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Let’s Call Gun Violence What It Is: A Public Health Disaster

If a disease killed 30,000 a year in one country, you'd expect a travel warning. Not in America.

By Crawford Kilian 7 Oct 2015 |

Crawford Kilian is a contributing editor of The Tyee.

[Editor's note: Oct. 2, 2017: Tyee contributing editor Crawford Kilian wrote this story almost two years ago after what was then the latest mass shooting in the U.S. We’re reposting it today in the wake of yet another American, gun-based tragedy.]

Between December 2013 and September 2015, the World Health Organization says 28,424 people contracted the Ebola virus and 11,311 died of it.

That outbreak ruined the economies of three West African countries and even shook governments where stray cases turned up: Nigeria, Spain, Italy. Just one case showed up in Dallas, Texas, and threw the United States into a nationwide panic.

Granted, this was by far the biggest Ebola outbreak in the 40 years we've known about the disease. Earlier outbreaks in central Africa tended to be in small villages easily sealed off. This time, before anyone knew what was happening, a single case in rural Guinea in 2013 managed to get into some big, dirty cities without much healthcare. Ebola is still smouldering in Guinea and Sierra Leone, though we're not likely to see a major resurgence.

As South Korea also learned this spring and summer, you don't need a 90 per cent mortality rate to suffer from a seemingly minor disease outbreak. One Korean businessman returned from Saudi Arabia last spring, bringing with him a case of Middle East respiratory syndrome (MERS). Before he was finally diagnosed, he spread it through three or four major hospitals. The total number of cases? One hundred and eighty-five, plus a runaway case who turned up in China. Thirty-six died. The damage to the economy? Somewhere above $20 billion.

So the actual disease cases are the least of a public-health disaster. It's the economic and political effect on the healthy we have to worry about.

Now consider a country where a preventable disease routinely sickens 73,000 people and kills about 30,000 a year, or over 80 daily. It has done so year after year since at least the 1960s, with some outbreaks getting a lot of attention while others don't even make the local media.

You would expect the World Health Organization to issue a travel alert about such a country, if not a full-blown Public Health Emergency of International Concern -- the step just below declaring a pandemic.

You would be wrong.

Ten times worse than terrorists

The country is the U.S., and the disease is gunshot deaths. In 2013, 33,636 died that way, bringing the total since 2001 to 406,496 -- the figure includes homicides, accidents and suicides. In the same period, 3,380 Americans died by terrorist action.

I was in the U.S. army in the early years of the Vietnam War, and I can tell you that the army was more obsessed about gun control than any bleeding-heart liberal. We couldn't leave the firing ranges without telling our drill instructors: "No brass, no ammo, sergeant!" Not even an empty cartridge, much less a live round.

What's more, the U.S. army in the mid-1960s was still shocked by what had happened in the Second World War and Korea: only about one soldier in four had even fired his weapon in combat, let alone aimed it at an enemy. That finding has been criticized, but our drill instructors took it as gospel. They tried to teach us to aim and fire reflexively, but few of us did so in training or in Vietnam, where about 15 per cent still failed to fire when in contact with the enemy.

Vietnam cost about 60,000 American lives (and over a million Vietnamese lives), and the Americans have not yet fully recovered from that loss. But American civilians seem all too eager to aim and fire reflexively. So they have shrugged off a domestic Vietnam every two years since the 1960s.

Granted, only about 11,000 American gunshot deaths each year are homicides. Twice that many are suicides: in 2013, 22,175 Americans took their personal leave from the land of the free and the home of the brave by shooting themselves. The availability of firearms makes it easy; done right, a gunshot is quick and painless.

Just another routine slaughter

The recent shootings in Roseburg, Oregon, were, in President Obama's words, "routine" -- just another disturbed young man taking his troubles out on his English teacher and classmates. (Having taught English in a community college for 40 years, I took this event more personally than most.) Obama expressed his frustration at the impossibility of controlling hundreds of millions of firearms, and the commentariat wrung its collective hands about it.

Others, including the ineffable Donald Trump, have blamed Roseburg on the lack of guns. If only the teacher and his students had been packing, he argued, they would have made short work of the shooter. Knowing what I do about teachers and soldiers, I doubt that arming them would have done anything but raise the body count through friendly fire.

Public-health experts have added up the "butcher's bill" of gun violence, but the message has not yet sunk in. If anything, the Americans seem increasingly deaf to it.

Ebola took almost two years to kill as many West Africans as gunshots have killed Americans so far this year. Since 2012, when it was first identified, MERS has killed just 568 people. Gunshots kill that many Americans every 19 days.

Admittedly, we have bigger public health problems than American gunshot deaths. According to Worldometers, by early October about 750,000 people worldwide had died of malaria this year, 1.2 million of HIV/AIDS, and 3.8 million from smoking.

Firearms? Don't even ask

Still, the Americans like to think they have one of the world's best healthcare systems, and they're the go-to people when new diseases break out. You would think that American doctors and nurses, at least, would blow the whistle on something that was killing so many of their patients.

Incredibly, such healthcare workers often can't even talk about the problem. A Florida law forbids doctors from even asking patients if they own or possess firearms. A National Medical Council on Gun Violence was created only in 2013, and seems not to have accomplished much so far.

I confess I'm as stumped as Obama about how to deal with this. In the late 1940s, little boys like me enlivened our days by playing guns with cap pistols. Now a child may be suspended from school by pointing an index finger at a classmate and saying "You're dead!" Yet my generation couldn't always pull the trigger even in combat, and some of today's properly reared young men choose schools as their preferred free-fire zones.

The rest of the world, including Canada, is in the position of Dr. Ignaz Semmelweiss, a Hungarian doctor in Vienna in the 19th century. He realized that his colleagues were killing their patients, especially mothers giving birth, by wearing filthy, blood-crusted aprons and not even washing their hands. The aprons were a mark of status, and Viennese doctors laughed at Semmelweiss despite his evidence.

Semmelweiss broke down, was committed to an asylum, and within two weeks was dead after being beaten by his guards. A similar fate awaits any American politician who even whispers about gun control, and woe betide any foreign country that criticizes American access to firearms.

So for the foreseeable future, the advanced industrial nations must put up with a senior colleague enjoying decisive influence over the planet but zero influence over a few dozen disturbed young men within its borders. Those young men, supported by American gun fetishists -- not the president or senators or members of Congress -- will determine American public health policy for the rest of our lives.  [Tyee]

Read more: Rights + Justice

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