One Flu East, One Flu West, One Flu Over the Cuckoo's Nest: A Cross-Cultural Investigation of Pandemic Influenza Paradoxes in Epidemiology
Vu, Chrissy Thuy-Diem
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This comparative case study examining epidemiological practices in Vietnam and the US revealed three pandemic influenza paradoxes: The paradox of attribution which asserts that pandemic influenza comes exclusively from Asia even though historical evidence points to the contrary; the paradox of prevention which encourages industrial methods (i.e., factory farming) for combating influenza even though there is conflicting evidence for any superiority of this method in terms of means of production or disease prevention; and the paradox of action where epidemiologists act in ways not consistent with prevailing epidemiological recommendations. The existence of these paradoxes may, in fact, impede efforts at stopping and preventing pandemic influenza. In order to find the root causes of these paradoxes, this study examined indigenous media and historical and contemporary research reports on pandemic influenza. This archival information was juxtaposed to viewpoints garnered from ethnographic interviews with epidemiologists who have worked in Vietnam, the United States, or in both countries. This study found that these paradoxes endure because of the dual nature of science " the known and the unknown elements of current knowledge " and assumptions made between the two. The dual nature of science describes both the information that has been codified and information that has not been codified and the implications between the two. In other words, in between the spaces of known information, there are attempts to fill in the gaps in knowledge, which results in paradoxes. Of particular importance in this gap-filling process are the three "C's" of collaboration, conflict, and competition. Collaboration is integral to the successful prevention of influenza pandemics; however, it is this same collaboration wherein which epidemiologists are trained to be so highly specialized that they often depend on unvetted external expert information. Conflict and competition occur from the geopolitical level all they way down to the level of the individual epidemiologist and are influenced by the political and scientific economy along with social and cultural factors.
- Doctoral Dissertations