BETRAYAL OF TRUST -- Part 1

I'm in the middle of reading BETRAYAL OF TRUST:
The Collapse of Global Public Health by Laurie Garrett.

Normally I would not attempt to
review a book until I'm finished
reading it, but there're good
reasons to make an exception here.

1. It's a very long book. By the
time I reach the end, I'll have
forgotten most of what I wanted to
say about the early sections.

2. It's split up into a few long
sections -- which are really minibooks
in themselves, and therefore it's
not unfair to review each of those
sections.

Although I'm less than halfway
through, I've read more than enough
to say that like her earlier book
THE COMING PLAGUE this book is full
of well-researched detail and
interesting anecdotes.

And of course it's obvious that her
agenda is to boost the power of
public health.

And I must agree with many of her
points although we certainly part
company in some ways.

For instance, Chapter One concerns
an outbreak of pneumonic plague in
India in 1994.

The subtitle "Pneumatic plague hits India and the
world ill responds." illustrates her point that
the world SHOULD respond.

To be fair, she does a great job of presenting the
facts and at pointing the finger as Indian
authorities. She blames the government
for spending money on the military
instead of medical infrastructure.

I've been to India and it's certainly
fair to say that India will be a public
health disaster until it's cleaned up -- and
it's hard to see how that's going to happen.

Ms. Garrett mentions that India at the
time was undergoing a lot of economic
progress. She does fault India for
channeling extra money to the military
instead of to public health.

Connecting the advance of economic (read: capitalist)
interests with the decline in public
health seems to me to be Ms. Garrett's
basic agenda, which will be further
illustrated in the later chapters I've read.

My own response is first of all, that
when I went to India just a year later,
it was still dominated by a cumbersome
bureaucracy and the hammer and sickle of
communism could still be seen painted on
walls in Calcutta (though I'm not sure
whether or not communists still ran the
city government there).

Secondly, as Ms. Garrett does note (she's
always very factual), India is threatened
by the Middle Eastern Islamic states.
Muslims hate the pantheistic Hindus
and have been trying to take over India
for over a 1000 years.

Plus, India is threatened by China. They
fought a small war in 1962 (now long
forgotten by everybody except India and
China). They are the two emerging superpowers
of Asia.

Since, as a democracy and a country also
targetted by Islamic fanatics, India is
more or less an ally of the United States,
it's not unlikely that India may
someday again clash militarily with China.

(Many Chinese think they will eventually
have to go to war with the United States -- they're
certainly preparing for it. We hope that
doesn't happen. But if it does -- would we
want a democratic and highly populous Asian
nation on our side? Of course. So it's
quite possible that India will someday fight
China -- by itself and alongside the U.S.)

She quotes an Indian official to the effect
that if India can afford an aircraft
carrier, it can afford to vaccinate its
children.

She doesn't consider that in the face of
China's strong militarization, to
neglect aircraft carriers may mean that
her vaccinated children are someday
conquered by China.

Her criticisms of the world response to
India's plague do point out that
people are still people and will
overreact to the threat of disease.

Still, to criticize quarantines imposed
on travelers because an antibiotic
is available to cure the disease does
not take into account the feelings of
travelers who do not want to be
exposed to infectious diseases.

I'm glad that the plague can still
be controlled with an antibiotic
and I'm all in favor of helping those
who need it.

But that doesn't mean that I want to
be exposed to the plague just because
somebody who is carrying it insists on
their right to travel in an airplane
with me. I don't want to actually
catch the plague and I don't want to
have to take antibiotics unnecessarily.

So the close monitoring of travelers
from epidemic countries does not seem
to me in and of itself a bad thing.