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Tara O'Toole, MD, MPH Speaker biography | Summary | Audio Transcript
Thank you, Monica. If you believe the extensive literature that demonstrates what Monica affirmed, namely that the public is a capable partner in dealing with disasters, and has been throughout history-many of you are not only witnesses, but also direct representations of that phenomenon-the question that arises is: how do we make the general public capable partners and active participants in disaster planning, response and recovery? That is the question that we are going to delve into today. I want to emphasize that we-my colleagues and I at the Center for Biosecurity-have been thinking about bioterrorism and large-scale epidemics since around 1997. We don't regard citizen engagement and participation as an ancillary factor of epidemic preparation and response. This isn't an add-on; this is something that is going to be critical to dealing successfully with a large-scale epidemic, whether it's a deliberate bioterrorist attack, or campaign of attacks, or a large-scale, fast moving lethal epidemic, such as pandemic flu. Camus said in "The Plague" that is very difficult for people to imagine human suffering they cannot see. Remember in that story, the town afflicted by plague was behind a wall, and outside the wall, human business went on as usual, inside the wall there was great suffering and calamity and a completely different world. In the modern world, if there is a real plague, we are all going to know about it and we are all going to feel vulnerable. Epidemics are very different from other types of disasters. They grow insidiously. They don't begin with a distinct flash and boom. The situation in Indonesia right now may, or may not, be the beginning of an actual pandemic of influenza. We don't know; we can't know until we let things unfold. Everybody is potentially vulnerable. This is particularly true if it's a contagious disease, but if there is an attack with anthrax in Washington D.C., you can bet the people in New York and LA are going to feel very vulnerable, as we saw with the anthrax mailings in 2001. Epidemics last a long time; they don't end very quickly and you have to figure out how you are going to sustain vital services throughout that long period. Moreover, we in the modern world-at least in developed countries-have very little experience of large epidemics. We haven't really had to think through how we would take care of each other and ourselves and how we would maintain vital institutions in the course of an epidemic, particularly if we thought that our neighbors and coworkers were potentially lethal, delivery devices of a contagious disease. We need to understand how critical citizen engagement is to epidemic response, and we need to find new forms of actually bringing citizen engagement to bear. How do we imagine this, how do we organize to do it, how do we make it possible for those who are willing to engage and participate [to do so] effectively? The speakers and the audience for this conference have been very carefully selected, and I can tell you, in looking over the names, it's a really weird group of people. This is an amazing, very multi-disciplinary collection of people, with a very wide range of experience. All regions of the U.S. are represented, as well as Canada. There are people here, both amongst the speakers and the audience, who have direct experience in a spectrum of modern disasters, including people who were directly involved in the 9/11 attacks on New York and Washington, people who were involved in SARS, people who were victims and responders to the Loma Prieta earthquakes, and many other types of disasters in this hemisphere and around the world. The audience includes activists, academics, health professionals, government officials from virtually all of the U.S. federal agencies, congressional staff and volunteer groups. We are going to try and make this meeting as participatory as possible. One of the people who I read frequently when I am feeling discouraged and despondent-these days I have several volumes of his work close to hand-is Vaclav Havel, who, as you may know, was an activist on behalf of human rights during the Soviet era in Czechoslovakia. Because he thought it was his moral responsibility to do so, he later transitioned from being an intellectual and a playwright to a politician. He spent a long time-some of it spent in jail-thinking about the modern condition in the post Cold War world and what it meant. He wrote, among other things, that the modern era has reached a point of culmination, and if we are not to perish of our modern-ness we have to rehabilitate the human dimension of citizenship, as well as of politics. This is what I consider to be the principle challenge for the third millennium. He went on to say, in a speech he delivered in a joint session of Congress, that the salvation of this human world lies nowhere else than in the human heart, in the human power to reflect, in human modesty and in human responsibility. He said those words, as I said, before a joint session of Congress six weeks after getting out of jail, and as he held the position of President of the Czech Republic. I find those words very hopeful, and I hope you will too as we go through today's program. We need [to] make this up, we need to imagine what citizen engagement means, and we need to create the forms and the possibilities that will make that kind of citizen engagement possible, and that's what we are going to start to do today. Proceedings of the May 23, 2006 Summit: Disease, Disaster, & Democracy Transcription by CastingWords |
