In this day and age, we import fruits and vegetables, toys, oil, clothes and pretty much everything in between. All this may seem good and all, except for one minor detail: we are importing another good. It is one that doesn’t seem to be desired in the same demand, but still lurks in the shadows. Yes, all the while that we are importing commercially viable goods, we are also paving the way for the transmission of disease.
With more of this thing called globalization, we are endangering the lives of countless others through the spread of infectious diseases, notably TB. In fact, according to the U.S. News and World Report Vol. 142, No. 22, “In a world I nwhich one tird of the population is infected, the occasional traveler who goes to places steeped in TB brings it home. And in a country dependent upon the talent and energy of people migrating from high-Tb areas, the microbe has become a regular import. Moreover, the tubercle bacillus, a survivor that mutates around the drugs designed to wipe it out, is a formidable foe for a public-health system that has just shown itself to be inconsistent, disconnected, and underfunded.” Wow. Stepping back, it appears that we have a long way towards improvement. In this current society, we try to be all noble, helping others avoid political persecution, delivering military and financial aid and even providing jobs. Yet, there is always a dark side. In this case, it appears that we are in fact endangering the lives of others through TB.

Renovating Society

As we have already established, the plan to just find a new drug to treat MDR-TB is not a convincing solution. Yet, this does not mean that the disease will continue to mutate until everyone in the entire world is hopeless. No, instead it just means that we need to find a different kind of solution.

Though there are surely many possible solutions, one that sounds particularly interesting would entail a broader outlook that those presently under consideration. If in fact, MDR-TB is viewed as just another form of a disease that mutated into a resistant strain, then we can look at MDR-TB and all the other diseases at the same time. The plan would need a total renovation of our society. We need to start looking at all the resistant forms of the disease with the acceptance that a Fix-All-Society is not the right answer.

We need to find out how we can live in a society with a little bit of bacteria. Bacteria are not always bad for society. In some cases they can actually be beneficial. If we let the weak survive, then the strong will not necessarily mutate so quickly. Then, just maybe, disease as we know it will not be as deadly. Then, we will not be worrying about the possible new deadly form of a disease. Instead, we will find other worries to occupy our mind.

The Problem With Our Solution

There is all this hype about how we can cure MDR-TB. Yet, is it really possible to cure this highly lethal form of tuberculosis? At the present, I am very skeptical.
Though it would be very nice to banish MDR-TB from our vocabulary, we have to face reality. MDR-TB is not like TB at all. MDR-TB is not something that just magically developed thousands of years ago for some inexplicable reason, as in the case of TB. We created it. We are the ones who brought the drugs into environments in which the public was not ready to be cured. Granted, it is not really the fault of the public at all. The areas that are suffering the highest outbreaks of TB are the poor ones. In many cases, the infected in these areas does not have the choice to always get the treatment plans. Sometimes there are not enough drugs to cure the patients and sometimes there are not enough medical practitioners to ensure that the proper dosage is delivered. Even the most diligent people can be infected with the strain of MDR-TB by another person who cannot complete his/her treatment plan. So when it comes down to it, it is not really the fault of the people in the public.

Yet, this does not mean that the public is to blame. Though it is not the fault of the individual members of the general public, it is the fault of the general public as a whole. It is our fault that we nourish this insatiable desire for a Fix-All Society. We want to find a cure for everything. As a result, we kill the weak and help the strong. In the case of TB, this means that the more resistant strains mutate and become even more potent killers.

Developing new drugs for MDR-TB is not the option because the new drug will only aggravate the problem. People will just become resistant to that particular strain of TB and we will be in a larger predicament than when we started.

Is there hope for TB? Well, the CDC sure thinks so. In fact, they are working towards improving the protection plan in the hope of reducing the spread of the infectious Tuberculosis bacteria. They are concentrating their efforts in the hospital. Their aim in the improve hospital procedures to prevent drug-resistant forms, notably MDR-TB, from spreading. According to the latest update, the panel has a long way to go, but they are hoping for drastic improvements.

Starting at the hospital, while it may seem a bit strange, is actually a good idea. First of all, many people in developed worlds often get treated at the hospital for their TB. This means that if a person were to develop MDR-TB in the hospital, the CDC and the hospital officials could work towards learning more about the spread of the resistant form of the disease. Similarly, the hospital is also home to both sterile and extremely dirty environments. This too would help in both the further discovery of the path of mutation of the disease and the potential cure of the disease.

Epidemics in the US: Stories and Meaning

Though we have discussed various TB epidemics in developing worlds, we have hide away from those in the developed world. This is not to say that the developed world is exempt from TB epidemics. In fact, in 1995 there was an outbreak in Minneapolis.

The story goes as follows: One person in Minneapolis entered a bar on evening. This person happened to be infected with TB. Consequently, he infected 41 people in that neighborhood bar that evening. Stepping back, this story seems a little daunting. I do not believe that the customers of the bar that evening expected to be put into a dangerous situation.

This bar situation is not entirely unique. In Western Canada, a healthcare worker infected over 100 other people with TB. A postal worker in Tampa, Florida, also infected his coworkers. Clearly, developed worlds are not exempt from TB.
Yet, these outbreaks are not as prevalent as similar ones in developing worlds. Those in poorer countries occur more often and can often lead to more serious consequences. In developing worlds, the public does not have access to the drugs that it needs to cure the infected. Similarly, there is not enough staff to ensure proper completion of treatment plan. Consequently, developing worlds have a much higher death rate.

So then, how should the few cases in developed worlds be viewed? Are the unfortunate instances in which the public was put into danger? Does it reflect on the poor public security plan? Or, more likely, should these cases be seen as insightful instances that depict the disparity between the disease in developed worlds and that in developing worlds?

A Pleasant Way to Die

Tuberculosis is not the only disease that is facing mutations as the world becomes increasingly more globalized. In North America, clostridium difficile is making headway. Scientists are worried that it will become the next great killer. This superbug has a deadly resistant strain. In fact, “here are certainly dozens, perhaps hundreds of strains of C. difficile, most notably a superbug known as the epidemic strain. This hypervirulent variety has killed thousands of people -- often elderly patients in hospital -- across North America over roughly the past five years, particularly in Quebec. There, C. diff. killed an estimated 2,000 patients in 2003-2004 alone. Typically, the victims have been on antibiotics, which in addition to combatting infection, also wipe out the good bacteria normally found in the gastrointestinal tract. In their absence, C. diff. has no competition and thrives. The connection to recent exposure to antibiotics is so pronounced it is considered a virtual prerequisite for coming down with Clostridium difficile. Until now.”

The are multiple problems with this superbug. One of the most pressing issues is the fact that this bacteria is now spreading outside of hospitals and “into the community-at-large.” It has already reached some communities in Quebec and it could easily spread to many, many more. Another problem is that this superbug has spread to some foods. “The audience of scientific sleuths in Atlanta had heard much of this and more by the time Songer got up to speak. Songer said his lab had screened for the bacterium in meat bought in Arizona grocery stores.(In addition to striking humans, C. diff. also causes disease among commercial farm animals.)The samples included ground beef, pork and turkey, as well as a selection of beef, beef-pork and pork sausages. Incredibly, one-quarter of the samples were tainted with strains of Clostridium difficile. The workshop participants, who had been quietly listening, immediately broke into peals of nervous laughter intermixed with groans of disbelief.” Making matters worse, cooking does not kill it.

I’ve explained what the superbug is and the problems associated with it, but I have not explained how it kills. Let me elaborate. “There are few good ways to die, and lying in a pair of soiled diapers while waiting for the merciful end to arrive certainly isn't one of them. But patients fighting a severe Clostridium difficile infection frequently suffer that indignity, enduring 10 to 20 bowel movements a day. In addition to chronic diarrhea, the epidemic strain can cause a ruthless inflammation of the colon called colitis that sometimes necessitates surgical removal of that part of the large intestine. Sepsis, or blood poisoning, can also occur. Patients endure horrible abdominal pain, perilously low blood pressure and anemia that leaves them too weak to crawl out of bed.” Sounds fun, doesn’t it?

The Looking Glass

MDR-TB has many forms. It can range in severity, meaning that it can be a little harder to treat or it can be deadly. In 2006, South Africa had to learn this lesson the hard way. In Tulega Ferry, part of South Africa, “a deadly new strain of extremely drug-resistant tuberculosis discovered in South Africa is likely to have spread beyond the rural area where 52 of the 53 people diagnosed with it have died.” While it is very difficult to pin point the origin of outbreaks, especially when the outbreak happens to be in a developing country that lacks the adequate resources to fully evaluate the outbreak, it is presumed to have originated in Kwazulu-Natal. It is a region in the eastern part of South Africa. This outbreak was so severe that it is presumed to be across the country and maybe even across the world.

This outbreak is nothing unusual for MDR-TB. In fact, “drug resistance is a common problem in TB treatment, but the new strain appears particularly virulent. Worldwide, about 2 percent of drug-resistant TB cases are classified as extremely drug-resistant.” With our global practices, this percentage will only increase. As we become more mobile, it becomes even easier to transmit life-threatening diseases. The South Africa outbreak was just an extreme of this case. Because it was the MRD-TB strain that was spread and not simply a group of people who became resistant, the outbreak was more severe. According to Dr. Tony Moll, the doctor who discovered the super bug, “the strain was very highly troubling and alarming because of the very high fatality rate.” The strain was especially fatal because of the high percentage of the infected with already weakened immune systems, mostly from AIDS. Yet the severity of the outbreak should not be seen as the exception to the rule. Rather, it should be viewed as the looking glass to our growing epidemic.

Greed

Whether it’s happening in Bosnia, Afghanistan, or anywhere else for that matter, wars undoubtedly cause a lot of disruption. They disrupt the peace, destroy buildings and hurt families, just to name a few. Joe Sacco, the journalist, author and cartoonist of “Safe Area Gorazde,” tries to accurately reflect the heartache brought forth from the war. In many instances, he does a great job. It is easy to see the suffering that goes on in this war-torn place. Sacco does an excellent job a showing the transformation that happens to the victims. For example, he explains that neighbors who used to be friends are now enemies. While the neighbors of opposite descent are facing similar problems, notably the lack of security, the fear of what to come, and the loss of a stable home, they act as though they cannot understand their old neighbors. They have become strangers to each other. Yet, ironically, they share more in common with each other than they would like to admit. Unfortunately, Joe Sacco is not wrong in his illustration of some of the suffering.

Yet, among the description of the pains of these war victims, Joe Sacco points out something very interesting. It is something that a stranger to war life would not predict or even believe. It is greed. When Sacco recounts his stories of the people in Gorazde, he includes the part about the desires of the victims. They want jeans, cigarettes, and almost everything under the sun. Money is no object, because there is nothing to buy in Gorazde and relatives often send money. Pain, suffering and loss of identity are all aspects of Joe Sacco’s description of Gorazde that are easy to believe, but greed? That was a little harder to grasp.

At first glance, greed just does not make any sense. Why would these people who are faced with constant violence and fear want useless goods like jeans? Shouldn’t they be begging for peace rather than goods? What about a safe exit; isn’t that more intriguing? Don’t they understand that stocking up on material objects will not matter once there are dead? They cannot really be suffering if they are infatuated by greed instead of safety.

Stepping back, the desire for goods no longer sounds that preposterous. If victims are trapped in a ruined city with little to do besides hope for a safe ending, it is not unreasonable that their minds might leap to safer places. They might fantasize about a world without bombings, a world without war. Presumably, if the area that they were imagining were not plagued by constant warfare, it might have a dearth of goods that is no longer available in Gorazde. It might have jeans and food. Maybe, then, thinking about goods is just a way to keep hoping for a future. Maybe it is a way to momentarily step away from the violence that is tarring the city apart.

In fact, at this point, I don’t know if Joe Sacco’s claim that these victims are filled a desire for material goods is unique to Gorazde, or is something that steps beyond this little area. However, it appears to affect other cities in Bosnia. In the movie “Welcome to Sarajevo,” there appears to be a similar desire for goods. When the lead journalist, Michael Henderson, returns to Sarajevo, the driver, Risto Bavic, admits that he has an insatiable desire for dental floss. Later, he explains that recently he has been having many yearnings for goods. So, it is possible to assume that this greed is an element of the ethnic cleansing in Bosnia between 1992 and 1995. Maybe it is even common in other war-torn areas.

After overcoming the initial shock of the ever present greed, accepting that maybe greed simply is not that bad of a coping mechanism, and realizing that it was present in other areas beside Gorazde, I have come to wonder if greed symbolizes something even more powerful. Maybe it reflects our desire to ignore reality. Regardless of whether we are in a developing or a developed world, we have this insatiable desire to acquire meaningless material objects. We want the latest iPod, the newest computer or whatever else the present fad may be. Yet, in doing so, we often ignore the world around us. We create a consumer society to create a fascade of whatever ills that may be affecting us. War is just an extension of our greed or, maybe, it just sounds so unreal or too real in this case.

As we have already established previously in this blog, Tuberculosis has become increasingly more deadly because of the MDR strain of TB. This mutation of the disease makes it almost impossible, or at least very difficult, to treat. Yet, tuberculosis is not the only disease that is adapting to the aggressive human Treat-All mentality. Recently, infections like the Staph infection have popped into the headlines becauses of the new powerful resistant forms.

The community-Associated Methicillin-Resistant Staph Infection is causing a lot of problems recently. According to the Health and Human Services Department and the National Institute of Allergy and Infectious Diseases, in "Scientists Identify Factor Key to Severity of Community-Associated methicillin-Resistant Steph Infections," the "S. aureaus disease is a global public health concern because some strains, including community-associated methicillin resistant S. aureays, have developed resistance to existing antibiotics." As a result, "the newly described proteins in drug-resistant strains of the Staphylococus aureus bacterium attract and then destroy protective human white blood cells."

Thus, it has become evident that tuberculosis is not the only disease facing difficulties right now. Mutations are occuring at increasingly fast rates. As a result, strains are become ever more difficult to treat. I would not be surprised if once treatable diseases become incurable. Life sure looks great.

Scared of Bacteria?

Bacteria are bad, or so we may have thought. Well, actually leading scientists and other researchers are slowly reaching the conclusion that maybe bacteria are not as bad as we initially thought. In fact, we use bacteria a lot.

Bacteria are an essential part of human life. According to Jeneen Interlandi and Jerry Adler, “bacteria seem adjust levels of the hormones ghrlein and letpin, which regulate appetite and metabolism. Similarly, “the intestinal bacteria are a marvel, a virtual organ of the body which just happens to have its own DNA.” In fact, according to a study done at Duke University, the human appendix “serves as a reservoir of beneficial microbes which can decolonize the gut after is emptied by diseases such as cholera or dysentery.” In all regards, bacteria constitute “an essential step in the development of a healthy immune system.”

Yet, society often ignores the benefit. Increasingly, there is an effort to rid ourselves of the bacteria. Today, people “cover the dirt on the floor of the hut, banish the farm animals to distant feedlot, and treat an ear infection with penicillin” and the list goes on. According to Sachs, “Modern sanitation is a good thing, and pavement is a good thing, but they keep kids at a distance from microbes.” This in turn tips “the immune system in the direction of overreaction, either to outside stimuli or even to the body’s own cells. The result is allergies or asthma.” Are you still scared of bacteria?

Our approach towards bacteria has evolved over the last century. According to Jerry Adler and Jeneen Interlandi, the authors of “Killing Germs May Be Hazardous to Your Health,” “most of the last century is dominated by the paradigm of Total Warfare.”It seems like we as a society attempt to treat any and everything. Even the mildest infections seem to get treatment. “We try to kill them off with antibiotics and hand sanitizers.”

In some regards, this Fix-All-Society is good. It often helps prevent some infections. For example, during the SARS outbreak at the start of the millennium, using Purel was thought to be the appropriate course of action.

Yet, as we find more and more supplements for every infection, the strains of bacteria also evolve. To our misfortune, this is not a good thing. In fact, the bacteria mutate into super-bugs, becoming even harder to kill. For example, “When penicillin began to lose its effectiveness against staph, doctors turned to methicillin, but then MRSA appeared … ranging threat that can strike almost anyone… To be sure, MRSA is a scary infection, fast-moving and tricky to diagnose.” Our approach has become like a vicious cycle, killing the weak and helping the strong.

What does this approach to disease reflect in our society? To some, it is an attempt to gain power in this increasingly complex world. Nancy Tomes, the author of “The Gospel of Germs,” says that she “can’t protect [herself] from bin Laden, but [she] can rid [her]self of germs.” This may be true now. Yet, there is no way of promising that it will be true later. Despite our desire to control every little aspect of life, whether that means killing microbes or even producing human life, we are not powerful enough to truly live with the responsibility of our actions.

What About the General Public?

Though we have established in previous blog posts that neither the initial patient nor the authorities pose as logical culprits for the spread of Tuberculosis, we have ignored another important player: the general public. If this blog has presented anything useful, it is that the spread of disease is a complicated issue to pinpoint the exact culprit.
If we really cannot full-heartedly blame neither the infected nor the authorities, could we blame the general public? First of all, let’s define the term “general public.” In this case, let’s use it to encompass not only the active members of society, but even the seemingly innocent and banal bystanders that for this case happen to be experiencing some bad luck and are in the a potentially dangerous situation. Simply put, the term basically encompasses everybody.
Well, this is a fairly large group of people if I do say so myself. Yet, by framing the term “general public,” to encompass such a large group of people, well no one can truly be exempt. Then, by these standards, the culprit must be in the group. Well, one would think.

The Irony of Fighting Globalization

Where have Gustavo Esteva and Madhu Suri Prakash been all of these years? The authors of “From Global to Local: Beyoun Neoliberalism to the International of Hope,” present a convincing argument that shows the problems associated with Globalization. Globalization, once a popular fad, is causing a powerful local fight for flight.

No one anymore wants to be global. Whether that means that globalization is going to be criticized from the locals or even the once-global-leaders, there is going to be distrust. “Even the most single-minded and ambitious free trade advocates cannot fail to recognize the social and human costs of the politics they are promoting.” No one can truly think global. Even organizations that claim to be global cannot be global. They have to have a home base somewhere, and that in turn helps shape their outlook. “Global proposals are necessarily parochial: they inevitably express the specific vision and interests of a small group of people, even when they are supposedly formulated in the interest of humanity.”

Few can deny that globalization is not always the best force in society. Global solutions cannot solve the local problems. This is especially true for the case of TB. When a global effort to banish TB from local societies, especially in developing countries, was established, the plan backfired. Doctors did not prescribe the correct dosage and the patients did not take the full treatment plan. This in turn caused the infectious disease to become even more powerful than even before. With the mutation of the strain to become MDR-TB, no drugs could cure the disease.

However, the efforts to reduce the force of globalization in the past have not encountered much success. Esteva and Prakash claim that “until now, … most of the social movements of campaigns trying to resist the new “global” phenomena have proven to be highly ineffective. Some of them are even counterproductive.” The problem is that humans are limited. Local forces are tiny compared to the massive global strength that sits as the opposition. Before, there seemed little hope of reducing the force of globalization.

Now, there is hope. Everywhere around the globe, there is a general push towards acting locally as opposed to globally. Esteva and Prakash claim that people “are trying to abandon the global thinking with which “industrial eaters” enter their local grocery stores: buying “goods” from any and every part of the earth, motivated solely by the desire to get the “best” return for their dollar.” In order to fight the global force, opponents fight with understanding. There is now a generally thirst for local knowledge. People want to know where their food comes from, and learning that the food is not local has started to pose a greater threat than ever before. Local forces can act together. “The local peoples often need outside allies to create a critical mass of political opposition capable of stopping those forces.” Though the coalition of local forces is not always as powerful as that of the global leaders, it is a start.

Globalization is something that needs to be changed. It is moving society in a direction that is abysmal. These authors make such a good argument. Ironically, it will need a global force of local organizations the fight the global power.

Rethinking the Initial Culprit

Tuberculosis is not always like the common cold. Some people who have tuberculosis do not always know that they have it. According to the CBC News article “Tuberculosis: Anatomy of a Killer,” “Most people don’t even realize they are infected. They don’t feel sick and don’t show any symptoms. In fact, 90 to 95 per cent of people who get infected never get sick.”

This changes everything. If we were to blame the spread of the disease on the people who spread the disease, this accusation would be unfair. Taking the benefit of the doubt, maybe the initial patients did not know that they were endangering the lives of others. Maybe they were totally unaware of the potential implications of their actions.

Yet, if we were to take the benefit of the doubt and assume that the patients are innocent, who then is to blame? Well, this requires a different look all together. Perhaps we could accuse the authorities for the spread. The term “authorities” is very broad. It could refer to the people who maintain the order, such as law enforcement agents. In all respect, law-enforcement agents could have supplied better infection-prevention procedures. On the other hand, it could refer to the people who have the authority to protect the public. In this case, the term would broaden to encompass people in the scientific field as well. People often hold scientists accountable for creating harmful drugs. But, should scientists also be blamed for not creating the appropriate treatment plan? The term “scientific field” would refer to not only scientists, but also the people who help distribute the treatment plan as well. What about globalization? Has this earth-shrinking process, what I like to refer to as “Modern Imperialism,” brought others to the forefront as well? Surely we cannot forget the people who helped encourage the global expansion and later the distribution of drugs into third world countries. Taking this general principal, we still have not found a logical culprit for the spread of TB.

Waste of Time

What’s so important about TB? Well, Tuberculosis is nothing new. In fact, it has been around for over 5400 years. However, Globalization is changing the face of TB.

Not long ago, this deadly infectious disease appeared to be on the road to recovery. Everything appeared to be solved when the vaccination for TB was discovered and a strong line of drugs were created. The vaccination appeared to be part of the solution to killing TB. BCG is a live vaccine against tuberculosis (TB). BCG stands for Bacillus Calmette-Guerin after two doctors who introduced the vaccine. It was developed in the 1920's and remains the only vaccination available against TB today. However, this vaccine seems to only be slightly preventative and works only about half the time at most.

Similarly, the drug treatment initially seemed to bring more hope. According Dr. Gokhale, at Howard Hughes Medical Institute international research scholar based at the National Institute of Immunology in New Delhi, India, “tuberculosis patients take a cocktail of four drugs, and each inhibits a single enzyme." Treatment for the fortunate in developed countries is no problem. It is a simple treatment.
Globalization changed all of this. All this hope changed when the drugs started appearing in developing countries. Although most doctors brought these drugs over with the good intention of curing many of the infected patients, their plans backfired. There are not enough resources in developing countries to provide and enforce the complete treatment plan. “Patients do not take all their medicines regularly for the required period [partly] because they start to feel better, because doctors and health workers prescribe the wrong treatment regimes, or because the drug supply is unreliable.” As a result, “strains of TB resistant to all major anti-TB drugs have emerged.” According to the WHO, “a particularly dangerous dorm of drug-resistant TB is multidrug-resistant TB (MDR_TB), which is defined as the disease caused by TB bacilli resistant to at least isoniazid and rifampicin, the two most powerful anti-TB drugs. Rates of MDR-TB are high in some countries, especially in the former Soviet Union, and threaten TB control efforts.” MDR-TB is basically incurable.

Because globalization is not only responsible for encouraging development in developing countries, but also the migration from developing countries to developed countries, TB has become even more problematic. Those who are infected with MDR-TB can spread this incurable disease. This means that those who could once have been treated with the traditional drugs can no longer be treated. All they can do is wait to die.

Is there any hope? Despite the efforts of the WHO in their DOTs program, Globalization does not appear to be the solution. It is because of globalization that this disease has gotten out of hand. If a new drug is created that can treat the multi-drug resistant form of TB, who can say that it will not be abused like all of the other TB drugs that are currently on the market? In fact, it could increase the strength of the MDR-TB disease even more.

Stepping back, it is apparent that this idea applies to more than just TB. We as a society are currently functioning as a Band-Aid-Society. This means that as we encounter a particular problem, in this case it happens to be illnesses, we devote all of our attention towards fixing the problem. We develop new drugs. Though it works for the time being, it is not long before the bacteria or virus adapts, and the drugs no longer work. We then start from the beginning again. The only difference is that this time it is even harder to fix. This Band-Aid-Society is a cycle that continues to waste time and money. We can’t keep living like this. At some point in time no invention is going to be able to solve our problems. Then what are we going to do?

The Problem With Immigration

Countries with open boarders are often portrayed as lands of hope. Immigrants from all across the world and from all walks of life often gravitate to these countries. In fact, most of the immigrants to these types of countries emigrate from their old countries in search of a better life. They want more prosperity. Many of these people who fit this hope-seeking new lifestyle are often from poor countries. Though it is wonderful that countries that have the luxury of supporting open boarders accept refugees, whether they are political, economical or other types of fleerers, this generosity, in most cases, can sometimes backfire.

Across the world, people are in danger. Some hear the sounds of bombs day in and day out. Others are victims of political oppression or genocide. There are few places of the world that are completely safe. In fact, I do not know of any country that is void of problems. As a result, many people want to flee. Some spend their lives waiting for a chance of a better life. They tell imagine a better life, free from whatever may be ailing them. Others are more successful and actually immigrate to the Promise Land, wherever that may be for that particular individual. According to the World Health Organization “in 1994, more than 23 million refugees had fled their homes, and an additional 26 million people had been displaced worldwide. In other words, one out of every 115 people in the world has been forced to leave home.”Regardless of the particular part of society that a causes a person to want to leave a particular country, having countries with open boarders helps satiate the hope of one day reaching safety.

Though the Open Borders concept appears wonderful on the surface, there are some problems. This foreign policy can actually endanger local civilians. It is no surprise that many of the immigrants come from developing countries. Many of these immigrants are classified as some type of refugee. The problem with this is that according to the WHO, “half of the world’s refugees may be infected with TB.” As these infected people travel to the new countries, they expose more people to this deadly virus.

Even more discouraging, immigrants from developing countries are more likely to spread an incurable form of the disease. Since many of the people from developing countries do not have access to the entire dosage of the medicine to cure the disease, their treatment is compromised. Soon enough, the disease progresses into a drug-resistant form. There is no treatment for this form of the disease at the present moment.

As the immigrants arrive in the developed countries, they bring with them not only their heritage, but also the multidrug-resistant tuberculosis. They then expose countless individuals to this disease, which is arguably a totally different disease. It is not as simple to cure as the normal strain of the disease. It is a totally different beast. As a result, the drugs that those living in developed countries normally have access to are no longer appropriate for the treatment of this disease. The infected have no other option but to die and, in the process, expose other people.

Globalization has helped facilitate a totally new creature. Let’s rethink the Open Border Policy or find some way to treat this disease.

Note: Information used from:

Anonymous. “WHO Report on the Tuberculosis Epidemic 1996,” Groups at Risk, 1996. http://www.sirs.com (accessed January 26, 2009).

The Anti-Thesis

There seems to be a push towards homogenization. As John W. Meyer, John Boli, George M. Thomas, and Francisco O. Ramirez argued in “World Society and the Nation-State,” those that flee from the forces of globalization just get drawn closer into the sphere of globalization. This idea is nothing new. In fact, Roland Robertson argued a similar point in “Globalization as a Problem.” In this article, Robertson believes that the term globalization attempts to simplify this complex world. He says that the “present concern with globality and globalization cannot be comprehensively considered simply as an aspect or outcome of the Western ‘project’ of modernity or, except in very broad terms, enlightenment.”

Though this argument appears to be sound, there is one little inconsistency. When Robertson goes about his thesis, he draws a diagram. He tries to create generalizations. He goes about this argument by creating a diagram in which there are four categories. There are “four major aspects, or reference points… These are natural societies… relationships between national societies […and]humankind.” Through this diagram appears to have good reasons behind it, it is the antithesis. Generalizations are exactly what he claims is wrong.

What is it a about humankind that we prefer to make generalizations? There is something about it that we try to control everything. We want the answers and will do everything in our power to gain control. However, our plans often backfire. This is especially true for the case of TB. In striving to kill this disease, we have created an even more powerful beast.

Resistance is Futile

Freedom is the ultimate utopia. It is common to here some reference to “if I just have more freedom.” People spend their lives imagining or envisioning what their life would be like if they had more freedom. They want freedom from almost everything, whether that means family, rules, authority, even the force of globalization. But is it really realistic? Is it realizable? John W. Meyer, John Boli, George M. Thomas, and Francisco O. Ramirez do not seem to think so, especially when it comes to the creation of nation-states. In their work “World Society and the Nation State” these authors argue that “the world-society models shape nation-state identities, structures, and behavior via worldwide cultural and associational processes.”

In the past few decades, it has become increasingly popular to create nation-states. These creators often flee from the traditional oppressive society in search of a society free from the homogeneous mold of the world. In fact, “more than 130 new nation-state entities have been formed since 1945.” All these people are clearly fleeing from something, but from what exactly still needs to be decided.

As these new nation-states explore a new set of rules that appear to break away from the traditional ones they were once obliged to follow, an ironic pattern seems to emerge. These nation-states become homogenous. They become exactly what they were fleeing from. The authors of the article state t hat “orientation to the identity and purposes of the nation-state model increases the rate at which countries adopt other prescribed institutions of modernity.” These nations are forced to comply with the set guidelines established by a higher power, often the UN. As they follow these rules, “the policies look more like enactments of conventionalized scripts. Even if a state proclaims its opposition to the dominant world identity models, it will nevertheless pursue many purposes within this model. It will develop bureaucratic, authority and attempt to build many modern institutions, ranging from a central bank to an educations system. It will thereby find itself modifying its traditions in the direction of world-cultural forms.” Unknowingly, these nation-states lose their uniqueness.

Resistance to the force of global rules is futile. “Resistance to world models is difficult because nation-sates are formally committed, as a matter of identity, to such self-evident goals as socioeconomic development, citizen rights, individual self-development, and civil international relations.” Essentially, “if a nation-state neglects to adopt world-approved policies, domestic elements will try to carry out or enforce conformity.”

In this light, there appears to be little incentive to become a nation-state. Who would willingly embrace a plan that inevitably bring he/she back to the start? These nation-states become the oppressors from which they were fleeing. The force of globalization is massive - so massive that it is futile to resist. There is nowhere to hide.

The Danger of Globalization

Globalization is not always a positive good. In some instances, it can even cause chaos, or at least some form of disruption. According to Peter Evans, the author of “Counterhegemonic Globalization: Transnational Social Movements in the Contemporary Political Economy,” there are three basic forms of “transitional social movements aimed at counterhegemonic globalization: labor movements, women’s movements, and environmental movements. Each of these movements confronts the dilemmas of using transnational networks to magnify the power of local movements without redefining local interests, of transcending the North-South divide, and of leveraging existing structures of global power without becoming complicit in them.” These categories are not the strong points of globalization. Instead they are areas in which globalization should be ashamed.

In the eyes of Peter Evans, globalization is causing the worse problems in the job sector of the world. “Jobs are being informalized, outsourced, and generally divorced from anything that might be considered a social contract between employer and employee.” There is a loss of social contract. This is even more damaging for women. Mr. Evans sights that “the disadvantages of allocating resources purely on the basic of market logic will fall particularly harshly on women.” Women have constantly fought and will continue to fight for even a mere resemblance of justice.
All this is true, but Peter Evans is missing an important point. Globalization is not just ruining the social contract in the economic sphere, it is also hurting the health sphere. Whether people are subject to more inhumane working conditions or traveling in dangerous environments, people are endanger. As more companies begin to outsource their products so that they can make the largest profit, the workers’ health is subject to be compromised. Similarly, with the world interacting more and more, contamination of disease, especially TB, is becoming more apparent.

Thus, while Peter Evans understands that the effects of globalization are often problematic, he underestimates the true debilitating affects. We need to readjust our values before there is nothing left to save.

NGOs and a new solution

Where does the future of the world’s problems lay? Can we continue to rely on the world’s governments for a solution to all of our problems? Jessica Mathews, the author of “Power Shift,” does not seem to think so. She points out that the world’s problems are changing. We are now faced by a series of “nontraditional threats, […] -- terrorism, organized crime, drug trafficking, ethnic conflict, and the combination of rapid population growth, environmental decline, and poverty that breeds economic stagnation, political instability, and, sometimes, state collapse.” These new threats cannot merit the same action plans that their predecessors once merited.

As a result, NGOs appear to be the new solution. Mathews strongly believes that “internationally, in both the poorest and richest countries, NGOS, when adequately funded, can outperform government in the delivery of many public services. Their growth, along with that of the other elements of civil society, can strengthen the fabric of the many fragile democracies. And they are better than governments at dealing with problems that grow slowly and affect society through their cumulative effect on individuals—the "soft" threats of environmental degradation, denial of human rights, population growth, poverty, and lack of development that may already be causing more deaths in conflict than are traditional acts of aggression.”


Maybe this is true. Perhaps the NGOs are the solution to our new problems. Never before have we encountered problems like we have today and will have in the future. Relating back to the TB topic, the issues resulting from MDR-TB are new. We have no way of relying on the drugs of the past to cure today’s illness. In fact, using these drugs would only worsen the problem. We cannot resort to past methods of intervention because clearly they failed miserably. It is because of these past interventions that we have the problem not being able to treat people with the Multi-drug resistant form of TB. So yes, maybe, hopefully, NGOs can bring about a solution to the problems our previous leaders have caused.

Air Travel Mixes with Danger

Not only do passengers worry about the safety of the plane, but now they have the paranoia that another passenger could infect them with a deadly virus. In case you have not heard, planes are not entirely safe. With the plane crash in New York a couple of weeks ago, air safety has once again been questioned. Though the airplane industry has reassured the public that the actual aircraft was not at fault and that there was really nothing that the company could have done to protect its passengers better, the fear has spread.

However, the safety of the airplane is not just about the physical structure of the plane. The spread of disease is another factor that can easily endanger the other passengers and thus merits close attention. In 1994, a 32-year old woman traveled on four different planes while infected with Tuberculosis. During her trip, she endangered over 1042 passengers. Her timely death prevented punishment for this act.

Let’s just think for a moment. What would have happened if she had been alive long enough to endure possible punishment? Would she have gone about infecting others? We have no idea, but the fact remains: air travel is a serious matter.

In fact, “Domestic air travel in the United States increased by 62 percent from 1980 through 1993 — from 275 million to 445 million passengers per year. Air travel from foreign countries to the United States increased by 182 percent, from 12.6 million passenger arrivals during 1975 to 35.5 million in 1991. The projections of the World Health Organization for the worldwide tuberculosis epidemic include 90 million new cases during the present decade. Increased air travel, the presence of tuberculosis worldwide, and immigration to the United States from countries with high rates of tuberculosis increase the probability that passengers on commercial aircraft will be exposed to persons with tuberculosis.” These were the numbers in 1993, image the numbers today.

The story of the 32 year old woman is nothing new. In fact, “the CDC received unsolicited reports of another 30 airline passengers with tuberculosis, including 10 whose diagnosis was already known at the time of travel, who were on commercial flights from July through December 1994.”

Next time you think about traveling, think again.

TB is Not Alone

Tuberculosis is not on the only global infectious disease that merits attention. In fact, almost all disease that can be transmitted should be looked at. These diseases range from TB, AIDS, Avian Flu, and even, the flu. Why should any individual endanger another?

The flu is an infectious disease from which we cannot seem to break away. Each “flu season,” people rush in to get their shots to protect themselves against this deadly outbreak. In response to this, “the White House released the Implementation Plan for the National Strategy for Pandemic Influenza, which reiterates the importance of state and local preparedness; clarifies roles and responsibilities; and includes information, guidance, and recommendations for preparedness. While preparedness may seem largely a public health responsibility, law enforcement has a very critical role in the response to these incidents.”

This brings about a new question. What is the role of the government in deadly outbreaks? There are two types of outbreaks: manmade and naturally occurring. Though the flu is often considered to be naturally occurring, other infectious diseases do not land neatly in a specific category. On the one hand, if someone infects another person without any preconceived notion of causing harm to the individual, most likely the spread would fall into the naturally occurring category. If, on the other hand, a patient willingly knows the risks and goes about infecting another individual, then the spread is considered to be manmade.

Regardless of the type of outbreak, law enforcement officers often go about the situation in a similar manner. They may go about it by “enforcing public health orders (e.g., quarantines or travel restrictions), securing the perimeter of contaminated areas, securing health care facilities, controlling crowds, investigating scenes of suspected biological terrorism, and protecting national stockpiles of vaccines or other medicines.”

In most cases, people who are aware of the spread of a potentially dangerous pandemic often try to leave the infected area. However, what happens when they can’t leave? “Approximately 1.7 million people are housed in correctional facilities in the United States, many of whom have numerous health problems. Our nation's criminal justice system is in real danger of facing a public health crisis as a result of excessive disease and substance abuse in the inmate population. Studies clearly show that the incarcerated population is disproportionately affected by HIV/AIDS, sexually transmitted diseases (STDs), tuberculosis (TB) and other diseases.” Though the CDC, the Center for Disease Control, is trying to improve the health of these inmates, they are not often successful. “Because the identification and reporting of suspected or confirmed cases of disease among incarcerated populations is slow, incomplete or insufficient, it becomes difficult to develop a meaningful public health response or controlled effort to protect the community at-large.”

The world is a scary place. Despite efforts to protect others from the spread of infectious diseases, no human can guarantee that the risks are nonexistent.

Mimicking Globalization

The debate continues. Whether globalization is good or bad continues to intrigue many historians, especially John Micklethwait, Adrian Wooldridge, Amartya Sen, and John Gray. These historians remain divided, refusing to come to agreements, almost like nations refusing to accept the force of globalization. Despite their differences, all of these authors seem to agree that globalization is neither entirely good nor entirely bad.

John Micklethwait and Adrian Wooldridge focus mainly on portraying a positive outlook on globalization. In “Hidden Promise: Liberty Renewed,” they claim that “restricting overmighty states and elites is all very well, but globalization increases the basic freedom of individuals as well…Globalization is helping to give birth to an economy that is closer to the classic theoretical model of capitalism, under which rational individuals pursue their interests in the light of perfect information, relatively free from government and geographical obstacles.” To them, people have more freedom because of globalization. Even more importantly, they see the main benefit of globalization as a creator. “It is also helping to create a society that is closer to the model that liberal political theorists once imagined, in which power lies increasingly in the hands of individuals rather than government, and in which people are free, within reasonable bounds, to pursue the good life wherever they find it. (17)” However, they do acknowledge that this system does not often provide those who benefit the most with the loudest voices. In fact, it is often the case that the opponents of globalization express their discontent more convincingly than the supporters. Thus, globalization has not yet achieved its ultimate success.

Amartya Sen also sees globalization through a similar pair of eyes. He wrote "How to Judge Globalism." While he strongly believes that globalization is a positive development, he explains that the lack of understanding as to the real globalization has weakened its effects. One of his main arguments is that globalization is not synonymous with the West. He explains that “over thousands of years, globalization has contributed to the progress of the world through travel, trade, migration, spread of cultural influences, and dissemination of knowledge and understanding… They have not necessarily taken the form of increased Western influence. Indeed, the active agents of globalization have often been located far from the West. (19)” The author goes further by saying that “to see globalization as merely Western imperialism of ideas and believes (as the rhetoric often suggests) would be a serious and costly error, in the same way that any European resistance to Eastern influence would have been at the beginning of the last millennium (21).” Globalization is misunderstood. These misconceptions have helped carve the way to even more crucial areas. People often go about the issue of poverty in the wrong way. Rarely do people ask about the “distribution of gloablization’s benefits (22).” Instead, they often compare the amount of wealth of a given group, which is the wrong way to go about the discussion. Like the other historians, Sen also acknowledges that the global situation needs to be improved. “Global capitalism is much more concerned with expanding the domainof market relations than with, say, establishing democracy, expanding elementary education, enhancing the social opportunities of society’s underdogs (24).” Thus, despite the success of globalization, there is still room for improvement, according to Sen.

John Gray, the author of “From the Great Transformation to the Global Free Market,” represents the opponents of globalization. According to him, globalization works against the Free-market, a system that is prized in the US and other areas of the world. He claims that “economic globalization… actually threatens the stability of the single global market that is being constructed by American-led transnational organizations (28).” He goes further by saying that “no reformist programme today has a chance of success unless it understands that many of the changes produced, accelerated or reinforced by New Right policies are irreversible (29).” Essentially, it is impossible to return to the way things initially were or were intended to be. While he does acknowledge that for a brief moment, the problems from globalization may remain hidden, they soon become apparent. Globalization creates “instability.”

Is globalization really increasing the spread of Tuberculosis? In many regards, the answer is yes. Before I elaborate, keep this in mind: it is very difficult for a patient to infect a bystander. A person must have a prolonged period of exposure for the virus to even be spread. Regardless of this fact, transmission is always a possibility and always seems to at least spread fear.

Fear was definitely plaguing many students who attend IPFW, a school in Fort Wayne, when a commuter student was supposedly diagnosed with “an active case of tuberculosis” on Monday, January 12, 2009. Though the vice chancellor of the school, William McKinney, assured the students and the faculty that transmission of the disease was highly unlikely, many students believed the unlikely. They feared that, despite the odds, they might be infected.

Why the fear? Sure there is a slight possibility that the classmates could have contracted the disease. Maybe some of them did. However, what is truly interesting is that so many people resorted to fear. This shows that few of the students actually knew a lot about TB. Why is this?

In order to help raise awareness, Hillary Clinton plans to devote more attention to the relationship between this disease and HIV and AIDS. In the words of Diane V. Havlir, a reporter for the San Francisco Chronicle, “there is a deadly synergy between HIV and TB. TB is the major cause of death among persons living with HIV. Further, TB can spread easily, from a cough or a sneeze or by breathing in the exhaled air from a TB-infected individual, and too many HIV patients may be acquiring tuberculosis as they sit in health clinic waiting rooms…At least one-third of the 33.2 million people living with HIV worldwide are carrying TB and have up to a 15 percent risk of developing active TB disease every year. Inadequate TB-control programs jeopardize success of these efforts, and fail to prevent the emergence of drug-resistant TB. Drug-resistant TB strains produce high death rates, especially among persons already infected with HIV.”

Despite the grim case stories about the disease, the US is actually faring pretty well. According to Havlir, the 2008 year ended with the fewest cases of TB reported since the tracking of the disease began. Other parts of the world, however, have yet to experience such positive statistics.