Understanding the Politics of Pandemic Scares

An Introduction to Global Politosomatics

Mika Aaltola

• Publisher: Routledge
• Year: 2012
• Print ISBN: 9780415603812
• eBook ISBN: 9781136650154
• Topic: Politics & International Relations
• Subtopic: American Government
• Index: Politics & International Relations

Reactions to pandemics are unlike any other global emergency; with an emphasis on withdrawal and containment of the sight of the infected. Dealing with the historical and conceptual background of diseases in politics and international relations, this volume investigates the global political reaction to pandemic scares.

By evaluating anxiety and the political response to pandemics as a legitimisation of the modern state and its ability to protect its citizens from infectious disease, Understanding the Politics of Pandemic Scares examines the connection between international health governance and the emerging Western liberal world order. The case studies, including SARS, Bird Flu and Swine Flu, provide an understanding of how the world order, global health governance and people's bodies interact to produce scares and panics. Aaltola introduces an innovative new concept of 'politosomatics' based on the relationship that links individual stress, strain, and fear with global circulations of power to evaluate increasingly global bio-political environments in which pandemics exist.

This book will be of interest to students and researchers of International Relations, Global Health, International Public Health and Global Health governance.

1 Introduction

Diseases desperate grown

By desperate appliances are relieved,

Or not at all.

Shakespeare, Hamlet

In emergencies, the prevailing global sentiment is often one of mobilized empathy. The sight of a starving child in Africa may lead to a sense of compassion and the need to rush in to intervene on behalf of this distant sufferer (Aaltola 2009). Highly rehearsed ritualistic donor behaviour and rescue efforts may follow. Yet, the sight of the dead and suffering swine fu victims in Mexico in the spring of 2009 led to a sudden global jolt of aversion and fear. The immediate global reflex – a similar reaction to the emergence of those infected by other perceived pandemics – was that of distancing and severing contacts with the site of the unfamiliar and deadly disease outbreak.¹ The momentum of pandemic emergencies is towards disengagement with the suffering distant other. It is one of containment, rather than compassion. In this sense, a pandemic’s affective flows are unlike other global emergencies – they are seemingly non-compassionate rushes towards withdrawal and to contain the disease in a certain place, spot or ‘zone’. If there is other-interestedness, it is towards the people living close by or towards the ‘general public’, conceived of in terms of national, international and global public health.

These acute global relationships of worried containment shed light on the power-related dynamics of pandemic scares. In this work, I will use the term ‘politisomatics’ (i.e. ‘politico-somatics’) in reference to how lived life individual somatic-level anxieties couple with the hierarchical interconnectedness of the global polity. Politico-somatic relationships interlink the global hierarchy’s differential spread of risk – the inequalities in the disease burden together with associated imbalances of wealth and power – with individuals’ fears of bodily harm.² In this context, the world order translates into a configuration of differentially exposed bodies, which, in turn, causes stress and anxiety and leads to market panic, races to develop vaccines, fear of public spaces, wearing of masks, changing social expressions, and other types of disease-related ritualistic behaviour. The more encompassing political ‘bodies’, such as states or the world order itself, can also be felt as being under pressure and duress. People often sense their wider surroundings and their world as embodiments with which they identify in varying ways and on behalf of which they worry. They feel the world’s pains and, as a result, these wider embodiments may turn into bodies in pain. And, it can be suggested, these world related pains have long cultural histories that condition our contemporary sensitivities, as, for example, when it comes to regressive processes and ‘fatal blows’ such as lethal epidemic diseases. These imageries of regressive circulations and flows cannot be anything but intense. Their bangs lead to expectations of corresponding pain in other less expansive bodies, such as individuals’ bodies. In this way, actual and feared political pain may become somatized with the result that it is possible to speak about politico-somatics in much the same way as it is possible to discuss psychosomatic or socio-somatic disorders.³

Diseases exist, flourish and die in wider than physical environments, where they adapt to local memories, practices and cultures. For example, the communal responses to avian fu were commonly based on the practical logic developed on the basis of existing stereotypes, media representations, government information campaigns and popular rumours (Padmawati and Nichter 2008: 31). Moreover, diseases are embedded in and violently react with the fabric of political power. In this process of mutual adaptation, the responses to diseases inevitably turn into signifiers of the underlying patterns of power. For example, in the early 1980s, the Soviet authorities insisted that HIV was the outcome of an American military experiment that had gone terribly wrong (Nelkin and Gilman 1991: 39). The purpose could have been to point out that the United States of America (the US) was a vicious and underhanded superpower that should not be trusted. Moreover, for the Soviet Union, the HIV and AIDS epidemic offered an opportunity to point out that it was AIDS-free because it had no ‘degenerate’ and ‘corrupted’ homosexual elements. However, HIV and AIDS never became a very potent propaganda weapon, partly because it could be externalized into ‘undesirable’ internal elements such as homosexuals, prostitutes and recreational drug users. In other words, many people in the West connected the disease with the ‘unnatural’ gay community, rather than with the general ‘corruptness’ of Western societies. HIV and AIDS were also used effectively by the American neo-conservative movement at the beginning of the 1980s to promote its own message about family values and the need for religious revival in the US (Aaltola 2008: 67). It may be further argued that the public meaning of suffering from HIV and AIDS changed the expressive pain behaviour of those who had the syndrome. Their suffering was stigmatized and used for political purposes. The fact that the suffering became more silent was in itself a politico-somatic phenomenon. HIV and AIDS, like many pandemic diseases before and after it, reacted with the prevailing perceptions of power, hostility and enmity. People tend to decipher the world through them and the world tends to give meaning to diseases. Pandemics seem to forcefully register the world of hostility as well as the world’s hostility (Tuan 1979: 87).

In the case of pandemics, the power-political embeddings are increasingly global. However, in most studies on lethal epidemic diseases, this macro-level political aspect is missing or only implicitly recognized. There are a few notable studies that have focused on the power aspect of pandemics and researched how public health has interacted with conquest and governance (McNeill 1976; Price-Smith 2009; Panisset 2000). Contrary to the overall overlooking of power and politics, I will chart pandemic diseases and their scares as being inherently power related (Aaltola 1999a, 1999b, 2005a). I will use the term ‘politico-somatics’ to describe how the constitution and interaction of different embodiments – ranging from the wider political embodiments to the somatic ones – are shaped by macro-level political processes. Political imageries can be deeply integrated into the understanding and awareness of the body. The direct impact of the political context on the various kinds of disease experience and on the practices of pain-expressing behaviour is to be expected. Disease, as a socially interpreted physical and physiological process, is fundamentally shaped by prevailing political culture and practices. In this way, pandemic scares can be identified as polysemous, yet forceful, idioms of distress and anxiety. By using politico-somatics as an analytical concept I will explore how these disease-related hyperbolic and widespread experiences of fear are linked to global power structures, which differentially expose bodies to various risk factors. While the prevailing and underlying political anxieties may be projected into interpretations of pandemic diseases, the opposite is equally likely: the emergence of acute pandemic emergencies reinforces the corresponding imageries of both declining and reviving political power. I will draw from disease-related memories and histories to show how these politico-somatic interactions are supported by traditions of political theory and thought that are still under research.

It can be argued that the recent pandemic scares may be regarded as ‘politico-somatic disorders’. It has been widely recognized that ‘disease behaviour’ – that is, how people express their fear of diseases – is influenced by factors other than physiological ones. For example, people react differently to pain and death in a way that reflects their ‘learning history, socialization, and cultural predisposition to behave in certain ways in particular circumstances’ (Chapman and Wyckoff 1981: 35).⁴ Moreover, this relationship is often perceived as complex and en tangled with ‘cultural, psychological, and physiological factors’ (Bever 2000: 581). However, studies on pain behaviour invariably fail to appreciate our political embodiments, their wider interrelatedness, and the associated grammars of politically expressible pain. The politics of bodily suffering, pain and death has two main dimensions. First, physical suffering is a highly iconic and readable part of disease as well as of different forms of political violence. Second, there exists a long tradition in which political bodies – such as societies, communities, empires, states, nations and humanity – have been seen as ‘subjects’ of suffering. In the case of pandemic diseases, which often provoke the image of much hyped ‘blows against civilization’, both the somatic and political embodiments can be seen as suffering and the expressive language of these sufferings can be Connected. Politico-somatics is a bridging concept in discerning the nexus between the different forms of ‘bodily’ pain.

Susan Sontag (1988) noted that all attention-catching diseases were always ideally comprehensible entities in their own time. They served to crystallize epochal individual and political fears. I will use this insight to claim that the reason pandemic scares become so ‘scary’ stems from the prevailing declinist imageries and from other historically conditioned political sensibilities, insecurities and vulnerabilities. The present pandemic scares and, very importantly, the silence of pandemics that do not catch public attention are intimately connected with the contemporary construction of crises and threats in global politics. The politico-somatic perspective links the recent phenomenon of pandemic scares to the imageries of political decline and regression of the prevailing world order as a hegemonic embodiment. The central theme in these imageries is that the interaction between different perceived crisis factors and dynamics – as, for example, global warming, the amassing of weapons of mass destruction (WMDs), collapsing public health, economic turbulence, and changing demographics – will further induce the likelihood of eruptions of perceived emergencies and catastrophes. The related uncanny anxiety creates a political context pregnant with anticipation of different imageries of coming bodily discomfort. Such declinist crisis imageries also make the time ripe for perceptions of pandemic emergencies. Furthermore, the appearance of other forms of emergency, especially large-scale wars, heightens still further the expectation of pandemic spectacles. Pandemic scares can be seen as symptomatic of the underlying political power worries. Thus, they embody many fears that stem from visible stress on the existing world order. This world order has been able to provide specific forms of bodily comfort. The blow by a pandemic plague is a major way of imagining and embodying the possible unmaking of this bodily comfort. Thus, the added value of the politico-somatic approach stems from the ability to understand the nexus between macro-level political processes and disease imageries.

The world order, as a hierarchical hegemonic political embodiment, causes incongruence with the more or less peripheral local, national and state embodiments. These conflicts and contestations reflect, in turn, on the individual somatic bodies caught in the middle. All this finds an expression in the ritualistic nuances and entanglements of pandemic scares. Outside of the West, many just suffer, expressing their misery through their local iconic pain language, which does not come under the global public gaze if there is no sense of an uncontained contagion. In other words, pandemics, as embodiments of feared ‘dis-eases’, are reflective of the underlying power flows and circulations in the prevailing human polity. In this sense, the specific forms of pandemic scares reveal the underlying political dynamics. Figuratively speaking, lethal epidemic diseases provide an X-ray of their embeddings (Herdt 1992: 8). This resonates well with Sontag’s notion that all attention-catching diseases are always ideally comprehensible entities in their own time: they fit their political surroundings, as their alarming nature is constructed from the prevailing declinist fears and from other historically conditioned political sensibilities, insecurities and vulnerabilities (Ungar 1998: 37). This book examines the overall politico-somatic dynamics of pandemic scares. What are their common tendencies? What do they reveal, and how is that linked to their production and staging? How do political concerns shape the emergence of lethal epidemic diseases? The answers to these questions are based on rediscovering some of the central proto-political myths involved as well as on illustrating how they shape present-day pandemic scares.

The most recent pandemics (Ebola, BSE, SARS, avian flu, and swine flu) have been more like duds – scares with relatively few deaths or low mortality – than feared civilizational blows. However, the spectacular and hyperbolic pandemic scares are themselves worthy of critical examination. Their imageries are so interwoven with the fabric of global politics that, by studying them, crucial knowledge can be gained concerning how power and legitimacy are created through hyperbolized somatic threats. It should be noted that power embedded politico-somatic pains and anxieties can lead to a sense of relief and restored normalcy. The sentiments of fear, anxiety and scare are converted into opportunities for legitimizing power spectacles branded as ‘effective health governance’ till the hyped devastating blow is once again averted and the scare subsides. It can be suggested that disease fears and scares are among the main ways in which the globalizing world is felt and sensed. I will use the dynamics of politicosomatics to illustrate these power-related pandemic sensations and emotions. The phenomenon of politico-somatics allows for a more comprehensive and critical evaluation of how pandemic scares are much more substantive parts of the global experience than would first appear. Pandemic scares are regarded as politico-somatic disorders that link individual level stresses, strains and fears with global circulations of power, and with the global and local polity’s production of legitimacy. While examining their underlying dynamics, this book provides an overview and history of recent politico-somatic pandemic scares.

The focus of this book is on the politico-somatic dynamics of recent pandemic scares, which ‘suddenly burst forth in a catastrophic manner’ (Kilbourne 2009: 218). The diseases in themselves, as physical phenomena, largely fall outside the scope of this work. The emphasis is on how diseases are interpreted in their social and political contexts and how these interpretative constructs interact with perceived sudden pandemic emergencies. The pandemic scares are defined by hyperbolic attention, which, in hindsight, appears to be ‘grossly disproportional in relation to its low mortality rate’ (Caballero 2005: 483). The status of recent pandemic emergencies as ‘scares’ does not detract from their significance. On the contrary, pandemic scares are highly significant situations that highlight the intensively embodied ways in which global politics is inherently glued on to individual bodies. On the one hand, pandemic scares can be seen as bringing the global reaches closer to human bodies in that they contain medicalized topologies of power. Fears and anxieties connected with the circulation of disease agents are always non-abstract. They are deeply felt. People sense their globalized surroundings, thereby creating points of attachment for relevant understanding of their own ‘locatedness’ in the interconnected global embed-dings. Waking up to a world that is experiencing a mysterious disease said to be extremely serious and deadly, instantiates a relationship of worry that is bound to have a more than fleeting influence. Through them, people re-remember the high personal stakes involved in the global polity. On the other hand, this interface allows for highly meaningful re-enactments of power, which are seen as highly pertinent to the present circumstances faced by differentially situated individuals. Because these connections to a part have been instantiated just then, they appear to be still murky and ill-defined. They are explicated at the level of abstract public health knowledge. Yet, at the same time, the themes involved – that of plague and people – are ancient. Only the scale has changed and much of the old ‘disease frame’ has been forgotten because of the triumphant claims in the mid-twentieth century that the era of major lethal epidemics was over. The recent pandemic scares reactivate and rearticulate the older and almost instinctive registers of making the interconnectedness and inter-locality of people relevant. The use of the term, politico-somatics, involves an effort to explicate the silent knowledge involved in the disease–politics nexus.

This work is fundamentally about bodily pain, fears of it, and about the pain conducting links between differently embodied kinds of suffering. My main concern is with how pandemic diseases are seen as inflicting bodies of different qualities, both somatic and political. Besides being abstract, the study of politics can be seen as embodied. Its main subject has been the various political bodies – yours, mine, and ours. It has strived to understand also more encompassing embodiments such as polis, state, world and, now, globality. Often, without being aware of it, the corpus of political knowledge has charted the sensual entanglements through which these bodies interact and feel each other. The central conceptual configurations have tried to understand the violence between the bodies as well as to come to terms with the internal violent conflicts of contesting and failing bodies. Much of modernist research energies have focused on the way in which political bodies are constituted and built – that is, on progressive narratives. At the same time, the shadow of the intense regressive processes of decomposition still looms large over the ways in which the world is sensed. Against the background of the unravelling of the modernist progressive paradigm, the central research interest is on how the narrower and larger of our political bodies can become entangled in mutual regression. Politico-somatics entails an awareness of the interrelated nature of embodiments. The pulses of political shivers, pains and convulsions travel through the political fabric, which echoes worries over interrelatedness. These pulses build up and are felt in seemingly disparate ways on different ‘skins’ of the wider and narrower ‘bodies.’

Thus, politico-somatic intimacy involves sensing the world’s pains on one’s body. The two most distant embodiments – that is, individual bodies and world order – come into direct contact in pandemics and their scares. As a child growing up during the 1980s, I remember when the worst case scenario consisted of a nuclear holocaust. Posner (2004: 71) aptly states that ‘during the half century of the cold war …, the catastrophic risk that attracted the most attention was that of a nuclear and a thermonuclear war.’ Imagining what a nuclear holocaust would mean sent shivers down the spine of the young boy that I was.

It was felt bodily in sweating and nightmares. The worst case scenarios of more recent times have focused on pandemic diseases. Many people, young and old, feel them. Pandemic scenarios have become more ideally comprehensible about our times than the scenes of nuclear war. Pandemics ft their political power surroundings and their alarming nature is sculptured from the prevailing sensibilities concerning what might go wrong. These bodily felt world order anxieties are also involved in the recent pandemic diseases enabled by the ancient sediments of memories written in the language of bodily disfigurement and suffering. An individual nested in and enabled by the world must have near instinctual sense of the power dynamics which enable large-scale disasters.

Turning to the theoretical framework of this book, I remember reading with keen interest Elaine Scarry’s 1987 book, The Body in Pain, while lecturing at the University of Minnesota on the nexus between lethal epidemic diseases and world politics during the spring of 2008. In it, I saw many bridgeheads to the politics of pain. As one can imagine, Scarry’s work was full of morbidity: the words and many visuals in it described a world of contorted and convulsing human bodies, vivid images of agony, and a masterful account of the unmaking of bodies through the processes of torture and war. The intensity of the pain language brought to my mind the classical account of war, Thucydides’ History of the Peloponnesian War. For Thucydides (c.460 BC–c.395 BC ), the deepening and widening vortex of macro-level war induced pulses and co-currents. These emerging sub-currents occurred in the vicinity of the war’s rhythmic expression of regressive energy. The increasingly violent circular motions meant that intervals in extreme pain production became progressively shorter: violence kept coming back, cutting across and within bodies in increasingly intense spirals, circling round and back, again and again. The drama that Thucydides describes spreads from the inter-poleis level to local slaughters and to that unforgettable sub-current of war, the Plague of Athens. The holistic nature of Thucydides’ work, which covers the macro, local and individual levels, might be better understood through a comparison with how he might have approached contemporary times: the wars fought by the hegemonic power, the US – such as in Iraq and Afghanistan – open a context where individuals’ disease-related fears – those of SARS, avian flu and swine flu – can be interpreted as sub-manifestations of the overall dynamics of terror and war in our world. In the same way, the failure of local states and communities from Somalia and Darfur to Afghanistan may be interpreted as symptoms of an underlying wider regressive flow. The crisis at the individual, communal and world levels spill over and result in complex entanglements, the tru...

Table of contents

• Front Cover
• Understanding the Politics of Pandemic Scares
• Routledge studies in governance and public policy
• Title Page
• Copyright
• Contents
• Abbreviations
• 1 Introduction
• 2 Containments and compassions of pandemic dramas
• 3 Understanding the Vortex of War and Disease
• 4 Trajectory of a pandemic drama
• 5 Vortexes of SARS
• 6 The pandemic geography of Avian Flu
• 7 Beyond global public health
• Notes
• Bibliography
• Index