There are still many unanswered questions surrounding the outbreak of Listeriosis.  The Minister of Health of South Africa has been under pressure to find the source of this pestilence and root it out.  This is because of the panic that starts to rise in citizens who are familiar with the history of plagues.

The Great Plague left an indelible memory on mankind.  Sometimes called the Black Death, this pestilence ravaged the whole world for 4 years.  About 30% of the population or Eurasia and North Africa was decimated.  India was depopulated.  Mesopotamia, Syria and Armenia were covered in dead bodies.  Florence lost 50 000 of its 100 000 inhabitants. England lost four out of ten citizens. Untold millions of people perished. World population did not recover to pre-plague levels for 4 centuries.  Governments could do nothing to prevent citizens because no one could get to the root of the problem.

Of course most people at that time still believed that the world was flat.  But there were already universities graduating doctors of medicine.  No one could figure it out.

Only in 1894, in another outbreak in China of this dreaded pestilence, did a Russian scientist working for the Pasteur Institute finally identify the bacterium.  He had the dubious honour of having had it named after him! Only then did the domino-effect of the bubonic plague come to be understood.  The bacterium is indigenous to Siberia and Mongolia.  It lives naturally inside fleas that drink blood from “hosts” usually rodents (e.g. rats) or alternatively humans.  Rats travel on ships laden with grain (on board the fleas bite sailors too).  So ships from strategic sea ports in the Grain Trade carried the pestilence from port to port.  Sailors and rats interacted with city folk, spreading the infection.  Thence it spread around the world.

The scapegoating in this instance was that Europeans turned on the Jews in racist fury.  They said they suspected the Jews of poisoning wells.  As this race dressed differently, due to its religious customs, it was identifiable.  Pogroms began – especially in Germany.  Long before Hitler, anti-Semitism reared its ugly head.  People get scared silly by pestilence.

Citizens in South Africa are caught between two forces today – the right to know, and the lack of definitive proof.  Already some companies like Tiger Brands and Rainbow have been named.  The share price of these companies has crashed as a result of a proactive recall of suspected meat products.  But the companies are not apologizing yet…

Only a century ago, in 1917, came another unexpected pestilence – the Flu Epidemic.  Comparing the Spanish Flu, as it came to be known… three times more people died of the influenza epidemic than died in combat in World War I which was raging at the time.  Within a few months, a third of the global population came down with the virus.  In India it killed 5 per cent of the population (15 million people).  On the island of Tahiti, 14 per cent died.  On Samoa, 20 per cent.  In the copper mines of the Congo one out of five labourers perished.  Altogether the pandemic killed between 50 million and 100 million people in less than a year.  World War I killed 40 million over four years.

There was a reverse feature of this strain of flu virus.  Usually the most vulnerable to influenza are children, the elderly and the weak.  But this strain took out healthy adults – like soldiers.  Nearly half of the population aged 20 – 40 in the USA perished – a disproportionately high rate by age bracket.  Life expectancy in the USA dropped by 12 years!  Native American tribes were particularly hard hit.

No one really knows for sure where it started (possibly in Kansas?), nor can anyone explain why it ended so abruptly – about two weeks after the second surge peaked in late 1918.  So the scapegoating began… one conspiracy theory emerged that Big Pharma was behind this epidemic.  This narrative is that it had produced a flu vaccine and wanted to cash in on the profits before the war ended.  So it mobilized mass vaccination of both troops and civilians.  Not just in the USA but in other countries.  Soldiers started dying in the USA before there were ever deployed to the front in Europe.  Some countries like Greece declined the vaccines and were not devastated by the epidemic.

The outbreak of Listeriosis brought such scenarios to people’s minds.  Of course there have been huge advances in medical science and technology, but for a year now the researchers have been stumped.  The rather abrupt announcement that a culprit has been found raises some eyebrows in a country where there is no shortage of conspiracy theories – from the recurring “third force” to allegations of “regime change” agendas.  The Department of Health has to provide scientific proof of its finger-pointing, according to the CEO of Tiger Brands.

Then in the 1980s another pestilence appeared.  South Africa is now at the eye of this storm, in terms of its prevalence, of this AIDS pandemic.  Close to 15 percent of its citizens are now HIV-positive.  Other countries like China and India may have more infected people in absolute terms?  But as their base populations are so huge by comparison, it is a relatively low infection rate.

This is also classified as a “sexually-transmitted disease” although there are other ways that it can be contracted.  Thus there is a double-jeopardy involved – called Stigma.  This has its roots in the images of pandemics past, where just getting infected was a death sentence.  Not to mention that it is an STD with all the connotations that this term can bring to mind.

AIDS was a very devious disease.  Unlike the bubonic plague or the Spanish flu, those infected could not detect it right away.  Furthermore, this HIV virus itself is not the killer.  Instead, it compromises the body’s immune system, so the victims die of “opportunistic infections”.  This is one reason that you rarely heard of people “dying of AIDS” – the other reason was Stigma.

This made it very difficult to track down the root of the pestilence.  But within 2 years medical science had identified it, and within 10 years, treatment was available.  Meanwhile, to date, 30 million people have died of this pandemic.  Tens of millions of others have either been “infected” (i.e. they are now HIV-positive) or “affected” (e.g. the “deluge of orphans” as Dr Stephen Lewis once put it in his aptly-titled book Race Against Time).

Again there was scapegoating.  Some nasty conspiracy theories emerged around the AIDS pandemic.  They never did find “Patient Zero”… but the Science Museum’s History of Medicine website includes a section titled “The fault of others: exiles, scapegoats and the human face of disease.”  It describes the tendency throughout history to target marginal groups, minorities, and the poor as scapegoats for plagues and diseases.  It was a means to allay fears and reinforce prejudices.  Examples cited include the Black Death that was blamed on Jews and cholera on immigrant Irish workers.  Syphilis was called “the French Disease” in England, and the French in turn blamed the Italians who in turn blamed the French.

In fact, AIDS involves multiple epidemics.  As well as an epidemic of HIV, we experienced epidemics of fear and of stigmatization, scapegoating and discrimination.  These are associated with any pestilence in general and with AIDS in particular.  In order to deal humanely and compassionately with AIDS and persons living with HIV and AIDS – and to protect society (including the fundamental principles and rules on which it is based) – a primary requirement is to recognize that we are all living with AIDS, whether infected by it, affected by it or at risk.  That is, in the context of AIDS, it is imperative that we overcome any divisions into ‘them’ and ‘us’.

Dealing with plagues and pestilence is never easy – either from the medical or the social point of view.  The Department of Health needs to provide conclusive proof of its findings.  Companies have suffered reputation loss, there could be significant job losses, and investors have taken a hit. 

But of course, the paramount concern is that 181 lives have been lost.  Above all, their families and loved ones are the ones who need answers.  Real answers, not conspiracy theories.

Chuck Stephens is the Executive Director of the Desmond Tutu Centre for Leadership writing in his personal capacity

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