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Preventive Medicine


8 January 2002

Several years ago, I heard an Israeli pacifist interviewed on NPR's "Fresh Air". The interviewer, Terry Gross, began with the obvious question: How could Jewish pacifists deal with Hitler and World War II?

The answer, roughly paraphrased, came in the form of this parable. Imagine a middle-aged man who is obese and sedentary, a smoker, with a diet high in fat and cholesterol. His doctor tells him that he's seriously at risk of having a heart attack, and urges him to change his lifestyle. He laughs at the doctor, telling her the advice isn't realistic, and goes on eating, smoking, not exercising.

Fast forward ten years; he's had two coronaries, his heart muscle is seriously damaged, and he begs the doctor to save his life. The doctor tells him, with sadness in her voice, that there's nothing left to do; even heroic measures can't save him. The man is infuriated, raging at the doctor, "Medical science is useless!"

Pacifists were in the same position at the start of World War II; after years in which their suggestions aimed at preventing war were ignored, suddenly war had engulfed the world, and they were derided for being unable to offer a solution.

We're in a similar situation today. For years people in the peace movement have suggested steps to reduce the level of tension and hatred in the world, including the Middle East. Like the doctor, they were ignored -- and now the unthinkable has happened.

We are at war, albeit a most peculiar sort of war; judging by recent statements of American leaders, it's a war with more resemblance to the Cold War than to, say, Viet Nam or Desert Storm. However, even in these painful times, it may be fruitful to consider possibilities for prevention -- steps to lower the level of hatred and fury in the world, and to begin resolving problems in other ways.

Some of the suggestions I make will be very small, others more sweeping, but all are, in their own way, homely and unspectacular. Idealists have, for many years, postulated that human beings will need to change their mode of thinking for the species to survive. I'm writing this on Yom Kippur, the Jewish holiday devoted to personal transformation and atonement. Having seen individuals undergo radical transformations of personality on occasion (through therapy, life-changing experience or simply "getting their act together"), I think it's possible for individuals to transform themselves deeply -- as individuals.

I remain pessimistic, though, about the possibility for similar changes taking place quickly among societies. Certainly, societal behavior *does* change, but glacially slowly; it usually takes a generation or more for deeply-held patterns to alter. Frankly, I don't think we have the luxury of waiting; the next gang of terrorists may have nuclear or biological weapons.

So I'm proposing a few measures that can be taken within the general framework of social and political behavior as they exist now, not as we'd like them to be. Some are relatively easy and cheap, others difficult and expensive -- but with possible large payoffs.

School Days

During the Cold War, the United States and the Soviet Union courted the nations we now call the Third World. One of the most effective tools of courtship was education; the two superpowers helped finance universities and technical schools throughout the developing world, and gave scholarships to universities in the USSR, USA and Europe (western and eastern).

That doesn't happen much any more. The USSR no longer exists, and Russia doesn't have the money to educate its own people, let alone provide foreign aid or scholarships. Without the competition of the Soviet Union, the USA has scaled back similarly. As a result, young people in the Third World -- including the Islamic world -- have limited opportunities for education.

Islamic fundamentalists have stepped into this breach; in many parts of the Middle East, the only chance a promising young man has for education is to attend one of their schools. Indeed, many of those thought to have participated in the plane hijackings of Sept. 11th took exactly that route; their education at fundamentalist-run schools shaped their fanatical outlook.

I suggest that this monopoly on education in the Middle East needs to be broken, and quickly; a relatively modest expenditure (compared with the cost of running a war) could create a network of high-quality colleges and universities throughout the region that would offer an education toward humane ends, not hatred.

The Loyal Opposition

Since the beginning of the Cold War, the United States and its allies have backed some of the most repressive and anti-democratic regimes on earth, and few were worse than those in the Middle East. (In a comment after President Bush's speech to Congress a week after the attacks, Frank Mankiewicz, former press secretary to Robert F. Kennedy and an astute observer of American politics, noted in this context that the president had repeatedly referred to justice for America, but had never mentioned the possibility of justice for anyone else.)

Less obviously, a succession of American governments (and their allies) have helped eliminate the democratic opposition to these repressive regimes. Beginning with Mossadegh in Iran, who was overthrown in a coup the CIA made no bones about having organized, democratic and left-wing elements were systematically removed from power, and often jailed or exiled. These exclusions were justified by the State Department as part of the crusade against Communism, although most of those silenced were not Communists; a cynical observer would say that the chief qualification for removal seemed to be an unwillingness to go along with the oil-company deals that kept local despots in power.

As a result, we inadvertently created another vacuum; anyone who opposed the policies of the corrupt local governments had only one place to turn -- the Islamic fundamentalist movement. Again, we left no sane alternative.

It's a bit hard for foreigners like ourselves to walk in and build a loyal opposition in nations run by dictatorships, and perhaps presumptuous besides. Nonetheless, it's worthwhile to at least do no further harm: to use what leverage we have with local leaders to press for political pluralism and democracy, including tolerance for opposition leaders and movements that aren't to our immediate liking. In the end, we damage our interests far more deeply by suppressing these leaders than by tolerating them.

Earl, Brother, Earl

This is a big chunk to bite off, so I offer it with some hesitation -- but it may be time to rethink this nation's deep addiction to oil. At the time of the OPEC oil shocks of the 1970s, some progress was made (automobiles have better mileage, industry uses energy with somewhat more efficiency). But we've backslid, and the economy is now more than ever dependent on gasoline and fuel oil. Many of the political decisions made by governments of industrial nations take cognizance of this endless appetite, just as a junkie's daily routine is profoundly influenced by the need to score drugs. Oil, unfortunately, also fuels at least some of the fury in the Middle East. Many of the repressive regimes of the region are there because they're willing to cooperate with foreign oil companies, or because oil revenues give them enough loose cash to buy off the opposition.

Diminishing the reliance of America and the rest of the industrialized world on oil could, in the long run, help lower the temperature of the Middle East by lowering the stakes. Paul Krugman, of the New York Times, has argued that cutting oil imports would actually make the situation worse, by diminishing American leverage in the area. He may be right in the short run, but I suspect he's wrong in the long run -- the stability and sanity of the region would be increased if there wasn't the constant struggle for cheap oil. And, given the deep resentment of the West's leverage in the area, perhaps diminishing it wouldn't be such a bad thing.

Of course, cutting the industrialized world's dependence on oil is a huge task; wrenching the economic engine off one track and onto another is a lot harder and more disruptive than founding colleges in Beirut. But some steps seem reasonably doable, if our leaders are willing to invest modest amounts in them.

First, the distinction must be made between various forms of energy use. "Process energy" (for example, the heat that drives a blast furnace) is probably less amenable to alteration than the energy used for transportation. A quick look at the transportation situation in America (and, to a lesser extent, other industrialized nations) reveals several possible points of attack.

Since World War II, there has been a profound transformation in the American freight-transport picture; where most cargo used to be shipped by rail (or, occasionally, barge), a significant portion has shifted to trucks. Unfortunately, trucks are less efficient; they use significantly more energy per ton-mile. (They also put out more pollution, including greenhouse gases, and the highways on which they travel take up wider rights-of-way and require more energy for maintenance than rail lines.) Shifting the majority of intercity freight transport from trucks back to a rationalized and revitalized rail system, centered around "piggyback" and containerized freight cars, and using trucks only for local deliveries at the termini, could significantly cut our oil consumption.

Similar arguments can be made for intercity passenger travel; it simply makes no sense for short-haul trips to be made by air, rather than via the more energy-efficient railroads. On short trips, there is no longer a time advantage, taking into account the 2-3 hour wait in airports created by new security measures, and the major congestion over large metropolitan airports. Even before the attacks, it was quicker (and much more energy-efficient) to travel from New York to Boston by regular-speed train than by airplane, and quicker to travel from New York to Washington by high-speed train.

If the nation (read, the government) invested some of the money it puts into subsidizing the air transport industry and the trucking industry toward creating a modern, quick, reliable rail network (for people and cargo), recasting air travel as a mode aimed primarily at longer trips (overseas destinations, or domestic journeys longer than 350 miles), there could be a significant reduction in consumption of imported oil. (As a bonus, there'd also be a reduction in air pollution.)

Part of such a major readjustment would involve the shrinkage of the airline industry, and provision would have to be made for retraining and transfer of displaced airline workers to the newly-expanded rail industry. Indeed, it might be worthwhile to consider making existing airline companies shareholders in Amtrak; one of the less-heralded and unique achievements of American capitalism is its invention of a new business structure, the "quasi-public" corporation, of which Amtrak and the Postal Service are exemplars. It's possible -- I add, with haste, that I'm no economist or business theorist -- that the integration of private corporate structures into this quasi-public entity might save some of these companies from collapse, and could provide an infusion of trained work-teams into a radically-expanded rail enterprise. (At this point, I freely admit, we're in the realms of speculation. But speculation can sometimes be fruitful.)

Similar arguments apply to public transit. These arguments have been hashed over so many times that I won't go into them deeply here; let it suffice to say that the creation of decent mass rail transit systems, including "park-and-ride" lots, and the shrinkage of urban sprawl, could create significant savings in gasoline use; low-interest mortgages for home buying in or near job locations are a low-tech way of cutting oil consumption -- and, perhaps, saving some cities from decay.

Finally, it's way past time to devote serious research and investment to the conversion of many automobiles to run on alcohol, or at least a gasoline blend that incorporates more than the skimpy 10% found at gas pumps today. Ethanol's brewed from corn (I cherish the story of the old farmer during Prohibition who, asked how his corn crop was doing, told a visitor, "Great -- we get about 30 gallons per acre.") As such, it has the extra advantage of not adding to the burden of greenhouse gases (every gram of carbon dioxide coming out of the tailpipe is a gram that was taken out of the atmosphere by the corn plants). Hybrid gas-electric autos offer possibilities too (Honda and Toyota sell them now), but replacing the entire national fleet with hybrids is a daunting proposition. In my understanding, modifying current autos to run on hooch is not all that difficult or expensive, and could conceivably be a subsidized proposition. It's still cheaper than a war.

It's also time to resume government aid for research into alternative propulsion systems; during the 1990s we gave Detroit money to investigate better batteries and fuel cells. That money seems to have dried up; it's time to start the flow again, and more of it. Electric vehicles make sense for commuters -- and commuters use a lot of oil. (Note added later: GM is showing a concept car that runs on hydrogen fuel cells at this year's auto shows. It might be in the national interest if the government helped subsidize a fuel distribution system, or ordered a fleet of hydrogen-powered vehicles for government use to help the companies amortize tooling costs.)

Don't Commute -- Communicate

This one's already happening: since the tragedies of Sept. 11th, we've cut down on business travel. Americans and Europeans use an awful lot of fuel to send junior executives flitting across the country on errands that could just as easily be handled with a teleconference hookup and fax machines. (Thanks to Arthur C. Clarke for the slogan.) The Bomb

Or as Dick Gregory said, "It's not 'The Bomb' we should be worried about -- it's the ten thousand bombs." Since the fall of the Soviet Union there have been ten or twenty thousand nuclear weapons rattling around waiting for someone to steal and sell them. For a while we were paying the Russians to destroy them, but the Bush administration seems to have stopped doing that. I submit that it's time to start again; I'd rather see us pay for destroying these weapons than have them suddenly appear for sale on the internet.

E Pluribus Unum

It's been remarked that, in the end, terrorists are criminals, and as such they're really a matter for the police and courts. I agree; to me, groups like Al Qaeda resemble nothing so much as organized crime families. We don't go after gangsters with guns blazing these days (and we haven't since the days of Dillinger). Instead, we dig into their bank records, cultivate stoolies, and send them to jail for life. It works, too; ask John Gotti. (For that matter, on the other side, ask Rudolph Giuliani; he sent a lot of them up.) To that end, I'm encouraged that the Bush administration's first concrete move against the bin Laden terrorists was to freeze bank accounts, and to put pressure on foreign banking institutions to cooperate. Frankly, this is exactly the sort of practical step that's likely to prove effective in the long run.

Unfortunately, the United States has, in the last decade and particularly in the last year, renounced precisely the sort of collective action that's likely to be effective against terrorists and other war criminals by its decision to oppose multilateral agreements in several spheres, particularly the International Court of Justice. It's time, I suspect, to rethink that decision, despite the opposition of the American right wing. (Curious how the same folks who immediately postulate that we must trade off some of our individual constitutional rights when confronted by terrorist dangers go ballistic at the notion that the nation might similarly trade off a bit of national sovereignty for the protection of an international system of justice.) The killers of Lockerbie were brought to The Hague and tried; Milosevic is there now, awaiting trial for crimes against humanity. I'd love to see the planners of the September 11th crimes in the same dock, but it's not likely if our country doesn't recognize the court's jurisdiction.

Fiddling for Peace

This is a very small step, but -- do we still sponsor cultural exchanges? I have in mind not big-deal tours of high-dollar stars, performing on a distant stage for the local big shots in Third World countries, but something closer to the ground. I'd love to see performers of American indigenous and vernacular music and dance -- people like Bruce Molsky, Mike Seeger or the Jody Stecher-Kate Brislin team -- sent on State Department tours. And the tours should be more than fly in-give a concert-fly out again; the performers should spend several days in each place, with a chance to meet local musicians, stay up all night drinking coffee, exchange tunes, songs and styles. Right now much of the world only sees the worst and most intrusive of America's commercial culture (boy bands, action flicks, McDonald's); this would give people a glimpse of a different America. Just possibly, it might be harder to hate someone you've danced with.

Hammer and Tongs

Last but assuredly not least, it's now obvious that there must be peace between Israel and Palestine. Period. The bloodletting there is not only repulsive to humane sensibilities; it also furnishes the most volatile fuel to the hatreds that drive terrorism. Put simply, the Israel-Palestine conflict has become a luxury the rest of the world can no longer afford to condone.

So how to end it? It ain't easy -- it would require the entire world to lean on all of the participants and say, forcefully, "Enough". But it's not quite impossible, either; it worked with the white racists in the American south. That took a couple decades of federal registrars, but Mississippi now lets its black citizens vote.

Transformations

Well, I've rambled a bit in this essay. A few of the suggestions I've made (Israel/Palestine, oil) are grand in their scope, but most of them aren't; they're homely, mundane, very ordinary acts. Building universities. Allowing democratic dissent. Low-interest mortgages. Research on batteries.

Since the terrorist attack of September 11th, there's been some (not enough) attention paid to the root causes of the terrorists' rage. The government and media have, for the most part, done a poor job of approaching the issue of why Americans are hated by many people in the Third World, and especially the Islamic world, but there's beginning to be some attention paid.

More is essential. There's an unfortunate tendency to assume that looking at root causes means taking the position that, somehow, we had it coming. We didn't; no human being has earned the agony that was suffered by the passengers on the hijacked airliners, or the working people at their desks in the World Trade Center and the Pentagon. I wouldn't put Adolf Eichmann in those places. U. Utah Phillips, a longtime critic of American policies and actions, expressed it cogently on the day of the tragedy when he noted that "The fact that the United States has also bombed innocent civilians does not put moral currency into the pockets of the killers, to be spent until we're even." Evil is still evil; murder is still murder; death is still death.

Looking at root causes remains essential. When peoples and nations are voiceless, they resort to terrible, desperate actions. Without some body of popular support, terrorist fanatics cannot thrive. My conviction is that it's not possible to completely eliminate terrorism from the planet, but some attention to underlying grievances can help to marginalize and drastically reduce it.

The prospects otherwise are grim. By my calculations, each plane that struck the World Trade Center contained the equivalent energy in its fuel of 0.8 kilotons of TNT, about 1/20 of a Little-Boy-type atomic bomb like the one that was dropped on Hiroshima. (For you physicists out there, this is a "back-of-the-envelope" calculation that doesn't count the kinetic energy of the plane's motion or the gravitational potential energy released by the buildings' collapse.) A "tactical" nuclear weapon of the Hiroshima type would cause far greater destruction than the hijacked planes, and render the area of its detonation dangerous for years. Biological and chemical weapons, while nowhere near as easy to make and use as the press would have us believe, present the possibility that the next terrorist attack could take ten times as many lives -- or more. The recent anthrax scare provides only a taste of the possibilities.

There is no solution except prevention -- and while short-term preventive measures such as improved intelligence are certainly necessary, the real need is for long-term prevention. Just as the real solution for heart disease is not spectacular treatments or even early detection of trouble, but rather prevention of the underlying disease mechanisms that silt up the arteries, so the ultimate cure for terrorist war is also prevention. The suggestions I've offered above are only examples of the steps we and our fellow citizens of the world should be taking; I offer them, not only for their own sake, but also to stimulate more ideas and discussion. They're small steps, mostly unglamorous, without the political glory of bombastic speeches and reviewing the troops. In the end, though, these small peacelike transformations may offer some hope for a livable world.

Paul J. Stamler
Published by Common Dreams © 2002 Paul J. Stamler



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