Tag Archives: community

Ebola, Kaci Hickox, and Fort Kent, Maine

by Carrie Levesque

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Let’s be honest, what small town doesn’t love a little drama? A little controversy? The pot stirred? Something to keep the conversation hot as another cold winter approaches?

Normally, there’s nothing my hometown  of Fort Kent, Maine loves so much as some good gossip. But the media circus that has recently engulfed our isolated community of about 2,500, on Maine’s northern border with Canada, has been a lot for even the most seasoned gossips to handle. While the locals respect and admire the service that nurse Kaci Hickox has provided to Ebola victims in Sierra Leone, many are a bit less enthusiastic about her refusal to abide by a state-imposed quarantine to ensure that she has not been exposed to anything that could bring such a horrific disease to a small community with limited resources for fighting such an outbreak.

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Let me first say that I understand that Kaci Hickox is extremely unlikely to pose any threat to those around her. She is asymptomatic, and as numerous authorities on the issue have vigorously insisted (including the Centers for Disease Control and the New England Journal of Medicine), there is no scientific basis for ordering quarantine for asymptomatic healthcare workers returning from West Africa. Kaci Hickox, at this time, is not contagious.

But it seems to me that what Kaci Hickox is, is her own worst PR headache.

In her defense, her actions over the last week are understandable. She has been through an exhausting, emotionally draining experience that few of us could ever imagine—and that was before she touched down in Newark. What has happened to Hickox since she revealed to airport personnel where she had been and what she had been doing would certainly anger, frustrate and demoralize any of us.

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She was detained for hours at the airport and interrogated repeatedly, sometimes, according to her account, by people who didn’t bother to introduce themselves. She was tired and hungry from a transatlantic flight and given a granola bar and water for her troubles. After four hours of this, her temperature, recorded by a forehead scanner, registered 101. Her doctors at University Hospital in Newark would later concur: her ‘fever’ was the likely result of being flushed and upset. At all other times during her confinement, Hickox’s body temperature was normal.

I imagine you know much of the rest of the story. Her ordered confinement, her vow to sue for the violation of her civil rights, the invitation from the eloquent humanitarian Gov. Chris Christie: “Whatever. Get in line.” Her eventual release and escort back to Maine, where she first went into hiding in an attempt to avoid the networks that had already schlepped cameras and crew hours through the Maine wilderness to the town where the road ends, to her rural home in Fort Kent, ME.

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But here is where my empathy for Hickox’s story is tested. Not because she disagrees with the recommended 21-day home quarantine (Yes, “science,” I understand), but for her combative insistence on the rightness of her actions and for her repeated threats at litigation. For what I perceive as a failure to defend her laudable and legitimate interests while also addressing the concerns of the community with a bit more sensitivity.

The unavoidable fact is, whether there is a scientific basis for it or not, many people are concerned for their own safety and for the safety of their loved ones. Concerned for the “what ifs” in this situation which, while unlikely, are, as of this writing, still possible. In the absence of any guarantees, these concerns are understandable. Even if they should not be what drives policy—even if, in an ideal world, we could reason them away—it is not unreasonable to expect Hickox to acknowledge the feelings of the community when she makes choices about where she goes, and when.

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Having lived now in another culture for 2 years, it’s hard not to see the situation as characterized by a very American attitude that my individual rights are more important than the community’s peace of mind, that I will insist on my individual rights whatever the social consequences. As someone in my town said to a journalist friend of mine, “She’s holding this small Valley town hostage to a point of principle.” I think it’s worth asking why doctors returning to other countries are willing to submit to quarantine, but it becomes a civil rights battle in our country.

At the end of August, a Norwegian newspaper reported on the experiences of a doctor who had just returned home after serving with Doctors Without Borders in Liberia. He quietly quarantined himself at his family cabin for three weeks, waiting out the incubation period.

No drama, no fuss, no lawsuits, no government. Just simple concern for the community around him in an uncertain time.

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After all the fear that the media have stirred up around ebola (yes, even in Norway), including an article linked to the one cited above that ran with the headline “WHO: Ebola epidemic can infect 20,000 people,” is it honestly so surprising that people are not putting aside their fear so easily?

What’s more, as Hickox has witnessed firsthand the hell that so many others in less economically-developed parts of the world live every day, I have a hard time accepting the idea that home quarantine is a serious civil or human rights issue. That seems pretty insulting to the people who experience oppression (and global indifference) in their lives every day, circumstances that endure for much longer than 21 days. While we often discuss in my BLS courses the unfairness of comparing or ranking oppressive situations, I also think if we throw around the term “civil rights violation” too liberally, it ceases to be taken seriously. It becomes just another media sound bite.

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Yes, the situation is unfairly tough for Hickox because she is one of the early cases of her kind and states are still figuring out how to proceed. Yes, I support her demands that governors craft policies based on science and not fear, and that she be allowed reasonable freedoms, like her recent bike ride. But in the meantime, her situation is not Guantanamo Bay, and the current discourse has done little locally but escalate the drama and rhetoric, and, once again, distract us nationally from real human rights violations taking place every day.

My friend Julie Daigle, the local journalist mentioned earlier, said something that seemed to me very fair. “The thing is, she may in fact be making a point that needs to be made in the bigger picture, and in the long run, we may all be better off for her refusal to allow her behavior to be affected by the fears of those around her. But to castigate people for a very predictable response to having to face a sizable fear (again, regardless of how reasonable that fear is) and their clear understanding that she is choosing to ignore their fears is as demonizing an action as those seeking to cast her in the role of the witch.”

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I understand Kaci Hickox’s anger. I understand that she feels that she has already given enough—and in all fairness, she has given far more than any of us. She’s right. At the same time, especially in a small community, it is sometimes better to be generous and patient with a difficult situation. Even when we’re right.

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Author’s update: Hickox responds to a judge’s order lifting the quarantine, and members of the Fort Kent community respond to the whole debacle.

I think my main concerns are still valid—that this whole media circus is avoided in cultures where people just put the concerns of their neighbors first from the start. What do you think?

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Views From the Middle

by Wade Maki

Kearney-NEThis fall I had the privilege of speaking at a multi-day symposium on free market health care at the University of Nebraska Kearney. Kearney is a small college town in the middle of the Great Plains. Being from a small town in the upper Midwest there was a lot of familiarity such as the friendly people and predominance of pickup trucks. However, the experience of the Great Plains with its big sky and near lack of trees was a new experience. As my host joked, if you ever find yourself in a zombie apocalypse head to Kearney where you can see them coming for miles!

One of the most striking things flying into Kearney was just how much of the land is farmland. Corn is the crop, and with prices holding up the region didn’t experience the recession the way most of the country did. Everywhere I went there were brand new trucks reflective of how well things were doing. True to form, the humble Midwest farmers I met would only say “we’re doing O.K.” when they were clearly in good times.

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I met a great many students in my days at Kearney. Some attended the symposium, others were in classes that I visited, and a few I met when we had leftover food to share. For all my difficulty as an instructor keeping students attention I only needed to say “anyone want some free food” and suddenly I was the center of attention.

The symposium consisted of speakers and panels from diverse areas as hospital directors, lawyers, and a philosopher (yours truly). The audience consisted mostly of students many of whom were very concerned with the Affordable Care Act which is also known as “Obamacare” (which is true in that he does care).

One of the most powerful ideas expressed by the students was a sincere concern that they were being forced into paying for the health care of others. This of course isn’t new as it is the basis of social security, welfare, and medicare. However, I found their attitudes very familiar as I was a college student in 1993 when President Clinton was pushing his version of health care often called “Hillarycare” (which was true too since she did care). Hearing students complain about having to pay for others care was a mirror of my own feelings back in 1993.

ObamavilleThen as now students find themselves confronted with a conflict between two very Midwestern ideals: The “live and let live” independence and the “we’re all in it together” belief in community. These ideas are not unique to the Midwest but have particular attraction there because when your neighbor may be a mile or more away everyone gets used to having more freedom and responsibility for themselves which doesn’t lend itself to being forced into anything including a health insurance plan. At the same time there is a recognition of being in it together that we need to work together (be it to survive harsh weather, wild animals, drought, or the lack of anyone else to help when we need it).

While there are other factors in play and perhaps better ways to explain it, there is a real tension between two things most of us value in the health care law. The students do see themselves as part of a community that takes care of its members while also as a free individual that shouldn’t be forced to help anyone. We might boil this down to, “well if something bad happens to a neighbor I will choose to help out but don’t tell me I have to help!”

View of a park in Kearney with the town surrounded by cornfields nearby.

View of a park in Kearney with the town surrounded by cornfields nearby.

Perhaps the best way to see the health care issue is a conflict not of values but of methods. Students want access to affordable quality care but they are skeptical of legal requirements. There was recognition of the problems in the health care market (limited suppliers, no price information until after purchase, no quality comparison information, and no ability to say no when you need care). Each of these factors makes health care a different market than for example a smartphone (where you know the price, features, can compare phones, have different providers to choose from, and can go without a phone). Just as students saw the problems of the market they also saw perils of government (political decisions, dominance of special interests, collusion with big companies, the entrenchment of ineffective programs, and no ability for the individual to opt out).

All in all I learned a lot in my days interacting with students in Kearney. Perhaps most of all how much hasn’t changed. Students don’t like being told what to do, they do want to help others, and  most of all free food is awesome.

Actually, We Can All Just Get Along…And Do Most Of the Time.

by Wade Maki

Who’s out to destroy America? If you believed everything you hear over the next few weeks the answer is just about everyone. Greedy capitalists, lazy moochers, and every candidate running in a competitive race are just some of dangers. Of course if you watch the news you’d also conclude that we’re all about to die from the weather (hurricanes, earthquakes, tornadoes, snow oh my), can’t swim in the oceans (sharks), can’t fly (crashes), and we will be the victims of terrorism, swine flu, computer hacking, identity theft, or sudden onset obesity any minute now.

Similar to how the news exaggerates the risks of daily living, campaigns exaggerate the evil intent of every “other” in society. Luckily, when disasters really do occur most of us get along pretty well (and days without disasters too).

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Are the presidential candidates really villains from Batman?

Our predisposition towards cooperation became especially clear to me this summer during a trip to visit family in the hills of northwest Arkansas. On the surface this is a unique region, as you learn when flying into what appears to be nowhere. You land at a very large and modern airport (thanks to Wal-Mart headquarters being in the area). The many small communities contain people from all over the country—most notably retirees seeking warm weather, affordable living, low taxes and a large supply of golf courses.

We stayed with relatives up winding roads in the hills filled with middle class houses and large trees. During the second night of our stay we experienced a very fast and violent storm. The power went out after dark and we experienced the “what do we do without electricity” quandary faced by those too used to technology. Luckily, I had an iPad to light the way until we found a flashlight and got candles lit. As there wasn’t much to do, we grabbed a flashlight took a midnight stroll to see what had happened.

Quickly we realized that this was not a unique idea as there were people roaming all over the neighborhood (in the dark the bouncing flashlights were visible for blocks). Trees were down everywhere. Not just small Imageones but massive trees lay across yards, power lines, and on top of homes as well. It was bad and everyone was making sure everyone else was okay. We hadn’t made it a block before running into a man with a flashlight strapped atop his head by his shirt and his long wet hair hanging down his bare shoulders looking for the chainsaw he had set down along the street. This was the first, but not last person, who in the middle of the night was already getting to work helping neighbors get massive trees removed from damaged homes.

All night and most of the next day we heard the roar of chainsaws as the cleanup continued. People from outside the neighborhood were driving around offering their services to those needing tree removals (some were professionals, others just a guy with a saw trying to make a buck). It is at a time like this you realize that the “greedy capitalist” you hear during campaign season is a good thing to have around when an 8’ wide oak tree is crushing your roof.

For most of the next day power was out (the company workers were doing their best) as a mixture of Imagevolunteers and for profit professionals assisted those in need. One elderly couple had a very large tree crash right into their bedroom. Luckily they weren’t home. Rather than wait to contact them, or wait for an insurance assessor, that same mix of neighbors and professionals got together, removed the tree from the house and put a tarp on the roof to protect this couples’ home from further rain.

There were no bad guys that day. Despite the different political yard signs around, no one viewed anyone else as out to destroy America. When something really bad happened it was amazing how everyone (volunteers, for profit professional, neighbors, etc.) just did what needed doing. As a microcosm of society it is a good reminder of just how well most things work (which is the real magic given how many things could go wrong).Image

Sure there are problems, differences, and our decisions about what policy or person to support can make things better or worse. For the most part though, society is full of pretty good people trying their best, in their own way, to get what needs doing done. Something to remember as you experience the drumbeat of doom from political ads and “news” outlets—We can and do get along just fine…most of the time.