By Dr. Howard Brody
I recently listened to two stories on National Public Radio about polio.
The stories began by noting that the effort to eradicate the disease everywhere in the world had hit a snag, particularly in Pakistan, and suggested that ignorance and superstition were playing a large role in public opposition to vaccination in areas controlled by the Taliban.
It seemed a good opening for the “we’re wise, other people in the world are stupid” way of thinking that so often dominates the airwaves.
But the stories fairly quickly changed. Why were some Pakistanis so upset about polio vaccinations? One big reason is that the CIA was actively involved in Pakistan during the time that Osama bin Laden was being pursued.
The successful effort to kill bin Laden, at a critical juncture, involved a fake hepatitis B vaccine program. People claiming to be a part of the vaccine program took DNA samples to identify people suspected of having ties to al-Qaida.
Apparently, the vaccine part of the stunt was a failure. But the program worked very effectively at stirring up all the suspicious, anti-Western sentiment that could be expected in those parts of the world.
And “stirring up sentiment” is the least of the worries — some 60 vaccine workers have been killed in Pakistan recently as a result of Taliban activities.
The program was started in a poor neighborhood in the city of Abbottabad, Pakistan, and people in that region were given the first of three scheduled hepatitis B immunizations.
But then the CIA workers moved off to another part of town where they suspected (correctly) that bin Laden was hiding out. So the people who first agreed to the hepatitis vaccine got only one of the three required shots.
It might seem that for some Pakistanis to get only one of three shots in an immunization program was hardly a big deal. But that shows the difference between a sham and a real medical procedure.
When a person gives consent to become part of any study, or to receive any medical treatment, that person enters into a special relationship with whoever obtains the consent. The person places his trust in the healer. Whatever was said in the consent process is not simply verbiage. It forms the basis of trust.
For a person to treat another in this sort of setting and say things to them about medical treatment, knowing all the while that no real medical treatment is going to happen, counts as a major betrayal of trust.
The person cannot then say, “Sorry, that was just the exception to the rule; now you can really trust me.” We all know that trust betrayed is not regained easily or quickly.
Leslie F. Roberts of Columbia University suggested that the result could be a 20-year delay in the eradication of polio, and an additional 100,000 people becoming infected.
It’s been said many times that a person who tells a lie usually makes some simple calculations about how much harm is likely to be caused by the lie — calculations which are almost always way too modest.
The hepatitis B vaccine sham by the CIA appears to be one more example where we will spend years reaping the whirlwind of a convenient lie.
Dr. Howard Brody is director of the Institute for the Medical Humanities at the University of Texas Medical Branch.