A recent New York Times article describes one of the most frightening images one can imagine: a hospital where patients are imprisoned by “three fences topped with coils of razor wire,” guards and more; they are encouraged to enter the hospital, but as patient Siyasanga Lukas describes, “the only discharge you get from this place is to the mortuary.” The hospital the article describes is the Jose Pearson TB Hospital in Port Elizabeth, South Africa. The hospital is specifically for patients with drug resistant forms of TB, ranging from multi-drug resistant to the most serious type, XDR-TB, an “extensively drug-resistant” strain of TB that kills most of its patients, especially in countries in which HIV and AIDS are prevalent.
XDR-TB is spread mainly through the air when patients cough or sneeze; therefore patients with XDR-TB have a high probability of spreading the disease when in public places, or even in their own homes. But does this mean that government officials have the right to lock up these patients in a hospital, isolated from their families and the rest of society? Health officials in Port Elizabeth argue that, “infected people cannot be relied on to avoid public places;” an argument that does hold weight (as we saw in the US a couple of years ago when a patient with multi-drug resistant TB boarded a flight to another country). As Dr. Bongani Lujabe describes the situation, “XDR is like biological warfare. If you let it loose you decimate a population, especially in poor communities with a high prevalence of HIV/AIDS.”
Despite the reasoning of the hospital officials, I would argue that imprisoning patients in a hospital is not the solution. Imprisoning the patients causes future patients with the disease to hide their illness, furthering the spread of the disease by not seeking treatment. As outlined in the article, officials should strive to treat patients in their own homes, and turn only to confined hospitals as a last resort. As Mrs. Hansen, a patient that previously escaped from Jose Pearson Hospital, states, “[N]othing can replace your freedom.”
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But the issue here is quarantining the disease. What method would you suggest to contain the disease, and to keep it at bay? To put all the people under "house arrest" would be expensive and time costly. I think you are right that the government has a duty to proactively resolve this problem, but if the quarantine hospital is not the answer, what is?
In terms of public health measures, I honestly do think that in terms of the socioeconomic conditions in South Africa, the quarantine is the only feasible way to control the disease. If the form of tuberculosis is in fact that dangerous, then what other way can the welfare of the general population be maintained? Should the disease be spread out it could have the detrimental effects equivalent to the black plague. In this case, some people must be sacrificed for the general welfare of the population.
The suggestion that each person should be quarantined in his or her own house is not only economically feasible but wouldn’t make any scientific point. If this were to be done so that they could keep in contact with their family, then the risk of spreading tuberculosis would still be present. The person would still be isolation and because each individual would be in their own unique isolation there would be much less likelihood that the laws of quarantine would be obeyed as it would be impossible to monitor each one.
The question now lies in the reasoning of whether common good is more important than the individual good. Today we live in a society that values the rights of the individual over the common good. It is inherent in our nature to look for the pursuit of happiness and to recognize each individual as his own entity. Perhaps the government should invest more money in finding a happy medium between public health safety issues and respect for the individual .
This is one of those situations that just makes you go "eeeeeeew!" Because there is no good answer to the problem. Nonetheless, I agree, in principal, with the South African government. In order to properly protect the citizens of their nation, they must contain this disease. I rarely argue that the good of the community is more important than that of the individual, but in this case, the costs to the community are simply too high. In fact, I believe that South Africa is obliged to do whatever they can to stop TB, not only for their citizens, but for the citizens of neighboring nations.
To put this in very American terms, allowing a large population of TB-carrying people to live with the general population infringes on the rights of healthy people to live their lives in the way they want to.
I don't necessarily agree with the idea that people should be quarantined if they have TB. If people contract the disease, they have not done anything wrong and this quarantine facilities seem comparable to prisons.
We must be much more hesitant to agree to putting people in prison-like settings. it seems that a common theme in the other responses is that this is the only feasible way for South Africa to contain the disease, but I believe that adopting this fatalist and pessimistic point of view will not ultimately help the situation. When thinking up solutions, we should try to be creative and innovative, finding ways to preserve rights and the health of a population. Maybe the government or scientists could come up with face masks (like gas masks) that make sure that the TB will not spread, but these people could still have their freedom with this method.
Overall, I think we need to think of more innovative solutions than a prison for the sick. The idea of this prison seems like it would work, but at much too high a cost to be the solution.
What is the role of the government? When individual freedom conflicts with the protection of the society, does the government have the right to compromise individuals’ rights for the benefit of a greater society? I believe that the answer is quite evident: the primary goal of the government ought to be to protect the society, even if it means that individuals may be sacrificed. Such is the reason why governments have the right to recruit members to the army: in order to preserve the well-being of a society, some sacrifices on the part of individuals may need to take place. In the case of the the prison of patients diagnosed with TB, I agree with Marina that given the socioeconomic circumstances in South Africa, prison-like hospitals such as Jose Pearson TB Hospital in Port Elizabeth seem to be the only alternative to allowing the spread of TB and making the other population vulnerable.
However, it may also be true that the government can take too much of an authoratative role towards its citizens. In order to prevent such systems, the government’s activity ought to be continuously evaluated and restricted. However, in places like South Africa where there is a checks-and-balances system like in America (a system with Westminster parliamentary and juducial branches) then the government, with the help of professionals, ought to be responsible for determining what is most beneficial to the society. I cannot imagine how a government responsible for preventing mass epidemics such as the TB could not respond by restricting those who are afflicted to an enclosed, isolated spot.
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