The recent earthquake in Haiti and the resulting human drama is a microcosm of the world in which Merrill Singer has spent his entire professional life.
In Haiti, says Singer, multiple issues – including poverty, a long history of external political control, and the effects of human-caused global warming on weather patterns – combine to make this island the poorest nation in the Americas and one of the most disadvantaged in the developed world. When a culture as fragile as this is impacted by a natural disaster such as a magnitude 7.0 earthquake, no layer of society escapes the resulting public health problems but the effects are always much worse for the poor.
Singer, a medical anthropologist with a dual appointment in the Department of Anthropology and the Center for Health, Intervention, and Prevention in the College of Liberal Arts and Sciences, seeks to find community-based solutions to acute public health issues that may be confined to areas as small as individual neighborhoods. At the same time, he actively challenges the world’s socio-political powers to engage in collective problem solving of global public health concerns.
Singer says he has tried to use anthropology to look at the “big issues” in the world today. His interests embrace global warming (Global Warming and the Political Ecology of Health, written with co-author Hans Baer, Left Coast Press Inc., 2009); syndemics (Introduction to Syndemics … A Critical Systems Approach to Public and Community Health, Wiley Jossey-Bass, 2009) – an exploration of the interaction between two or more diseases and the resulting burden placed on a specific population; and establishing an effective needle-exchange program to reduce the spread of HIV/AIDS in Hartford. Whatever the topic, Singer says, “It’s not always easy to know where to start, but you start where you can. The needs are great.”
What is clear, he says, is that disease has always been politicized. “We tend to think of it as a health issue … a medical issue … but disease has always been political. There’s this issue of who to blame. Is somebody to blame for putting people at disproportionate risk? Who is going to have access to prevention and treatment?”
He says the H1N1 pandemic is a prime example. “All this early anti-Mexico bias from right-wing talk shows … attacks on Mexico, attacks on undocumented immigrants … all this misunderstanding about what epidemics are and how disease travels. Even if the first cases of H1N1 initially showed up in Mexico, the people there didn’t do anything to create the flu or to cause its spread.”
On the subject of global warming, Singer cites the notion that individuals can help solve the problem by using fluorescent light bulbs and turning off their radios, “that’s all fine, but what we really need is more collective action. We need to stop pretending. Stop rationalizing. And we need to get out of our ‘rigidity traps,’ where people stay wedded to what they know and feel comfortable with.”
Equally important is to stop treating global warming as an issue where there are ‘winners and losers’ because, he says, “The science is clear. It’s not a question of ‘if’ global warming is happening; the question is when will we reach a point of no return?”
His latest book, The War Machine and Global Health (edited by Singer and G. Derrick Hodge, AltaMira Press, 2010), brings together chapters by anthropologists working on the numerous and often overlooked health consequences of war and the global arms industry.
In addition to documenting the heavy toll of armed conflict on human health and well-being, and providing analyses of the underlying structural causes of war, the book offers ethnographically based accounts of how war directly and indirectly damages human health in diverse local settings around the world.
As with the other issues he studies, war almost always affects the poorest and most disadvantaged members of society to a disproportionate degree, Singer says: Those with the fewest resources typically suffer the most severe consequences.
When asked about the frustrations inherent in trying to solve multiple problems with myriad causes, Singer says, “I don’t spend a lot of time thinking about measuring success. It’s possible to have a sense that one’s work is useful, with the background that the problems are far, far larger than the impact of any one program.
“You can’t solve all the world’s problems,” he adds, “but all those little starts can connect. I tend to focus on what to do next, rather than what we’ve done so far. The barometer is, ‘is this work useful’ rather than ‘have we solved the world’s problems.’”