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Published in:
Innovative Healthcare Systems: An Introduction Read chapter Read first chapter

2017 | OriginalPaper | Chapter

5. The Infector Stigma: Centralizing Health Policies in an Age of Global Migration Flows

Authors : Liborio Stuppia, Emilia Ferone, Lamberto Manzoli, Andrea Pitasi, Massimiliano Ruzzeddu

Published in: Innovative Healthcare Systems for the 21st Century

Publisher: Springer International Publishing

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Abstract

The key focus of this paper is on the link between the development of global health policies and the management of social stigma about the infector. The specific battlefield to deal with this topic is the policy modeling and policymaking of the migration flows and the labeling of the foreigner and stranger as a potential infector. In this labeling process, common sense stigma mixes pop scientific beliefs and ideological biases. This mixture can generate social risk at a higher level than health risk. That is why it is strategic to design viable strategies to prevent that health policies can be turned into no science-based politics.
Health policymakers, in the current global scenarios, are tackling transnational and supranational problems, which go beyond the area of competence of national—even less local—traditional health authorities.
Furthermore, those phenomena show two general features that make difficult any activity of comprehension and decision-making: on one hand, any reliable information is missing; on the other hand, those data belong to very diverse domains, so that their interpretation requires many different cultural backgrounds.
Typical example is the health policies linked to global migration flows, especially those that, in the very last years, have been taking place in the Mediterranean context both from East and from South. There is general agreement on the fact the main problem related to the management of this refugee and migrant flows is the lack of a central authority, who is in charge of any crisis no matter where it takes place. In fact, national authorities manage those emergencies according to protocols that significantly differ country by country; because of the high mobility of these flows, granting an equal and fair sanitary assistance for all involved migrants turns often unfeasible, in spite of the big funds established for migrant assistance.
This work aims to provide a systemic approach to the study of migration phenomena, which can take into account, at the same time, the emergence issues on any flow, as well as the strategic issues related to permanent settlements of alien communities in the hosting lands.

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Footnotes
1
This quotation of Michel Foucault is taken from A. I. Davidson, Introduction, in M. Foucault, Abnormal, edited by Valerio Marchetti e Antonella Salomoni, Verso, London and New York, 2003, p. xxiii.
 
2
Referring to Parsons’ theory (Parsons and Shils <CitationRef CitationID="CR33" >1951</Citation Ref>), Luhmann defines double contingency as a problem of social action indeterminacy between Ego and Alter. Habitually, both Ego and Alter are considered as individuals, whose interaction is only possible if their reciprocal expectations integrate in one system—in Parson’s Scheme—or if a communication system emerges, which is “transparent” enough in spite of the individual’s reciprocal indeterminacy (Vanderstraeten <CitationRef CitationID="CR51" >2002</Citation Ref>, 84).
In this paragraph, however, Ego and Alter will define larger social groups (namely, scientific communities and public opinions) or better the communication systems related to those groups, whose circular interaction in a larger macro-system produces social representations on migration.
 
3
This distinction is based upon the Palo Alto school’s notion of two levels of knowledge: “knowledge of things” and “knowledge about things.” According to Watzlawick and others (<CitationRef CitationID="CR54" >1967</Citation Ref>):
The former is that awareness of objects which our senses convey (p. 260).
The authors define the second kind of knowledge as ‘meta-knowledge’, i.e. the capability of providing with a meaning the objects that our senses perceive. The typical example that the authors report to explain this distinction is related the famous ‘Pavlov’s dog’: in his famous experiment, the Russian physician demonstrated the existence of the classical conditionings on dogs, by matching their food provision and the ring of a bell. Polo Alto School defines sensorial information - in this case, hearing the bell ring and then seeing the bowl of food- as ‘knowledge of things’. ‘Knowledge on things’ (or meta-knowledge, or second-order knowledge) occurs when the dog can organize the received sensorial information, match the two events and guess that he is going to receive food when the bell is ringing.
The reason why Watzlawick and the others used an animal example to explain those concepts, is that
In an adult human, first-order knowledge alone is probably a very rare thing. (p. 261)
In fact, cultures have the function of providing the instruments to give sense to all the events that happen in the everyday life, as well as to comprehend the unexpected events, that it is impossible to define though the familiar cognitive frameworks.
The point is that we can use Watzlawick’s notions of ‘knowledge of things’ (or 1* degree uncertainty) and ‘knowledge about things’ (or 2* degree uncertainty), in order to describe all the cases, in which social actors are compelled to make decisions with no -or very poor- cognitive reference point.
In fact on one side we can talk about ‘uncertainty of things’ when we have only few information on the object and do know what we are actually missing; on the other side we shall call ‘uncertainty about things’ the condition where we do not even have a clear idea on the information that we need for a better knowledge on that object.
 
4
While literature on Luhmann often highlights the positive aspect of double contingency, which consists in the emergence of a system based upon communication, in this case I think that this notion is a useful instrument for recognizing and dealing with dysfunctional phenomena.
 
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Metadata
Title
The Infector Stigma: Centralizing Health Policies in an Age of Global Migration Flows
Authors
Liborio Stuppia
Emilia Ferone
Lamberto Manzoli
Andrea Pitasi
Massimiliano Ruzzeddu
Copyright Year
2017
Book
Innovative Healthcare Systems for the 21st Century

Print ISBN: 978-3-319-55773-1

Electronic ISBN: 978-3-319-55774-8

Copyright Year: 2017

DOI
https://doi.org/10.1007/978-3-319-55774-8_5