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Spy, Patrol, Police: Black Life and the Production of Epidemiological Knowledge from Atlanta, Georgia to Freetown, Sierra Leone

Black Lives Matter: Global Perspectives Webinar Series

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Spy, Patrol, Police: Black Life and the Production of Epidemiological Knowledge from Atlanta, Georgia to Freetown, Sierra Leone

Adia Benton is a cultural and medical anthropologist and is currently an Associate Professor of Anthropology and African Studies at Northwestern University. She won the 2017 Rachel Carson Prize for her book HIV Exceptionalism: Development Through Disease in Sierra Leone from the Society for Social Studies of Science. Her talk, entitled "Spy, Patrol, Police: Black Life and the Production of Epidemiological Knowledge from Atlanta, Georgia to Freetown, Sierra Leone," considers the role of militarized police action during the West African Ebola outbreak and in the urban United States. This project explores the tensions in the fields of public health and medicine between the rhetoric and practices of safety and care and those of security and discipline.


Nina Harawa is a Professor-in-Residence with the David Geffen School of Medicine at UCLA, and Associate Director for Research, Charles R. Drew University of Medicine and Science’s Center for AIDS Research Education and Services (Drew CARES).

Samar Al-Bulushi is an Assistant Professor of Anthropology at the University of California, Irvine.

Organizers: UCLA International Institute Black Lives Matter: Global Perspectives Webinar Series

Co-sponsors: UCLA Center for Social Medicine and Humanities (Semel Institute), David Geffen School of Medicine; Global Health Program, David Geffen School of Medicine; Department of Anthropology; UCLA Luskin Institute on Inequality and Democracy

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Duration: 1:30:39



Ippolytos Kalofonos 0:05

Hello, my name is Ippolytos Kalofonos, Assistant Professor in the UCLA Center for Social Medicine and the Humanities and in the UCLA International Institute. Before I begin my introductions, I want to note that UCLA, as a land grant institution, acknowledges our presence on the traditional ancestral and unceded territory of the Gabrielino/Tongva peoples, the traditional land caretakers of Tovaangar, the Los Angeles Basin and the South Channel Islands. On behalf of UCLA's International Institute, it's my great pleasure to welcome you all to this morning's event with Adia Benton, Associate Professor of Anthropology at Northwestern University. Today's event is part of a series that we began to organize last summer, galvanized by the massive movement for global -- global movement for Black lives and the urgent political issues it raises about systemic racism and institutional violence, and in particular police brutality and mass incarceration in the US and the world. Given both the global history and the contemporary sweep of racial capitalism, an international perspective is fundamental. Today's presentation examines the ways violence against Black bodies has been mobilized, justified, and understood within the public health framework, specifically within the US Centers for Disease Control with the professionalization of an epidemiology of violence and in response to the recent West African Ebola epidemic. Before we begin, I want to give our special thanks to International Institute Senior Associate Vice Provost and Director Chris Erickson, and Vice Provost Cindy Fan, who strongly supported this first ever collaboration across the Institute's many centers and programs. And to my wonderful colleagues on the organizing committee, including Jorge Marturano, Robin Derby, Shana Potts, Laurie Hart, Alden Young, Erica Anjum, and the chair of our group, Jennifer Chun. We are, as always, indebted to the amazing staff at the -- at the Institute, who make all this possible in and out of pandemics.: Kathryn Paul, Peggy McInerny, Kaya Mentesoglu, Alex Zhu, Oliver Chien, Chloe Hiuga, and Steven Acosta. We're grateful to Ananya Roy, Director of the Institute on Inequality and Democracy, and to the Program Manager, Vania Sciolini, for this collaboration. I'd also like to thank the TAs from my Introduction to Global Health course, Eva Melstrom, Izem Aral, and Jeremy Levenson, who are generously monitoring our Q&A behind the scenes. Today's event is co-sponsored by our partners, the Luskin Institute on Inequality and Democracy, the Center for Social Medicine and the Humanities at the Semel Institute, the David Geffen School of Medicine Program in Global Health, and the Department of Anthropology.

Ippolytos Kalofonos 2:36

Our format today will include the speaker's presentation, followed by comments from our respondents, followed by a moderate discussion and Q&A. We ask that attendees submit their questions on the webinar's Q&A, which you will find at the bottom of your screen. Feel free to write questions into the Q&A at any point. Although we will be limited in time and be able to respond during the webinar to fewer questions than we'd like, your questions are valuable and will be saved for the speaker. A video recording of the event will also be posted on the International Institute's website. For time's sake, we have posted links to the full bios of our distinguished discussants in the group chat, but let me briefly introduce them now. Samar Al-Bulushi is an Assistant Professor of Anthropology at the University of California, Irvine. Her research is broadly concerned with surveillance, policing, and militarized urbanisms in the context of the so-called War on Terror in East Africa. She is a contributing editor at Africa is a Country and her work has appeared in public outlets such as The Guardian, Al Jazeera, Intercepted, Jacobin, and Pambazuka News. Her book project Citizen-Suspect: Militarism, Race, and Geopolitics in the East African Warscape explores Kenya's entanglement in the ongoing war against the militant group Al-Shabaab, drawing on ethnographic research with politicians, diplomats, human rights activists, and young people in the cities Nairobi and Mombasa. It grapples with the relationship between the imaginative and grounded geographies of the War on Terror in East Africa today. Dr. Nina Harawa is a Professor-in-Residence with the David Geffen School of Medicine at UCLA. She also has a faculty appointment at Charles R. Drew University of Medicine and Science, where she serves as Associate Director of Research for the University Center for AIDS Research Education and Services. Trained in epidemiology, Dr. Harawa's research involves developing and testing holistic interventions for encouraging prevention, care, and treatment for HIV, sexually transmitted infections, and substance use disorders, and leading efforts to examine the impact of various policies on racial and ethnic health disparities. She directs the policy impact corps of the NIMH-funded UCLA Center for HIV Identification, Prevention and Treatment services, which examines how proposed and enacted policies may support or hinder efforts to end the HIV epidemic in the US and abroad. Because of her commitment to health equity, Dr. Harawa started Reach UCLA Health, a faculty group dedicated to increasing access to the UCLA health system for people of color and those with publicly funded health coverage. She's conducted innovative research with a variety of populations including sexual minority men of color, Black and Latina cisgender women, transgender women of all backgrounds, and sexual and gender minorities who have experienced incarceration. Now let me turn to our main speaker. It is an honor to introduce Adia Benton, an anthropologist who's interested in patterns of inequality in the distribution of care and in the politics of care and settings socialized for scarcity. This means understanding the political, economic, and historical factors shaping how care is provided in complex humanitarian emergencies, and in longer term development projects like those for health. These concerns arise from her previous career in the fields of public health and post-conflict development in sub-Saharan Africa and Southeast Asia. Adia's first book, HIV Exceptionalism: Development through Disease in Sierra Leone, explores the treatment of AIDS as an exceptional disease and the recognition and care that this takes away from other diseases and public health challenges in poor countries. That book won the 2017 Rachel Carson Prize, awarded by the Society for Social Studies of Science and has been reviewed in over a dozen venues. Her second book, The Fever Archive, is under contract with the University of Minnesota Press, is a series of essays about the 2014-16 West African Ebola epidemic, focusing on the militarization of public health response, US biosecurity and the global War on Terror, and what she has called the racial immuno-logics of triage and the politics of care. Her recent publications have focused on visual analyses of humanitarian images, race and humanitarian professionals, security and military paradigms during epidemics, and temporality in an era of antiretroviral therapies for HIV-AIDS. Adia also has a prominent voice as a public intellectual through her blog,, and on Twitter as ethnography911, and regularly appears in popular media presentations and podcasts. I've had the good fortune of knowing Adia since we were both graduate students studying AIDS-HIV interventions across the African continent from each other. And her scholarship, her creativity, and her wit continue to inform and inspire me. Please join me in welcoming Adia for Spy, Patrol, Police: Black Life and the Production of Epidemiological Knowledge from Atlanta, Georgia to Freetown, Sierra Leone.

Adia Benton 7:03

Thanks, Ippy, that was great. You are also very inspiring to me, so people, check out that article that we co-authored about temporality and AIDS, it's, um, it was actually a pleasure to try to work on that issue. We're still -- so, today, and speaking of, you know, a collaboration -- so one of the reasons that Ippy asked me to talk today was, was because of my work on militarization and securitization of outbreaks. I'm actually going to share my screen, as is always the...And one of the things that we were kind of thinking about, or I've been thinking about a lot and written quite a bit about, is this: the use of -- the literal use of the military to try to address epidemic, uh, epidemics. And so here, there's a picture of the security forces of Sierra Leone, standing guard at a checkpoint in Kenema, which is the first place that I actually worked when I first moved to Sierra Leone in 2003. But also, one of the things that I've argued in a lot of that work is, even though this is a sort of visible, obvious, overt use of the military, there's also a security element that is, is sort of always built into the landscape. So these are our checkpoints that were reanimated in the aftermath of the war. And this is the sort of literal, you know, and then there's this this sort of overt violence exercised by the military, overt use of what I call overt use of military assets and military might. These examples are part of a long, I guess, history of talking about the militarization of, or the critiques of militarization of outbreak response more generally. But as I began to start to kind of delve into this research, this was not what I was actually planning to write about it. After my first book, I was actually planning to write about surgery in the global -- the movement to improve surgical access in the developing world. I came to this because in the middle of my working on that project in Sierra Leone, this Ebola outbreak happened. And so, the more I began to think about my critiques of militarization and securitization of health, I realized when I started talking to Ebola survivors, when I started digging through the oral history archives in, at the CDC, that I needed to think more broadly about martial politics. And I needed to also think about the role of, say, field epidemiology. All of -- and how, and how these look, the practices of field epidemiology, of field sciences like anthropology resemble policing more as much as they resemble something like military or security. And so as I started my reading, I came across a work by Stuart Schrader, who talked about counterinsurgency and policing. And one thing that I noted was how he distinguished the military and the police in terms of the relationship between discretion and the hierarchy, the bureaucracy of the military and the police. So in other words, discretion by the police happens at the sort of field level, and reduces as you move up the hierarchy, and with the military that's inverted. And so it had me thinking about what the everyday practice of epidem-field epidemiology, what field sciences of policing looked like. And so I focused -- began to focus more on policing and detection as key practices and modalities within these different, in ,within outbreaks. And so the key concerns that I'd like to address today is -- and somehow this is missing, and this is a -- the question is who lives in the epidemiological imagination? This question was prompted by my reading Ruha Benjamin's work, but also Octavia Butler, James Baldwin, Dionne Brand, Toni Cade Bambara -- it's all a, I guess, coterie

Adia Benton 11:25

of B-named people -- who actually start talking about the distinctions between narrative and the calculus, the calculus and calculative logics of future thinking, and what that looks like when it is racialized or mobilized in relation to Black life. The second question that I'm interested in is what constitutes the field across the cases that I examine, in terms of the domains of knowledge making and sites of labor? So what are the practices, products, and values associated with field work? And so just to kind of put a finer point on this, I've been writing about the field Negro in house Negro as this critique of the managerial elite responsible for managing the epidemic, such that the people who are outsiders were protected from the disease spreading overseas. So what constitutes the field in the epidemiological, the policing, and anthropological imagination? And then finally, what are the stakes of this exorbitant analogism? And that's something I borrowed from a scholar by the name of Seltzer. What is it, what is at stake in the exorbitant analogism constituted in those fields, in which say, crime and disease or analogized, war and disease, and by extension, sovereignty and freedom in relation to disease transmission? So the problem with exorbitant analogism, and I'll talk about this later, I hope, is that at some point, you have the literalization of crime and disease as similar, or the violence, the literalization of the violence becomes more obvious, more apparent. So all of that to say, let's go to Atlanta in 2017. So I went to, I, on a, it was a summer day and in August of 2017. I joined this curator tour of the EBOLA: People + Public Health exhibit at the David J. Sencer Museum, which is the CDC's museum in Atlanta. And I went the night before this main tour, but I also arrived early to go through two security checkpoints. One was near the entrance of the campus, and another was at the entrance of the museum itself. And the tour was meant to last two hours. But we actually ended up spending half of that time lingering in the first third of the exhibit's 21 sections with Louise, who's in the white skirt, and Pierre, who's a French physician and epidemiologist and veteran Ebola responder, Louise, who was conscious of our time together, quickly moved us to her favorite object in the exhibit near the center of the main floor exhibition hall. It's the thing in the black box. It's a white board, and it's in this sort of custom built black wall. And she turned to us and she said, isn't it the most spectacular piece? And I remember looking around at everyone, like, do they all think this is spectacular? Is it just me? I'm not sure. So we're all looking at this object, and this white board is divided by dotted black lines, into black and blue lines, actually, into five generations, which altogether covered, cover something like two months of 2015. So each of these generations contains a red, black, green squares with black letters and numbers written neatly inside each of them. The leftmost square is the index case. And it is, it's, it reads MKM/35O06/06R16/06S. You know, very esoteric until...And so in this cluster of Ebola infections, MK is thought to be the primary case from whom others in his neighborhood, Magazine Wharf, contracted Ebola. MK is a 35-year-old male, he first experienced the symptoms of disease on June 6 of 2015, and recovered on June 16, and survived his infections. So each of the arrows leading from MK signals a friend, a coworker, a neighbor, and, and often looked like they were friends caring for one another. So Magazine Wharf is one of these places, it's actually -- let's see if I can highlight here or use a laser pointer here. It's, wait a second, where is it, it's right somewhere around here --

Adia Benton 16:17

And it's, the earliest writing that I was able to find about Magazine. Worf was from 1926. And most of that writing focused primarily on the extent of mosquito breeding, the variety of anopheles in that area, and usually accompanied by the measurements of children's malarial infections through like spleen, spleen measurements, and things like that. And so, I was curious about this, because the history of Freetown is such that it's, you know, it's a colonial city, founded in the 1700s. And one of the things that, that stands out about it is how it is very much built up around colonial needs. And so the measuring of mosquito breeding grounds also led to racial segregation policies in Freetown. So people living closer to the water were considered to be, were for sure Black and native, or indigenous. And then the people who lived up the hill were White, or European. So contemporary writing about the places largely centered on the public health and development projects that are implemented through the community-based organizations and market associations with the assistance and guidance of national and international partners. Local news...Pretty much every time I've watched local news about, say, water and sanitation, Magazine Wharf is one of the places, locations that they talk about. And among the oral history interviews in the CDC Digital Archives, for individuals of the 100 or so who were involved in the CDC's response, or who gave oral history interviews, four of them offered insights into what happened in this Ebola cluster depicted here. I don't think I'm actually going to read full excerpts. But there, I was thinking a lot about how and what people are willing to say as a part of this, this collection of interviews. So there's, there's one interchange between Redd, a man named John Redd -- and I can't remember Bennett's first name -- and Bennett. And they're recounting an incident that's actually quite well known because it's referred to in different people's interviews. But it's the scene in which a White expatriate worker from the CDC gets, is very sick but is still participating in the field visits and going house to house. And one of the things that struck me about this is how Redd and Bennett began to talk about this. And they say, because they're, they're actually worried about being called hypocrites. So it's, Redd says, these teams were, there were probably eight of them, eight teams, each of which probably had 10 to 15 people. It would vary a little bit. There were really a lot of people down in Magazine Worf, who were clearly looking for Ebola. It was easy to tell who was an expat and who wasn't. And not just because of skin color, but, and then it interrupts, yeah, yeah. Because there was a lot of responders that were not, there that were not, people had t-shirts and, and Redd responds, yes, yes, there were loads of locals, but they would have always have t-shirts or something identifying them. The woman had been down a magazine and it was very, very hot. We trump up and down the stairs. It was pretty brutal. She got up to the -- bear in mind, they're down there asking, does anyone have diarrhea? Is anyone vomiting? And she got up and she walked by the fish market and was just so overcome by the smell and vomited and word went around the wharf pretty quickly that she'd been sick. It was incredibly quickly. It's a talking culture and the people are so densely packed, boy, stuff would...And then they sort of go on and on about how is it that we were unable to get information about people who were sick amongst this community. But the second a White woman comes in and starts vomiting, everyone's like, aha, there's a person with Ebola. A less experienced, uh, epidemiologist also was interviewed, and she is a Ghanian American who was specifically assigned to Magazine Wharf, and she actually talks about this cluster, and talks about -- I'm not sure if everyone can see this or notices this, but there's some really small children in this cluster. There's a red,

Adia Benton 20:49

a red box at the bottom that says, Son, I believe that's a 23-day-old person who was a male and died, yet died on his, 23 days into his life. And so there's a piece here about this baby: the baby actually died. And we were trying to find out how we missed her. Eppies always say this, there's always when there's that missing link, and you're pushing, and you're pushing, and you're pushing, and you're not getting information. But you know that there's something here that is unresolved. That's exactly what happened. And it goes on and on about the sort of particulars of missing this case, and the people who escaped notice by the, the apparatus set up to do this, this tracing to kind of one of the things that I was pushing up against or thinking about was this means of sort of entry into communities and also pushing, and pushing, and pushing investigations for the sake of understanding the origins of the, of the disease, and how that -- how, even under these circumstances, there's defiance against that imperative to, to collect information and to gather intelligence for the -- for the sake of completing the information on this, this diagram. So I returned to the question, was this a spectacular piece? Many of us struggled to make sense of what we were seeing because it hadn't been constructed for us, but for and by epidemiologists working the case. It was exhibited for us. But it, you know, it wasn't for us. And it's worth noting that even if its contents at first seemed cryptic to us, we were familiar with it, at least the whiteboard as an object and how it plays in certain professional fields. Specifically, it's a standard object in epidemic thrillers and also police procedurals, and I mentioned that I've been sort of obsessively watching them. So, you know, here, this is where I am, I based my whole field assignment, field work is based upon watching police procedurals. But in films like Contagion and Outbreak, the whiteboard is a medium through which epidemiologists communicate their expertise about patterns and dynamics of disease transmission. So you know, Kate Winslet explaining are not, but actually drawing really relationships between individuals. But in the police procedural, an analyst or detective uses the whiteboard as a mnemonic device to keep track of or to remember relationships among suspects and victims and accomplices, and bodies of evidence linking them to a crime. Here, the whiteboard diagram functions as a technology that enables intervention and exhibition. And it reconfigures the boundaries between representations of scientific facts and cultural artifacts. The whiteboard enacts object relations linking the imaginaries of health to imaginaries of policing, is the synecdoche of, of Operation Center, and it helps to orient the strategy for mobilizing boots on the ground -- which, you know, I didn't just pull this out of the air, field epidemiology training programs that come out of the CDC explicitly use that language -- and alongside shoe leather detectives, such that they can reach every point of contact among kin, neighbors and colleagues. So when I first started to conceptualize this book project, I was spurred by the connections between dual crises spanning the Atlantic: the movement for Black lives in the US and the fight against Ebola in West Africa. And I started to think about the outbreak response in relation to racial capitalism and concepts of capture, enclosure and containment which form threads through the chapters.

Adia Benton 24:45

When I started that reconceptualization, I happen to be asked to comment on Vinh-Kim Nguyen's recent work, and to think about where he was talking specifically about the Democratic Republic of Congo's Ebola outbreak that was happening a few -- couple years back, and there's another one that in fact may be starting again. And he introduced this sort of undertheorized, you know, still in progress idea of humanitarian capture, which I've been trying to think with as well. Specifically, I found the modifier "humanitarian" useful for thinking about how humanitarian practices are sutured to market mechanisms and logics of extraction, exploitation, dispossession and displacement. But what specifically, uh, humanitarian lends itself to in these practices, the showing of concern. So for me and the purposes of this talk, the museum has been a key site for examining this form of capture for the CDC, an actor in the in the outbreak response, the key actor. This was the CDC's largest ever response, in fact, to an outbreak. There were 1,500 deployments to Liberia, Guinea and Sierra Leone. There were 80,000 person days of effort -- so very much US government agency talk -- and then a Level 1 operations emergency operations, er, Level 1 Emergency Operations activation, which is the 24-7, people in the Situation Room kind of thing. And then they set up labs in three countries and processed approximately 80% of the samples. That's according to this. There's a, that number is probably debatable, I have some reasons to think it might be slightly different. But just so you can understand that, the scope of this. And so, these capture logics and practices are mirrored in the museum on multiple levels. So one level concerns the context in which the diagram was made. What collecting and gathering practices makes it possible for MK to exist as an index case in this cluster, and for his neighbors and coworkers to be depicted as implicated in several generations of infection? There, these are, these are linked to representational practices of outbreak investigation management, like the whiteboard, but also a stunning array of graphs and forms, and all of these things that fill up the walls of the museum. A third level might focus on how the CDC chooses to represent those practices to the public. So how and why do all of these objects make their way into the collections of the CDC museum? And how and why do some objects fit into the very story the CDC wants to tell about itself? So again, I want to draw attention to the relations among these objects, and how they relate more broadly to a version of global health that is very much US-centric and operates through US racial, bureaucratic and administrative frames, which circulate widely in the developing world. What might the gathering and collecting practices in one context have to tell us about those same or similar practices in the other? So I'm looking at the double lives of these objects in the field, whatever that is at this point, and the museum to help me think through the logic of humanitarian capture, which in the case of US public health bifurcates, and institutes, and reproduces labor hierarchies and moral and racial coding associated with them. So these domains include distinctions between work in the field and the office, or the field and the hotel, as was the case in this protracted emergency. So, the reason I bring that up is because anytime I talked about the CDC with someone who worked for, say, the WHO or an NGO, or some other government agency, they would really kind of call out the CDC personnel for spending their time in a hotel when they should be in the field, or live in the Cave, which is this place that they set up at the Radisson hotel to do their work.

Adia Benton 28:49

There was this -- there's also this other bifurcation that, I think, is, is sud-is now suddenly kind of becoming really critical for how we're thinking about COVID-19: the distinction between clinical medicine and public health. So caring for patients on one hand, versus containment ideologies and slaking epidemiological models' thirst for data. And then there's this other bifurcation between patrol work and detective work. So who is, like, doing that sort of day-to-day work of being there, and collecting information, and prevention, and who is intellectually equipped to perform the labor of detection, sort of investigation and going back to find these things out, analyzing information. So circulations across these boundaries are focused on bringing the action back home and projecting a certain vision of the agency's value to US national health and wellbeing in the place of Black life, of blackness in this vision, in the calculations of value. So I want to go back to -- actually, now going to August 2014, which also happens to be where we saw sort of the height of the, that Black Lives Matter movement, even though some people seem to think it just sort of happened, like, last -- last year, is, this is the story of where the exhibit begins, or -- and on that day, August 5, the missionary nurse Nancy Writebol was the second American evacuated from Liberia. And she got some, she was, ah, she arrived in Atlanta. And she was accompanied by these FBI and police escorts from the Air Reserves base, and Writebol was met by some attendants on Clifton Road. So this was an uneventful ride to the hospital, but the media were following. It drew negative attention to the CDC for reasons, people were worried that they were unleashing Ebola on the US population. And for people who don't know about the geography of Atlanta, or at least this particular strip, the CDC is right next door to Emory University, and the Emory University Hospital is just down the street. And so the the media were kind of basically parked outside of both gates, and there's like, helicopters and media vans. And so, when I talked to the curator about this, she said -- the curator of the CDC Museum -- she said to me, this was an opportunity. This is a big deal. And she also said that she wasn't going to let this thing happening, that happen again. And so I was going through my notes, you know, like, what does she mean by that? And then I started to read, when I read my notes, I realized that she had, she had previously been talking to me about the 1979 to 1981 Atlanta child murders and disappearances. And you probably are wondering, like, what does this have to do with some nurse landing in Atlanta? Well, so here's the story. Louise arrived in, in Atlanta in nineteen-se-in the late 70s. And she'd been working for the city's Historical Society. And she was collecting and cataloging materials of historical significance. And as a part of her work at the CDC Museum, which she's been doing for, I think, 20 years or more now, she mentioned that she had been doing research to fill out another part of the exhibit and went to the Historical Society and realized that there was not a lot of information, or there was less information that she would have wanted there. And basically, the -- the story there is that there were two dozen, more than two dozen Black children from Southwest Atlanta, mostly boys but there were also some girls, and they went missing or they turned up dead. Most people have probably heard the story, because there have been lots of documentaries, true crime accounts. And if you're old enough, you might have even caught the, um, the TV movie that came on in the mid-80s about it. But, so she was referring to these deep reverberations through the city's Black poor and working class neighborhoods, all of which were at the time and what, the opposite pole of the city from the CDC's main campus. So why had that, her failure to document the murders of Black children aged nine to 14 been her point of reference that day for her work documenting the Ebola crisis? So, I sensed that there was some shame and some guilt here. And for me, I kind of wanted to tap into that, even though I did not actually explicitly asked her, because I think maybe what would have happened, and this is maybe this is me just being

Adia Benton 33:35

cautious. But,

Adia Benton 33:38

I think to have admitted the connection would have been admitting some other, I guess, limitations. So, how do you, do you openly acknowledge the racial, gendered and class underpinnings of your failure to conceive of crime or crimes against Black children as historically significant? So, I would like to suggest that if we start with her feelings of guilt and shame regarding the silence about Black suffering in Atlanta's formal archives, it's possible to discern how US racial politics along with global racial hierarchy suffuse CDC institutional memory and memorial practices. And in this case, it serves as the motivation to begin rapid response collection, again, modeled after Ferguson activists' decision to begin to collect materials from their protests and archive the formal organizing that they were doing. So put bluntly, the same racialized, gendered and class inequalities that made it a story of historical insignificance have also supported archival humanitarian impulse to demonstrate concern through collecting objects that testify to and signify victims' and heroes', struggles tragedies and triumphs. But this was only part of the story because I actually, in addition to going to that museum a few times in 2017, I went back in 2018 and found more about this story in relation to the CDC. So down in the basement of the CDC, there is the, what they call The Story of the CDC. And this is the permanent part of the exhibit, it doesn't really change. And there's this piece called Public Health Approach to Violence. And basically, it's this diptych panel that chronicles the role of the CDC in establishing violence as a public health problem, as you can see on the -- on the right hand side that there's, like, a timeline, they put 1973 there because that's when we actually began to learn, or they began to sort of put out a series of papers saying, hi, we've looked at all of the homicides over the course of this decade, or whatever. And we have discovered that, you know, the things that. actually. we already know -- that we currently know about violence were enumerated here. So what we knew was large -- that homicide was largely exercise-or what is homicide? So it, the kill-basically, this violence is largely exercised among intimates or people known to each other. All of these things that we know to be true about violence. So those kinds of things that we, we take for granted now as, as knowledge about violence and the patterns of violence. Now, looking more closely at this exhibit, you know, An Epidemic of Murder. This is a 1981 clipping from Newsweek magazine and the headline is outlined in, you know, red crayon, or what I call red red marker, to kind of highlight that, what I guess to match the exhibit's black, white and red scheme, and the photograph features four individuals sitting at a table, presumably in the basement of the Fulton County Health Department -- and Fulton County is one of the counties where Atlanta is -- the photo's caption reads: Medical sleuths in Atlanta were considering these crimes a health hazard. This is one of many newspaper and magazine articles covering the controversial decision to bring CDC scientists into the investigation team. At this point, they had already enlisted the assistance of, of psychics and clairvoyants. So epidemiology did not see too far off. And in fact, when I interviewed one of the authors of this paper that's here, he said that. He said he saw it in the newspaper in September of 1980, he saw this thing about the psychics and he said, hey, maybe we should be involved. I mean, we can do better than a psychic, right? So I can talk a little bit more about that at some point. But I just wanted to point out right here that when, one of the things that the Public Safety Commissioner Lee Brown said, in response to the CDC's response, he said, we have to determine how their services can be used. I suspect the techniques that they use are not much different than the techniques we use, but we are looking at various methodologies and areas where their expertise can be of assistance.

Adia Benton 38:22

So I thought that was a really interesting point. But one of the things that I should point out is that the police were not really pleased with the CDC's wanting to be involved. And one of the authors told me that, and I thought this is a really fascinating way to think about it. This person was a long term employee of the CDC after completing their Epidemic Intelligence Service time. And they said that, "No one really goes out for an investigation without a shot at getting, if they don't think that they have a shot at getting the answer. You design studies to not miss the thing that you hope is the answer. Police are the same, but they're less organized about it. So anyone who tells you they're entering the field objectively, they're lying." A key difference I will return to later, however, is detectives are sensibly trying to figure out whodunnit. What epidemiologists, in this case, are trying to find out: what made it possible for those things to happen to those people in that particular place in time, or what is the likelihood that those things happened to those people because of particular behaviors that made them susceptible to that thing? I know, it's really wild. I will just leave that there. But I want to talk about this, these -- a lot of these ideas that I'm still working through. There's actually temporal and, and intentional differences or motivational differences. It cannot be overstated that public health was not well understood nor were CDC's motivations above reproach, particularly where Black communities were concerned. The comedian and political activist Dick Gregory, like many, had -- they publicly questioned the decision to enlist the CDC's help given their limited expertise in forensics or pathology. There were also rumors that the CDC themselves had kidnapped and killed the boys for experiments. Others, if you might also recall that the US Public Health Service, of which CDC is a part, had at that time been publicly criticized for its role in the Tuskegee syphilis study. But it is what, it is that field epidemiology, what -- but what is it the field epidemiologists, epidemic intelligence officers, disease detectives, whatever you want to call them, what do they think they're doing? Joe McCormick, who investigated lassa fever outbreaks in Sierra Leone and the first outbreak of Ebola in Sudan and Zaire -- at the same time, actually -- he wrote in his recent memoir: An outbreak investigation is very much like the investigation of a crime. It consists of detective work, following hunches, carefully collecting evidence. In epidemiology, however, the criminal is the bug. Find the bug, and then find out how it got to a team it hosts. The bug's motive? Making a lot more bugs, I guess. But it's not just bugs you're dealing with, you have to deal with people, especially the victims, and it requires some effort to explain to them what you're doing and then to convince them to cooperate. And he describes his primary tool, the case control study, which is, you know, super common, and in fact, the use, I'll talk a little bit about that. But he says, this is a scientific method used by epidemiologists to discover the most important differences between those people who did become sick, and those who did not. If you can determine those differences, you are usually close to pinpointing the case for the root of infection. So this clipping from the 1984 article in the journal is also a Journal for the American Medical Association, or JAMA, is in the exhibit panel. The epidemiologists that I showed you in the Newsweek piece are the authors. They're all, or the first three of them were, EIS officers at the time. And two of them were in the Interior Disease branch, so the people who basically say, who tell you that the potato salad was what made everybody at the church picnic sick. And then there are, um -- there was one person, so actually the only woman on this was the, was, that had actually been a pediatrician who had been working on questions of child abuse and domestic violence.

Adia Benton 42:44

So she was sort of the only subject matter expert on the, on the group. Another author was an employee of the police department and moved on to this sort of citizen policing group that is kind of esoteric and weird that I'm still trying to understand. But basically, that's what happened. And so they use a case control design, with the cases being children who had been found dead or gone missing, and the controls being similar children, so children who were matched to victims by age, sex and location. A team of public health nurses were listed in the acknowledgments section only. They conducted the interviews inquiring about the child's schedule, like what time they went to bed. when they went out at night unaccompanied, whether they had expressed interest in a person of the same sex, and whether the family received public assistance. There's a long list, but what was left unasked but was marked and observed by the nurse interviewers were other presumed markers of socioeconomic status: the cut and quality of the children's clothing, the condition and cleanliness of the home. By the time they conducted the study, it was late in the investigation. The family of the missing or dead children would have already been investigated and questioned multiple times. The widespread terror sweeping these affected communities, assuredly, as the paper's authors briefly acknowledge, would have changed how children moved in and around their neighborhoods. They would have, they would have known. So there's another list of some of the things in case, this actually draws from the original document that they submit to the agency when they've completed their investigation. So I wanted to also say that a goal of this, and it comes...You can see this in the exhibit, a goal was to cut, certify whether or not the number of cases exceeded the expected or normal number of cases. In other words, is there a cluster of deaths and disappearances, or is this just random occurrence? And even more sinister and addressed in the paper, are the police negligent or incompetent? Another goal is not to identify or profile the killer or killers, as the newspaper article reminds us as well as the exhibit, but to identify the characteristics that made the child vulnerable or susceptible to being killed, kidnapped or killed. Broadly, the CDC's involvement in the case, if you look at official timelines, including the one in the exhibit, is named as a key factor for allowing for the development of a violence branch and later an entire center within the CDC. In other words, the deaths and disappearances of Black children and by extension, the vilification of Black parents, their practices, form the institutional basis for the agency's extension into fields of violence and injury, and these issues into key public health problems. So, in closing, I've tried to think with these objects in the CDC museum and Louise's provocation, which linked to failure to collect and secure the stories of Atlanta's murdered children with an archival and curatorial impulse to capture and enclose humanitarian objects related to the CDC's involvement in the West African Ebola outbreak. An institutional narrative about the role of the agency and outbreak response is built up on the symbolic deceit of each of these objects as a tool, as tools of connection, of evidence of control, surveillance, marketing and care. The substance of the institutional narrative rests in the bowels of a peripheral, semi-public space on the campus' headquarters relating a broader story about the agency's brand and its primary exports of epidemic intelligence, field epidemiology and expanding notions of what constitutes a public health hazard. And for a brief period, another narrative straddled the museum's two levels, in which Black people on both sides of the Atlantic were subjected to mechanisms of policing propped up as a form of pastoral care. More broadly, the whiteboard and the JAMA article, and the story surrounding their production and display, brings together the three areas of concern or at least the questions that I tried to raise about the field, about the epidemiological imagination, about the exorbitant analogies and that exists amongst or between these fields. And so I'll hopefully you'll pick that up in the comments and I'll address some of those things in the Q&A.

Ippolytos Kalofonos 47:18

Thanks, Adia, for giving us quite a lot to talk about and think about. Well, to get started with our discussion, we're going to turn it over to our two discussants and we'll start with Samar Al-Bulushi.

Samar Al-Bulushi 47:36

Thanks very much, Ippy. Can you all hear me okay?

Samar Al-Bulushi 47:42


Samar Al-Bulushi 47:43

So, thank you to all of the organizers and thank you, Adia, for this fantastic talk. I am grateful for the opportunity to be in dialogue today. You've offered us a fascinating window into a set of dynamics that help us think about the interconnections between seemingly discrete populations and territories: Atlanta, Georgia and Freetown, Sierra Leone. It's seldom that we as US-based scholars, and especially anthropologists, put in the time and the effort as you have done to make these kinds of links. As many of us are painfully aware, the emergence of area studies frameworks during the Cold War has over the years functioned to the divide and to circumscribe our thinking. Of course, this is not accidental, as the US government, particularly in the context of anticolonial struggles, conceived of alliances between and across Black populations as a threat. The effect has been that scholars studying the world outside of the United States have been trained to diagnose distant dangers that are supposedly confined to particular regions. Even comparative studies generally remain bound by the nation state, and thereby obscure broader power formations that are in need of scrutiny. And what you're doing here is helping us unmoor our analysis from the nation state form, and from lingering conceptual binaries like center and periphery, like local and global. And instead, you're pushing us to think about interconnected realities, about geopolitics, and questions of collaboration, entanglement, and complicity. We often think of geopolitics as a phenomenon that unfolds in quote, unquote, important places among important people. So I'm thinking about trade agreements, about peace talks. Now that may be true, but it's only part of the story. As your talk today illustrates, it's equally, it's not limited. It's not limited to these spaces, and it's equally about everyday spaces in places like Freetown, in places like, like Atlanta, that are shaped by social relationships, by material processes, by fields of representation and meaning. And of course, all of this is unfolding in the context of asymmetrical relations of power. Perhaps most importantly, and this is where intelligence actors, spies and health officials come in, it's dominated by a political economy of information and expertise. In light of the fact that many of the actors that you have focused on are in some shape or form connected to the realms of policymaking, decision making, this pushes us to think critically about the kinds of actors that we typically associate with expertise, like doctors, like economists. It pushes us to think about who positions themselves as experts, as sources of valuable knowledge. And you raised an interesting dimension of this a few minutes ago, which is, what do these people think that they're doing as they carry about their, their daily work? you're also getting a sense think about what kind of language is used by actors and institutions who claim expertise when they make a diagnosis or propose a new direction in policy, including, of course, what kinds of questions get asked. Now all of this is unfolding in the context of global processes and hierarchies that are rarely articulated or understood explicitly in the language of race. Terms like the international community and good governance appear to be free of racial tropes, but in fact have racialized connotations. International community typically connotes actors in the global north who are white, who are Chris-who are Christian and who are men. Meanwhile, the twin concepts of good governance and state failure are often articulated in the form of statistics, and charts and graphs that position Europe at the top and Africa at the bottom. This contributes to racialized imaginative geographies that paint certain parts of the world as always, already exceptional and in need of intervention. What's important here is that the collection and dissemination of information in these contexts is not necessarily driven by commitment to precise scientific knowledge. And what you're kind of giving us a sense of here in the CDC exhibit is that it's often about or just as much about aesthetics rather than it is about substance, wherein the presentation of information rather than the information itself takes precedence. This then shifts the broader public's attention from epistemological certainty to the realm of emotion and meaning, to the domain of common sense, and ultimately to the manufacturing of consent. And of course, another element of this that you just touched upon is that of branding when it comes to an institution like the CDC.

Samar Al-Bulushi 52:25

With that said, as easy as it is to ascribe both omnipotence and omniscience to global north health policymakers, to professionals, to spies and security bodies, these actors often suffer from information deficit. And the image of the whiteboard that you showed us is really productive here. Because, as we know, in so many of the scenes of these police procedurals, right, the people involved in doing this kind of detective work are frustrated by the gaps in their knowledge. And as you mentioned, there's this kind of constant thirst for data. And part of the reason they're, these gaps exist is because many of these people are often disconnected and removed from the street, quote, unquote, where they be able to fully grasp a given scenario. Sometimes it's the people who are on the receiving end of global power formations that are the most knowledgeable about what's going on. When we think about the ways in which these people make sense of their situation, especially in the form of rumors and conspiracy theories, there's something to be said, for taking this kind of knowledge, seriously. As you yourself have talked about, Adia, in some of your previous work, but I want to specifically kind of frame it as a form of geopolitical analysis, right? Because that's really what people are doing. So it's not just policymakers, health experts who do the diagnosing, right? The average person equally has the ability to put two and two together, and in many cases, quite literally has a front row seat to some really interesting dynamics. But rarely are these kinds of individuals recognized as sources of authoritative knowledge. And just as an aside, I want to note that even US-based activists are often guilty of dismissing this kind of grounded knowledge, often because the folks on the ground are not framing their analysis in macropolitical terms like capitalism and imperialism. And of course, it gets much more complicated when people on the receiving end of intervention actually welcome it. As you have noted, in places like free Freetown, for example, the average citizen is, has more reason to be skeptical of their own security apparatus, both because they interact with it regularly and because it's often the domestic forces that are tasked with violent enforcement, whereas the intervening troops that come from outside are focused on things like logistics. So I just want to flag these as sticky questions that have yet to be sufficiently tackled by those of us who are committed to making connections between different geographies of struggle in the name of transnational solidarity. I'll close by returning to some points that you raised in the opening of your talk where you're kind of provoking us to think about the CDC as, essentially as a policing body. We tend to think of the police as tasked with enforcing the law internally and with the military as operating externally. Policing is generally associated with everyday peacetime, whereas the military is associated with the exceptional and with wartime. So how can we learn to think about the norm and the exception, about peace and war, and about policing and militarism, as always, already intertwined? I raise these questions because we often hear talk about the militarization of US policy towards Africa. But perhaps this is a misnomer. If we take the time to study, as you have done, the role of civilian agencies like the CDC in what might be considered police work, surveillance, and of course, in constructing particular notions of order. In other words, is it productive to think equally about the civilianisation of militarism and policing? What would this mean for the questions we ask, the institutions we scrutinize, particularly in the context of movements for abolition?

Samar Al-Bulushi 56:20


Ippolytos Kalofonos 56:26

Thanks, Samar. And now I'd like to invite Nina Harawa to share some of her comments.

Nina Harawa 56:36

Thank you.

Nina Harawa 56:39

And thank you for this great opportunity to reflect on these issues. As an epidemiologist, Adia's work addresses and brings to mind what, for me, or what I would describe as the placement of the problem and how different fields place problems of disease and security and safety within, in different places. Epidemiology has its origins in the study of infectious disease. And even though so much of our work, even the type of work that I do, which has focused on HIV, so much of our work is actually not like the outbreak investigations that Adia talks about. Much of it is focused on diseases that have multifactorial causes, things like heart disease, chronic inf-chronic, and other chronic conditions that have multilayered causes. Nevertheless, we're very much influenced by that history of the origins and the study of infectious disease. And I think it is, in part because of that the placement of the problem is often with looking for an agent, and then that agent is placed within bodies and therefore we act on those bodies that are often the victims of disease and the conditions that produce disease. Much of the work of Black and other people of color, people of color scholars within public health has been to broaden that perspective. Certainly not just the work of people of color scholars, but certainly a big part of it. And I would include a matter to start with W. E. B. Dubois, who spoke back to work on, on tuberculosis and other conditions affecting African Americans that place the blame of the high rates of death from those conditions on the populations themselves, and spoke to the context and the conditions in which African Americans lived that he argued was the problem. There are many, been many epidemiologists since then that have worked to promote theories such as the socio- social, social ecological model, and the risk environments framework that broaden our perspective to look at the context in which people are exposed to factors that produce disease, including infectious conditions, including, and including harms from things like drug abuse, drug use and drug abuse. I think it's because of our focus on the agent, and often the bodies in which the agent causes or leads to pathology, that we often have this lens that then contributes to forms of structural violence against populations. This can be manifested through non-public health measures when we look at, for example, the violence against drug users in the Philippines, but it also has manifested regularly in efforts to produce what, what people perceive as safe environments that end up contributing to harms, especially. And I would like to speak to this, especially in terms of people who use substances. So for a long time, now we've had a war on drugs. It followed a war on poverty. And someone said that war on drugs has led to the incarceration of people who use substances, and the associated damage to the families and the communities from which those people come. But there are many people who use drugs on a regular basis that don't experience the same kinds of harms, and those people are disproportionately middle class and white. Again, it's where we place, it's where it's where epidemiology and public health has a field looks at the problem. The other, I wanted to speak too to the, the statement that that Adia made when she talked about

Nina Harawa 1:01:01

violence and how violence came to be looked at as a public health problem. And you, you spoke to what we know now about violence, and that it's often a experience of, perpetuated by intimates. And even though that's true for one type of violence, it's also not true for many other types of violence, like state-sponsored violence against communities and against foreign countries. And it's in part because, again, of the ways in which public health has shifted, as, has decided to focus on violence, that we have this one conception that misses all, many other types of violence. And I can leave it and I can address another example of that. For years in the American Association of Public Health, there was an effort to declare police violence as a public health problem. And that finally was added as a platform, but it encountered resistance for many years before it was finally accepted as a platform. I also want to speak to, and I think you're, you pointed out a number, a number of times already, but it often calls to mind to how the language of public health is similar to the language of military and paramilitary organizations like policing, terms like surveillance, investigation, targeting, all and disease detectives, which sort of a lay term for epidemiologists, you know, all call, are all the types of terms that are also used by military and paramilitary organizations. And it's no wonder when that sort of terminology is so common, it is no wonder that populations often mistrust the work of public health, and are less willing to share information with public health investigators, whether that is people who may have the Coronavirus and are being asked about their contacts and contact tracing, or people who are being encouraged to take the COVID-19 vaccine who work within healthcare settings.

Nina Harawa 1:03:17

The last thing

Nina Harawa 1:03:18

I wanted to just reflect on a little bit was, and we'd love to hear more of what Dr. Benton has to say is where CDC is now. I have colleagues and friends who work with, within CDC and I can certainly tell you that it's been a demoralizing, to say the least, year for them because of many of the failures within public health, of communication and the actions of the previous White House administration related to the COVID-19 pandemic. Well, what probably many people don't know is that in this past year as well, there have been efforts within CDC to promote a different approach to race and racism. And there's been a call by employees of CDC to adopt seven acts related to addressing racism and its impact on health. And two of those acts are declaring racism as a public health problem and creating an institute specifically for the study within CDC, specifically for the study of racism. Again, studying racism is placing the focus in a different way than we're used to as epidemiologists. It's different than saying minority health for example, or health disparities even. I, I recently had the opportunity to read a letter that was shared with leadership within CDC related to this and, and speaking to the new director and I, of CDC, encouraging her to adopt the seven acts against, related to racism. And it was striking to me because in this personal reflection, the staff member started by talking about the fact that his grandfather, it was his grandfather or great grandfather, had been lynched and murdered by the grandparents of the children that he went to school with. And so he started with these acts of violence, and then went to and spoke about health and racism within our health systems, and the need to address that. But it's, it's, I think, for Black people, that the connection between the two, between state violence, and the experience of discrimination within healthcare, through public health, are not, are never far apart. But I think for other communities, it's much less clear. And so I really appreciate the contribution that you're making to help other communities understand how often this is inextricable for us but not so obvious for many other people in the community and, and possibly why we have so many people perplexed about things like vaccine hesitancy, for example, in Black communities. And I'll stop there.

Ippolytos Kalofonos 1:06:20

Thanks, Nina. And so at this point, I'd like to kind of open up the floor for a discussion, invite, I'd like to invite Samar back, kind of back in our virtual room here. And, and again, audience, this is a great time, we've already gotten some great questions, great time to post questions, if anyone has any questions or comments. Adia, would you like to sort of get the discussion going by responding to some of the points? Some of many points raised?

Adia Benton 1:06:45

Yeah, there's so many good ones to, to address. So one of the things, you know, it's funny, as I was listening to Nina speak, I was thinking about one of the things that I always end up cutting out of versions of this talk, which is the, the museum, the thing that's interesting about the museum is how little...So, so how it actually tries to address the fact that public health isn't just disease detective shit, right? Like, they're, they're kind of like, oh, by the way, obesity, by the way, nutrition, like, you know, but what's also fascinating is the reason people come to this museum, because it is not super easy to get into, is they want to see, um, the cool stuff. And the cool stuff is the outbreak investigation. And one of, you know, I went to public health school, and, you know, I did infectious disease epi. But one of the things that I remember, you know, like, I was really shocked by what I was learning because I was like, oh, but that, you know, there's this really great person named Nancy Krieger, who does ecosocial framework, where I was like, listen, like, Camara Jones, why aren't we doing any of that in my classes? Like, why aren't we doing the cool stuff on the ecosocial frameworks or these broader sort of...and so one of the things that I kind of, you know, what I, because I actually get a lot of, I get pushback from some global health people who are like, but this isn't what I do, I don't do any of this. I go, no, but here's the thing. The fate, the aesthetic, there's an aesthetic choice being made and a branding choice being made to foreground or to constantly, like, bring into circulation this particular vision of public health, which has a sort of, have the police. It's like cop, it's copaganda for health. And in which we are not engaging with the everyday work of public health, which actually is happening, but we don't know that it's happening because it's working. Right? Or that we don't know that's happening, because it's it's subtly addressing or addressing things that make things, make our lives function, the reason we can drink water out of the faucet, the reason we can have, you know, have lead mitigation, all of these things kind of fall from view. And this is especially true with something like the field epidemiology training program, which you know, is like, EIS lite for the third world. They say, you know, and I was reading this amazing ethnographic account of what that's like in Guatemala, and, I think by this anthropologist whose last name is Ceron, he was talking about these, these Guatemalan physicians who went through that program called it a maquila for like, you know, factory, for, for a, for public health. You know, it's just sort of cranking them through and teaching them these methods. And in Sierra Leone, that's now sort of the cornerstone, is that they have these, you know, disease detectives who've been to these field epidemiologists, who've been trained to kind of patrol the scene and do surveillance work when there's always been, like a public health system with, you know, health, primary health units, nurses, and nurse assistants who reach out to the community, community health workers, who encourage baby weighing. But why? You know, like, why is this propaganda? So anyway, all of this to say I love that you were like bringing back Dubois' work and, and all of these people who sort of have a foundational, foundationally pushing back against public health paradigms that are rooted in, you know, maritime economies, fumigation and larvicide and basically imperial expansion. You know, so that's the other piece that sort of sits in the permanent exhibit of the story of CDC is like, the origins of the US Public Health Service was about, you know, managing New Orleans Port, making sure yellow fever and typhoid don't come in, and all of this other stuff, or the Argentinian case, which is like fumigating, sanitary officers fumigating the streets and getting rid of rats. I just totally turn Argentinian public health history into some, basically like, raid. They just, like, just spray for rats. Um, so yeah. And so anyway, which brought me to these broader questions about, I love this idea of the civilianisation of military and policing. Because that, that's, I think that's something that I was trying to kind of, also, I was thinking about, particularly under COVID-19, where I'm seeing people actively police, like they're all like, wear your, #wearyourmask. I saw this, the number of times in a day, if I'm on Twitter, but somebody just basically tells about the person that they saw not doing the right thing,

Adia Benton 1:11:40

whatever that is. You know, it's like, it's calling out the police in our hearts. Like it's really this. This is what we're finally, we're kind of dealing with, like, yeah, hearts and minds. I'm, I'm, I'm also I really love the reframing of the CDC as a policing body. One of the things that I've been trying to kind of also think through is the ways in which this year, that the discussion about the CDC, which I don't think is the reality of the CDC, is, um, is almost how it failed to be a policing body. Like that's the fundamental failure of it to do it, because I don't think people again, fundamentally know what it is that the folks at Clifton Road or the Buford Highway office or any of those things do. A lot of what this work is is mundane, bureaucratic stuff. It's subcontracted sometimes to community-based organizations that do it better. It's lab work. It's, you know, it's a bunch of stuff. And it wasn't just politicized this year. It's, it's a government agency. It's, everything about it is political at its core. Um, one of the people who authored that JAMA paper, and I'm sure, so I've talked to two of the authors and plan to talk to the others who are still alive. And one of the things that the longer term employee of that agency said was, you know, they, I'll use the pronoun, they made the case that some of the work that they tried to put into the MMWR in 1985 got nixed, the fact that I have that rep-that EPI-2 report from the closeout of that investigation, supposedly, I'll see if this is really true. The reason that people couldn't find it for many years was because it was pushed away. That paper is not the only finding, set of findings that were produced by that report. They also did a school-based study where they went through the children's records.

Adia Benton 1:13:58


Adia Benton 1:14:00

had someone go through the children's records to talk about their testing scores, and, like, their performance in relation to their likelihood of being killed. So yeah, so the, I mean, and I was reading it, and I, you know, I've talked to these people who are, you know, good hearted, well intentioned folk. And I still can't understand, like, I asked, I'm like, so how did you come to these questions or this series of questions that made you think, you know, like, what is it about? What is your evidence base, you who claim science as your mantle, what is the evidence base that produced this questionnaire, this way of looking at these families? One thing that I do know from talking to them is, the police did tell them, actually, one of the reasons the data look the way they do. The police told them two things: We know some of the parents did it. We know some of the parents killed these children. And, but we can't tell you who. And we don't, we didn't do the, our due diligence. We don't have the right, we can't pull, we can't prove it. So there's that. So that's, were the first piece of, of whatever. The second is: And you can't see our records. We can only give you what you, what we give you. And so this is why you get the, let's go in, go to the neighborhoods and figure out like, what is, what is wrong with these kids that made them? I mean, they don't put it that way. That's how I put it, because that's how it reads. What is fundamentally wrong with these particular children that made them more vulnerable? What is it about them? What is it about their families? And,

Adia Benton 1:15:44

Yeah, it's the placement of the problem.

Adia Benton 1:15:46

And I kind of like, as I read this, I was like, I mean, there's no win, there is no win for these moms, and these dads. And I kept, you know, the thing that actually kept bringing me back to this, because I was like, I can't write about this, this is not relevant to my Ebola project, is because of, it kept coming back like James Baldwin, something James Baldwin wrote, came back to me and I was like, oh, this is a great quote, where'd it come from? It was from his talking about the Atlanta child murders. And I was like, oh, I guess I have to deal with it. And the thing that I had to, and so as I start going through the paper, going back to that exhibit, that picture of those moms in Chicago, I don't know if you saw that on the on the exhibit, there's moms in Chicago with their kids hanging on to them, saying, we're with you. We, we are, we are here for you, moms of Atlanta. Like, we, we know what you are dealing with. You lose your, you lose your kid. And these people are blaming you and they're interrogating you. And they're asking you what you did wrong. And I saw a police officer say, this woman was a hooker, she let, you know, she used to give her kid McDonald's before she went out to walk the streets now. And she can't, that's why her kid's dead. And she, she killed them, I think. She just, she was a barrier to him, he was a barrier to her life. And I was like, there's no mom who's making sure that her kid has breakfast every single day who wants her kid dead. Like, I'm sorry, it's just not, that's not the way this works. She had to work to get that, that baby food. But we have to ask these other questions, which is like, well, there are a lot of questions to ask about it. But I mean, I see this, these forms of violence, enacted through administrative and bureaucratic methods. Right? So it's, it's one thing for the police officer to say it and to turn his, and to speculate. It's another thing to have this turned into a matter of epidemiological data, to just figure out what the susceptibility of a child is, was clear. The child was in a, in a vul-was, was vulnerable. And I guess the way that I've been trying to think about this, you know, as I watch these people kind of go through, ah, you know, what is the thing linking all of these things together? What is the pattern? And the pattern is the question, always the question, too, so it's the blame. And the question is the placement of the problem, that the pattern, and I said the pattern was Black disposability, that's what the moms were saying. There's a reason that this didn't become a cluster until someone said it was. And there's a reason that the investigation didn't happen until they until they said it was a cluster. And there's a reason that we have, they have convicted a man who maybe killed a couple of adults, maybe, with no link to how this, and I think it also links back to this Magazine Wharf case. in a different way. So what is slow action? What does slow action in Magazine Wharf mean? It was one of the earliest cases in Freetown, but it's also the last case in Freetown. The only interest in Magazine Wharf is intervention. But only intervention insofar as it's about containing the outbreak there, not necessarily about making sure that people in Magazine Wharf have, you know, safe access to water sanitation, durable housing. This is a very low lying area so the yearly floods with the rainy season are devastating to this community. Anyway, I'm, I'm rambling.

Ippolytos Kalofonos 1:16:47

You know, when one thing that's, I mean, but this whole conversation just makes me think about is, is, again, in looking at the Atlanta study, you know, the method they did choose to use, case control study, right? It compares individual cases to individual cases. And it's all about identifying, you know, behavioral differences, lifestyle differences, individual different individual traits, which, right, in and of itself is, you know, a certain kind of framing that hides certain things and, right? And, and, and it leads you to certain conclusions, right? One, and I'm glad that, like, Spirit of 1848, you know, Nancy Krieger social theories are brought up, because one of the, I think, real pushes of that group within the APHA has been this push to have a more political-economic framing, right? Because this lifestyle framework leads you to conclude it was certain choices that lead to these bad outcomes. And there's something wrong with the people making those choices. Right. And that's the locus of action and intervention. I mean, we, you know, why didn't they do a sort of neighborhood analysis, right? And why, why weren't neighborhoods sort of the, what was the scale of compare-unit of comparison rather than individual kids? And it's, and it touches on this whole history that you're drawing out, right? Right? Militarization. You know, it's, it's the, it's the story, right? The military-militarization in public health. It's the history of global health, right? It's not the strange thing, it's actually strange when it's not, right? Going back to, right, the emergence of global health and colonial medicine. And there's the example of Warwick Anderson, right? It's about like the cholera wars in the Philippines where it was a literal war with, the US waged against, you know, you know, Filipino, they call them, like, insurrectionists based on having cholera, right? They saw literally cholera-infected people as, as political threats. And, and any smallpox eradication also, right, was a very military,

Adia Benton 1:21:41

The Order of the Bifurcated Needle is what those men called themselves. They even had certificates made.

Ippolytos Kalofonos 1:21:48

In the Philippines, in the Philippines. Yeah.

Adia Benton 1:21:50

I mean, oh, I could, no, I just, I was, I am assuming none of them would have come to this talk. But I was trained by a few of the Order of the Bifurcated, you know, including actually, Bill Fahey, who was the director of the CDC at the time, he was also a member of the Order of the Bifurcated Needle, the knights, the knights who saved us from smallpox. I, actually I only bring that up, though, because one of the, as I was talking to, so I was texting with an old friend. And he said, Oh, you know, Bill, Bill's thing was, he wanted to deal with gun violence, which is why he kept pushing for more research on violence. And in fact, this got approved. So this police collaboration was approved by Bill Fahey. I don't think they normally go all the way up to the director to get approval for, like, an outbreak study or outbreak investigation, you only need an invitation from the state or the county or whatever. And when the person proposed this, it went all the way up. And Bill was like, Yes, this is part of Yes, because that was part of his agenda. This was where CDC began to think about themselves as also prevention. So not just control. But prevention. This is where a prevention tip that I was, I was kind of raised in the rah rah prevention. model. So it's like, you know, which I think also was a, an interesting way for medical doctors like Bill Fahey to go.

Adia Benton 1:23:17

You know what, let's,

Adia Benton 1:23:18

let's try not to think so much about the clinical medicine part, really focus on that, keeping things from happening, this sort of predictive work that I think, also, people kind of criticize as this feature of policing that they're uncomfortable with, right? This sort of retrospective, prospective way of addressing things. I don't know. I'm just, now I'm really...

Ippolytos Kalofonos 1:23:43

So it's actually police, police using epidemiological methods. But I wanted, there's a couple of questions from the, um, audience that I wanted to pose you guys. So the first one, I'll just, this, this is from Philippe Bourgois, who's, I'll tell you, you'll hear why I tell you who's around: So thanks for great talk. Congrats on your work on the discretionary, violent power of often racist police in the street. I've been studying the racialization, criminalization of substance use disorder, as well as intimate suffering, as well as the intimate suffering caused to users since the early 80s in US inner cities and rural indigenous villages and shanty towns across Latin America. There's also an in-our-face, billion-dollar profit making system exasperating these harms of industrial area drug use and policing and the rumors, including both legal and illegal psychoactive drugs. I also worry about the misrecognition of profit making in analyzing the stakes of racism and health and science and, and, and who suffers violence most. And that's a bit we haven't really brought up. I guess, are there any, you know, is there an angle? How does sort of corporate, you know, profit making and sort of industry factor into some of this some discussion having?

Adia Benton 1:25:02

I can talk briefly about it. It's part of the book. So one of the things I flashed very briefly in my talk was about the new medicines and vaccines that emerged from this outbreak. And in fact, this ongoing study by the CDC, uh, it's so weird because the CDC rarely has this kind of presence. So it's like, very bizarre in a bunch of ways. But they, one of the ways that they continue to do this is they set up a field, they actually set up a formal field office in Sierra Leone that was not necessarily there before that's overseeing this ongoing project about the semen of, semen of Ebola survivors. As in, they are collecting, that's a longer story, but they're collecting semen from people all over the country, and trying to see how long Ebola persists in the semen which, of course, raises lots of questions. But there's, so there are many technologies that existed before this outbreak happened that were in development but were not scaled up appropriately, until there was a financial incentive which the West African Ebola outbreak offered, right? So Ebola vaccine that had been in development since the 90s, because of, you know, spotty biosecurity funding, suddenly could be scaled up, tested, because they were in, finally enough subjects to test it on. But also finally enough sub-possible pool for speculation or more, more money. There's also the pandemic bond that came out of this, which is modeled on the catastroph-catastrophe bond or CAT, CAT bonds, you know, speculating on the non-death of African people, because most of it, well, that's not true.

Adia Benton 1:26:53

It is sort of,

Adia Benton 1:26:55

Africa, I'd say, African and Asian people, because it, the, the way that the tranches were built were on specific diseases that are specific to particular regions, and have specific thresholds. So, there, I'd say those are the most overt, but then that you I mean, one of the things I constantly write about is like what it takes to set up an office in a country, right? Like, you have, you, you suddenly have people who need to build things, you suddenly have people who, or you're renting from someone, you change the mar-the local markets in terms of, you know, what is valued, like, grape-bought, I used to buy grapefruits, which are actually something you can get very easily and cheaply in Freetown. Guess what? There's a different price for me. Also, guess what? There's a different price if you live close, in certain part of town because of, because that's where the, the white, I mean, essentially, that's where the white people are, okay? And, and, and those markets kind of build up. So I actually write about this more mundane sort of, okay, if you build, if you're building country offices in the aftermath of a war, or an outbreak, new, labor condenses in a particular way in terms of basically serving, serving these new people, new personnel. I know I have one minute. There's, there's new commodities, new products that sort of emerge from this. And some of its linked directly to the securitization, that security landscape that I'm talking about, which is, like, private security guards, SUVs that can traverse certain kinds of terrains, um, visa, visa costs, like, I don't know. It's, there's, it's, it's everywhere, you can't, people are speculating on all of these elements of, of epidemic response, but also on Black life. If I'm being real, like that's why I talked about the fact that there's a center that emerged from not just a general interest in violence, but at least aesthetically and at least part of the branding emerged from the murders of 30 kids. Like, they're like, hey, as a result of our concern for these children in our, in this set part of town, we decided that we were going to really build our career on this. And the, the cynical read by at least one of those authors was that. This is a chance for the CDC to expand itself. And its agenda. Webinar is supposedly over, no? I don't know.

Ippolytos Kalofonos 1:29:40

Well, so thanks, Adia. Um, unfortunately, uh, you know, even though I feel like we just got our discussion going, we are, we are out of our time. So thank you, Adia, and Samar and Nina for joining us and bringing so many different, rich perspectives to discuss-this discussion. And thank you to everyone in the audience for joining us. So on behalf of the International Institute and our co-sponsors, I want to thank everyone for being here today, and encourage you all to join us for our next events in April. We're going to have Deborah Silverman, Distinguished Professor and University of California Pres- Presidential Chair in Modern European History, give a talk on Belgian colonialism and the question of statues. And on Friday, May 7, we'll hear from British historian Olivette Otele with a talk on her book African Europeans: An Untold History. Thanks, everyone, for joining us today, and have a great weekend and Happy Chinese New Year.

Nina Harawa 1:30:31

Thank you.

Duration: 1:30:39


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12 Feb 21
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