In The Viral Network, MacPhail tells her readers that “one cannot talk about biology without recourse to geography” (77). She also makes the case — albeit less pointedly — that one cannot talk about geography or biology without recourse to time and temporality. This connection comes into focus in MacPhail’s account of Hong Kong as a post-colonial space (itself a spatiotemporal descriptor), as a setting for collectively-imagined influenza origins, and as a site where distinct public health cultures intermingle and expertise is forged. Notably, MacPhail demonstrates how “stories we create about pandemics…loop back and forth in time and space and weave fears about death and disease into the fabric of our daily uncertainties” (131). Earlier influenza outbreaks occurring in 1918 and 1997 (and 2003 and 2005), she argues, form the basis for planning for present and future H1N1 outbreaks.
Person, place and time are the building blocks — the elementary structures, if you will — of descriptive epidemiology. The spaces of post-colonial global health expertise and knowledge are produced through what Johannes Fabian has called the ‘uses of time.’ This means that if one is tracking the various kinds of epidemic narratives “thickening” in time and space, as MacPhail does quite fluidly in her book, one cannot simply configure her analyses in terms of past, present and future. Rather, accounting for temporality in ethnographic studies of epidemics also means engaging in deep study of timing, sequencing, tempo, and synchronization, among other things. MacPhail begins to sketch some of these dimensions in her ethnographic accounts of the tempo of everyday laboratory work, the sequencing, timing and duration of public health agency operations, and the improvisational aspects of ‘evidence-based’ decision-making. I will briefly address the latter two.
In chapter three, MacPhail recounts a debate among officials in the U.S., Europe and Hong Kong on the effectiveness of quarantine. She notes that Hong Kong public health authorities agreed with American and European experts about quarantine’s inability to stop transmission. But they disagreed with them on whether the epidemic could be sufficiently slowed for the purpose of planning or minimizing its potential effects (99). Delay as a part of a calculated strategy for addressing an epidemic flu outbreak, then, is a way that difference — manifest in ideology and practice — is produced as a function of time. In this way, the uses of time not only become techniques or tools of power (as others have convincingly argued), or another way in which references to the past bear on present decisions about the future, but also the means through which effective action, of taming chance, is articulated and understood by different actors.
In chapter four, MacPhail examines how public health experts strategically deployed uncertainty to justify future and continued knowledge production about influenza. The management of risk through these strategic deployments, to borrow loosely from MacPhail’s analogy to the sirens’ song, resembles musical improvisation — rhythm, tempo and key are preserved, a theme is repeated, but at points, the melody changes at the will of the performer. Yet the song never ends, if we are to take seriously MacPhail’s suggestion that the expert narratives about uncertainty are consistently open-ended. What we know about flu is, therefore, circumscribed by loose conventions of composition in the form of predictable uncertainty. In light of these very brief meditations on this book, my question, then, is this: how might an even more thickened conception of time and temporality — beyond loops of past-present-future — open up how expertise and knowledge about pandemic flu is produced and circulated, how viral networks constitute themselves?
Adia Benton is Assistant Professor of Anthropology at Brown University. Her research and teaching focus on ideologies, cultural practices, and political economy of global health. Her new book, HIV Exceptionalism: Development through Disease in Sierra Leone, is an ethnographic account of how HIV exceptionalism — the idea that HIV/AIDS is an exceptional disease requiring an exceptional response — shapes local institutions, cultural and political idioms of development and the lived experiences of HIV-positive individuals.