Friday, May 1, 2009

Different Masks; The example of swine flu

At Julie's spurning, I'll try to write a post. A timely topic would seem to be the swine flu. Perhaps I'm just not taking things seriously enough, but I can't help but feel that this is a kind of irrational global panic. Almost makes me buy into the conspiracy theorists screaming "They want you to live in fear so you don't know the TRUTH!". Almost. Okay not really. But still I've received, on both my University email account and on my company email account, notes that basically tell me I should try to be careful not to catch swine flu. Where's the emails telling me to be careful when I cross the street? This is not to say we shouldn't have disease control by medical professionals, quarantines of infected patients, whatever. Its more the spread of panic throughout the general populace that seems disconcerting. For example, why such the buzz in Japan when there have been no reported infections of swine flu in the entire country (last time I saw). Yesterday, getting ready for work, my homestay parents came to me with a mask to wear on the train. They had already pushed me to wear the mask on the train before, and in this instance I (relunctantly) decided to concede to their request. It wouldn't be very nice for me to contract the virus and spread it to them, after refusing their simple request to wear a mask for a few minutes on the train.

On the masks: I can't remember if I've blogged about it before, but in Japan it is very common practice for people to be wearing these masks out in public. They are exactly what you imagine a surgical mask is: a white thing that wraps around your ears and covers up your mouth, nose, and much of the bottom half of your face in a way that reminds me vaguely of a Ninja. Usually they are used when people have a cold and don't want it spread to others, when they travel on the train and don't want to catch anything themselves, or when suffering from seasonal allergies (which are quite bad in Japan). This seems quite logical to the (Japanese) people I've asked. They were, in fact, quite surprised that people in other countries don't do this. One interesting thought was that in Japan, when you get sick, you are still expected to go to work. Therefore the mask helps to stop the spread of the disease among coworkers. This contrasts with Canada, where usually the boss prefers you to just stay home, get better quickly, and avoid spreading illness throughout their entire work force.

Anyway, partly what I find quite interesting about the face masks is not just the use of them, but the explanations that these invariably trigger from Western people (whether anthropologists or otherwise). I've read a bit on the internet, some blogs, talked to some Americans or Europeans I know here about it. As you might imagine if you have some familiarity with stereotypes of Japan, a quick explanation is that Japan is a "collectivist" or "communal" culture. The logic is simple. In Japan, you must be always thoughtful of other people. So you wear the face mask (which I really found uncomfortable--makes it stuffy and hard to breath). This is a sign of respect towards others. Of course, the tone is that in Japan it is obsessively so. That is "obsessively thoughtful" or "obsessive respect".

At first glance that seems a plausible explanation I suppose, though its not one I've gotten exactly from Japanese people. They tend to focus on the actual "natural" or "scientific" reason for wearing it. You've got allergies. The mask stops the pollen. So why wouldn't you wear a mask? It just makes sense. The same with illnesses. There's no reason to spread your sickness to other people if you can help it. That just makes sense. The train is filled with people coughing all over you. Its packed full of people, since Japanese trains are very busy. Its the same thing as when you fly and you always get sick from that recycled air. Again, it just makes sense to wear the mask. I must admit, it kind of does. If thats the case, why don't we wear the masks in Canada or England?

I don't think too many Westerners would say because we are callous people and/or we are too stupid to protect our own bodies. My bit of experience would be that people will debate the actual practical benefits of these masks. Maybe they don't help. Maybe you catch the flu or cold because you touch things on the train and don't wash your hands. It has nothing to do with breathing in germs, so the face masks are superfluous. But washing your hands and "gargling" are also ("obsessively") stressed in Japan, definitely in my homestay family anyway. A quick response would be to return to a cultural explanation of that: Japan is a society that stresses cleanliness (not exactly wrong). That's why people wash their hands. Add back in the old cultural explanation: people wear the masks in order to fit into a group. That's a Japanese thing to do! Again, maybe not exactly wrong. Face masks are Japanese culture.

But this to me really represents an interesting question about social and cultural "explanations" of behavior. Because, like I said, people wear the masks because they think it protects them. Surprisingly often when I ask why a Japanese person why they do something a certain way, they will say "culture" (another interesting issue). But facemasks are not one of those times.. So I was really curious whether there have been actual studies on the effectiveness of masks. I saw a few, but nothing really conclusive. It would probably be hard to really map the epidemiology of such common and undocumented illneses as colds and flus on an entire society anyway(I would imagine, not being an epidemiologist I couldn't say). But, as a thought experiment, it seems perfectly reasonable that you could find the masks really do help. On the other hand, you could find the masks are useless. Both are completely plausible.

What do these two possibilities do for the kinds of explanations we would probably find, though? In the first case, the impetus would therefore be: how do we combat the "cultural" resistance of, say, Westerners, where people refuse to wear masks, for whatever superfluous reasons as aesthetics, comfort, machoism, etc. How can we clear their minds so they are like the logical, naturalistic, scientific Japanes?. But if its the second, you get a situation where the Westerners are being common sensical and the Japanese are burdening themselves with social and cultural fluff. "Obsessive" again.

It's kind an inflection of the Universal, with a capital U. Sombody needs to be on the side of Reason. But who can it be, when everyone seems to have their reasons? I think it presents a big problem for instance in the way anthropology is done (and how it comes up with explanations for various kinds of behavior). One anthropological way of looking at is just to go relativist and say well we all just do it our way because that is what our culture "tells" us to do. But that, to me, seems to underestimate basically everyone's intelligence. On the other hand, I think this issue with universalism also presents different kinds of problems for the strategies and assumptions that I think development agencies use when they are working on something like health policy in Africa. Maybe I am being unfair, but it seems like they tend to assume simply that they have the "universal" medical knowledge and they need to lift the fog of custom. But, like I pointed out before, it is neither simply that nor its straightforward negation that is quite right.

Anyway, I still don't like having to wear a face mask on the train.


Julie said...

Interesting that you bring up face-masks/swine flu because there is a lot of panic surrounding the flu here too but the face mask response is quite different. for example, people i know that have been traveling recently mention people that WERE wearing masks in the airports as sort of a novelty and really strange. like "there are some really paranoid ppl out there! get this! i saw one guy that was wearing a surgical mask in the victoria airport. can you believe that??". and then everyone listening to the story debated about how the swine flu is getting out of proportion (like SARS) and how some people get waaay too paranoid about these things (as evidenced by wearing said masks). so there you have it. discussions going on in canada on the same disease and the same practice but from very different perspectives!

Michael said...

Yeah guess I am really canadian then :P But reflexively, its hard to really say why face masks seem paranoid and condoms seem just good sense, for example...