Darkness in El Dorado - Archived Document
Internet Source: Public Anthropology: Engaging Ideas, May 27th 2001
NEW LIGHT ON THE DARKNESS: New Evidence and
We arrive at the final round of this discussion having found ourselves able to agree to the extent of identifying some of the issues that need to be discussed. The participants have addressed the points in question in ways that have usefully brought out further aspects of their positions. Moreover, the discussion has so far been limited to only a few of the many issues raised by Tierney’s book--mainly those arising from the 1968 AEC expedition and the measles epidemic, Chagnon’s statements (and silences) about Yanomami savagery, and his attacks on the NGOs and missions which were struggling to prevent the break-up of the Brazilian Yanomami reserve during the crisis of the late 1980's and early 1990s. These issues are important, but they are only a fraction of the issues arising from the conduct of Chagnon, Neel and the 1968 AEC Expedition.
Surely we can all agree that no discussion of Tierney’s book can be considered complete without some attention to the other chapters, principally those dealing with Chagnon’s work. We can also agree, I trust, on the importance of taking fuller account of the important new evidence that has become available from new sources such as Neel’s papers in the Archives of the American Philosophical Society and the work of the Brazilian team of medical experts assembled by Albert. Albert has mentioned some of the main Brazilian findings, but the Neel papers have up to now remained almost entirely outside the discussion. These new sources afford independent evidence on most of the major issues raised by Tierney’s book. They thus open up fresh critical perspectives on Tierney’s allegations and findings, and more importantly, the conduct of Neel, Chagnon, and others involved with the Yanomami over the past three decades.
I will concentrate on exploring the implications of the new evidence from all three of these sources in this final paper. First, however, I must respond to comments addressed to me and other participants by Hill in his second round paper. His opening statement that "the debate on the Tierney book has to some extent been symptomatic" of the "destructive level of tension" between what he calls "scientifically-oriented anthropologists and non-scientific or even anti-scientific anthropologists" has indeed been exemplified, in microcosm, by much of the discussion in this round table, particularly its tendency to become side-tracked into dealing with essentially irrelevant stereotypes of "scientific" and "anti-scientific" assumptions, which have little to do with the ethical or empirical issues of what has actually been done to the Yanomami.
These essentially sterile arguments have resulted in the failure of much of our discussion to develop into a genuinely critical dialogue on the real issues at stake. These are, as I see them, the ethical issues arising from the impact of science as a social activity on the human subjects who are the objects of scientific investigation (including, but not restricted to, medical effects and responsibilities); the moral and ethical obligation to represent the human (social, cultural, and political) reality disclosed by one’s research as truthfully as possible, and above all to avoid using it untruthfully to damage the public image of the people with whom one does research, or as a basis for false charges against political or scientific enemies; to refrain from field methods and conduct that lead to disruption of the social peace of communities in which one carries out research: and to do what one can to help those with whom one has done one’s research, in reciprocity for the hospitality and cooperation they have given to make possible one’s research. There are other ethical and scientific issues in question, but these four seem to me to be the most important.
Hill’s critical attacks on those of us he considers "non-scientific or even anti-scientific" have demonstrated how easily such Manichaean stereotypes of unmediable difference can become a self-fulfilling prophecies. It is too bad to have to use space that could be more usefully devoted to discussing the real issues responsible for the convoking of this round table to dealing with Hill’s projections of his idŽes fixes. Since these unfounded and inappropriate allegations are presented as critical attacks on the contributions of myself and others with whom I have found myself in agreement, however, it is necessary to make some response before proceeding to the real questions at issue.
I begin with Hill’s charge that Albert and I operate with a "double standard", holding only biological, medical or, in a word, "scientific" anthropologists accountable for ethical conduct, while supposedly exempting cultural anthropologists from any need for regulation by ethical standards (presumably including the Code of Ethics of the AAA, which I helped write). His grounds for this charge are that we both focused our two earlier contributions to this round table on the issues arising from the 1968 measles epidemic and the AEC expedition’s conduct of its medical and research activities. In Hill’s words, the two of us
...appear to have drawn no lessons at all from the Tierney book concerning ethical issues that might apply to cultural anthropologists and various types of applied anthropologists. I find that double standard to be unfortunate.
Whose "double standard"? As Hill himself points out in his last paper, citing no less an authority than Albert, Tierney’s allegations about the AEC Expedition and the measles epidemic are the gravest (and also the most complex and poorly understood) in the book, so it is natural that anyone attempting to come to critical terms with the book should begin by focusing on them, regardless of "cultural" or "scientific" persuasion. This implies no "double standard". Hill doesn’t recognize that his Manichaean polarization of "scientific" versus "cultural-applied-advocacy" anthropologists is itself a kind of double standard, which repeatedly gets in the way of understanding what the cultural anthropologists in this round table are trying to say. Albert, Martins and I have all stood for the application of ethical standards to the work of social and cultural anthropologists, ourselves included, both in our publications and our careers as activists. I recognize that Hill, Hames, and Peters have done the same.
Speaking for myself, I would have thought that by now I have made it abundantly clear that I have drawn a number of lessons concerning the ethical behavior of social/cultural anthropologists, such as Chagnon, from Tierney’s book (among other sources). As I mentioned, I was a member of the first AAA Committee on Ethics, which drew up the first code of professional ethics for the Association as a whole, cultural and applied anthropologists included, in the late 1960's. More recently, I served as a charter member of the AAA Committee for Human Rights and am a co-author of its statement on the (ethical) responsibilities of anthropologists (social, cultural and applied anthropologists included) for human rights issues. Finally, I am the author of several statements calling certain statements and conduct of Napoleon Chagnon, who is a social-cultural anthropologist, to account on ethical grounds. Some of these statements are cited, accurately enough, in Tierney’s book. But perhaps I have missed something. I would be obliged to Hill if he would spell out more specifically which "lessons" about applying ethical standards to cultural and applied anthropologists he feels I have failed to learn.
It seems to be axiomatic in Hill’s dualistic world view that "cultural" and scientific approaches in anthropology are incompatible. I disagree. Hill to the contrary, most anthropologists who deal in one way or another with cultural forms and meanings are not animated by irrational antipathies to scientific research and those who practice it, and being a "cultural anthropologist" does not automatically commit one to the other fatuous convictions Hill asserts go with the territory, such as extreme cultural relativism, knee-jerk political correctness, and the belief that minority peoples can do no wrong. I quote:
Anthropologists, still enamored with an ideal of pure cultural relativism, often seem prepared to ignore or even defend gross human rights violations when committed by members of small ethnic minorities...
Statements like this, framed as abstract, impersonal generalities, are obviously meant, in the context of this discussion, to apply to present company, specifically the cultural-applied-advocacy anthropologists in the group. The best way of measuring the gulf between Hill’s neo-Gnostic stereotypes and the real views and actions of those of us to whom he obviously intends them to apply is once again to review some relevant aspects of our own careers. Albert and Martins can and doubtless will speak for themselves. Speaking for myself, I have long been on record as arguing that anthropological activists should criticize and work against internal exploitation and violations of human rights within indigenous societies and cultural minorities, as well as against their oppression by modern nation states. In my article, "Anthropology and the politics of indigenous peoples’ struggles" (1979), I argued for supporting the campaign of the revolutionary government and feminist movement of the newly independent state of Guinea-Bissau to reform or abolish the bridewealth system of tribal peoples where it clearly operated as an instrument of exploitation of women and young men by senior men. I have followed the same principle in my work with the Kayapo, for example in urging them to include women in the voting membership and directorates of the new self-development associations that I have been attempting to assist them in developing over the last ten years. As Hill should be aware, in 1997 I co-edited an issue of the Journal of Anthropological Research with his colleague at the University of New Mexico, Dr. Carole Nagengast, dedicated to a critique of cultural relativism as applied to human rights, and arguing for universal standards of human rights that would apply equally to relations within and between all societies, including indigenous ones.(Nagengast and Turner 1997) My own article in that issue is a general argument for universal (anti-relativist) principles of rights, as embodied in the AAA statement on Human Rights, which Nagengast and I helped to draft (1997:113-124). I conclude the article with an attack on post-modernist legal theories of "difference" as a relativist principle of human rights. There are a number of other actions and publications I could mention, but perhaps enough has been said to make the point.
I must also correct Hill’s groundless allegation that I think Tierney’s errors and misrepresentations, such as those in his chapter on the measles epidemic, are all "just small peccadillos," in contrast to his own "insistence on the importance of truth". I have made it clear on numerous occasions in the recent debate that I regard allegations, whether direct or indirect, of responsibility for the deaths and suffering of other people as matters of the utmost gravity. Let me remind Hill that I have repeatedly stated in numerous places, both in writing and in public lectures (one at the University of Michigan) that I find some of Tierney’s allegations to be inaccurate and matters of the utmost gravity. I have also publicly expressed regret over the effects of the public circulation of these charges on Neel’s reputation and on the feelings of his family. I did so because the memo in which Leslie Sponsel and I summarized Tierney’s allegations, as we understood them from reading the galleys of Tierney’s book, became, without our knowledge or consent and against our intentions, the initial vehicle of the public circulation of these allegations. Hill states incorrectly that I "apologized" for these regrettable effects. I did not, since neither I nor Sponsel were responsible for the unauthorized circulation of our memo, which led to them. Nor do I accept Hill’s insinuation that my further research on Neel’s papers is somehow inconsistent with my expressions of regret over the circulation of Tierney’s erroneous allegations. It rather represents my best attempt to correct those allegations and to discover what if any real basis for criticism of Neel’s behavior may exist.
I am sure that Hill’s shock and indignation over false allegations of responsibility for Yanomami deaths are as genuine as my own, so I confess my bewilderment over why he and other defenders of Chagnon in the current controversy have never expressed regret, let alone ethical outrage, over Chagnon’s groundless charges that the Salesian missionaries, and some evangelical missionaries and NGOs, are responsible for "killing [the Yanomami] by kindness" (knowingly causing elevated death rates among Yanomami through counter-effective medical programs and treatment centers, and distributing shotguns used in raids and murders), and, in the case of the Salesians, covering up their guilt by blocking the investigation of the Haximu massacre (thus making themselves accessories after the fact of that act of mass murder as well). These charges of Chagnon’s are false, as critical analysis by Tierney and others (Lizot, Albert, and myself) has shown (I review the evidence below). Hill is explicitly on record as deploring double standards. Here is an opportunity for him to correct the most glaring case of double standards in the entire Yanomami controversy.
Hill’s rhetorical sallies are essentially attempts to deflect criticism of Neel and Chagnon by discrediting the critics. I do, however, agree with a few of Hill’s points, such as his homilies about the importance of telling the truth, and specifically "the importance of truth in the battle for indigenous human rights". Did he suppose that the rest of us actually stood in need of these exhortations?
As Hill reports, I sent a memo to AAA officials in November 2,000 stating that there was strong evidence that Neel’s vaccination campaign "was essentially an experiment rather than a preventative measure". I did so because there was already strong evidence that Neel originally conceived the vaccinations as a research tool, and had already decided to include the vaccinations in the AEC expedition’s program before he ever heard of the outbreak of the measles epidemic in late 1967. The evidence on this point has since become overwhelming, much of it drawn directly from Neel’s own papers (more on this in the following section). I must emphasize, however, that I never said, and do not think, that because Neel was interested in the vaccinations for research purposes he was not also concerned with their medical value as "a preventative measure". The two are not mutually exclusive, and I have never suggested that they were. Contrary to Hill’s puzzling assertion that I "now appear to have backed off from this charge [i.e., that the vaccinations were "experimental"] as well", I have not done so. Hill may be referring to a statement that the vaccinations were not an experiment designed to exploit the specific properties of the Edmonston B vaccine, but ere rather part of a more general program of research on the genetic effects of a number of epidemic diseases. As I have consistently maintained, vaccinations were used by Neel and others, such as Francis Black, in research on the ability of populations to produce resistance to "natural stressers" like disease as selective pressures leading to genetic variation. On this issue, I have found myself in the good company of Francisco Salzano, Neel’s student and long-time collaborator, who affirmed in a statement in the Brazilian newspaper O Globo that the vaccinations were done to study variations in the level of reactions as between isolated and exposed populations. (Salzano in O Globo for September 2000).
Speaking of Salzano, Hill brings up Tierney’s mention of him on the third page of his book as an example of "sleazy" journalism. The reference consists of a single clause, in which Salzano’s name is not mentioned, in which Tierney refers to a Brazilian geneticist who collected blood samples during "the darkest days of the dictatorship". Anyone familiar with the Brazilian anthropological scene would know from the context that the geneticist in question is Salzano. Although Tierney draws no explicit connection between the collection of blood specimens and the bloodiness of the dictatorship, some sort of shameful association is implied. I agree with Hill that this qualifies as journalistic sleaze. A group of Brazilian medical doctors travelled to the Nov. 2000 AAA convention to defend their colleague against Tierney’s innuendo. As a sometime collaborator of Salzano myself, who has had the opportunity to get to know him personally, lectured in his department at Porto Alegre and talked politics with him and his students, I knew that his politics were on the left and in strong opposition to those of the dictatorship. When my turn came to speak in the open forum discussion of Tierney’s book at the AAA meetings, I therefore used part of my time to speak out in defense of Salzano. The principle involved was the same as when I have spoken out in defense of Davi Kopenawa Yanomami when he has been untruthfully attacked as a "parrot" of NGOs by Chagnon. One does not sit quietly by when someone one knows and respects is wrongfully maligned, whether or not one finds oneself on the same side of a dispute.
All other differences aside, I do strongly agree with Hill that "the question of Neel’s priorities during the measles epidemic is "an important ethical issue to be discussed". Neel’s papers in the APS Archive have much to say about this question, as I shall relate below. Hill opens his discussion of the issue by asking, "Did Neel adequately prioritize Yanomamo health needs during his field expedition of 1968?" Without attempting to answer this question directly, however, Hill passes directly to the more general question of "Should we expect people who clearly state that they have come to indigenous populations to do a job (whether it be to collect data or lay down a fence line) to provide medical services that should be the responsibility of national and local government agencies?" The answer, surely, is yes, in cases where the national and local agencies are not fulfilling their medical responsibilities (the normal case in Amazonia) and the medical need is urgent.
Hill jumps directly from this rhetorical question to a renewed charge that I once again reveal my "blatant double standard" , because I supposedly maintain that "cultural anthropologists can go to the field for years and provide no medical services...whereas biomedical researchers are obligated to donate their time and resources to provide help at whatever cost to them personally". Where does Hill get this? I have never maintained such a thing.
I have in fact spent a good deal of my time in the field doing medical work. I always considered that it went with the territory as a social anthropologist working in Kayapo villages, whether or not government agents or missionaries were present. Before going to the field I took some medical training and took with me a stock of medicines, in the belief that medical services were one way I could repay the community for their hospitality and cooperation in my research. I have been in Kayapo communities during two epidemics of Ôflu, in 1963 and 1966. On one of these occasions I was the only non-indigenous person present. A number of people died in these epidemics. I did medical work every day for as long as I could stay awake, and helped bury two of my patients because their relatives were so prostrated they could not lift their corpses. My research was funded by the US government and the terms of my grant did not cover medical work, but I did not consider that by doing this I was breaking faith with the US taxpayer. Hill says that by suggesting that Neel should have made vaccinating Yanomami communities his top priority for the first week or two of the five he was in the field, I "imply that Neel should have abandoned his research (and his ethical commitment to the US taxpayer that contracted him to do [his] research and paid for it)". I do not imply that. In response to my suggestion that Neel, like any scientific researcher who has brought with him a large supply of medicines and a team that includes medical doctors, including himself, should have given top priority, however briefly, to meeting the medical needs of the Yanomami situation, Hill does grant that "Perhaps this is partially true in the case of extreme medical emergencies". Off-hand, I cannot imagine a more extreme medical emergency than an epidemic of measles in a virgin soil population--the situation of the Orinoco Yanomami in 1968. So what "part" of this proposition does Hill consider not to be true in that case?
It is relevant that Neel was a medical doctor, presumably guided by the principles of his Hippocratic oath. As I understand it, this did commit him to a "double standard" of sorts, in the form of a level of responsibility to render medical help to his fellow humans above and beyond that of ordinary, medically untrained persons. It seems to me from my reading of his papers that Neel accepted this responsibility, and tried to fulfill it within the limits of his overriding commitment to his research, which he also may have felt was an extension of his commitment to medical values. I think it is clear that, Hill to the contrary, Neel did consider medical care of the Yanomami to be "his job", at least to some degree, while he was among them with his medical and research team. It was a tragic coincidence that the measles seems to have arrived in the Yanomami area just long enough before Neel’s vaccinating team to render many of the vaccinations ineffective, and a tragic irony that Neel’s tardiness in delivering the vaccinations resulted from his higher priority on his research goals, which he may have felt were an extension of the same medical values as the vaccinations themselves.
PART II. NEW RESEARCH: THE NEEL PAPERS
I now want to present an overview of the main findings of some of the new research I referred to in the introduction, concentrating on the study of the Neel papers that I and my research assistant, John Stevens, carried out in early 2001, and bringing out its convergences with the main points of the report of the Brazilian medical experts organized by Albert. Stevens and I visited the Archive of the American Philosophical Society in Philadelphia in December 2000 to examine the collection of James Neel’s papers deposited there. The APS Archivist, Robert Cox, provided generous and invaluable assistance. We spent two days going through hundreds of letters and documents in the uncatalogued collection, selecting and copying all we could identify as pertaining to Neel’s research on Amazonian Indians in the 1960s and early 1970s. Cox had many of these papers copied and sent on to us in the months following our visit.
The papers proved to be a rich source of data on many of the controversial issues surrounding the 1968 AEC Orinoco Expedition and other aspects of Neel's research and ideas. We found, however, that the lack of a comprehensive annotated catalogue was a major obstacle to using the papers. They were not only chronologically unordered but were only roughly categorized by subjects and correspondents. We therefore resolved to create a catalogue, with the dual purpose of providing a time-saving research tool for other scholars and, through our brief annotations, a rough guide to the content of the documents for anyone interested in what they might contain. We began by making a master list of the papers in the order that we found them, categorizing them only as COR (for "correspondence") or DOC (for "document"). All letters and documents were numbered consecutively according to their order on this list. We then produced a chronologically ordered list (although it was impossible to place the numerous undated documents in serial order in this list). We had found Neel’s field journal (missing its first 35 pages, but beginning on p. 36 a month before his departure for Venezuela), and produced a day-by-day summary of its entries, listed consecutively by page number and date (the journal was denominated as DOC 1). This outline of the journal forms the third section of our index. As a final, fourth section, we did a topical cross-index of selected letters, documents and journal entries. In March 2001, I posted the completed index on the web site of the Program in Anthropology and History in the University of Michigan web page, and the Hume web site on the University of Connecticut web page. I also notified the AAA El Dorado Commission of the existence of the index and its accessibility at these web addresses.
I provide here an annotated topical outline of a selected sub-set of the more important papers and documents, loosely based on the topical index comprising Part IV of our original annotated index. The topical designations and selection are my own, not Neel’s. General topics are denominated in capitals and enumerated by Roman numerals. Topical titles are followed by a brief summary of the content of the papers listed under that topic, followed by references to the relevant source documents. All correspondence is listed consecutively in chronological order following the designation "COR"; all documents are similarly listed consecutively following the initials "DOC". The field journal is designated DOC 1. Individual letters or documents are indicated by a number set off by semi-colons. Citations from the field journal are designated DOC 1 followed by a colon, the page number and the date of the entry, as in "DOC 1:50-51.16 Jan" These coded references index entries in the full annotated index, which have more detailed information about content, and in some cases include short quoted passages. The annotated index, of course is essentially intended as a guide to the original documents in the APS Archive. The sketchy captions are intended only as general indications of content, not self-sufficient summaries.
ABRIDGED AND ANNOTATED TOPICAL INDEX
I. RESEARCH ON DISEASE AS AN AGENT OF SELECTIVE PRESSURE
A number of the documents and items of correspondence deal with various aspects of Neel’s long-standing interest in research on disease as a "natural stresser", and as such, one of the selective agents responsible for genetic micro-variation. The measles epidemic of 1968 gave Neel an opportunity to observe a paradigmatic case of epidemic disease exerting selective pressure on a "virgin soil" population. He interpreted what he observed as confirming his theoretical hypothesis of the uniformity of genetic capacity for resistance to disease across all racial differences. In his journal, Neel writes he "has now seen with my own eyes" that "the spectrum of reaction to disease (or vaccine) was no different in Indian than in nonIndian...This bears on...how infectious disease functions as a selective agent." Neel’s assertions of the uniformity of "racial" resistances were however criticized by Francis Black, an immunologist who had worked with indigenous population (COR 149).
DOC 1: 104 (20 Feb)(COR 2;7;20 [linked to DOC 8]; 29;132;134;138;139;140;141. DOC 1:37-38; 44;47;48;91)
II. USE OF VACCINATIONS AS RESEARCH TOOL
In the 1967 field season, Neel or his colleagues took blood specimens which upon analysis revealed an absence of measles antibodies, except for a few cases at the mission station of Ocamo, the point of the most frequent interethnic contacts on the Orinoco. This made Neel aware that the Yanomami, especially those at other settlements than Ocamo, were highly vulnerable to measles and therefore could be said, from a medical standpoint, to stand in urgent need of vaccination. The historian Susan Lindee suggests that this knowledge supplied the motive that led Neel to undertake the vaccination campaign carried out by the 1968 AEC Orinoco expedition, and that the motive was purely humanitarian. Lindee does not, however, take account of the relevant historical context of Neel’s long-standing interest in the formation of antibodies to newly introduced diseases in isolated populations (U.S. Atomic Energy Commission 1951). She does not question the reason for Neel’s initial blood testing in 1966-7 that revealed the Yanomamis’ lack of measles antibodies. She simply assumes that Neel’s motives, like those of the vaccinations that followed, were purely humanitarian, and apparently on this basis seems to exclude the possibility that he might have had a research purpose for the vaccinations. This not only does not follow logically but is historically inaccurate, as we will see later in this section.
Neel’s papers show that he envisioned vaccination campaigns for TB, whooping cough, smallpox, chicken pox, German measles and mumps in addition to measles. A letter to Dr. Robert Hingson of Case Western Reserve dated 15 September 1967 requests help (donations of vaccine) for immunization campaigns against all but the last of these diseases: COR 29). This was over two months before he learned of the actual outbreak of the measles epidemic among the Yanomami of Brazil. Plans for these other vaccination campaigns appear to have been dropped following the 1968 disaster and an abortive scheme floated by Neel in 1970-71 to vaccinate Yanomami with a trivalent vaccine for measles, German measles and mumps manufactured by Dow Chemical. It was Dow that turned down the project, after a careful review, in 1971. Its reasons are interesting. Dow’s director of Biological Clinical Research, Dr. J.E. Jackson, wrote to Neel that
I began to be haunted by the suspicion that, with regard to non-transmissablity of the rubella component, safety data accumulated in the U.S. Population might not be fully applicable to the Yanomamo population. The cultural and epidemiological differences are obviously very great and some of the differences could enhance the risk of fetal infection with the rubella vaccine virus. (COR 4)
Jackson also wrote that he doubted that Neel’s expedition could be relied upon to do reliable follow-up blood testing to check on resistance levels (titres) at the desired interval of 8-10 weeks after vaccination, or to have medical workers remain with vaccine recipients to provide care for vaccine reactions for the recommended periods of up to 14 days for measles and 21 days for German measles (COR 1;2;3;4; DOC1:52; DOC1:54; DOC 2;13; 42; 95). Neel apparently did not argue with Jackson, at least in writing, on any of these points, and dropped the project. The Dow experts’ criticisms of this scheme and the experience of the 1968 measles campaign may explain why Neel and his colleagues did not attempt any of the other vaccination programs Neel had envisioned. The critical reservations of Dow’s experts are also relevant to the 1968 Orinoco expedition. Their fears about the possibility that the rubella vaccine might produce infectious cases of the disease, despite U.S. Experience to the contrary, show that knowledgeable experts considered it possible that at least that vaccine might be capable of generating communicable cases, as Tierney hypothesized for the Edmonston B vaccine.
III. TRIP TO CENTERS OF DISEASE CONTROL IN NOVEMBER 1967
Correspondence with various scientists at CDC reveals that Neel’s trip there shortly before leaving for Venezuela was for purposes of discussing aspects of disease research, not consulting on the properties of the Edmonston B vaccine, as Lindee and others have asserted. (cf.Lindee 2001a;2001b, Stevens 2001, COR 26;28;124;126;131)
IV. SELECTION OF VACCINE
None of Neel’s correspondence, including letters soliciting donations of vaccine, betrays the slightest interest in or concern about the specific properties of the Edmonston B vaccine. That’s negative evidence, but the impression left by this correspondence is that Neel took the Edmonston B vaccine because it was what he could get free from the manufacturer, not because he was specifically interested in its reactive properties for experimental purposes. He does make it clear that he did get it free. In his letter to Layrisse dated December 11, 1967, he tells Layrisse that he knows that he can get 2,000 doses of vaccine free. This may have been the result of a direct negotiation with the manufacturer or of help he had requested in September from the Brother’s Brother Foundation.
(COR 5;6;11;40;48;181. DOC 1:39; 71)
V. PLANNING AND FOLLOWING EXPEDITION ITINERARY
Numerous letters and documents show that Neel began planning the itinerary of the expedition as early as February 1967 (COR 67: 2 February, to Layrisse), and a plan close to the one the expedition actually followed was settled upon by mid-November 1967, before Neel received news of the measles epidemic coming from Brazil. Neel made minor changes to the planned itinerary in the field, but none of these appear to have been motivated by medical considerations. He also at one point contemplated lengthening the expedition’s time in the field, but only for research purposes, not to make possible more medical care, as the following journal entry makes clear:
Can’t contact, locate Patanowatedi. Consider altering itinerary. I am at this point sufficiently pessimistic that already beginning to wonder how I can possibly prolong my stay. Would be most unfortunate to feel I had to leave just when we begin to have Indians in all directions. (DOC 1:83, 7 Feb).
(COR 37;53;54;56;65;67;70;77;78;96. DOC 1:43-44; DOC 1:48; DOC 1:83-84; DOC 1:95; DOC 1:99)
VI. OUTBREAK OF THE EPIDEMIC
Correspondence showing Neel first learned of the outbreak of measles in Brazil and its movement down the Orinoco towards the Yanomami villages on 28 Nov Ô67 in a letter from Robert Shaylor, a missionary with the New Tribes Mission (COR 39). Two weeks later (11 Dec. Ô67), Neel requested a Venezuelan colleague (Layrisse) to arrange Venezuelan government permission for him to vaccinate, citing the Brazilian epidemic (COR 5).
Neel’s journal entry for 20 Jan (his last night in Caracas before going into the field) reports that he was informed at a party by the head of the Venezuelan Indian Agency that measles has erupted in the upper and middle Ventuari (the next major river system to the west of the Orinoco). This, coupled with Neel’s information that the epidemic had started in the Brazilian Serra Parima to the east of the Orinoco and was at that moment working its way down the Orinoco towards his planned research area should have told him that measles was rapidly becoming established in the whole area, if indeed it had not already become so. There was plainly no time to lose if medically effective preventive measures, such as vaccinations and quarantines, were to be taken. Nevertheless, Neel did not alter his research schedule or his plan for the movements of the expedition, or attempt to take any special measures against the epidemic until a month later, when he got the first news of the outbreaks of measles at Ocamo and Mavaca (17 and 18 February, respectively). Even thereafter he did not significantly modify his schedule in order to vaccinate all remaining groups in his area as quickly as possible.
The "All Orinoco Plan" he formulated between 2 and 4 AM on the night of February 17 after learning that the epidemic had actually arrived at Ocamo and Mavaca called for vaccinating at five villages, two of which had already been vaccinated, two others of which had been abandoned by their inhabitants fleeing the epidemic, and one was being attended to by a missionary whom Neel had already supplied with vaccine. The one deviation from the expedition’s planned itinerary this involved was to send Centerwall to vaccinate one of the five villages. Centerwall, however, found that the villagers had fled the epidemic and returned empty-handed the following day. The "All Orinoco Plan", in sum, was a hasty stop-gap measure concocted on the spur of the moment, and was a dead letter virtually from the time of its conception. The five villages were selected because they were the main ports of entry and exit into and out of the Yanomami area (the plan also called for quarantining and vaccinating travellers).
If a ring or barrier was to be erected around the Yanomami area, these were the logical places to do it. The problem with this approach was that the measles was already both inside and outside the area. It had come into the area from the Upper Orinoco to the south and the Brazilian Serra Parima to the east, and was already over into the adjoining river system of the Ventuari to the west and northwest. There were thus already outbreaks or cases of measles on the southern, eastern, northwestern and western flanks of the middle Orinoco area, so there was little point to trying to confine it within the area bounded by the five ports of entry. On the other hand, it was too late to try to keep it out of the area by vaccinating and quarantining the ports of entry, as it was already inside it. The time to have instituted such a plan would have been when Neel first arrived in the field a month earlier. At that time it might have had some hope of success in keeping the measles out of the immediate region of the middle Orinoco villages. That Neel spent that whole month in the field without formulating any plan to deal with the rapidly approaching epidemic suggests the low priority medical measures against measles held for him.(COR 5;6;14;15;22;38;39;41;46; DOC 1: 60;103;105; 18;19;60;71)
VII. SPREAD OF THE EPIDEMIC
Letters from missionaries and colleagues informing that epidemic continued to rage out of control after the departure of the expedition show that the expedition’s medical work did not, as Neel claimed, "avert a real tragedy". It did not, in other words, prevent the epidemic of measles from establishing itself and spreading in the area in which the expedition was working, although it did succeed in immunizing several villages where it arrived in time to vaccinate before the 72-hour grace period after exposure to the disease virus had run out. The epidemic was, and continued to be, "a real tragedy" for the Yanomami.
(COR 17;42;43;45;62. DOC 17)
VIII. NEEL’S CORRESPONDENCE WITH MARCEL ROCHE
This correspondence is significant for three main reasons. Firstly, Neel wrote to Roche on 4/4/68 asking him for confirmation that he (Roche) had diagnosed a Brazilian boy with measles at Ocamo shortly before the outbreak of measles among the Indians (this would have been tantamount to identifying this boy as the carrier responsible for bringing the epidemic to the Yanomami of the Orinoco). Roche, however, replies on 23/4 that he could make no specific diagnosis of measles, although the boy had severe broncho- pneumonia and a very high fever for a week (this letter was unaccountably omitted from the annotated index, and is therefore listed as uncatalogued). Tierney claimed that Roche told him the same thing when he interviewed him many years later, but critics claimed that Roche was by then too far gone with Alzheimer’s to be a reliable source. The existence of this letter written in April 1968, however, proves the accuracy of Roche’s memory at the time Tierney interviewed him, as well as the accuracy of Tierney’s account of the interview. The point was important to Neel, as it has been to his partisans in the recent debate, because if the Brazilian boy had been able to be identified as the vector of the epidemic, it would have removed the possibility that the expedition itself might have been the vector, as Tierney suggested. Neel was apparently worried about this possibly.
The telegram from Roche to Neel (DOC 5) informing Neel that the donation of vaccine that Neel proposed to ship to Venezuela was "acceptable to our government" became the center of a mini-controversy. The historian Susan Lindee found this document while going through Neel’s papers at the APS, and claimed that it proved that Neel had received permission from the Venezuelan government for the AEC expedition to carry out the vaccination campaign in February-March. Unfortunately she failed to notice that the telegram is dated April 19, and refers to a future shipment of vaccine by Neel after he had returned to the U.S.. It is clearly a response to a telegram from Neel to Roche, of which only the draft survives, with the date April 15, requesting confirmation from Roche that a shipment of vaccine would be acceptable (DOC 6). Lindee recognized her error, and despite the continuing absence of direct evidence nevertheless made a convincing case that Neel must have received government permission based on indirect evidence (Lindee 2001b). Lindee’s conclusion has been reinforced by the discovery of official authorizations for some of Neel’s Brazilian visits from Presidents of FUNAI (Albert 2001)
The third document of special interest in this set is Roche’s letter to Neel written May 6 confirming the arrival of the shipment of vaccine.(COR 181) Roche informs Neel that the Venezuelans will not use the Edmonston B vaccine shipped by Neel for vaccinating Indians, because "studies" had shown that one-third strength doses of the milder Schwarz vaccine were as effective in instilling immunity and produced much less problematic reactions. The "studies" on the Schwarz to which Roche refers may well have involved Dr. Helen Casey and others associated with the CDC during the preceding year. These studies must in any case have been known to Neel, or at least have been made known to him when he visited Casey at the CDC a couple of months before leaving for Venezuela. These data raise questions about Neel’s use of the Edmonston B vaccine despite the reservations and alternatives that were persuasive to Roche and the Venezuelans. It may be that Neel simply did not care enough about the more severe reactions to Edmonston B (especially as administered in full doses) to forego the free donations of the vaccine he had received from a manufacturer. There is not enough evidence to decide the point either way, but there is enough evidence from documents such as Roche’s letter to suggest that Tierney’s questions about Neel’s use of the vaccine are not entirely out of line. (COR 16;50;181; COR [uncatalogued]13 April 1968; DOC 5;6;7)
IX. VACCINATIONS: WHERE AND HOW MANY CARRIED OUT; USE OF GAMMA GLOBULIN.
Records of vaccinations by various medical personnel and missionaries at a number of different villages are scattered through Neel’s papers and the field journal. Taken together they comprise a complete and detailed record of the vaccinations carried out by the expedition. These records show that gamma globulin was administered along with all vaccinations carried out by Neel and his team with the exception of some vaccinations at Ocamo. The two Brazilian mission stations of Auaris and Surucucu were the only places where entire communities were vaccinated without gamma globulin. Reactions to the vaccine in these two places were extremely severe (COR 182) . The documents provide no answer to the question of why gamma globulin was not supplied to the missionaries along with the Edmonston vaccine, and why Roche was not told that he should use it when he vaccinated at Ocamo. There is no evidence, however, that this was part of an "experiment". It may simply have been a result of the relative indifference and low priority that seems to have attended other dealings with the vaccine. The records also show that the "half village" vaccination procedure recommended by Centerwall in his "protocol" memo to the Brazilian Evangelical Missionaries was not followed once the epidemic arrived in the villages where the expedition was working, as I explain in the next section.
(DOC 1:62;63;72;56;110-111); (DOC 14;50;51:52;53;54;55;56;57;64;65;66)
X. CENTERWALL’S PROTOCOL AND THE "HALF VILLAGE" POLICY; EXPERIENCE OF MISSIONARIES ATTEMPTING TO APPLY IT; YANOMAMI REACTIONS
On 9 Jan 1968, W. Centerwall sent a memo to missionaries at Yanomami villages in Brazil to whom Neel was sending 1,000 doses of anti-measles vaccine, giving instructions on the use of the vaccine. This memo is the closest thing to a general protocol for the vaccinations that has come to light: it is unclear if Neel ever wrote one. The policies Centerwall recommendations were also presumably intended to be followed by the expedition itself. As will be noted, the memo recommends vaccinating only half of the people of a community, because the reactions to Edmonston B vaccine are likely to be so strong that those inoculated will be prostrated, and the others should therefore be left unvaccinated, and thus without reactions, in order to care for them. Despite this clear indication that the expedition was fully aware of the probability of intense reactions to Edmonston B, no gamma globulin (which cuts the fever levels of reactions in half) was shipped to the missionaries along with the vaccine. I quote here the full text of this memo:
To Whom It May Concern:
In brief, it should be realized that the Edmonston strain of vaccine though immunologically effective is known to cause significantly high fevers and reactions in some persons. This is perhaps even more likely among measles-free peoples. The concomitant use of gamma globulin would help modify the reactions but in the absence of gamma globulin, measles vaccination is still considered very much worth the risks providing certain precautions are taken, i.e.:
(1) avoid vaccinating infants especially under 1 year of age, TB patients, acutely ill people, and persons who are old and/or infirm.
(2) vaccinate only half of the able-bodied village population at one time so the unvaccinated individuals will be able to care for the needs of the vaccinated ones.
(3) vaccinate populations which can be observed during the resting period (8-12 days post vaccination) so that any high fevers can be treated with aspirin and fluids and any bacterial complications treated with antibiotics or sulfa drugs...
(4) alert the people being vaccinated that they may feel a bit ill from the vaccination but not as badly as the disease from which they are being protected.
(9 January 1968 COR 179 Willard R. Centerwall)
Centerwall also mentioned that the expedition planned to follow this "half-village rule" in a letter to Francis Black written on 10 January- (COR 6; COR 15).
Centerwall’s "protocol" with its "half-village policy" is further evidence that medical personnel of the expedition were fully aware of the probable strength of Yanomami reactions to Edmonston B, and were nevertheless prepared to go ahead with its use, even without gamma globulin, on the grounds, clearly stated by Centerwall, that the medical benefits outweighed the inconvenience of the reactions. It is true, as many contributors to the debate over Tierney’s statements about the Edmonston vaccine have insisted, that the vaccine was considered a "state of the art" vaccine at the time, and not medically "counter-indicated" for use on any group. On the other hand, studies of the effects of the Edmonston B vaccine on Native American groups in Alaska had concluded it is evident that knowledgeable expedition personnel expected that it was likely to give the Yanomami a very rough time. Other uses of the vaccine on indigenous groups in North America had produced extremely strong reactions, leading to warnings that "the risk of severe febrile response was an impediment to the use of Edmonston B " among such groups (Brody et al. 1964:339-42; Mann 2000a). As the Brazilian medical report notes, it is therefore a fair question why Neel’s team nevertheless opted to use the vaccine when less problematically reactive alternatives were available. In the absence of evidence to the contrary, the most probable answer is that suggested above: in the words of Francis Black, Neel chose Edmonston B in spite of its drawbacks "because he could get it for free" (Mann 2000a:416).
Centerwall’s protocol does conclusively settle the question of the reason for the policy of vaccinating only half of a community at a time. Whereas Tierney and others have suggested that this might have been an experimental tactic, designed to divide the population into a "control group" and a group receiving the experimental treatment, Centerwall’s document shows that it was conceived instead as a medical safety measure. From the vaccination records among the papers, it appears at any rate to have been followed by the expedition itself only at Ocamo, its first point of arrival in Yanomami country, and was otherwise attempted only by the missionaries at the Brazilian Yanomami villages of Auaris and Surucucu to whom Neel sent vaccine, following Centerwall’s instructions. The missionaries at Surucucu, who were not given gamma globulin to mitigate the force of the reactions to the vaccine, were so appalled by the reactions of the first group of villagers they vaccinated that they gave up the attempt to follow the half-village policy as recommended in the Centerwall protocol. They realized that after having seen the reactions of those who had been vaccinated, the other half of the villagers would never allow themselves to be vaccinated with the same vaccine. They therefore used Schwarz vaccine for the unvaccinated half of the village (COR 182) .
Based on Centerwall’s protocol and letter to Black, and the lack of any subsequent statement to the contrary, I wrote In my rejoinder to Clifford Geertz in the New York Review of Books that the expedition had followed the half-village policy during the epidemic (Turner 2001:69) I discovered upon making a thorough review of the vaccination records among Neel’s papers that this was an error. The expedition appears to have made only one abortive attempt to follow the "half village" procedure at Ocamo, before the epidemic had broken out there (this is not certain, but is a plausible interpretation of why Chagnon was sent ahead to Ocamo with only half the number of measles vaccine doses needed for the total population of the village). In every instance after the measles arrived at Ocamo and Mavaca, the villages in which they had worked or were then working, the expedition’s medical personnel simply vaccinated everyone they could get hold of at the same time. The reason for the change is presumably the obvious problem that leaving one half of a community unimmunized for 8-12 days to wait for the other half to recover would have meant exposing the unimmunized people to contagion. In this respect, then, Neel and Centerwall did change one important aspect of the expedition’s schedule and medical program in response to the epidemic.
At the very least, the "half-village" policy betrays a lack of anthropological imagination. Given the indistinguishablility of some reactions to the vaccine from actual cases of wild measles (a frequent enough problem for members of the expedition, but doubtless in any case a distinction without a difference for the Yanomami) the response of healthy Yanomami to the sight of Yanomami with measles (or what Neel calls "measly" vaccine reactions) was normally not to stick around to care for the diseased persons but to flee the village that had become a site of contagion. Neel records several instances when whole villages fled, either from the threat of vaccinations or the disease itself--from the Yanomami point of view they came to much the same thing.(DOC 1:76; DOC 1:103) Once away in the forest, of course, the fugitives were also cut off from medication, especially antibiotics against pneumonia. Those who fled with pneumonia, or who got pneumonia from the reactions or measles itself within days after leaving the village, stood a poor chance of surviving without medical care. How many died in this way is unknown, but no doubt enough to justify Tierney’s remark that the medical disaster on the Orinoco in 1968 was not simply a "measles epidemic" but a complex social and medical disaster comprised of measles, vaccine reactions, pneumonia and social panic. -
XI. NEEL’S LOW PRIORITY ON VACCINATIONS IN RELATION TO SPECIMEN COLLECTING
Neel expresses his impatience with the vaccinations as an interference with the research work of the expedition in several passages of his journal, such as the following:
The measles vaccination--a gesture of altruism and conscience--is more of a headache than bargained for--I would either put this into the hands of the missionaries or place it at the very last. Also, anxious to avoid distracting W.C. [Centerwall--TT] who is pursuing so many things. DOC 1:79 (5 Feb)
Ironically, it was the outbreak of the real measles epidemic that transformed the vaccination campaign from a combination research operation and humanitarian medical effort into a pure "gesture of altruism and conscience" for Neel, since the onset of wild measles rendered the vaccinations superfluous as sources of antibody formation. This redundancy of the vaccinations from the research point of view may have been at least partly responsible for Neel’s growing exasperation with the burden they imposed on the research work of the expedition. This attitude was expressed in the cutting remarks Neel addressed to Timothy Asch for filming Centerwall treating a sick Yanomami, quoted by Tierney from the sound track of Asch’s video tape of the incident. (Tierney 2000:95). Neel even considered the possibility of cutting out vaccinations altogether from the final stage of the expedition’s work, as is shown by the following passage of the journal, where he sets out his order of priorities in detail:
Plan order of priorities for work in next phase, at Patanowatedi. Concentrate in first 3-4 days on Physical Examinations, anthropometrics, dentals, bloods. Next, do same to Ashedowa-tedi, to be invited to come to Patanowatedi for the purpose. Also at Patanowa-tedi we will make our principal collection of biologicals...thus I will get stools and soils while Bill [Centerwall--TT] does P.E.s for 3-4 days; then get blood, saliva and urine...then inoculate if at all. DOC 1:80 (5 Feb) [my emphasis: TT]
The most revealing of these passages, however, is Neel’s meditation on his responsibilities as leader of the expedition to compel the collection of biological samples as the supreme priority, on account of the massive grant and research apparatus that has been mobilized to process the specimens:
The leadership role under these difficult conditions is complicated by the fact that I am incompetent in the two key languages, and do not claim to know the Indians as well as Nap or the jungle as well as Chas. However, certain basic principles do come out at times like this...we have such a lab set up behind us--something not all the crew recognizes--that we must get specimens. DOC 1:106 (20 Feb)
These journal entries plainly show that once the expedition arrived in the field, Neel was taken aback by the time and effort required by the vaccinations, and rapidly came to perceive them as a threat to the primary business of the expedition: the collection of biological specimens. The intensity of his surprise and frustration over the amount of time the vaccinations and other medical work were taking appears to bear out the observations of the Brazilian medical team about Neel’s failure to plan adequately to deal with the epidemic. Journal entries such as those just quoted show that under the pressure of his ambitious program of specimen-collecting, which even without the additional medical needs of dealing with the epidemic would have been virtually impossible to complete in the limited period of time available, Neel seriously considered jettisoning the "altruism and conscience" of the vaccination campaign and abandoning the vaccinations altogether. In the end, to his credit, he did not. These passages starkly reveal where Neel’s real priorities lay, and help explain Neel’s otherwise inexplicable unconcern for and resentment of medical work and precautions. By the same token, they underline the moral significance of his ultimate refusal to discontinue the vaccinations and to carry on, despite his reluctance, with the vital medical support the expedition was providing.
XII. NEEL’S UPPER RESPIRATORY INFECTION
Neel recounts in repeated entries in his journal how he contracted a severe upper respiratory infection (URI) in Caracas just before going in to the field. He nevertheless went in on schedule with the rest of the expedition, and continued to vaccinate and associate with the Yanomami while the infection persisted and worsened throughout most of the time in the field. As Francis Black has noted, the side effects of the Edmonston B vaccine are exacerbated if the patient has a cold (Mann, Science 291 (5503):417). Some of Neel’s journal entries about his URI are particularly striking as they occur in juxtaposition with references to the growing frequency of respiratory disease, including grippe and bronchopneumonia, among the Yanomami, and the danger that it will interact with and reinforce the measles. For example, Neel refers to a current epidemic of grippe, and notes that there is now much more such disease than in earlier years, with 5 deaths at Mavaca. (Doc 1:94) He worries that the current epidemic of grippe could interact deleteriously with the measles (DOC 1:99). At Mavaca, he notes "another Indian ill with pneumonia, presumably in the wake of the flu outbreak here of about a month ago"(DOC 1:103).
Neel’s failure to observe elementary medical precautions for avoiding infectious contacts with the Yanomami, especially in the case of a respiratory infection that he knew would be likely to exacerbate the reactions to the vaccine he was administering, reinforce the already existing epidemic of respiratory illness, and thus in turn potentially interact with and further exacerbate the measles epidemic itself, is puzzling in a medical doctor. It may reflect a similar attitude to that which Neel seems to have taken toward the Edmonston B vaccine--that although the reactions and complications might be severe, the net benefit to the Indians would still offset the increment of suffering it would be likely to cause in a number of cases. This robust disregard for ordinary precautions against aggravating the Yanomamis’ deteriorating health situation seems of a piece with the relatively low priority Neel allotted to medical concerns in other respects, as compared with the importance of the research in which the expedition was engaged. (DOC 1: 58;60;87;92;94)
XIV. NEEL’S SEARCH FOR THE INDEX OF INNATE ABILITY: A POSSIBLE CORRELATION BETWEEN HEAD FORM, REPRODUCTIVE SUCCESS, HEADMANSHIP, AND "INNATE ABILITY"?
Finally, we come to the documentary evidence that Neel was seeking a material diagnostic index of superior genetic capacity (which he called the "Index of Innate Ability" or IIA). He theorized that this increment of genetic superiority was the basis of headmanship and was therefore directly correlated with superior reproductive success (because headmen in primitive societies like the Yanomami supposedly have more wives). He hoped to find evidence for this item of eugenic faith among the Yanomami and other Amazonian societies like the Shavante and Kayapo, in the form of a correlation between head measurements, headmanship, and reproductive success. Perhaps needless to say, nothing came of this. (COR I47, 148, 174,175,176; DOC 1:39) The correspondence between him and his colleagues, notably Salzano, on this point reinforce the evidence from his publications that he regarded the political and reproductive arrangements of the Yanomami, considered as a paradigmatic example of pre-agricultural (or incipient agricultural) human society, as superior to those of modern mass societies from a eugenic standpoint ( COR 147,148,174,175,176; Turner 2000).
It must be emphasized, in contrast to Lindee’s and Geertz’s dismissive remarks about Neel’s eugenic ideas being merely a matter of "semantics" and relatively inconsequential by comparison with the ideological programs of the eugenics movements of the early Twentieth Century, that they played an important role in the context of his and Chagnon’s work with the Yanomami. There is no question that Neel played a progressive role in opposing eugenicist causes in the domain of national politics (schemes for compulsory abortion, selective immigration, etc.). There is, on the other hand, equally little question that eugenic and genetic reductionist ideas dominated Neel’s thinking about the evolution of human society and the nature of contemporary primitive peoples like the Yanomami. He is quite explicit about this in his writings on the eugenic advantages of Yanomami social organization, which in his view provided optimal conditions for males with superior genetic endowment to rise to leadership and thereby to attain superior rates of reproductive success [Neel 1980: 277-94; 1994:301-316 (see especially 301-304); Turner 2000]. Neel’s ideas in turn appear to have shaped Chagnon’s sociobiological interpretation of Yanomami social organization. Tierney astutely observes that Chagnon’s major theoretical formulation about the higher rates of marriage and reproduction attained by dominant Yanomami men (defined as such, on the basis of what turned out to be ethnographically inaccurate claims, as men who had killed, and thus demonstrated superior "fierceness"), was actually prefigured by Neel’s writings on Yanomami headmanship (Tierney 2000:159)
ETHICAL ISSUES RAISED BY NEEL’S PAPERS AND THE REPORT OF THE BRAZILIAN MEDICAL TEAM
The investigation of the medical aspects and circumstances of the 1968 measles epidemic by the Brazilian team of medical experts organized by Bruce Albert, and Stevens’ and my research on Neel’s papers at the American Philosophical Society archive, have now established an independent basis for assessing the conduct of Neel and the AEC Orinoco Expedition. Taken together, they afford an alternative analytical perspective to that of Tierney on the one hand and the web postings of the defenders of Neel and Chagnon, including the University of Michigan and University of California at Santa Barbara web pages, on the other. The latter, while making some valid points in correction of some of the errors of Tierney’s account, have generally failed to go beyond their concern with rebutting Tierney’s accusations and killing the messengers, Sponsel and me included, to produce a viable account of what really happened to the Yanomami. This is partly because they have relied almost exclusively on Neel’s and Chagnon’s published writings rather than do any original research, partly because they have been unwilling to entertain the possibility that some criticisms of those they have been at pains to defend might in fact have merit, and above all because getting at the full story of what happened to the Yanomami has not been an important concern for them.
While Stevens’ and my research on Neel’s papers and the Brazilian team’s study of the available data on the 1968 epidemic converge in clearing Neel’s reputation of the more sensational allegations (e.g., that he might have deliberately caused dangerously severe vaccine reactions or even death as part of an experiment, or that the vaccine he used might have caused the measles epidemic). They nevertheless raise certain ethical questions about Neel’s and the expedition’s conduct. These focus around the prioritization of research over medical needs and the issue of informed consent (understood in its broadest sense to include misinformed consent and prevarication in withholding information about the disposal of specimens).
The papers make clear that Neel originally planned the expedition for the purpose of collecting blood samples and other biological data (specimens of urine, stools and saliva, anthropometric measurements, etc.), and that the vaccinations were originally conceived as part of this research program. Neel’s use of vaccines to study the capacity of isolated groups to generate resistance to disease (as measured by rates of production of leukocytes or white blood cells) long antedates his Yanomami research. In the studies of the effects of long term radiation from the A- and H-bomb tests in the Marshall Islands, with which Neel was associated, the use of whooping cough (pertussis) vaccine as a "lymphocytic stimulating substance" to "challenge" and thus test for "lymphopoetic capacity" was discussed by the medical investigators. Among papers recently declassified and released by the Department of Energy is a letter from Dr. Robert Conard, the head of the Navy Medical Team with the Marshall Islands Project, which mentions the use of pertussis vaccine for this purpose, and also cites Neel in another connection (Letter from R.A. Conard, Brookhaven National Laboratory, 25 Sept. 1957, Washington National Records Center, Collection 32681-6, Box No. 1).
It can thus be established that in his work in the Marshall Islands at least ten years earlier, Neel had been associated with research on levels of disease resistance that employed vaccinations to stimulate the production of antibodies as a way of measuring genetic capacity for resistance (Conard 1957). Neel’s correspondence also reveals that he was interested in reconstructing the "pre-contact disease picture of the American Indian" (e.g. COR 67: 6 March 1967). He was especially interested in determining the Yanomamis’ levels of antibodies for various diseases because of their extreme isolation from Western contact, which made them a potential model for the "pre-contact disease picture" of Amerindians more generally. His discovery, through his analysis of the blood specimens taken on the 1966-67 joint AEC-IVIC expedition, that the Yanomami were a "virgin soil" population for measles, made them, in the context of his research interests, an ideal base-line group for research on the capacity of such virginal groups to generate resistance (antibodies, or leukocytes) on the same order as the populations long exposed to periodically recurring epidemics of the same disease.
The historical context of Neel’s blood sampling in 1967 in his own previous research and that of colleagues in the AEC and Marshall Islands Project thus points to a research purpose both for the initial sampling for antibodies and the vaccinations which followed in 1968 (Stevens n.d.; cf. Lindee 2001a; 2001b; 2001c; 2001d). Of course Neel also recognized that the Yanomamis’ lack of antibodies made them vulnerable to a measles epidemic and that they therefore stood in urgent need of immunization. This constituted a strong humanitarian reason to vaccinate the Yanomami against measles, but this medical motive, far from excluding or conflicting with Neel’s research interest, was obviously convergent with it. Vaccinating the Yanomami would serendipitously serve Neel’s research purposes by allowing him to study the levels of antibodies the Yanomami would produce in reaction to the vaccinations, which could be treated as "modelling" antibody levels stimulated by a real epidemic.
When Neel received the first reports of the outbreak of the epidemic in Brazil, and quickly thereafter of its advance into Venezuela, he responded promptly by shipping 1,000 units of vaccine (without accompanying gamma globulin) to the missionaries with the threatened Brazilian Yanomami villages, but made no other changes in his plans or preparations. He knew from reports from the missionaries, and also from a conversation with the head of the Venezuelan Indian Agency on the night before his departure for the field, that the epidemic was moving down the Orinoco and had also reached the Ventuari, so he had every reason to believe that time was running out before it would reach the villages he was heading for. From a medical point of view, the prudent move would have been to try to vaccinate all the villages the expedition could reach immediately upon arriving in the area, leaving the blood and stool sampling until later.
Neel, however, made no such alterations in his planned itinerary. He did not take up the implied offer of Venezuelan help from the chief of the national Indian agency with whom he had spoken at a party in Caracas the night before the expedition left for the field, presumably because he was worried that bringing in a group of alien personnel would interfere with his research objectives. He did not even formulate a plan for defending the middle Orinoco region against the epidemic by vaccinating at the main points of access to the area until the epidemic actually broke out in the villages where he was working, after he had been in the field for almost a month. He did formulate such a plan when the measles arrived in the villages where he was working, Ocamo and Mavaca, but by then it was too late. This was the so-called "All Orinoco" plan that I have discussed above.this has been described as an attempt to vaccinate a barrier around the epidemic, but the disease was already past the points of entry into the region in both directions: eastward in the Serra Parima and westward and northward into the Ventuari. Two of the five ports of entry that made up the "barrier" had already been vaccinated, a missionary had already set out to vaccinate a third, and the people of the other two turned out to have fled, so in fact the plan actually entailed no extra work and no deviations from the planned itinerary for the expedition, contrary to the Brazilian report’s suggestion that "the path of the expedition was determined by the needs of urgent medical assistance".
The program of research that Neel had planned for the expedition was almost impossibly demanding, with no spare time for extra medical work. As he wrote in his journal, "This one [i.e, expedition--TT] is almost two times as complicated as the last, and about ten times as complicated as that first trip into the Shavante in 1962. If we are successful--even 70%--maybe even 80%--[I] will think we have earned a bonus, low pressure trip of some type." (DOC 1:41,11 Jan) The itinerary left little room for dealing with a measles epidemic in a virgin soil population "on the side", as it were. Neel’s energy and interest was fully invested in this planned research itinerary. He resisted modifying it to give more than the minimal necessary attention to medical work during the epidemic. Shortage of time rendered it impossible for the expedition to fulfill its full schedule of research tasks and simultaneously to devote more time and personnel to medical care for measles victims and those suffering from vaccine reactions. In this connection, it is worth noting that in an entry into his journal Neel did consider at one point the possibility of lengthening the expedition’s field stay. Significantly, however, his reason for this contemplated extension was to give more time for the collection of specimens, not to make possible more effective medical work (DOC 1:83. 7 Feb). After the epidemic arrived (a week after he wrote in his journal about possibly extending his stay), he never again raised the possibility (at least in writing) of extending the expedition’s time in the field. --
Against the background of Neel’s hard-driving research schedule, it came as a surprise to discover from numerous entries in Neel’s field journal and correspondence that medically pertinent issues associated with the vaccinations, such as the type of vaccine to be used, how large a dose needed to be given, and how to deal with the expectable complications (especially pneumonia) of reactions to the vaccine, seem to have held relatively little importance for him, not only before but even during the epidemic. Planning for specific measures to deal with an actual wild measles epidemic, such as the one the expedition actually encountered in the field, plays no role in the written record of his planning of the expedition, even after he learned of the outbreak of measles among the Yanomami of Brazil.
Enough has perhaps been said to give force to the comment of the Brazilian medical team that
Given that J. Neel already knew about the risk of an epidemic during his preparations for the trip...some additional precautions could have been taken or foreseen in his working plan, which would have reduced the difficulties encountered in the field. Among these, training of vaccinators, information about potential complications and treatments, supplies of medicines and antibiotics, planning and timing of the itinerary of villages to be visited, etc... (de Castro Lobo et al. 2001: Section 5.B.3., "Concerning lack of treatment and selective vaccination")
Or as they say a few pages later,
Since Neel was aware of the speed with which the disease spread and the difficulties encountered in this type of fieldwork, the only question is whether, given his prior knowledge of the epidemic in Brazil, better planning and training of the teams of vaccinators could have reduced the impact of the epidemic. (de Castro Lobo et al. 2001: Section 7, "The cause of the epidemic and its deadliness" )
The Brazilian team, after rejecting Tierney’s suggestions that the expedition might have caused or spread the epidemic by its use of the Edmonston B vaccine, or that Neel had actually sought to produce the heavy vaccine reactions as part of an experiment, presents a plausible alternative theory of the origin and spread of the epidemic. Starting from the proposition (for which they advance very persuasive arguments) that the epidemic originated in Brazil rather than independently on the Orinoco , they hypothesize that it reached a number of the Orinoco villages a few days before the expedition arrived and began vaccinating. Given that vaccinations applied three or more days after exposure are ineffective in preventing the outbreak of the disease, this meant that in many cases the expedition’s vaccinations came too late to do any good. This scenario also explains why measles appeared to break out in reaction to the vaccinations, as the witnesses cited by Tierney testified. Rather than the measles breaking out as an effect of the vaccine, the Brazilian team suggests, it was the ineffectiveness of the vaccinations, owing to their lateness, that allowed the measles to break out within the period of incubation of reactions to the vaccine (six to eight days). In the Brazilians’ view, in short, it was above all the failure of the expedition to move fast enough to get to many of the villages before they became exposed (or at least within the three day grace period after exposure, during which vaccinations could still be effective) that was responsible for the failure of many of the vaccinations to prevent the onset of the disease or to stop the epidemic. As they say,
...if measles reached the region before the team arrived, the planning and organization of their movementsÑregardless of whether they gave priority to either medical care or researchÑprobably had a greater impact on the failure of the vaccination (since immunization took place later than 3 days after infection) and the lack of control over mortality (due to the ill-preparedness of the team for dealing with the serious complications of measles, mainly pneumonia), than on the spread of the epidemic. (Lobo et al. 2001: Post Scriptum, point 2)
Revising the "planning and organization of their movements"--i.e., the research itinerary that called for spending enough time in each village to collect enough specimens to approach the target of 1,000 blood specimens--to permit the most rapid possible vaccination of all the villages within the expedition’s reach would however have meant giving the vaccinations top priority at the expense of the tightly planned research program. This in turn would have meant abandoning the target sample sizes for blood and other specimens and settling for less significant research results. As a number of entries in his field journal make clear, Neel never entertained this possibility, but pressed on for collecting the maximum possible amount of blood samples, while sacrificing collection of some other types of data (e.g., anthropometry and dental impressions) to allow more time for vaccinations and medical care.
The evidence in Neel’s papers for the low priority he allotted to medical work and the higher priority that he gave to his research agenda thus both complements and reinforces the findings of the Brazilian team, and helps to clarify the motives and causes behind the slowness of the expedition’s vaccinations and the failure to take additional measures to strengthen its ability to deal with the epidemic. It also confirms and greatly reinforces the Brazilians’ inference that the vaccinations originally had a research purpose, and as such had been conceived as an adjunct to the collection of biological specimens, rather than primarily or exclusively as immunization against a real outbreak of the disease. The Brazilians lacked access to Neel’s papers, but somehow had got hold of his correspondence with Dow Chemical (discussed above) about the abortive scheme to test a trivalent vaccine on the Yanomami, and independently deduced Neel’s research interest in vaccinations from this (COR 1,2,3,4: DOC 13).
The Brazilian report’s reconstruction of the chain of contacts along which the epidemic probably moved from Brazil into Venezuela and the disastrous timing of the arrival of the vectors just before the expedition began to vaccinate, provides an elegant theoretical model that explains the key features of the relation of the outbreak of measles to the vaccinations which had been the basis of Tierney’s inferences about the vaccine causing the disease. To quote the Brazilian report:
A possible conclusion of this epidemiological chain would be that rather than causing the epidemic, the Neel team’s vaccinations was ineffective in preventing the deaths observed in some villages. In other words, the villages visited 72 hours or more after contact with the measles virus could not acquire the protection offered, which explains the disastrous impact of the disease. In this case, the eruption of measles symptoms shortly following vaccination, which so impressed several observers cited by P. Tierney, would be explained by the outbreak of wild measles rather than by an exacerbated reaction to the vaccine. (Lobo 2001: Section 6. My translation TT)
When measles broke out within a few days of the arrival of the expedition and closely following the vaccinations, Neel and the other members of the expedition were surprised and bewildered. Under enormous pressure and without any clear understanding of what was happening, Neel tried to do the impossible: attend to the urgent medical needs of the Yanomami while continuing to carry out he most important parts of his research program. He cut out some of the less important research tasks to make more time to attend to medical needs while keeping to his previously planned itinerary. He and his medical personnel made great efforts wherever they were to vaccinate and care for those suffering from the reactions to the vaccinations and the measles itself. They used up all their vaccine, vaccinated virtually everyone in all the communities through which they passed, and doubtlessly saved many people. If they had been willing to make more serious changes in their planned itinerary so as to vaccinate more villages upon their first arrival, or had devoted more attention to planning and preparing to deal with the epidemic when it should arrive, they could certainly have saved more, and perhaps stopped the spread of the epidemic, at least in their region. As it was, as the Brazilian report puts it,
...the ill-preparedness of the team for dealing with the serious complications of measles, mainly pneumonia [contributed to] the lack of control over mortality.
Neel wrote several times in his journal of how great a burden the vaccinating and other medical work had become, because it was taking too much of the expedition personnel’s time away from their research tasks. In planning for the last part of the trip, at the village of Patanowatedi, he wrote of the need to set firm priorities for the various research tasks, starting with the collection of blood samples, and only after completing all the rest of these higher-priority duties "then inoculate--if at all". From these and other entries in his field journal, it is clear that Neel felt an overriding responsibility to fulfill the scientific goals of the expedition, including the granting agency (the AEC) and the laboratories at IVIC and the CDC in Atlanta that had agreed to process his specimens. That he did fulfill the expedition’s main goals of specimen collecting the under the terrible and chaotic conditions of the epidemic attests to his effective leadership, but also his unwillingness to sacrifice more of his research program to the special needs of helping the Yanomami get through the epidemic by moving faster at the outset to complete the immunizations before the epidemic would arrive.
In the event, NeelÔs first act upon finally arriving at the village of Patanowatedi. was to vaccinate everyone he could get his hands on, although, as he noted in his journal, he "hated to do it". This was in direct contradiction to his draconic ordering of research priorities for Patanowatedi written 16 days earlier (Feb. 5, in DOC 1:80, quoted above), in which he called for leaving vaccinations until last, or perhaps skipping them altogether. The reason for his 180 degree reversal of priorities was that he knew that two Yanomami from Patanowateri had arrived together with the expedition from Mavaca, where they had been exposed to the measles. Neel had written in his journal that "in a surfeit of conscience" he had decided to leave four Patanowateri guides behind in Mavaca because of their exposure to measles there. Instead, he declared his intention to take guides from Patanal. When he got to Patanal, however, he found that the population had fled in fear of the epidemic. Unable to locate Patanowateri without guides, Neel ultimately compromised with his conscience and sent Chagnon back to pick up two of the exposed guides from Mavaca (DOC 1: 105-6,20 Feb.). He remarks that they now "might as well take [the trade goods] since measles carriers are with the Pats anyhow" (DOC 1: 106, 20 Feb.). Having overcome his "surfeit of conscience" by bringing the exposed guides after all, he tried to make up for it by vaccinating everyone in the village immediately upon arriving (everyone, that is, but infants and very old or very sick people, considered too weak to withstand the reaction to the vaccine, but therefore also especially vulnerable to measles...)
This is not the portrait drawn by Tierney of an amoral experimenter indifferently putting at risk the lives of his subjects, but it is certainly that of a man capable of compromising what he himself recognized as ethical standards ("conscience") for the sake of his research where necessary. The real story of Neel and the 1968 epidemic that emerges from Neel’s papers is that of a tragic collision between the institutional requirements of big-time scientific research --"Big Science"--as implemented by a conscientious and hard-driving scientific bureaucrat, and the medical needs of a people defenseless against an alien epidemic that threatened to wipe most of them out. Neel agonized but held firm to what he saw as his obligation as leader of the expedition to fulfill its scientific mission, foregoing a more rapid, and therefore more effective response to the medical needs of stopping the spread of the disease. Sitting in a motor launch on the Orinoco toward the end of the expedition, debating whether to risk going into the village of Patanowateri and becoming trapped there if measles were to break out and incapacitate their carriers, Neel wrote the following entry in his journal:
The leadership role under these difficult conditions is complicated by the fact that I am incompetent in the two key languages, and do not claim to know the Indians as well as Nap nor the jungle as well as Chas. However, certain basic principles do come out at times like this...we have such a lab setup behind us--something not all the crew recognizes--that we must get specimens.(DOC 1:Feb 20, p. 106)
The passage makes clear that Neel felt driven not merely by personal commitment to his research goals but by his "recognition" (which he felt was not shared by all of his colleagues) that the whole massive research apparatus that he had set up, with the arrangements for cooperation with the labs at the CDC and IVIC, and of course the big grant from the AEC, constituted an institutional imperative, a "basic principle" that it was the essence of his "leadership" role to uphold. It was this institutional complex, as he tells himself, that imposed the overriding priority to "get specimens".
In the end Neel managed to vaccinate almost all of the people within range, but not promptly enough, according to the Brazilian medical team’s reconstruction, to arrive within three days of exposure to the virus, after which the vaccination would no longer have given protection. The result was that the epidemic was not arrested, and "mortality was not controlled", in the words of the Brazilian medical team’s report. It was the slowness with which the vaccination team moved, not the failure to vaccinate everyone, that was in the opinion of the Brazilian medical experts the decisive factor in the failure of the AEC expedition to arrest the measles epidemic.
In conclusion, it seems to me that both Tierney and Neel’s partisans on the web, with their defense of "science", miss the real story of the 1968 Yanomami tragedy, in complementary but opposite ways. Tierney’s account tries to explain what happened as the result of Neel’s idiosyncratic personal motives, as a rogue scientist engaged in amoral human experiments. Tierney does attempt to bring in Neel’s institutional association with the AEC as relevant background, but its specific relevance is never conclusively explained. Many of Neel’s defenders, on the other hand, have rushed to repudiate the criticisms of Neel and his junior colleague, Napoleon Chagnon, by Tierney and others, as attacks on "science", by "moralists" or "activists" supposedly hostile to science, logic and empirical data.
The basic problem with both sides is that neither grasps the relevance of the fact that "science" on the scale of the AEC Orinoco expedition cannot be grasped simply as an ideal system of abstract truths, nor still less as an activity of autonomous individual scientists. It must rather be understood as a complex social activity, shaped by the collective institutions and socio-political conditions that make scientific research possible. The actions of individual scientists as they conduct their research are consrained by the historical, institutional and economic forces on which they and their research depend. This is all the more true when the scientific project in question is a collective effort of the scale of the AEC Orinoco expedition, requiring large amounts of money and resources dependent on a network of government agencies, universities, and laboratories. The relative priority Neel attached to the fulfillment of what he deemed to be the essential parts of his research program-- a study of the Yanomami as a biological population--and his maintenance of this order of priorities over the medical needs of the Yanomami as a people after the arrival of the epidemic, is to a large extent a function of the constraints under which he, as leader of the expedition, was placed by the institutional requirements, organizational pressures and expectations of government-funded Big Science. As Neel wrote, it was the infrastructure of laboratories that had been set up to process their field collections that meant that "we must have specimens". Neel saw himself as the bearer and enforcer of these impersonal institutional imperatives, even as he also recognized, and tried within the limits of his institutional commitments to fulfill, his humanitarian medical obligation to help the Yanomami.
The result was that for Neel, the institutional and economic requirements of scientific research, together with the research goals of the collective effort, took precedence over (although they did not exclude) humanitarian medical concerns. This had fateful results for the Yanomami. These results can be understood as the outcome of a tragic conflict between two altruistic commitments: the medical commitment to give help to fellow human beings in immediate and desperate need, and the impersonal commitment to scientific research that Neel doubtless hoped would in the long run benefit humanity at large. At the same time, one can disagree on ethical grounds that the long range benefits to science and humanity as a whole from a big research project like the AEC Expedition justify the expedition’s failure to render more effective short range assistance to the communities with which it was carrying out its research, while they stood in imminent danger of medical catastrophe on the order of a virgin soil measles epidemic. The way Neel and his colleagues split the difference between these commitments was an ethically fraught choice. It is not one that could be made in the same way by a contemporary anthropological researcher. The language of the American Anthropological Association’s Code of Ethics is unambiguous on this point:
Anthropological researchers have primary ethical obligations to the people, species and materials they study and to the people with whom they work. These obligations can supersede the goal of seeking new knowledge, and can lead to decisions not to undertake or to discontinue a research project when the primary obligation conflicts with other responsibilities, such as those owed to sponsors or clients. (Clause III.A.1.)
Could recognition of the sui generis ethical problems posed by the social dynamics and institutional pressures of large-scale scientific research projects serve as a common ground on which the advocates of "science" (conceived purely in abstract terms as organized knowledge) and the advocates of human subjects’ rights and indigenous peoples’ rights, who have been on opposite sides in the Yanomami controversy, could come together? Both sides should be able to recognize that there is no argument among us about the value of science in the abstract; could we not agree in recognizing that it is the social aspect of science as a bureaucratic project that became the decisive issue in the 1968 Yanomami tragedy? Such a consensus might even be able to produce some positive suggestions; For example, It might well have helped, in the situation Neel and the AEC expedition faced in February 1968, if there had been an interdisciplinary research convention along the lines of the clause of the AAA Code of Ethics quoted above recognizing the ethical obligation of researchers to give first priority to medical assistance in collective medical emergencies such as epidemics, and enjoining granting agencies to consider favorably requests for funding extensions of field stays to compensate for time lost in emergency medical assistance.
In conclusion, we come to the issue of informed consent. The discussion among ourselves thus far has focused on the question of whether there was a lack of informed consent in the AEC Orinoco Expedition of 1968, and if so, whether such a lack might have been justified under the circumstances. I must say that I fully agree with Albert’s position on this question. It seems to me, however, that there are two additional issues that arise in the context of the Yanomami situation that have not yet been confronted by our discussion but that should be included under this heading. They are those of misinformed consent and prevarication (as a time-release mode of lack of informed consent).
Firstly, concerning misinformed consent. It is not only ethically incumbent on researchers to inform human experimental subjects as accurately as possible of the research reasons for the experimental procedures they propose to carry out, but also not to misrepresent the reasons for the procedure, and the nature of the procedure itself, so as to secure consent. In the case in question, it appears that the spokesperson or persons of the AEC expedition led the Yanomami to believe that the collection of biological specimens either was itself a medical measure or would be of medical benefit to the Yanomami. According to Raymond Hames in his second round paper in the Yanomami Round Table (Borofsky 2001), Chagnon told him that during the year before the arrival of the AEC expedition in 1968, he told Yanomami that the collection of biological specimens would benefit them medically. Tierney also records Chagnon as claiming that the sampling was for the medical benefit of the Yanomami. This claim was plainly intended to secure their assent to the taking of blood and other biological samples, as well as the support of missionaries for this effort(Tierney 2000: 37,44). These claims were all of course untrue. Tierney also records the consternation of missionaries who had known Chagnon upon learning that the sampling was done for research purposes, whereas Chagnon had "always sounded so interested in helping the Yanomami" (Tierney 2000:45). In contrast, as Tierney says, the Department of Energy "did not pretend that [the sampling] benefitted the Yanomami in any way." (Tierney 2000:43)
The second of the additional issues that must be raised is that of prevarication: the omission of an important piece of information about the future consequences of an action that might well have led the Yanomami to be unwilling to cooperate if it had been made clear. I refer to the failure to inform the Yanomami that the blood specimens would be stored indefinitely for future research purposes, potentially outlasting the lives of the donors, rather than being disposed of immediately as they would have been if they had been merely part of emergency medical procedures. This entailed violating Yanomami cultural prescriptions for destroying and ingesting the bodies of the deceased. The failure to reveal this aspect of the intended use of the specimens, which can only have been deliberate, has emerged as a hot-button issue among contemporary Yanomami.
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