Antibiotics, Counterinsurgency and the Myth of Contagion
Back when the war in Afghanistan began, Donald Rumsfeld said that the U.S. strategy in fighting "terrorists" was to "drain the swamp they live in."
His malarial metaphor revealed deep connections between the way our culture perceives threats to our health and threats to our national security.
We operate on the idea that the biggest threats we face come from the outside -- bacteria, viruses, and parasites entering our bodies through cuts and bug bites and contaminated food; terrorists sneaking across our borders. And so we seek to eliminate those threats using the most potent weapons and strategies available, from broad spectrum antibiotics to the cruise missiles and laser guided bombs the military uses to secure "full spectrum dominance" on the battlefield.
But those approaches are backfiring. The indiscriminate use of antibiotics has spurred the evolution of newer, more virulent diseases. The medical establishment's primary response has been to develop new antibiotics that in turn spur the evolution of stronger bacteria. Large scale bombing, urban firefights, house to house searches, and the detention and torture of suspected insurgents in Iraq and Afghanistan have led to upsurges of violent resistance in both countries.
These failures require a reexamination of some of our fundamental assumptions about how the world works – and that re-examination has the potential to be a catalyst for some important cultural shifts.
The Germ Theory of Disease
The theory that our diseases are caused by tiny creatures infiltrating our bodies, and best treated by killing those creatures, is a recent one, advanced by Louis Pasteur in the late nineteenth century. Its rooted in a mechanistic theory of biology which sees our bodies as well ordered machines whose function is suddenly disrupted by the presence of contaminants that jam its cogs. It ignores the reality that rather than being discrete entities, our bodies are a complex community of many kinds of cells, some of which can't survive on their own and some of which function independently but symbioticly. Biologist Lynn Margulis has convincingly argued that at least some and possibly all of the individual components of plant and animal cells were once independent, free-roaming bacteria who came together to create new kinds of living communities. The distinction between "germ cells" and "healthy cells" is an arbitrary one.
Pasteur had his detractors among his contemporaries. Stephen Harrod Buhner writes in The Lost Language of Plants that:
"Pasteur's germ theory was not the only one; there were many competing schools of thought at the time. Researchers such as Max von Pettinkofer and Elie Metchinkoff insisted that it was not the bacteria that caused disease, but an interruption in the normal healthy ecology of the body that allowed pathogenic bacteria to infect it. To prove their point Pettinkofer in Bavaria, Mechtinikoff in Russia, and a number of others around the world ingested liquids filled with millions of cholera bacilli. Other than experiencing a mild diarrhea none became ill. Their point was that human beings live in a sea of bacteria all the time, and the human body has learned throughout its long development to deal with them. Something must be upsetting the body's normal ability to respond to such bacilli and that is what allows them to grow unimpeded. That is the source of disease."
For the late Dr. Marc Lappé, the advent of AIDS raised serious questions about the dominant model of treating disease in our culture. He wrote, "It is the body which ultimately controls infections, not chemicals. Without underlying immunity, drugs are meaningless. He expressed concern about the role of environmental toxins and poor nutrition in undermining our immune systems. He was also concerned that flooding ecosystems with chemical antibiotics excreted in human and animal wastes was causing bacteria to evolve at rates that outstripped our bodies' abilities to develop new immune responses.
In a 1995 interview, he told a public radio reporter:
"Not only do we have an intimate relationship with the bacteria that live in and on us, but we're in a very tight ecological relationship with virtually all the other bacteria in the world. But this image that we're facing an inimical horde of bacteria in part has led to the attempt not only to isolate ourselves from it, but with the mistaken belief that we can actually annihilate bacteria with antibiotics or other controls. We've essentially created our own nightmare by neglecting the value of vaccines, immunization, and natural controls and instead have relied entirely on this myth that a chemotherapeutic approach is an impenetrable barrier.
"We also share ecological niches wherever we live with the bacteria and viruses around us. When we disturb those niches, by taking enormous amounts of antibiotics, our bodies respond by allowing new organisms to overgrow our natural organisms. That's the origin of the epidemic of yeast infections in women, for instance. But on a grander scheme in the natural environment, for instance when we use antibiotics in feed lots, we cause an epidemic of resistance to the very antibiotics that we intend to use for treating disease later in humans. At this moment we are controlling the evolution, not just by decimating species and annihilating swaths of rain forest, but by shifting the balance towards organisms that can thrive in the environment that we create."
But rather than seeking to identify, understand, and correct those imbalances, conventional medicine identifies bacteria as the problem and seeks to eradicate them. An infected wound and a case of bronchitis are treated in much the same way. And doctors seldom address the factors that make their patients susceptible to infection.
In the same sense, discourses about terrorism and insurgency ignore the differences between a wide variety of violent and unstable situations, justifying governments' efforts to correct them by eliminating the people and organizations they believe to be responsible for the violence. As Colombian sociologist Ricardo Vargas Mesa noted shortly after September 11:
“‘Global terrorism’ is a loaded term that both hides realities and legitimizes policy decisions. In fact, those decisions are often pre-determined by the term's very use…. To begin with, it hides the political motivations behind dramatic acts of terror. Global terrorism is so shocking that it causes most to ignore the particularities of the conflicts that engender it – conflicts which generally involve multiple actors, dissimilar positions and in general a complexity of relations.
"The term has a sense of ‘the present’ that ignores historical trajectories. Time is thrown out of order…. It also confuses a means of irregular war, ‘terror,’ with an end in itself. It gives the appearance that there are no fundamental causes of conflict: what exist are terrorists, agents of insecurity, terrorist sanctuaries.”
Asking why people are angry and desperate enough to hijack airplanes and blow up buildings is taboo. And doctors are too busy trying to cure infections to spend much time looking at what conditions in the body allowed bacteria to start multiplying out of control. And so the doctors and the generals keep attacking the same problems with the same methods over and over again – never asking whether the methods they are using make future attacks more or less likely.
A lack of discrimination in diagnosing diseases and imbalances leads to the use of indiscriminate methods to address very different situations – and those methods tend to involve the use of powerful weapons that exact heavy “collateral damage.”
In the case of bacterial infections, conventional medicine favors the use of antibiotic drugs that kill all manner of bacteria. Chemical antibiotics first saw widespread use in World War II. A newsreel from that era proclaimed that “Disease, whose guerrilla warfare against the Red Cross flag has hitherto out-generalled even the greatest commanders, suffer[ed] a setback, thanks to the new miracle drug penicillin...”
It seems appropriate that penicillin and saturation bombing were developed at roughly the same time. Penicillin will kill streptococcus bacteria in the throat just as readily as it will kill any bacteria moving into a gash in the knee. The problem is that it will also kill the bacteria in the gut that are essential to digestion. And gut function is closely linked to immune function. So after a course of antibiotics, the body is more vulnerable to disease than it was before.
Likewise, a bombing raid cruise missile attack on a suspected "terrorist" stronghold will inevitably kill many of the "terrorists'" neighbors. A house-to-house search for "insurgents" terrorizes neighborhood residents and almost always leads to innocent people being arrested and shipped off to Guantanamo or Abu Ghraib. The fabric of the community is disrupted, creating more instability, and brutality creates rage that often provokes a violent response. Brutal "counter-insurgency" operations from Fallujah to Sadr City have radicalized many Iraqis and destroyed community institutions that once helped to restrain violence, creating more "terrorists" than the military killed or captured.
Resistance is Fertile
Living systems are almost infinitely creative and adaptable. Under attack, they come up with more and more ways to survive.
Buhner describes how antibiotics spur bacteria to develop and pass on new strategies of resistance:
“Bacteria have the capacity to generate scores of unique chemical compounds. As soon as a bacterium encounters an antibiotic, it begins to generate possible responses. This takes time, usually bacterial generations. But bacteria live a lot more quickly than we do: a new generation occurs every twenty minutes in many species, some 500,000 times faster than people. And in that quickened time scale, bacteria have found a lot of solutions to antibiotics. […]
“Once a bacterium develops a method for countering an antibiotic, it systematically begins to pass it on to other bacteria at an extremely rapid rate of speed. In response to the pressure of antibiotics … the first thing that [bacteria] do is share resistance information, using a wide variety of resistance mechanisms.”
In fact, the presence of antibiotics provokes such rapid evolution in bacteria that they often develop resistance to drugs they haven't yet encountered. In one experiment, the E. coli bacteria in the feces of chickens that had been fed low doses of tetracycline were found to be resistant to tetracycline, ampicillin, streptomycin, and sulfanamides. This resistance was passed on to the E. coli in the digestive tracts of a nearby group of chickens who hadn't been fed antibiotics, and eventually to the bacteria in the guts of the members of a nearby farm family who had no direct exposure to the chickens.
It’s worth noting, as Buhner does, that E. coli bacteria, which occur naturally in our guts, were not pathogenic until very recently, when the bacteria picked up genetic material from Shigella bacteria and evolved into a deadly new strain, E. coli O157:H7.
E. coli bacteria in turn are believed to have passed their antibiotic resistance on to Staphylococcus aureus bacteria, leading to the emergence of the virulent methicillin-resistant Staphylococcus aureus (MRSA) strains that are now responsible for more deaths in the United States each year than AIDS.
The parallels to counter-terrorism and counter-insurgency strategy are clear. Attempts to control dissent and quell unrest through violence and repression inevitably spawn new forms of more violent resistance:
- – In 1962, concerned that popular movements in Colombia's cities and small groups of armed militants in remote areas could combine to form a full-blown armed insurgency, a team led by U.S. Special Forces Commander, Gen. William Yarborough, urged the formation of armed paramilitary groups to "perform counter-agent and counter-propaganda functions and as necessary execute paramilitary, sabotage and/or terrorist activities against known communist proponents."
- The Colombian government adopted the U.S. recommendations, launching Plan Lazo, a brutal campaign against mostly nonviolent dissidents, and carried out bombing raids against rural militants. The repression spurred the development of two Marxist guerilla groups, the Army of National Liberation (ELN) and the Revolutionary Armed Forces of Colombia (FARC), which continue to fight today.
- – British repression of Northern Ireland's nonviolent civil rights movement, especially the 1972 "Bloody Sunday" massacre of 13 unarmed civil rights marchers by British paratroopers, spurred a resurgence of the Irish Republican Army's armed campaign to drive the British out of Ulster.
- Israel's repression of open resistance by Palestinians during the first Infitada in the Occupied Territories led to a rise in clandestine, armed resistance, including the widespread use of suicide bombers by later Palestinian resistance movements.
- – And, of course, the widespread use of "Improvised Explosive Devices" and other "terrorist" tactics by insurgents in Iraq can be easily traced to U.S. efforts to silence most other forms of resistance against the occupation.
Suppressing symptoms while leaving in place the fundamental imbalances that give rise to a problem promises increasingly strong attacks on an already weakened system.
Changing the Framework
How do we get out of the mess we’re in? Albert Einstein's maxim applies: the problems will not be solved by the consciousness that created them. Every new generation of chemical antibiotics will spur the development of “smarter” bacteria. Every new military strategy will create new resentments and new enemies. A new mindset is required – one that begins with going back to some older ways of viewing the world.
Herbalist Susun Weed points out that conventional medicine tends to define health as “the absence of disease” – and so lacking a proactive definition of what health means, it tends to focus on suppressing symptoms and destroying the organisms it holds responsible for those symptoms. Much of what passes for alternative medicine falls into a similar trap, simply replacing the idea of disease with the idea of toxins, and embracing an ideal of purity. Weed suggests another approach, drawn from the oral tradition of herbal medicine passed on by rural women in Europe and North America over hundreds of years:
“The Wise Woman tradition says that health is defined as flexibility. It can include disease and disability – it can even include death. Because health is not the opposite of sickness. Health is wholeness. It is not ‘fixed’ and it's not cleansed. You nourish what is there, and don't make it a fight – it's not a fight between the good and the bad, the dark and the light. It's wholeness where we can say ‘Of course I am good; of course I am bad. Of course I am light; of course I am dark. I am wholeness.’”
Such an approach views the body as a complex ecosystem and looks to restore balance where it has been lost rather than seeing it as a machine whose operation in impaired by foreign objects.
Dr.Lappé advised people concerned about disease to focus on maintaining healthy immune systems:
“First of all they can keep from annihilating their immune systems. Don't go out and sunbathe, for instance. Good nutrition, rest, are the key elements for maintaining the immune system. Be sure that you have an adequate intake of key vitamins that are essential for the function of the immune system, like vitamin C. Vitamin A is an immune stimulant; vitamin E is an important anti-oxidant. Stay off methamphetamines and things that run the system dry, and avoid medical products and devices like silicone-containing devices that screw up the immune system. Because chronic inflammation may activate the immune system in totally non-evolutionarily adaptive ways.”
When the immune system is compromised or an acute infection sets in, plant medicines can work with the body's own chemistry to promote healing – a process far too intricate for our best chemists to replicate with synthetic chemicals. Biochemistry is a language whose grammar and syntax the pharmaceutical industry has yet to grasp. As Buhner writes:
“The millions of plant chemistries that are released into ecosystems are done so in response to environmental needs – to communications directed to plants – while pharmaceuticals are released into ecosystems in the billions of tons without any reason whatsoever. Both types of substances affect the same metabolic pathways in living organisms and so cause significant changes in the functioning of ecosystems. However, plant chemistries are filled with meaning; they are a language, pharmaceuticals are not."
Plant chemistries are also constantly evolving in response to the same environmental conditions as our bodies and the microorganisms that inhabit or colonize them – and so plant medicine naturally adapts to changing conditions. And the subtle and complex messages of plant chemistry are less likely to provoke new forms of resistance than the relatively simple chemical structures of pharmaceuticals.
Ethnobotanist James Duke writes:
“When we borrow the antibiotic compounds from plants, we do better to borrow them all, not just the single solitary most powerful among them. We lose the synergy when we take out a single compound. But most important we facilitate the enemy, the germ, in its ability to outwit the monochemical medicine. The polychemical synergistic mix, concentrating the powers already evolved in medicinal plant, may be our best hope in confronting drug-resistant bacteria."
A good herbalist also relates to each of her patients as an individual, finding the right plant allies to assist each body in restoring balance rather than assuming that the same response is always appropriate for similar symptoms. We've come the long way around to reinitiating our relationships with plants that have co-evolved with us for thousands of years. And those relationships offer us the gift of coming to understand our own bodies as mini-ecosystems and our own world as alive.
Similar principles can be applied to the political violence we call terrorism. Terrorism is symptomatic of major imbalances in a society – a message that something is out of whack politically, economically or culturally. Responding only to that symptom through either violence or capitulation leaves the underlying problems in place. It may be possible to eradicate terrorists, but terrorism will continue to exist as long as the problems that give rise to it exist and other means of communication have broken down.
As such its a horrifying gift – an opportunity to recognize that the body politic is seriously ill and won't recover unless and until we learn to treat it as a living, breathing system and act to restore its health rather than simply destroying the perceived causes of its disease. Susun Weed's words about health and disease seem to anticipate this insight:
“A South American shaman said ‘The forces of the brightness will have destroyed the wholeness when there is no more night.’ So the idea then, in the Wise Woman tradition, is to see the problem as an ally of wholeness, and rather than to fight against the problem, to invite it in, rather than try to cleanse it away."
Here's hoping our failure to eradicate the darkness might finally lead us back to the whole.