Wear the Dang Plastic Protective Gear, You Numbskull by mattsteinglass
May 1, 2007, 11:12 am
Filed under: Health, United States, War

If the US took the same approach to encouraging people to wear condoms that it does to encouraging its soldiers to wear their protective eye goggles, would we be saving a lot more people from HIV? Atul Gawande notes the strategy docs at Walter Reed Medical Center came up with to get the rate of blindness-inducing injuries to US combat personnel down:

Instead of being proud of saving some soldiers from blindness, the doctors asked a harder, more unnerving question: why had so many injuries occurred? They discovered that the young soldiers weren’t wearing their protective goggles. Too ugly, the soldiers said. So the military switched to cooler-looking Wiley X ballistic eyewear. The soldiers wore their eyegear more consistently, and the eye-injury rate dropped immediately.

Now, US commanders, even after recognizing the problem, had a choice. They could fight the culture — order their soldiers to wear the eyegear, or face disciplinary sanctions. Or they could adjust to the culture — redesign the goggles. They were smart; they redesigned the goggles.

And then there’s HIV. US legislation mandates that PEPFAR spend 1/3 of its prevention budget in every country in the world on abstinence- and faithfulness-oriented education. It also mandates that no US-funded agency can work with prostitutes unless it’s explicitly trying to convince them to leave the prostitution business. This is the policy, regardless of whether you’re working in a Christian country in Central America which harshly represses prostitution, or a Confucian East Asian country in which patronizing sex workers is an accepted part of married life for men. Question: What if the US decided to treat the centuries-old cultural practices of other countries with the same seriousness and respect it accords to the fashion preferences of its soldiers? Might the “behavior change communication” portions of our aid programs be rendered more effective? Might our success in encouraging young American men to put plastic protective sheathing on their vulnerable tissue while engaged in dangerous activities be replicable in other, similar circumstances?


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