The current fuss about vaccinations reminds me of my Peace Corps experience.
I was a Peace Corps Volunteer in Liberia, West Africa, from 1985 to 1987. I was assigned to a “rural development” project and my particular task was communicating useful messages to people in villages around the regional capital of Zwedru.
The traditional power structure of West African people relied on a system of town, clan, and paramount chiefs – old men with dignity and stature. They settled disputes that arose between villagers, such as when one man’s cow trampled another man’s rice field. But the chiefs had no capacity to do anything new – no talent for marshaling resources or for cooperating with the outside world. Those villages didn’t have much occasion to interact with the world. They were isolated by dense rain forests and roads that were impassible for much of the year. They didn’t have electricity, either, though most had at least one battery-operated radio tuned to the Voice of America or BBC World Service.
In the 1980s, the Liberian Rural Communication Network was created to improve conditions in the countryside. The US government built radio stations in regional capitals like Zwedru, with transmitters strong enough to reach nearby villages. I worked alongside six Liberian men – two from each of three tribes that lived in the region. They were a good bunch of guys: young and ambitious. They all identified with a combination of western names (signaling they were educated) and traditional names (signaling that they were still “of the people.” My task was to help my colleagues with the technical side of radio production , and to join them on village visits where we encouraged the people to take actions that would improve their health and economy. (I spoke Liberian English pretty well, but I never learned any of the tonal West African languages well enough to communicate with village women.)
One of our biggest projects was support for a World Health Organization vaccination campaign. Every few years WHO came around to each village with a dry-ice chest full of vaccines. But often when the doctors arrived at the remote villages, few children were there to receive the vaccination. Some of the missing children were working at scattered rice fields weeding and driving away birds. But many more of them were being hidden by their mothers.
The WHO vaccination campaigns had been around for several years by the time I got there, and many of the villagers had experienced them. And they had observed that children would often get sick soon after taking the injection. Mostly the villagers were eager to take advantage of kwi medicine. But in the case of vaccination many of them used their better judgment and declined. (Kwi is the term for ideas and technologies coming from outside the familiar, indigenous tradition.)
So the task of my colleagues and me was to visit those villages a week or so ahead of the doctors, meet with the gathered people, explain why the vaccinations were a good thing, and persuade the mothers to cooperate. We did it with a combination of community-building celebration and serious discussion.
It wasn’t too hard to accomplish that. The villagers understood cause and effect. They also understood that some people knew more about health than they did. They were reasonable people. So we began by assuring them that their observation was correct. Children did get sick after taking the vaccine. (We didn’t know this at the time, but the formal theory of argument called Rogerian Argument recommends exactly what we did.)
We then explained why this was a good thing.
The villagers understood the idea of setting a controlled backfire in order to contain a larger brushfire. We used that image to explain that a small bout of illness induced by the vaccine could prevent more serious illness from the full-blown disease. They knew that cutting the heart from the palm tree meant it would grow no further, and we used that image to explain how the vaccine took the heart out of the sickness.
Our efforts were pretty effective. Through the combination of persuasion and community spirit, the mothers accepted the message we brought. They brought their kids to the doctors on the assigned days, and allowed them to get the shot. In fact, I remember there was some disappointment because the doctors ran out of vaccine before all the kids could get it. But all in all, the WHO campaign that year was a success and our small part in it was a positive. The net result was healthier kids.
I am struck by the contrast between then and now. What worked well 30 years ago in West Africa isn’t working in 2015 in the USA. Maybe it just isn’t being tried. Maybe it isn’t possible.
I remember thinking at the time that these village dwellers couldn’t be blamed for their ignorance. They just hadn’t had the opportunities to know as much about health and science as Americans. But here we are in American, 30 years later, with a worse and more insoluble conflict over a scientific question.
I think Ms. Hibben-White is right that people should have their children vaccinated. I think she’s right that all the reasons given for not vaccinating are junk science or worse. I think she’s right that people have an obligation to do the right thing for the good of the community. I think, “It’s my choice!,” while true, is never a justification for not doing the right thing.
But I think it is sad that her appeal only stirs outrage and scrutiny. She’ll get a million page views, but she’ll probably not persuade anyone. Part of this is her fault. She doesn’t respect the people she’s talking to. She resorts to name-calling and outrage. This doesn’t work. You can only bully people when you have power over them — something no one on the internet has over anyone else on the internet. You can only persuade people when they like you — which isn’t likely when you sling insults at them.
But the bigger problem behind the anti-vax controversy and other social issues is lack of community. The Liberian villagers were happy and eager to obey instructions, because by doing that they affirmed their place in the community. Many Americans today are conditioned to resist social suasion. So we get anger and stupidity, and, occasionally, the sickness and death of a child who might have lived.
I’m not suggesting America should be more like a West African village. A couple of years after my wife and I finished Peace Corps and left, Liberia erupted in a horrific civil war based on tribal tension and opposition to the corrupt government. Tens of thousands died, including at least one of my radio friends. Hundreds of thousands were dislocated. The children pictured above were certainly affected by that war. Our vaccination couldn’t protect them from every kind of harm.
What I am saying is that here in 2015, I still don’t think mankind has figured out how to live well.