MERRILL SINGER: PROPHET OF SYNDEMICS

 A RE-POST FROM 8/11/20

As I was doing the background reading for an article I’m just finishing up for an online e-magazine called “Rhizomes” which is about Deleuzeguattarian thought, I kept coming across the concept “syndemic” and the name of its deviser, “Merrill Singer.” He is a professor in Hartford, Connecticut, a medical anthropologist with a dual appointment in the Department of Anthropology and the Center for Health, Intervention and Prevention, University of Connecticut. 

I googled his books which were formidably expensive. So I made direct contact to see where he might deal with HIV/AIDS in adolescent boys, thinking I might be able to download an article. In response and almost by return email, he sent pdf’s of seven of his articles that are highly relevant. Like everyone else, he has never directly studied that specific demographic. Still, the material is powerful. 

The idea is that a “syndemic” (unlike an epidemic, which is an outbreak of disease, or a pandemic, which is a disease that is sweeping everywhere like HIV/AIDS) is two or more diseases interacting (like people who have HIV/AIDS which makes them vulnerable to Hepatitis C and tuberculosis) but then on top of that social conditions or environmental contexts create an ecosyndemic, like malarial mosquitoes, poverty, poor nutrition, bad water, violence, stigma, victimization, climate shift and so on. These complex forces create a net of vectors that make nodes of misery where many of them meet. 

This is not “Officer Krumpke’s” complaint that people think they should get off the hook of criminal punishment because Twinkies or pot made them do the crime. This is a cooler and statistically valid observational explanation of ghetto and what Singer calls the “hyperghetto” which interacts with both the prison system, which is a vital and functioning part of the larger society regardless of how we try to sequester it, and the military, which is constantly fed the low-level soldiers it needs by the desperation of bright young kids trying to escape drug-and-sex dominated culture. 

He does not take on the corrupt super-rich who support and promote child sex trafficking, but it’s not hard to see what the transportation around the globe of children, making them into human petri dishes, does for the spread of the diseases of sexual use. He can explain that AIDS is a particularly resourceful and shape-shifting virus, entering the human population from monkeys, possibly as early as 1880 and probably making first entry in Zanzibar, then called Leopoldville. Perhaps you’ve heard of this notorious center for colonial Belgian corruption and degradation and how it shipped everything everywhere -- the Devil’s natural resources. 

In fact, Singer’s article called “Doorways in Nature: Syndemics, Zoonotics and Public Health,” which appeared in the journal called “Social Science & Medicine,” is clear and bold, confronting squarely our stubborn human conviction that we are special. We cannot protect ourselves by claiming special status and developing miracle medicines. Pigeon holes are of little use when they were built “one-size-fits-all” but one is sorting as many turkeys and parakeets as pigeons. 

Less facetiously, it is a true Kuhnian paradigm shift to understand that life on this planet is a continuous dynamic sheet of interacting molecules only conditionally separated by skins and membranes. Grouping this life as plants versus animals, let alone species, is a thought-convenience. 

Long ago I read an article discussing the sharing of one-celled creatures between intimate humans: the horde of little “monsters” that live in our skin and guts, lodge in our eyelashes and livers. Not just lovers but also mothers and children, nurses and patients, siblings or pets who share a bed, soon host a submicroscopic migration between the continents of bodies that becomes a kind of bonding. 

To put it more crudely, I once heard a woman sigh to a friend, “Oh, I just hate to take a new lover because it always means a new yeast infection.” The answer to the yeast infections and eyelash monsters of the world is not sterility but accommodation. What global conditions of a woman’s body, what habits, what environment both in and around her body, will discourage infections of all kinds? 

The answer to process is always balance. But in a boy with HIV/AIDS, the defenses have been removed. So what are the vectors of eu-eco-syndemic? Religion? Prosperity? Kindness to one another? A far simpler and more regular life? Regionalism? Education? 

Just about the time we figure this out the whole mighty system shifts: one of Singer’s articles is entitled, “Ecosyndemics: Global Warming and the Coming Plagues of the Twenty-first Century.” The return of worldwide infections, now supported by modern transportation and shipping, is underway. We have witnessed the evasion of antibiotics by clever infectious agents and they never did affect viruses anyway. I always remember my friend who caught fungal pneumonia and nearly died because, as the doctors said, “The DNA of the fungus is foundational to human DNA, so what will kill the fungus will also be extremely destructive to you.” 

Ideas are powerful vectors, carriers of behavior that can interrupt disease, violence and mis-uses of substances. The statistics of MRSA, antibiotic-resistant infections, are now abating simply because of a return to the old protocols of washing hands and scrubbing contaminated materials. Other key terms are iatrogenic, damage caused by healers through carelessness or wrong beliefs, and anthropogenic, damage caused by humans in ignorance and -- often -- greed. 

Global warming imposes on all planetary life the consequences of greedy use of fossil resources, triggering change beyond anything we ever thought possible. But at the same time the planet itself is dynamic -- the continents are still adrift on tectonic plates that cause devastating earthquakes and volcanoes. I read once about the phenomenon of the magnetic poles (which are always moving slightly) suddenly switching ends. No one knows what that does to life. No humans had evolved yet the last time it happened. 

When humans become aware of all this, their first reaction might be panic and then denial or maybe sudden obsession with the deus ex machina that will save them if they beseech it properly. Personally, I have made the shift from salvation as personal and individual to the idea of salvation as participation in the Now. The least I can do is to think and act in a way that creates the greatest joy and beauty in the whole wraparound sheet of planetary life.