It’s the time of the year when we get away. The schools have broken up and between starting this blog and finishing it, I packed numerous bags and backpacks, got everyone to the airport, checked in and made it to the plane, flew 1500 miles, and started our holiday. One of the things I found myself packing was antibacterial gel, something we have in the house but never use. I’m not even sure why I brought it. Some combination of a vague suspicion about airports and memories of catastrophic camping holidays when one of the children has picked up a bug I think. We’re taught from an early age that bugs are dangerous, and foreign bugs are more dangerous still. But is this helpful? What are the advantages and disadvantages of this kind of hygienic nationalism?
Historians, sociologists and anthropologists of science have long tried to encourage reflection on the ‘military metaphors’ which frame infection at the level of the individual as invasion by ‘foreign’ bodies. Susan Sontag’s work is well known, but Emily Martin’s work on immunology is also still fascinating [I’m not sure how much this kind of thinking was possible before the 19th century with the development of microbiology, nor how much it has changed since. Nancy Tome’s work on the history of germs and ‘germ panics’ showed how some of these ideas became established as part of everyday routines designed to avoid bodily contact with external threats or remove them from the skin through rituals like hand-washing after using the toilet. But foreign travel has always been seen as risky, and fears of foreign infection get rehearsed every time we have a scare about a ‘new’ threatening virus – Zika is just the latest example.
In a highly global and networked world, infection in one country can create legitimate fear in another. One of the difficulties for public health is then how far to tap into those fears in seeking to promote health at home and create realistic messages about the risks. With Zika there have been attempts to dampen public concern. Athletes travelling to Rio have been said to be at low risk for example, and only pregnant women have been warned against travel to Brazil.
Some of this can feel rather uncomfortable for the ways in which we focus on ‘risks’ to us, forgetting about those already facing viruses and bacteria in their own environment. This point was made by one of the athletes travelling to Rio. Megan Kalmoe, an American rower, complained this week in the Guardian of a ‘troll component’ to the Olympic coverage, which she said was dominated by ‘outrage and disgust, disappointment and disapproval of the conditions that short-term visitors like athletes and spectators will be forced to endure for all of two weeks’ without thinking of those who ‘live their whole lives in Rio and don’t complain’. As someone competing in the sea, she said she was well aware of issues around water quality but asked that ‘everyone who is fixated on shit in the water: stop’!
While well-intentioned, this reminder to ‘check your privilege’ is still somewhat focussed on the dangerous bugs as located in Rio, becoming a risk for people who enter the city or its waters. This narrative feels problematic given the history of colonial conquest in South America. I had the same reaction to seeing the latest EU ‘patient stories’ videos warning about the dangers of bacterial infections resistant to antibiotics, two out of three of which show EU citizens talking to camera about their close calls with resistant bacteria acquired while travelling for work or pleasure. These, perhaps inadvertently, make travel risky, but of course infection travels too and we have plenty in the EU. There are now said to have been almost 200 cases of Zika identified in Spain. We have also grown our own ‘superbugs’ and E.Coli still kills in the UK.
Beyond the microbial xenophobia of these issues as risks to ‘them’ and ‘us’ – or bugs located ‘there’ or ‘here’ – media narratives seem to miss something more by returning again and again to stories of ‘nasty bugs as foreign threats’. We also live alongside numerous bacteria, many of which are useful or as least harmless. The marketing of probiotic functional foods tries to build the image of ‘good bacteria’ but mainly to sell products designed to ‘boost’ or reintroduce them for a price (as described by Nerlich and Koteyko). The very distinction between ‘good’ and ‘bad’ may be misleading. The dangers of bacteria encountered abroad are partly because they are ‘new to us’. De Laet and Mol’s classic paper on Zimbabwean water pumps observed that though international standards for water quality rested on hard lines between safe and risky levels of E.Coli, local communities appeared to ‘harmonise’ with local levels of E.Coli.
While stories about microbes can help encourage behaviour that keeps us safe, they can also feed suspicion of ‘foreigners’ and narrow views of bacteria as threat. We’ve a track at the EASST conference this summer asking people to think about microbes as more than antagonists, to consider ways in which they may be framed or experienced as ‘servants or companions’ and explore the multiple entanglements of humans, animals and bacteria in different locations. Thinking of microbes as close companions, exploring our co-living arrangements, may help develop new imaginaries for living with infectious disease and the real threat of anti-microbial resistance.