As someone born and raised in London during the tail end of the 20th century, polio was something that, on the occasions when I was, briefly, conscious of it, I would undoubtedly relate to places and people far away. No one I knew had polio. I have since spent time in four different continents, sometimes in countries designated as LDCs, and have never, to my memory, really interacted with someone exhibiting the debilitating effects of what was once a terrifying summertime reality all over the world.
Were you to ask a group of average 9-12 year old denizens of New Jersey what next summer held for them, it is extremely unlikely that the word ‘polio’ would pass any of their lips. Philip Roth’s captivating 2010 novel, ‘Nemesis‘, details the terrifying spread of infection in a mostly affluent, lower middle class New Jersey city during the second world war. The disease was a normalised reality back then, coming annually and targeting mostly children. It was a mysterious disease, particularly before the licensing of the vaccine in 1962, and affected an enormously diverse range of people, from inner city youngsters of Roth’s novel all the way to the very top:
“Franklin Delano Roosevelt, polio’s most renowned victim, had contracted the disease as a vigorous man of thirty-nine and subsequently had to be supported when he walked and, even then, had to wear heavy steel-and-leather braces from his hips to his feet to enable him to stand.”
Since the 1960s the disease has been all but eradicated in the USA – not to mention Europe, South America, some of Africa and large parts of Asia – thanks to extensive vaccination programmes. Although vaccines were available from 1955, it was Albert Sabin’s oral vaccine, developed in 1961, that truly broke the back of the disease in places were large-scale immunisation pushes were enacted. The last naturally occurring cases in the USA were recorded in 1979 amongst an isolated Amish community in the mid-west.
Just two generations ago, the disease was at its height in the large cities of the global north, an affliction that seemed to come from nowhere and one that resisted medical treatment for many years. The US epidemic of 1952 was the largest, with 57,628 cases reported leading to 3,145 deaths and 21,269 people left with mild to disabling paralysis. Roth’s book details a lesser epidemic, of 1944, but it succeeds in capturing the uncertainty, the fear, the misinformation, and all those societal ills that surrounded the medical issues.
“What is the city doing to stop this? Nothing!” “There’s got to be something to do – but they’re not doing it!” “They should inspect the milk the kids drink – polio comes from dirty cows and their infected milk.” “No,” said someone else, “it isn’t the cows, it’s the bottles. They don’t sterilise those milk bottles right.” “Why don’t they fumigate?” another voice said. “Why don’t they use disinfectant? Disinfect everything.”
With a combination of well-funded scientific research and the pioneering social prevention scheme led by people like former Red Cross chairman, Basil O’Connor, these problems are more or less completely unknown for people like me. Reading this book was startling not only for its horrific subject matter but, personally, because of how little I knew about a disease that had been such a real and regular fact of life even during my own parents’ childhoods. I found myself asking the same questions as the scared parents in the narrative: where does polio come from? How does it spread? How can we avoid getting it? Is there a cure?
This research took place during my commutes which give me ample time for reading. Occasionally I would down my paperback and get out my smart phone – a tool that I take for granted and one my grandparents know almost nothing about – to explore the internet for information on this disease. When I asked my grandmother, great uncle and great aunt about polio they responded knowingly, remembering it as a great scourge of their childhoods, albeit one removed from the rural upbringing they had experienced in Paris, Illinois. My parents, too, remembered being vaccinated for it and were slightly amused by my sudden interest in such an out of date issue. After the conversation my generational ‘technical skills’ were called upon to configure my grandmother’s new phone.
In February 2012, India was removed from the WHO polio endemic list. Although a new possible case has emerged in the last few weeks, only one has been confirmed in the last 2 years. In 1985, there were an estimated 150,000 cases. It is several decades later but it possible that, at the moment, we are living through what will be seen as a similar generational change.
The work has been done by an enormous coalition of local and international actors – it’s notable that the local press cites the activities of the local authorities, the international press much more likely to put attention on the INGOs involved. Even in the unprecedented success of this polio story more than the positive is revealed: the divisiveness of a single story, the ‘global north’ always seemingly at odds with the ‘global south’. What is interesting for me is that, as this story is one that I only really began to investigate when prompted by a piece of non-related American literature, I feel as though I am coming at it from a different angle – this isn’t, for once, a ‘news’ or ‘international affairs’ or ‘development’ narrative. As such, a whole variety of different questions and stimuli are feeding into it. Recently, I was sent this,
Usually, practitioners of sustainable development are proponents of an education first and foremost philosophy. In this case, the medical approach was one that might just go on to create a whole new generation of people like me; people accessing successful development narratives through literature, not the newspapers.
Part 2 will explore how different sources of development knowledge could help to shape the development policy of the future.