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Fishermen in the Information Marketplace
Behavioral, Economic and Social Changes Associated with Introduction of Mobile Phones in Fishing Communities of Kerala, India
By Marzieh Ghiasi (April 2012)

*Image source

What is the broad context?

The vast and rapid adoption of information and communication technologies (ICT) globally has led to a lot of speculation about how societies are integrating these technologies and how they are in turn being altered by them. According to Steward (1955: 38) unique local features such as subsistence needs are thought to affect local cultural contexts, socio-economic arrangements and the way technologies are adopted. Steward (1955: 40) outlined three steps to evaluate the how culture, technology and production relate and interact. The first was to identify the material and socially-derived needs in a society; the second behavior and exploitative patterns in a society; and the third, the extent to which these patterns affect other social arrangements. Examining each of these allows us to appraise what kind of needs ICTs are meeting, how they are affecting behavior, and broad social superstructures.

The state of Kerala, in South West India, has the second largest fishing output in India, and a substantial portion of the industry is based on traditional fishing practices. The cultural practices, the introduction of new technologies and the economic output of these communities have been closely monitored and cataloged. Throughout the years fishing industry has undergone mechanization, and the introduction of ICT into communities. However, these technologies have been received differently and have affected local culture differently. In this paper I examine how mobile phones, in particular, have been adopted to meet needs of fishing communities Kerala. I will further examine whether mobile phones are reinforcing or changing behavior and exploitative patterns in these societies. Finally, I look at how these patterns are influencing more indirectly other aspects of the culture.

What does this post explore?

Many studies on the mobile phones in the developing world focus solely on economic output as a measure of effective technology integration. Though on the short term, economic benefits lead to diffusion of technologies, over the long term and integration of technologies depend on how well they serve the social well-being of fishing communities. I argue that mobile phones in fishing communities of Kerala have been adopted and integrated into the culture because they enhance users’ the capacity for decision-making by increasing choice and reducing risk, by establishing evenly distributed information flow.

In the first section of this post I will describe the social and economic context of Keralite fishing communities prior to the diffusion of mobile phone technology. In the second section of the post I will examine the outcomes associated with the diffusion of mobile phone technology and its outcomes related to the communities’ fishing activities with respect to spatial and economic decision-making. Finally, I describe five ways that mobile phones have been integrated into spatial decision making, and the effect on economic arrangements. I will also examine the broader socio-cultural outcomes of the diffusion and adoption of this technology and its impact on socio-economic hierarchy, cooperation and collusion, and gender roles. I will conclude by assessing whether the outcomes observed in Kerala are a product of unique environmental, socio-economic and spatial arrangements in the region or if they can be generalized to elsewhere.
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The Origins of AIDS (2011)
Jacques Pepin
306 pages

AIDS was first identified in North America in 1981 and its infectious agent human immunodeficiency virus (HIV) was isolated two years later. In the subsequent 30 years, AIDS has become a global pandemic that has led to around 30 million deaths. Pepin’s book tackled the origins of this devastating infectious disease subject in three parts: first, he examined the origin of the virus itself; second, he examined the context that permitted and even promoted outbreak of the virus; finally, he examined the global routes by which the virus traveled. Each part of the story was addressed through a historical lens and supported several lines of evidence, including viral biology, epidemiological and sociological data.

The book began by examining current scientific understandings of where and when HIV made the transition from a simian ancestral virus to a human virus. Pepin examined colonial-era records, and modern molecular clock analysis of samples to pin-point the origin of the M strand of HIV-1 which is responsible for the vast majority of the global burden of AIDS. These lines of evidence point to a ‘patient zero’ in the Congo around 1921, with a confidence interval of ±10 years. Outlining the theories proposed to explain how the virus jumped, Pepin suggested that the most plausible is the ‘cut hunter theory’, where handling and consumption of chimpanzee bush meat is believed to have provided a route for cross-species transmission. However, palaeo-virological evidence suggests that simian variants of the virus have existed since at least the 15th century, in areas populated by humans. Why did the AIDS epidemic not emerge earlier?

To investigate this question, Pepin took the reader to late 19th century, where sociopolitical trends led to greater access to weapons for hunting, and increased urbanization and public health campaigns which facilitated the spread of HIV. The colonization of central and West Africa by European powers brought about increasing urbanization, accompanied by great gender imbalance as these newly created cities became predominantly populated by young men seeking jobs. In early 20th century, these urban centers became breeding grounds for the sexual transmission of the virus facilitated by prostitution.

While the behavioural component of the spread of AIDS has long been established, Pepin explored a second less-discussed but perhaps equally important factor: interavenous injections conducted as part of colonial public heath campaigns. I cringed a little when I began to read this part of the book since it quickly brought to mind the discredited AIDS origins theories. However, Pepin outright rejected such conspiracy theories. Rather what he described, thoroughly and with good evidence, is a classic “road to hell is paved with good intentions situation” and the culprit: un-sterile injections. Pepin provided evidence for repeated use of needles and lack of sterilization processes that may have exposed individuals to greater risk of exposure to HIV than they would have been otherwise. An excerpt in the book from medical archives describes common practices of the time, where “the syringe [was] used from one patient to the next, occasionally retaining small quantities of blood”. Pepin described “the largest ever iatrogenic epidemic” in Egypt where non-sterile anti-schistosomiasis injections were associated with a rise in blood-borne HCV infections. He postulated that in Central Africa the iatrogenic amplification of AIDS may have similarly occurred via “well-meaning” campaigns targeted to combating tropical diseases among the general population and containing sexually-transmitted such as syphilis among prostitutes and high-risk individuals.

The latter chapters of the book followed the route of HIV out of central Africa in the 1970s at the heels of globalization and decolonization processes that led to great inter-continental migrations and dispatching of foreign nationals into the area. Pepin provided evidence that the jump was likely facilitated by a single Haitian who worked in the Congo. In Haiti, the virus proliferated and jumped to North America via commercial blood trade and sexual transmission, though the author argued that the former is probably responsible for the vast dissemination of the disease. While the latter part of the book was very interesting, I felt that it lacked the detail of the former part of the book. I think this in part had to do with the fact that there has been massive investigations into the African origins of HIV, and details about the early years of HIV in the Carribean and North America remain more murky.

Overall, the Origins of AIDS provided a comprehensive and enjoyable to read account of the origins and the rise of AIDS. Through synthesizing current scientific research and archival documents Pepin reinforces the book’s central thesis that AIDS is a “tragedy… facilitated (or even caused) by human interventions.” The book’s narrative, interwoven with vast amounts of quantitative and qualitative evidence, made a compelling case that this global pandemic was not singularly driven by biology or individual behaviours, but broader social, political and economic frameworks.

http://www.mcgilldaily.com/2013/03/drug-resistant-tuberculosis/

Image source: Stop TB Parnetship

Drug-resistant Tuberculosis
Very much an issue, and it’s spreading like wildfire
By Marzieh Ghiasi
March 25, 2013

New strains of tuberculosis (TB) threaten efforts to eradicate one of the world’s deadliest diseases. An alarming study published in the March edition of the U.S. Centers for Disease Control and Prevention’s Emerging Infectious Diseases journal reveals the discovery of the first cases of totally drug-resistant TB in South Africa. These findings come on the heels of the discovery of virtually untreatable strains of TB in the hospital wards of Mumbai, India last year.

TB, a bacterial lung disease, infected an estimated 8.7 million people in 2011, according to the most recent statistics from the World Health Organization (WHO). While inactive in the majority of those infected, the active form is transmitted through air. The disease is a leading infectious killer worldwide. Second only to HIV/AIDS, it kills one person every ten seconds. In those afflicted, it leads to severe weight loss, chronic coughing – often of blood-stained mucus – and destruction of lung tissues. Dr. Madhukar Pai, a leading McGill tuberculosis expert, explained that the disease is not only physically debilitating, but also accompanied by social stigma and a heavy economic burden.

Multi-drug-resistant TB (MDR-TB) encompasses strains of the bacteria that do not respond to two critical drugs used to treat TB, isoniazid and rifampicin. When an individual is infected with the drug-resistant bacteria, physicians have to resort to ‘second-line’ drugs for treatment, which, according to Pai, have many side effects, are more expensive, and are not readily available.

“The regular drug-sensitive TB requires a standard six month treatment, [and] it’s not inexpensive, like three days of antibiotics,” he explained. “[For MDR-TB] that treatment lasts two years…even if you give all of this stuff for two years, about 50 per cent of patients are dead.”

In the past five years, a subset of patients has begun developing extensively drug-resistant tuberculosis (XDR-TB), which is resistant to even more drugs and has worse survival rates. Although the WHO has not yet formally adopted the term totally drug-resistant TB (TDR-TB), the strains identified in India and South Africa are believed by researchers to be unresponsive to all known drugs.

While the contexts of India and South Africa are very different, Pai says drug resistance in TB has similar “underlying drivers in both countries.” In India, the mismanagement of patients, which pushes them from physician to physician, has been identified as an important culprit in exacerbating TB. Poor diagnostics and fake drugs, which make up 10 per cent of the total TB drug supply in India, also leave patients receiving ineffective treatment.

The crisis is further complicated in South Africa, where nearly one out of every five adults lives with HIV. The presence of “extensively drug-resistant TB plus HIV” Pai says, “is a complete disaster.”

In recent years, a combination of efforts, including vaccination campaigns and national control strategies, have been implemented to fight TB by the South African government. However, the fight remains at a standstill as the casualties rise. The TB vaccine of choice BCG (Bacillus Calmette–Guérin), developed ninety years ago, is only partially effective. The rise of drug-resistant strains has prompted greater efforts to develop improved vaccines against the disease in order to protect people before they’re infected, but these efforts have led to disappointment. In February, MVA85A, which was touted at the first new TB vaccine in a century, failed clinical trials.

Meanwhile, control efforts have given mixed results. Some reports suggest that India’s current strategy to defeat TB may actually be promoting more deadly drug-resistant strains. In an interview with the Wall Street Journal, Dr. Zarir Udwadia, whose research team discovered totally drug-resistant TB in India, criticized the country’s strategy as “a futile exercise [that will] serve to amplify resistance.”

One of these strategies includes giving the same standard regimen of drugs to anyone suspected of having TB, without checking for resistance, which would entail additional costs. For some patients, these regiments do not work and only heighten the presence of drug-resistant strains. Similarly, in Eastern European countries, poor management of TB has only aggravated the problem. Other strategies have included quarantining. Notably, in South Africa, when extensively drug-resistant tuberculosis broke out, many patients were involuntarily detained in prison-like hospitals.

“It doesn’t work. They broke out,” Pai said. “Keep on doing the wrong thing and you end up with drug-resistant bacteria that don’t respond to any interventions.”

The broadest effort to combat TB, the Stop TB Partnership, consists of 1,000 international governmental and non-governmental organizations. The project aims to provide treatment for fifty million people and prevent 14 million deaths by 2015. However, the economic crisis has led some countries to reduce or stop contributing to TB prevention programmes.

On March 21, McGill University launched its International TB Centre in an event attended by experts from across Canada. Dr. Anne Fanning, researcher at the University of Alberta and the Chair of Stop TB Canada, described global efforts against TB, local efforts against TB particularly in Inuit communities, and scientific research as three areas that need serious attention.

“[All of this] needs the support of the government of Canada,” she emphasized.

Pai similarly believes that all countries need to take TB more seriously. He warned that the chronic underfunding of these programs across the world might only lead to compounded costs for everyone later.

“In today’s day and age there is no sense in thinking of global health as a problem that doesn’t bother us or affect us.” He said, “TB anywhere is TB everywhere.”