From the Series: Responding to an Unfolding Pandemic: Asian Medicines and Covid-19
Kansai International Airport, Osaka, February 16, 2020. As passengers are waiting in silence to board the plane leaving for Hanoi, I’m clicking my phone between unread emails and news about the unfolding events on Diamond Princess, a British cruise ship that was quarantined off Yokohama a couple of weeks before with more than 3,000 passengers and crew members on board, many of whom were infected with this new form of coronavirus. I’m off for two weeks to attend a field seminar in northern Vietnam with Japanese anthropologists, Vietnamese environmental activists, and Dao healers living near the Chinese border—which is, of course, now closed.
Incoming emails give me pause. Should I really get on this plane? On a university mailing list, two Japanese colleagues are advising me to cancel my trip. One of them is trained as an epidemiologist; the other is an expert in Vietnamese herbal medicine. The latter warns that I should not be misled by the recent news about the closure of the Chinese border and the lockdown of a rural commune north of Hanoi, portrayed by the state media as a “success” of containment strategy. In her reply to this, the epidemiologist tells us about her experience in China during the SARS outbreak in 2003, finishing her email with a cautious note about the “notorious untrustworthiness of the official figures in that country.” The same worries seem to fuel anxiety in Hong Kong this year. I put my phone in airplane mode and pick up a Japanese-language newspaper at the gate. The editorial on the first page condemns the sluggish response of the Japanese authorities and unfavorably compares it to the radical measures in Hong Kong a couple of weeks earlier.
I have been traveling between Vietnam and Japan for almost five years now as part of a research project that compares scientific and grassroots interventions in medicinal plants on the peripheries of traditional Chinese medicine. I am becoming familiar with these “expert” contrasts between East Asian modes of knowing and acting upon disease—communicable, chronic, or congenital (e.g., Chiang 2017). Yet still, I can’t help being stunned at the quick work of scaling that this emerging virus has performed in less than a month by bringing the size of village communities, national policies, and a global epidemic to mutually comparable proportions. Such scaling helps misunderstandings and frictions to thrive, which are as vital to the spread of the virus as its biochemical drive to mutate (Bardini 2017).
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Hữu Lũng district, Lạng Sơn province, northeast Vietnam, February 22, 2020. I’m having tea with a group of environmental activists and a local healer next to a garden of medicinal plants on the outskirts of a small town. We are waiting for a group of practitioners of Vietnamese medicine, a delegation of the regional association of herbal healers, with whom we have a meeting scheduled for the afternoon. The closure of the Chinese border for the foreseeable future and its effect on the level of trade has prompted them to increase the volume of locally produced herbs in their daily practice. That is easier said than done. Plants in the forest and gardens will not grow faster to satisfy rising demand. As the following conversation suggests, however, the actions of Covid-19 do not end with scales of magnitude but measure up against other scales as orders of knowledge (Corsín Jiménez 2005, 158).
The healer, a man in his sixties, picks a leaf from a plant nearby and tells me how it works as a remedy for “the virus.” He does not say “disease,” but “virus,” which surprises me a little. After all, this is a term of biomedicine, rather than Vietnamese healing practices. But I try not to interrupt him with silly questions. Rather than describing some surprising effect of the herb itself, he gently draws a line with his fingers on the thin veins of the leaf, which, he says, stand for the meridians inside the human body. Before long, we are in the middle of discussing ngũ hành, or the dynamics of the five phases (wuxing; 五行) in classical Chinese medicine, and how everything in the universe comes down to wood, fire, water, earth, and metal. “Even the coronavirus?” I ask, half-jokingly. “Yes,” my friend—the environmental activist on the other side of the table—reassures me, this time switching to English, “this plant is good for strengthening the immune system.” It will become important in the coming days as a preventive measure in the midst of the unfolding epidemic.
In Vietnam, the cultivation of medicinal plants and the difference between Chinese and Vietnamese medicine are ongoing matters of concern in political and scientific debates, as well as matters of care in clinics or medicinal gardens (Puig de la Bellacasa 2017). Rather than starting from abstract theories in textbooks‚ a physician in Hanoi once told me, the knowledge of Vietnamese healers derives partly from growing medicinal plants in their own gardens. In times of epidemic, however, such easy distinctions between “local” and “universal” seem to be overwritten by a virus that, despite regional lockdowns and village quarantines, jumps as easily between animals and humans, as between universal theories of wuxing or the immune system and local gardening practices.
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Osaka University, Japan, April 3, 2020. Back in Japan, we are now living amid a global pandemic, or so they say. And while most of the events associated with Covid-19 are presently deploying themselves on a planetary scale, fixed geo-political coordinates, such as “local” and “global” are being enacted and questioned in collective scale-making knowledge practices of zoonosis (Brown and Nading 2019). Moving back and forth between humans and animals and plants, transgressing borders of quarantined areas, and rapidly spreading around the globe, this new strain of coronavirus presents a specific case of rescaling the personal as planetary agent (Segata 2020).
The ongoing public debates about the efficacy of existing Chinese medicinal products is a case in point. There are well-known examples of herbal formulae that reduce fevers and have been used experimentally for treating warmth-factor epidemics in the past (see Peng and Hsu, this series). But while researchers around the world are engaging themselves in a quest to find a treatment to a global threat by re-evaluating “Eastern” remedies, and “Western” medication histories (Ecks 2020), some environmental activists in northern Vietnam are calculating the effect of the temporary halt of intensive logging by Chinese pharmaceutical giants on the practice of local healing practices. In this conflicted moment, collective markets struggle to develop the capacity to resist the extractive practices of transnational corporations, while other local healers find themselves left with growing stocks of raw medicinal materials as global supply chains are disrupted (oral communication, February 2020).
While we keep one eye on the exponentially growing number of infections in New York, Paris, and Tokyo concentrating our efforts to fight this so-called “global” pandemic, we may as well think of it as the first robust case of a planetary health predicament. The newly emerging concept of “Planetary Health” is grounded as much in burgeoning pro-environmental citizen activism around the world as in strategic funding of public health research by the Rockefeller Foundation and its scientific endorsement by The Lancet (Farman and Rottenburg 2019). What clearly sets it apart from its older sister, Global Health, however, is a vague promise that health, after all, is not merely an issue of converting local data (or individual suffering) into global scales. It is the experimental coexistence—kyōsei (共生), as my Japanese colleagues would say (e.g., Yamamoto 2011)—with other living forms, rather than their control or extermination that keeps scaling an open-ended process.
Bardini, Thierry. 2017. “Viral Life, at Last.” NatureCulture 4: 90–114.
Brown, Hannah, and Alex M. Nading. 2019. “Introduction: Human Animal Health in Medical Anthropology.” Medical Anthropology Quarterly 33, no. 1: 5–23.
Chiang, Howard. 2017. “From Postcolonial to Subimperial Formations of Medicine: Superregional Perspectives from Taiwan and Korea.” East Asian Science, Technology and Society 11, no. 4: 469-75.
Corsín Jiménez, Alberto. 2005. “Changing Scales and the Scales of Change: Ethnography and Political Economy in Antofagasta, Chile.” Critique of Anthropology 25, no. 2: 157–76.
Ecks, Stefan. 2020. “We Urgently Need to Understand the Medication Histories of COVID-19 Victims.” Dispatches from the Pandemic, Somatosphere, March 31.
Farman, Abou and Richard Rottenburg. 2019. “Measures of Future Health, from the Nonhuman to the Planetary: An Introductory Essay.” Medicine Anthropology Theory 6, no. 3: 1–28.
Puig de la Bellacasa, María. 2017. Matters of Care: Speculative Ethics in More Than Human Worlds. Minneapolis: University of Minnesota Press.
Segata, Jean. 2020. “Covid-19: Scales of Pandemics and Scales of Anthropology.” Dispatches from the Pandemic, Somatosphere, April 2.
Yamamoto, Tarō. 2011. Kansenshō to Bunmei: Kyōsei e no michi (Infectious Disease and Civilization: Towards Co-existence). Tokyo: Iwanami Shoten.