responses to infectious disease epidemics.

 

Rabid: A Cultural History of the World's Most Diabolical Virus (Bill Wasik and Monica Murphy)

“Rabies is a scourge as old as human civilization, and the terror of its manifestation is a fundamental human fear, because it challenges the boundary of humanity itself. That is, it troubles the line where man ends and animal begins – for the rabid bite is the visible symbol of the animal infecting the human, of an illness in a creature metamorphosing demonstrably into that same illness in a person.”

Rabid traces the proliferation and impacts of the rabies virus through human history, from ancient Babylon to a recent episode of The Office (“There’s no such thing as a rabies doctor.”). Despite being one of the best-documented infectious diseases in human history, rabies today remains, paradoxically, both a mystery and a very real public health threat. Rabies infections give rise to a terrifying constellation of symptoms with a near 100% fatality rate: hydrophobia, paralysis, hallucinations, and paranoia. Tens of thousands of cases are reported every year, but – as is the case with many neglected diseases – rabies research and prevention efforts nonetheless attract little funding.

Rabid is compelling and accessible synopsis of rabies’ etiology, including its symbolic and psychological links to vampires, werewolves, and zombies, prevention and eradication efforts around the world, and recent therapeutic breakthroughs. Wasik and Murphy also offer detailed portraits of the scientists who contributed to our understanding of the disease: Louis Pasteur, Rodney Willoughby, and Benjamin Rush. Most importantly, Rabid underscores the importance of understanding the dynamics of disease transmission at the human-animal interface.