Jonathan Smith filmed, edited, and directed the film They Go to Die. He is a graduate student at Yale University where he studies epidemiology of TB and HIV in the context of migrant populations, specifically South African gold miners. For his extensive work as an ethnographic researcher and for creativity in the field of global health, he was awarded the Yale University Global Health Leadership Institute Field Experience Award in 2010 and the distinguished Lowell S. Levin Award for Excellence in Global Health from Yale University in 2011. Since he began researching the issue, he has been invited to speak on the intersection of TB, HIV, and human rights at universities both domestically and internationally.
Before his research on this topic, he graduated with a Bachelors of Science in Biology and Chemistry from the University of Georgia. Soon after graduation, he began his global health work in South America, where he developed hepatitis B vaccination strategies for rural communities. It was this experience that brought him to the realization that many public health matters cannot simply be captured by traditional methods such as surveys and interviews, and created in him an appreciation for the concept of immersion into the very community at risk for disease.
In regards to his ethnographic research, Smith writes, “A narrow focus on a typically broad public health matter affords us the extremely important opportunity to add nuance as well as levels of depth and complexity to our understanding of broader health patterns and vulnerabilities. You must not undermine the richness of depth and explanatory detail that such microanalysis can afford to an understanding of the contextual dynamics and contradictions that influence health behavior.”
Jonathan can be reached by email at: firstname.lastname@example.org
By Jonathan Smith
Numbers form the foundation of public health. But in a sense, public health is overrun by the very numbers that strengthen the field. We take individuals and we group them, we stratify them, divide them, compare them. But we never identify them. There are actually stringent rules in place to ensure that the identities of our research subjects are completely erased: we reduce them to a number.
This can be appropriate in some contexts, and the importance of numbers in public health cannot be overstated. Numbers possess the power to create policy and shape rhetoric, all of which are activities that are hopeful attempts to create change for the better. What happens, though, when this political rhetoric falls on deaf ears? What happens when the numbers that we so adamantly defend in public health fall short in producing any true value to the people who are affected by the diseases that we study?
I came to realize the limitations of traditional research when I received an email from the National Union of Mineworkers in regards to a research proposal: “I should also caution you that there has been an outcry about never ending researches that are done within the mining sector and the people end up feeling like guinea pigs of some sort without seeing or benefiting from the outcomes thereof.” What is the point of research if there is no real benefit? For well over a century, gold miners have been sent home with diseases and left to die. That is the bottom line. Today, little has changed except the rhetoric and numbers that highlight the situation. I became acutely aware that the end result of any research conducted on this issue is that miners continue to die.
Does an individual’s story have a role in public health? In almost all cases, the public health community says no. Maybe because storytelling is very political, it all depends on who is telling it and how it is told; how the author wants to convey his point. If I told you the story of Godzilla backwards, it would be about a moonwalking dinosaur that rebuilds Japan. So in this sense, storytelling has failed to catch on in academic discourse. Does that mean it fails to have academic rigor? Of course not. It is simply discarded as such because numbers are much more comfortable. In the context of gold mining in South Africa, the same story of TB in the mining industry has been heard for over a century. In this case, numbers have failed us; there is no comfort. They get us no where. In turn, stories are all that remain.
People, in fact, are not numbers. They are, as I last checked, people. They have human characteristics. Living with the families of miners in South Africa, I learned that poor, black, former gold mine workers are no different from anyone else. But all too often, we look upon them as “them,” as in “Not Us” or “Other.” This is done for reasons I cannot yet understand. They have lives. They have senses of humor. They have arguments with their sons about playing music too loud. They have wives who they love, and who they fib to about liking their cooking. To the rest of the world these men disappear, but to their family and community these men are ever present. Unfortunately, as the numbers on this subject all too eagerly tell us, the end result is always death. A pointless, needless death; TB is curable and easily preventable. HIV is preventable and treatable. The solution to damming this river of disease that flows back into these men’s homelands as a result of this situation is not rocket science: treat the patient with TB until he is cured.
I hope They Go to Die provides a unique and never-before-seen perspective on this issue from the view of the person most affected by it, the person at the center of it: the former miner. By examining this issue from this perspective, I hope my film offers an in-depth, unbiased understanding of the complex legal, health, and human rights questions surrounding this preventable tragedy.