Explorations the Journal of Undergraduate Research and Creative Activities for the State of North Carolina

Volume V, 2010 Explorations The Journal of Undergraduate Research and Creative Activities for the State of North Carolina

www.uncw.edu/csurf/explorations.html

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Center for the Support of Undergraduate Research and Fellowships UNCW Honors Scholars Program Randall Library, room 2007 University of North Carolina Wilmington Wilmington, NC 28403 copyright © 2010 University of North Carolina Wilmington

Cover photographs: “Night Falls on the Capitol” © Alison Gantt “Dogwood Blossom” © Ken Slade “Charlotte Night” © Tony Shi

ISBN: 978-0-9845922-1-0

Produced in The Publishing Laboratory Department of Creative Writing 601 South College Road Wilmington, North Carolina 28403 www.uncw.edu/writers Staff

Editor-in-Chief Katherine E. Bruce, PhD Director, Honors Scholars Program and Center for the Support of Undergraduate Research and Fellowships Professor, Psychology University of North Carolina Wilmington Graduate Assistants Emily Beamon Department of Psychology University of North Carolina Wilmington Rebecka Brasso Department of Biology and Marine Biology University of North Carolina Wilmington Katherine Webb Department of Creative Writing University of North Carolina Wilmington Designer Brittany Creech Department of Creative Writing University of North Carolina Wilmington 2010 Board of Reviewers William Atwill, PhD Eric Jones, PhD Associate Director of Honors Research Scientist in Anthropology Associate Professor of English University of North Carolina Greensboro University of North Carolina Wilmington Jeanne Kemppainen, PhD Michael Benedetti, PhD Professor of Nursing Associate Professor of Geography University of North Carolina Wilmington University of North Carolina Wilmington Mark McCallum, PhD Nicola Davis Bivens, PhD Professor of Biology Assistant Professor of Criminology Pfeiffer University Johnson C. Smith University Louis F. McIntyre, PhD Francie Cuffney, PhD Instructor of Biology Professor of Biology Robeson Community College Meredith College Granetta Richardson, PhD Rebecca Duncan, PhD Senior Lecturer in Film Studies Professor of English University of North Carolina Wilmington Meredith College Reeves Shultad, PhD Carol Dykers, PhD Associate Professor, Hayes School of Music Associate Professor of Communication Appalachain State University Salem College Debra Terrell, PhD Elizabeth Fournier, PhD Assistant Professor of Psychology Assistant Professor of Political Science Johnson C. Smith University St. Augustine’s College Betty Witcher, PhD Steven Fulks, PhD Associate Professor of Psychology Associate Professor of Gerontology Peace College Barton College Sara Wrenn, PhD Tom Hennessey, PhD Assistant Professor of Psychology Associate Professor, Government & History Bennett College for Women Fayetteville State University Margaret Young, PhD Blake Hobby, PhD Assistant Professor of Biology Director, Honors Program Elizabeth City State University Assistant Professor in Literature and Language University of North Carolina Asheville Timothy Holley, PhD Director, Honors Program With special thanks and appreciation Associate Professor of Music to the faculty mentors and volunteer North Carolina Central University blind reviewers. Table of Contents

vii Letter from the Editor Biological, Earth, and Physical Sciences

3 Identification of Ginsenosides in American Ginseng Seedlings Hannah Ainsworth with Rachana Gyawali, L. Tiara Murphy, and Smriti Sharma

12 The Effects of Maternal Systemic Lupus Erythematosus on the Developing Fetus Endya Frye Humanities

29 From Freedom to Bondage: The Jamaican Maroons, 1655-1770 Jonathan Brooks

40 America’s Changing Mirror: How Popular Music Reflects Public Opinion During Wartime Christina Tomlinson Social Sciences

65 Forms of Social Support by Non-Relatives in Emergency Situations: Ecuador Brittany Burke

80 Defining Barriers to Acceptance of Westernized Medicine Among Montagnard Refugees Margeaux Corby

95 Ocular Health Knowledge Modifications Diana Gliga

109 A Game-Theory Analysis of US Efforts to Curb the Colombian Cocaine Trade Saumil Jariwala

128 Building Community Capacity in Resource-Poor Neighborhoods: Community-University Partnerships Kimberly Lancaster and Amanda Smith with Lindsey Carrier, Janna Dick, Elizabeth Dodson, Hillary Geen, Jessica Glovas, Lacey Hancock, Erin O’Donnell, and Allison Whitley 151 About the Student Authors 154 About the Faculty Mentors 157 Submission Process About the Student Authors Letter from the Editor About the Faculty Mentors e a r e d e l i g h t e d t o p r e s e n t v o l - perspectives on society and history. Brooks Submission Process W ume V of Explorations. Explorations examines the historical evidence related to is a unique publication; many universities the persistent enslavement of the Jamaican have their own undergraduate research Maroons, while Tomlinson offers an exten- publications, but I believe this is the only sive critical review of popular music during state-wide undergraduate journal. Truly wartime. this is due to the state-wide commitment All the articles published in Explorations to enhancing the undergraduate experi- have been through several levels of review. ence—evident from the several years of Not only were faculty mentors reviewers well-attended State of North Carolina for the articles, but the mentors obtained Undergraduate Research and Creativity two “blind” reviews from colleagues in the Symposia (SNCURCS). field before the papers were even submitted. Volume V contains nine original ar- Further the members of the journal review ticles from students attending eight col- board evaluated the submissions over the leges and universities in North Carolina, summer. I thank all of these mentors and including one article from a senior at the reviewers for their time and dedication. North Carolina School of Science and Thanks to several people at UNCW for Mathematics. While the topics of the arti- their support: Dr. Cathy Barlow, Provost; cles this year are varied, a theme reflecting Dr. Johnson Akinleye, Associate Vice outreach to the community runs through Chancellor for Academic Programs; Ms. several of the articles. Four of the Social Emily Smith and her wonderful team at Science articles present data on outreach the UNCW Publishing Laboratory; Ms. efforts and cultural perspectives related to Rebecka Brasso, Explorations web page de- improving health care and social support. signer; and Ms. Katherine Webb, copy edi- These studies range from Lancaster, et al.’s tor; both graduate assistants for CSURF; the unique community-university partnership Center for the Support of Undergraduate to Gliga’s study of health behavior promo- Research and Fellowships; and Mr. Bo tion in Romania to Burke’s assessment of Dean, Ms. Carole Reynolds, and Dr. Bill acceptance of social support following di- Atwill for support day-to-day in the Honors saster among citizens of Ecuador to Corby’s Scholars Program office. We also appreci- analysis of barriers to effective Western ate the support of Dr. Courtney Thornton, medical treatment among Montagnard UNC General Administration, who has refugees in North Carolina. promoted undergraduate research at the The other five articles in this volume are state level and lobbied for both SNCURCS also quite innovative. Also in the Social and Explorations. As always thanks are due Sciences, Juriwala applies a game theory to Dr. George Barthalmus at NCSU, a de- approach to the study of drug trafficking. voted and unflagging advocate of under- The two articles in the Biological Sciences graduate research state-wide, who has kept the section present a review of maternal lu- mission of Explorations and SNCURCS strong. pus erythematosus by Frye and a report Enjoy volume V! on techniques to identify ginsenosides in ginseng plants by Ainsworth et al. In the History section, we have two unique Katherine E Bruce, PhD

vii

Biological, Earth, and Physical Sciences

Identification of Ginsenosides in American Ginseng Seedlings

Hannah Ainsworth with Rachand Gywali, L. Tiara Murphy, and Smriti Sharma Salem College Faculty Mentor: Nita Eskew Salem College

Ab s t r a c t Ginseng, a medicinal plant, is reported to provide a variety of health benefits. Ginsenosides are the biologically active compounds responsible for therapeutic attributes. Historically, ginseng roots have been considered the source of medicinal properties and are harvested for use. Because of their slow growth rate and increasing demand in global markets, American ginseng (Panax quinquefolius) roots are now protected by the Convention on International Trade in Endangered Species (CITES) of Wild Fauna and Flora. The use of ginseng’s perennial leaves instead of its roots would preserve existent plant populations. However, there are few studies comparing ginsenoside concentrations throughout the plant. For this reason, our primary research goal is to investigate the presence of six dominant ginsenosides in the leaves and roots of American ginseng grown in North Carolina. Ginsenosides were extracted from seedling specimens and then separated with high-performance thin-layer chromatography (HPTLC). Utilizing densitometer software, comparisons of ginsenosides on digitized TLC plates identified the presence and relative amounts of ginsenosides. Initial results have indicated higher amounts of total ginsenosides in leaves compared to roots in seedlings.

Introduction m e r i c a n g i n s e n g (Pa n a x q u i n q u e - the plant.2 These ginsenosides are linked to A folius) is a medicinal plant, and the numerous medicinal properties, including biologically active compounds responsible enhancement of learning and memory, re- for its therapeutic attributes are known as duction of anxiety and stress, and reduced ginsenosides (Figure 1).1 Ginsenosides are risks of cancer and diabetes.3 stored in both the root and leaf portions of

3 Explorations | Biological, Earth, and Physical Sciences

With such diverse pharmacological Measures could be taken to investigate properties associated with the plant, the whether a larger market can be developed demand for ginseng roots has increased. to include American ginseng leaves. Wild- The average annual export of wild ginseng harvesters could be discouraged from over- roots from 1999 to 2004 was approximately harvesting wild mature and immature roots; 68,688 dried pounds.4 To obtain such a high instead, they could harvest the leaves so the yield of ginseng roots, an average of 19 mil- roots could continue to grow. Using the an- lion ginseng plants were harvested (an aver- nually grown leaves would preserve ginseng age of 284 roots per pound) in 19 approved plant populations from harvest to harvest. states.4 For the past 10 years, the average If the leaves have sufficient concentrations price of wild and wild-simulated (which of ginsenosides, they could be utilized in mimic growing conditions of wild ginseng)5 an array of value added products, such as American ginseng roots was $350/dry supplements and energy drinks. pound.6 However, in 2008 the annual har- The presence of ginsenosides has been vest of wild American ginseng was 59,537 detected in the leaves of P. quinquefolius. pounds.5 This decreased supply increased One study of ginseng in British Columbia the price per pound. Overharvesting wild found ginsenosides in the leaves of four- populations of ginseng plants has adverse year-old plants by high performance liq- long-term effects on ginseng as it has a uid chromatography.8 Another study inves- “slow growth rate, a long pre-productive tigated ginseng from wild populations in period (approx. three to eight years), low Ontario, Quebec, Maine, Vermont, and fecundity, and high seed and seedling mor- Wisconsin. In these plants, the leaves were tality.”4 In addition to the high prices paid found to contain an “appreciable amount for wild and wild-simulated ginseng roots, of ginsenosides.”2 While these studies used the high rate of unemployment in North older ginseng plants that were grown out- Carolina (11.1% as of March 2010)7 has side of the North Carolina region, based increased poaching.5 Furthermore, the on their results, ginsenosides were expected poor economy has driven less experienced to be detected in the seedling leaves we harvesters to practice unsustainable har- harvested. Thus, to investigate the relative vesting, meaning that they often harvest amount of ginsenosides in the leaves and less mature plants and fail to replant seeds roots of American ginseng grown in North from mature plants.5 Carolina, this project examines extracts using HPTLC and densitometer analyses, which provide a method of simultaneous analysis of multiple American ginseng samples.

Me t h o d s

For leaf and root extractions, this project utilized American ginseng seedling populations grown in western North Carolina at North Carolina State University’s Mountain Horticultural Crops Research and Extension Center (MHCREC). At the MHCREC, seeds were planted in a cultivated plot or a wild-simulated plot on January 30, 2009, to explore any differences between growing conditions.9 The

4 Hannah Ainsworth cultivated plot was shaded artificially and received regular watering and maintenance, as utilized on farms. In contrast, the wild-simulated plot received no interference that would alter wild growing conditions. Planted seedlings were randomly collected during one of four harvest dates: June 2, June 5, July 27, or August 24 of 2009. American ginseng seedlings harvested from the wild-simulated and cultivated plots were individually analyzed. The extraction protocol was performed on roots and leaves separately. Forty milligrams were crushed and sonicated in absolute ethanol and then filtered. Using the CAMAG Linomat 5 instrument,10 concentrated bands of the extracted samples were precisely applied onto a glass TLC plate (Merck, Silica gel 60

F254). For identification, a mixture of gin- depicting the relative intensity versus the senoside standards containing Rb1, Rb2, Retention Factor (Rf) value, the distance Rc, Rd, Re and Rg1 of concentration 0.2 travelled by the compound relative to the mg/mL was also spotted on each plate as distance travelled by the solvent. shown in Figure 2. Ginsenoside standards, purchased from ChromaDex (Irvine, CA), Re s u l t s a n d Di s c u s s i o n were dissolved in absolute ethanol. The plates were placed in a chamber with Each seedling was documented according an elution solution of chloroform, ethyl to plot location, harvest date, and mass. acetate, methanol, and water in a ratio of The largest, smallest, and average mass val- 7.5/20/11/4.5, respectively. For quanti- ues for each harvest time and plot location tative analysis via densitometer software, are listed in Table 1. Heavy rains in spring it was important for the HPTLC plates 2009 encouraged fungal growth on the cul- to exhibit maximum separation between tivated plot seedlings. components without losing the clarity of As a result, this seedling population was individual bands, and this was achieved harvested in June before significant plant with an elution distance of 87 mm. Once damage occurred; 33 seedlings were col- the solvent reached the predetermined elu- lected. The August-harvested, wild-sim- tion distance, the plate was derivatized with ulated seedlings yielded the highest aver- a 10% sulfuric acid in methanol solution. age mass, which is expected given they Plates were then heated in a 100 oC oven had the longest growing period. Seedlings for 10 minutes and subsequently scanned. that represented the largest, smallest, and To identify ginsenoside compounds, the average masses for a particular harvest scanned plate-images were analyzed by date and plot location were photographed UN-SCAN-IT densitometer software. This for documentation as shown in Figure 3. program measures the relative intensity of compounds on the TLC plate by measur- Pr e s e n c e o f Ginsenosides in Se e d l i n g s ing the number of pixels in each band. The UN-SCAN-IT software converts the TLC Once extraction had been performed on data into a chromatogram of each lane the leaves and roots for individual 2009

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Comparisons between ginsenosides in the roots and leaves are represented in Figure 6. In the four analyzed seedlings, ginsenosides Rb2, Rd, and Re were measured to have higher relative quantities in the leaves than the roots. These findings were similar to results from the study by Assinewe et al. who found high amounts of Rb2, Rd, and Re in their tested leaves.2 The greatest difference between root and leaf ginsenoside concentrations was shown in Rb2. While all seedling leaves exhibited high amounts Figure 3. Photographic documentation of seedlings. of Rb2, the roots contained far less in From left to right, the smallest, largest, and average seedlings by mass. concentration; and, in Seedlings A and D, Rb2 was not detected in the root extracts. harvested seedlings, four seedlings (desig- These high concentrations of Rb2 in seed- nated Seedlings A, B, C, and D) were ana- ling leaves also coincided with findings by lyzed via densitometer analysis of HPTLC Assinewe et al. who found Rb2 in “sub- plates. Seedling A was harvested in June stantial amounts” in their mature ginseng from the wild-simulated plot. Seedling B leaves.2 Three (A, C, and D) of the four was harvested in August from the wild- seedlings yielded higher relative amounts simulated plot. Seedling C was harvested in of Rc in the root extract than in the leaves; June from the wild-simulated plot. Seedling and in Seedling A, Rc was below the limit D was harvested in June from the cultivated of detection in the leaf extract. plot. By spotting the standard ginsenoside mixture on each TLC plate, ginsenosides in Reproducibility o f Da t a the extracts were identified by comparing their chromatograms to the standards. This Duplicated TLC lanes are expected to yield is illustrated in Figures 4 and 5 where the the same values. To evaluate reproducibil- root and leaf extracts from Seedling A are ity, the densitometer data were examined compared to the standard ginsenoside mix- for variations between duplicated lanes in ture by superimposing the chromatograms. the leaf, root, and standard extracts. When A summary of the densitometer’s detection analyzed, the TLC plates for the four tested of ginsenosides (measured in pixels x 10-3) seedlings exhibited different ginsenoside for the four seedlings is shown in Table 2. quantities between duplicated lanes. Figure (Continued on page 8.) Harvest Plot Location Seeding Largest Smallest Average Date Count Mass (g) Mass (g) Mass (g)

06/05/09 Wild-Simulated 15 0.122 0.057 0.091 ± 0.017 06/02/09 Cultivated 33 0.242 0.057 0.129 ± 0.041 07/27/09 Wild-Simulated 15 0.152 0.057 0.103 ± 0.027 Cultivated ------08/24/09 Wild-Simulated 16 0.191 0.088 0.134 ± 0.028 Cultivated ------

Table 1. Summary of Ginseng Seedlings Harvested in 2009

6 Hannah Ainsworth

Seedling A Sample Type Leaf Standard Root Lane 1 Lane 2 Lane 1 Lane 2 Lane 1 Lane 2 Plot Location Wild-Simulated ---- Wild-Simulated Harvest Date June 2009 ---- June 2009 Ginsenosides Relative Quantities (Pixels x 10-3) Rb1 5.323 4.439 9.949 8.976 6.561 6.016 Rb2 38.825 39.555 13.032 13.659 0.000 0.000 Rc 0.000 0.000 11.093 10.957 6.253 5.856 Rd 37.476 35.035 10.391 11.259 15.485 14.788 Re 22.447 18.778 7.079 7.308 6.722 7.241 Rg1 9.897 9.349 10.363 11.517 5.050 5.667

Seedling B Sample Type Leaf Standard Root Lane 1 Lane 2 Lane 1 Lane 2 Lane 1 Lane 2 Plot Location Wild-Simulated ---- Wild-Simulated Harvest Date August 2009 ---- August 2009 Ginsenosides Relative Quantities (Pixels x 10-3) Rb1 32.101 33.983 23.535 24.673 19.892 15.706 Rb2 65.044 59.195 29.923 28.060 6.701 7.177 Rc 23.420 24.859 27.843 12.332 10.482 9.992 Rd 38.604 39.970 25.582 23.036 28.060 22.922 Re 45.690 46.980 23.066 22.233 12.332 10.852 Rg1 8.150 9.443 21.866 23.738 5.487 4.890

Table 2. Data for each of the four tested American ginseng seedlings (Seedlings A, B, C, and D). The two columns for each leaf extract, standard, and root extract show the data for their respective duplicated lanes on the TLC plates. Table 2 continued on page 8.

7 Explorations | Biological, Earth, and Physical Sciences

Seedling C Sample Type Leaf Standard Root Lane 1 Lane 2 Lane 1 Lane 2 Lane 1 Lane 2 Plot Location Wild-Simulated ---- Wild-Simulated Harvest Date June 2009 ---- June 2009 Ginsenosides Relative Quantities (Pixels x 10-3) Rb1 20.771 22.974 16.120 16.581 12.361 13.970 Rb2 54.225 70.708 22.781 22.642 2.248 8.971 Rc 2.793 3.061 23.813 23.858 5.626 7.736 Rd 25.007 25.987 24.980 24.758 19.467 19.122 Re 54.860 54.520 17.046 21.423 18.638 18.936 Rg1 5.747 4.955 24.677 24.914 9.703 10.699

Seedling B Sample Type Leaf Standard Root Lane 1 Lane 2 Lane 1 Lane 2 Lane 1 Lane 2 Plot Location Cultivated ---- Cultivated Harvest Date June 2009 ---- June 2009 Ginsenosides Relative Quantities (Pixels x 10-3) Rb1 12.914 8.794 27.872 27.135 14.756 16.797 Rb2 51.920 62.076 33.718 36.936 0.000 0.000 Rc 8.885 8.172 32.252 31.739 13.061 12.644 Rd 36.987 44.145 26.012 23.866 33.973 36.110 Re 19.554 21.465 22.464 20.492 16.578 16.314 Rg1 6.594 8.942 27.026 26.575 6.585 6.886 Table 2. Continued from page 7.

6 shows bar graphs illustrating data for du- ginsenoside standards. However, varia- plicated lanes. tions in pixel intensity were observed be- Table 3 summarizes the percentages of tween duplicated TLC lanes. Although this difference between duplicated lanes for variation did not appear to significantly tested seedlings. The average percentages affect ginsenoside comparisons between of differences between duplicated lanes roots and leaves, the reproducibility of for Seedlings A, B, C, and D were 6.92%, the densitometer data must be further in- 11.45%, 25.36%, and 10.34%, respec- vestigated. When using the densitometer tively. The data highlight concerns about software, some bands with closer Rf val- the reproducibility of data as varied results ues were grouped together into one peak between duplicated lanes indicate the pres- despite their visual separation on the TLC ence of inconsistencies during HPTLC or plates as shown in Figure 2. These peaks densitometer analysis. had to be hand-defined, which introduced For the tested seedlings, ginsenosides a source of human error. Consequently, were successfully extracted and identified this may have contributed to the variations in the leaves and roots by comparison to found between duplicated lanes. Examples

8 Hannah Ainsworth

Figure 6. Densitometer data of duplicated lanes for each seedling.

Sample Plate Average Maximum Difference Minimum Difference Value Lane Value Lane Seedling A 6.92 16.61 Rb1-Leaves 1.23 Rc-Standard Seedling B 11.45 55.71 Rc-Standard 2.82 Re-Leaves Seedling C 25.36 37.50 Rc-Roots 0.19 Rc-Standard Seedling D 10.34 35.61 Rg1-Leaves 1.59 Re-Roots Table 3. Summary of the percentages of difference between densitometer-analyzed duplicated bands.

of grouped bands on the TLC plate for Fu t u r e Wo r k Seedling A are shown in Figure 7 (located on page 10). Future goals include comparing the densi- Because many of the densitometer's tometer’s pixel analysis to liquid chromatog- peaks needed to be individually defined, it raphy (LC) data as a means to determine the introduced an element of uncertainty dur- correlation of pixels to absolute concentra- ing analysis of TLC bands. An improved tion. By comparing the densitometer data densitometer program that provides better to LC data, the limit of detection will be as- automated band-distinguishing capabili- sessed. In addition, generating TLC plates ties for TLC plates would help resolve data with triplicate lanes would enable us to statisti- discrepancies between duplicated lanes in cally analyze reproducibility. Once confident our samples. To date, two densitometer in the reproducibility of data, all seedling ex- programs have been tested, and although tracts will be quantitatively analyzed. From we are currently using the best of the two, these data, we will investigate the impact of other programs should be investigated for harvest date, growing conditions, and plant future use. age on ginsenoside concentrations.

9 Explorations | Biological, Earth, and Physical Sciences

Co n c l u s i o n s program. However, we will continue our investigation for a reproducible means of Using this ginsenoside extraction and quantitatively assessing ginseng concentra- HPTLC protocol, we confirmed that the tions on TLC plates, as it provides an ef- methods are suitable for extracting and ficient way to compare multiple seedling detecting ginsenosides in our sample of extracts simultaneously. An established tool American ginseng seedlings. When com- for quantification, such as liquid chroma- paring the roots to the leaves, we found tography, would allow comparison of rela- that ginsenosides Rb2, Rd, and Re are tive TLC measured ginsenoside quantities found in higher concentrations in seedling to ginsenoside concentrations in the roots leaves which coincided with previously and leaves, thus enabling the study of leaves published research.8 There are quantitative as a potential renewable source of ginseno- limitations with our chosen densitometer sides for ginseng value added products.

Leaf Extract Root Extract

Standard Mixture Figure 7. Chromatograms of Seedling A

Ac k n o w l e d g m e n t s

We would like to thank Jeanine Davis, Ph.D., NC Specialty Crops Program Coordinator; and Amy Hamilton of the North Carolina State University Mountain Horticultural Crops Research and Extension Center, Mills River, North Carolina; Charles Pate, Ph.D. and George McKnight, Ph.D. of the Salem College Chemistry Department; Jennifer Cruse- Sanders, Ph.D., Director of Research and Conservation at the Atlanta Botanical Garden, Atlanta, Georgia; and all of the Salem alumnae who have dedicated their time and effort during the initial stages of American ginseng research at Salem College.

10 Hannah Ainsworth

Wo r k s Ci t e d

1 Corbit, R. M.; Ferreira, J. F. S.; Ebbs, S. D.; Murphy, L. L. Simplified Extraction of Ginsenosides from American Ginseng (Panax quinquefolius L.) for High- Performance Liquid Chromatography-Ultraviolet Analysis. J. Agric. Food Chem. 2005, 53, 9867-9873.

2 Assinewe, V.A.; Baum, B. R.; Gagnon, D.; Arnason, J.T. Phytochemistry of Wild Populations of Panax quinquefolius L. (North American Ginseng). J. Agric. Food Chem. 2003, 51, 4549-4553.

3 Banz, W. J.; Iqbal, M. J.; Bollaert, M.; Chickris, N.; James, B.; Higginbotham, D. A.; Peterson, R.; Murphy, L. Ginseng modifies the diabetic phenotype and genes associated with diabetes in the male ZDF rat. Phytomedicine 2007, 14 (10), 681-689.

4 Gabel, R. Non-detriment finding on CITES export permit applications for wild and wild-simulated American ginseng harvested in 2006-2008, 2006. United States Department of the Interior, Fish and Wildlife Service Web site. 11 Aug. 2010. http://www.fws.gov/international/DMA_DSA/CITES/plants/ pdf/2006ginsengfinding.pdf.

5 Gram, R. General advice for the export of wild and wild-simulated American ginseng (Panax quinquefolius) harvested in 2009 and 2010 from States with approved CITES Export Programs, 2009. United States Department of the Interior, Fish and Wildlife Service Web site. 7 April 2010. http://www.fws.gov/international/ DMA_DSA/CITES/pdf/Ginseng%20NDF%202009-2010.pdf.

6 Carroll, C.; Apsley, D. Growing American Ginseng in Ohio: An Introduction. Ohio State University Extension Fact Sheet F-56-04. The Ohio State University School of Natural Resources Web site. 26 April 2010. http://ohioline.osu.edu/ for-fact/0056.html.

7.Regional and State Employment and Unemployment, June 2010. United States Department of Labor, Bureau of Labor Statistics Web site. 26 April 2010. http://www.bls.gov/news.release/laus.nr0.htm.

8 Li, T.; Mazza, G.; Cottrell, A.; Gao, L. Ginsenosides in Roots and Leaves of American Ginseng. J. Agric. Food Chem. 1996, 44, 717-720.

9 Persons, W.S.; Davis, J.M. Growing & Marketing Ginseng, Goldenseal & Other Woodland Medicinals, Bright Mountain Books: Fairview, NC, 2005; pp 47-92.

10 CAMAG, Wilmington, NC. Application notes F-32, HPTLC identification of American ginseng. 11 The Effects of Maternal Systemic Lupus Erythematosus on the Developing Fetus

Endya Frye North Carolina Agricultural and Technical State University Faculty Mentor: Patrick Martin North Carolina Agricultural and Technical State University

Ab s t r a c t Systemic lupus erythematosus (SLE) is a systemic inflammatory autoimmune disease which can affect multiple systems of the human body. SLE can have a wide range of negative effects on a person’s health that vary from patient to patient. Typically SLE affects the integumentary and musculoskeletal systems as well as the developing fetus. The underlying cause of SLE is not fully known; however, genetics, heredity, and environmental features are associated with the severity and outcome of the disease. Due to the wide range of deleterious effects associated with SLE, pregnant women diagnosed with SLE are especially sensitive to SLE-associated inflammatory responses. Currently, a concerted effort is underway to determine the mechanism(s) by which SLE affects fetal development. Maintenance of the autoantibody levels in the mother's blood is vital and a key method in sustaining the health of the fetus by preventing the likelihood of maternal-fetal exchange of SLE-associated autoantibodies. However, these autoantibodies may cross the placenta and enter the fetus. When SLE autoantibodies enter the fetal circulation, the fetus can potentially form neonatal lupus erythematosus (NLE). NLE is a rare developmental disorder that results in cardiac, dermatologic, hepatic disorders and hematologic abnormalities in some infants. One of the more prominent abnormalities is the formation of congenital heart block (CHB). This review will focus on the mechanisms that permit maternal-fetal autoantibody exchange and regulate SLE-mediated congenital heart block as well as current therapies used to prevent autoantibody exchange.

12 Endya Frye

Sy s t e m i c Lu p u s Erythematosus a n d Table 1: 1997 American College Ne o n a t a l Lu p u s Erythematosus of Rheumatology Classification Criteria for Systemic Lupus u p u s is a g r o u p o f a u t o i m m u n e Erythematosus diseases named for the occurrence of L 1. Malar Rash a distinctive butterfly rash, resembling the 2. Discoid Rash bite of a wolf, that appears across the bridge 3. Photosensitivity of the nose. This multifaceted disease can 4. Oral ulcers present in four forms which include: cuta- 5. Nonerosive arthritis neous lupus, systemic lupus erythematosus, 6. Pleuritis or Pericarditis drug-induced lupus, and neonatal lupus 7. Renal Disorder NLE. In this review, we will focus on sys- 8. Neurologic Disorder temic lupus erythematosus (SLE) and spe- 9. Hematologic Disorder cifically how SLE affects fetal development 10. Immunologic Disorder in pregnant females. SLE is a systemic au- 11. Positive Antinuclear Antibody toimmune disease with major inflammatory responses (Matsushita, Higashino et Table 1. Summary of classification criteria for Systemic Lupus Erythematosus al. 2002). Studies have shown that SLE is ten times more prevalent in women than SLE includes a combination of physical men and two to three times more preva- activity, rest, medications, and healthy eat- lent in African-Americans and persons of ing habits. The regimen for therapy varies Latin American descent than Caucasians from patient to patient depending on the (McCarty, Manzi et al. 1995; Tincani, systems affected by the disease. Danieli et al. 2006; Smyth and Garovic The higher prevalence of SLE in women 2009; Borchers, Naguwa et al. 2010). has potential detrimental effects in pregnant To date, no cure has been found for this females such as increased frequency of mis- chronic disorder. SLE can affect any area carriages, still births, preterm birth, neona- of the human body, including dermato- tal lupus, and perinatal mortality (Buyon, logic, neurologic, renal, cardiologic, he- Clancy et al. 2009). A pregnant female with matologic, and other systems (Matsushita, SLE may pass autoantibodies to the fetus Higashino et al. 2002; Izmirly, Llanos et al. across the placenta which may cause devel- 2010). Some common symptoms of SLE opmental abnormalities. Furthermore, the are fatigue, arthalgia, arthritis, fever, skin presences of these antibodies can result in rashes, anemia, edema, pleurisy, facial rash, NLE and ultimately CHB, a major compli- photosensitivity, alopecia, Raynaud's phe- cation of NLE (Clancy and Buyon 2004). nomenon, seizures, and mouth or nose ul- NLE is a maternally acquired disease of cers (Khamashta 2006). The requirements the fetus that is associated with the cross- for diagnosis are assessed through patient placental transfer of anti-Ro/SS-A and/ history, hematologic tests—including com- or anti-La/SS-B autoantibodies, which are plete blood counts and autoantibodies as highly prevalent in individuals with SLE. well as physical examination. Individuals The Ro/SS-A antigen is a small nucleo- who present four of the 11 American cytoplasmic RNA protein complex (Ben- College of Rheumatology Classification Chetrit, Gandy et al. 1989; Chan, Silverman Criteria for SLE, simultaneously or within et al. 1999). The function of the Ro/SS-A the same observed time period, can be con- antigen is not completely known, although sidered positive for SLE (Table 1). However, it is hypothesized to function in the ribo- individuals who have fewer than four may somal RNA discard pathway (O'Brien and still be diagnosed with SLE. Treatment of Wolin 1994). The La/SS-B antigen consists

13 Explorations | Biological, Earth, and Physical Sciences of a 48-kDa protein and serves as a termina- Cardiac development begins with mi- tion factor for RNA polymerase III (Rinke and gration of pre-cardiac stem cells following Steitz 1982; Stefano 1984; Gottlieb and Steitz gastrulation (formation of the germ layers) 1989). The presence of these autoantibodies to the site of cardiac formation. The initial in the fetal circulation can lead to CHB. heart cells arise from pre-cardiac stem cells Clinical manifestations of NLE include that form along the midline of the devel- photosensitive rash and hematologic abnor- oping embryo. These stem cells then mi- malities (AlSaleh, Jassim et al. 2008; Walling grate to the thoracic cavity and begin heart and Sontheimer 2009). Some symptoms of development. The second major phase in NLE are temporary with the passing of heart development is the actual shaping of maternal antibodies in the fetal circulation the heart inside the thoracic cavity. After after birth however others are considered establishing the shape of each chamber of major. A major complication which occurs the heart, it must then be formed and de- in 2% of fetuses of SLE-affected mothers fined. The heart must define the four cham- is CHB (Jing-Bin, Ying-Long et al. 2009). bers that comprise the heart. Defining and CHB also referred to as atrioventricular forming these chambers is known as cardiac block is an irreversible condition which looping. The heart contains four chambers causes scarring of the cardiac tissue and that are separated by septa, connective tis- eventually affects the functionality of the sue that forms the cross formation associ- heart (Nussinovitch and Shoenfeld 2007). ated with the heart. The four chambers of the heart are the right ventricle and right Normal Fetal Heart Development atrium as well as the left ventricle and left Normal heart development of the fetus atrium (Figure 1). starts to occur at 15-16 days of gestation. As the chambers continue to form, valves The stages of heart development include that permit blood to flow from the atrial five basic steps. These five basic steps give chambers to ventricular chambers must rise to the fundamental architecture and form. These valves, known as atrioven- function of the heart. The initial step in tricular valves, also prevent the backflow of development of the heart and associated blood into the atrial compartments of the cardiac structures is the migration of car- heart. In CHB, cardiac tissue formation diac stem cells to the myocardial plate is disrupted with the introduction of scar (site of cardiac development). After these stem cells arrive at the myocardial plate the neonatal heart is formed by initiating cardiac looping, the process of developing the future cardiac chambers. Following formation of the cardiac chambers, atrioventricular valves (AV valves) are formed. The AV valves permit blood flow from the atrial (upper, blood receiving) chambers of the heart to the ventricular (lower, blood pumping) chambers of the heart in the fully developed heart. Once all chambers and valves have been completed, the cardiac conduction system as well as the car- Figure 1. Diagram of the adult heart divided into four diac vasculature is established (Moorman chambers. Gray arrows indicate the flow of deoxygenated and Christoffels 2003; Dunwoodie 2007; blood and black arrows indicate the flow of oxygenated Mitchell, Sander et al. 2007). blood.

14 Endya Frye tissue on the atrioventricular valve, which CHB, without treatment. According to the affects the successful circulatory flow of National Heart, Lung, and Blood Institutes blood through the heart and the develop- Disease and Conditions index, first degree ment of the fetal heart (Miranda-Carus, heart block constitutes decreased move- Askanase et al. 2000). ment of electrical signals travelling through Another major problem observed in the heart. Second degree heart block oc- NLE associated CHB is disruption of the curs when the movement of these signals is developing cardiac conduction system NLE decreased on a larger level. In addition to (Michaelsson and Engle 1972; Watson, Lane slowed movement of electrical signals in sec- et al. 1984; Buyon 1998; Buyon, Hiebert et ond degree heart blockage, some electrical al. 1998). The cardiac conduction system signals may not arrive at the ventricles. The requires that cardiac myocytes produce blockage of signal results in the non-con- and propagate the electrical impulses that traction of ventricles and their inability to are required to establish and maintain the pump blood throughout the body (Tincani, heart’s rhythm (i.e., heartbeat). The cardiac Rebaioli et al. 2005). Third degree heart myocytes responsible for the formation of blockage occurs when none of the electri- the cardiac conduction system develop and cal signals reach the ventricles. This degree are located in the right atrium adjacent to of heart block is the most severe form of the ventricle (Christoffels and Moorman heart blockage and is associated with in- 2009). At this location in the right atrium creased morbidity and lack of reversibility electrical impulses, due to calcium influx of the disorder in the fetus (Buyon, Clancy into the cardiac myocytes, necessary to et al. 2009; Reynolds, Buyon et al. 2009). cause heartbeats are generated. Specifically, Importantly, there are no standard treat- this area of the right atrium is referred to ment measures to prevent CHB during as the atrioventricular node (AV node). The gestation. Treatment after birth for babies production of an electrical impulse at the diagnosed with NLE-associated CHB con- AV node promotes ventricular contrac- sists of pacemaker implantation or steroid tion and the pumping of blood from the treatment of newborn infant (Mevorach, ventricle. However, this system is prevented Elchalal et al. 2009). from completely forming in severe cases of NLE-associated CHB (Michaelsson and Di s c u s s i o n Engle 1972; Watson, Lane et al. 1984; Buyon 1998; Buyon, Hiebert et al. 1998). Systemic Lupus Erythematosus, Pregnancy The immune response of the fetus to the and Medical Management maternal autoantibodies increases inflam- SLE can affect individuals of all ages; how- mation of the developing cardiac tissues, ever, it disproportionally affects women of block calcium influx in cardiac myocytes, childbearing years (McCarty, Manzi et al. and prevents the appropriate formation of 1995). Generally people with SLE can ex- the cardiac conduction system (Garcia and perience a wide array of symptoms which Campos-de-Carvalho 2000). can affect any system of the body, including the reproductive system housing a de- Congenital Heart Block veloping fetus. The fertility rate in patients There are three categories of congenital with SLE is relatively normal compared to heart block—first degree, second degree, the general population; however, fetuses and third degree heart blockage (Brucato, born to mothers with SLE may face ma- Cimaz et al. 2002). First-degree and sec- jor complications (Mok and Wong 2001). ond-degree heart blockage can progress These complications range from spontane- to third degree heart blockage, irreversible ous abortion to stillbirths (Mok and Wong

15 Explorations | Biological, Earth, and Physical Sciences

2001). Although certain studies suggest that an increased risk of spontaneous miscar- SLE-associated flares increase during preg- riage, pre-eclampsia, intra-uterine growth nancy, other studies show no change in the restriction, fetal death, and pre-term deliv- number of disease flares during pregnancy ery (Khamashta 2006). When these high- (Mok and Wong 2001). These differences risk pregnancies are identified, a team of likely occur because of a discrepancy in the doctors from a variety of disciplines (such definition of lupus flares and how disease as obstetrics/gynecology, internal medicine activity is assessed within each study (Mok and rheumatology) is advised to monitor and Wong 2001). Common characteristics the progress of the pregnancy. exhibited during pregnancy may be misread Because treating SLE during pregnancy as lupus flares. These lupus-like symptoms may present dangers to the developing include palmar erythema (reddening of the fetus, these treatments must be closely palms), temporary facial blush, increase monitored. Any treatment during preg- in protein in urine due to an increase in nancy should be evaluated for its terato- glomerular filtration rate, and postpartum logic effects on the fetus. Drugs such as alopecia (hair loss) (Buyon 2009). However, prednisolone, azathioprine, cyclosporine some of the conditions mentioned above, A, and hydroxychloroquine help in pre- specifically postpartum hair loss, are com- venting flares during pregnancy and can mon in all pregnancies; therefore, it is dif- be maintained (Esplin and Branch 1997). ficult to determine whether or not certain However, medications such as methotrex- SLE-associated conditions are truly exacer- ate, mycophenolate mofetil, and cyclophos- bated by pregnancy. It has been suggested phamide have been found to be teratogens that different measures to evaluate SLE (Esplin and Branch 1997). It is advised to symptoms are needed to decipher between stop these medications three months prior pregnancy and SLE-associated symptoms to becoming pregnant (Khamashta 2006). (Smyth and Garovic 2009). A specific Management of the disease is extremely timeframe of when SLE flares will occur important, while monitoring the type of in pregnancy has not been definitively de- drugs used for their possible toxic affects scribed in the literature thus complicating to the mother and/or the unborn fetus diagnosis. When SLE flares do occur, they (Khamashta 2006). An additional concern often present as skin and joint inflamma- that physicians have for pregnant mothers tions. Women with a pre-existing diagnosis with SLE is whether lupus will be passed of SLE who are planning to become preg- through maternal antibodies to the devel- nant are highly advised to have a six month oping fetus. Recent studies demonstrate period without SLE disease flares before that a subset of females with SLE may pass becoming pregnant (Khamashta 2006). on the disease causing maternal autoanti- Studies demonstrate that during this time- bodies to the developing fetus (Lee 2005). frame pregnant SLE females have an in- These data suggest that approximately 3% creased risk of premature labor, and those of the pregnant mothers with SLE pass the with active lupus nephritis increase the like- disease on to their babies (Lee 2005). lihood of fetal mortality (Clark, Spitzer et al. 2005; Khamashta 2006). Neonatal Lupus Erythematosus and Congenital Once pregnant, women diagnosed with Heart Block SLE are to be considered high-risk and Neonatal lupus erythematosus (NLE) is a should be frequently monitored to main- fetal autoimmune disease suggested to be tain the health of the mother and the fetus acquired by the passage of autoantibod- (Mok and Wong 2001). SLE pregnancies ies anti-Ro/SS-A and/or anti-La/SS-B are considered high risk because there is from the mother to the fetus through the

16 Endya Frye placenta (Oshiro, Derbes et al. 1997; Lee CHB can be a lethal disorder, and there- 2004). The exact mechanism as to how fore is important for early detection to re- this autoantibody exchange occurs re- verse the effects of cardiac scarring caused mains unknown and is the focus of cur- by the initiation of apoptotic cardiac cells. rent lupus research (Wahren-Herlenius In mothers with Ro/SS-A autoantibodies, and Sonesson 2006). The major condition 2-5% of neonates have been found to have associated with NLE is CHB; however, complete CHB, which develops during the NLE has other associated fetal disorders. 18-24 week gestation period (Salomonsson, Skin lesions similar to those in SLE, hypo Sonesson et al. 2005). Salomonsson and pigmentation (abnormal reduction of colleagues proposed a model for the mech- skin color), hepatitis (inflamed liver), and anism of the development of congenital thrombocytopenia (reduced platelet count) heart block in fetuses of mothers with Ro/ are additional conditions that have been SS-A autoantibodies (2005). They have associated with NLE. These non-cardiac identified Ro/SS-A antigens that contain disease manifestations are typically tempo- specific proteins which are pathogenic and rary and symptoms are non-existent once promote CHB. Specifically, the Ro52 pro- maternal autoantibodies have exited the tein, a Ro/SS-A antigen has been discov- fetal circulation (Lee and Jarrett 1990). ered in mothers with fetuses diagnosed with CHB is a rare disease in the absence of complete CHB (Salomonsson, Sonesson heart structure irregularities occurring in et al. 2005). Salomonsson and colleagues one out of 15,000 to 1 out of 20,000 in propose the following model: Maternal au- the general population (Wahren-Herlenius toantibodies, Ro/SS-A cross the placental and Sonesson 2006). Thirty-one percent barrier and enter the fetal circulation and (31%) of the children with CHB die, and bind to Ro/SS-A antigens on the surface 71% of them die in the first month of life. of the cardiomyocyte (2005). This bind- In children who survive, 67% require life- ing is very specific in pathogenicity, in that long pacemakers (Yang, Chen et al. 2005). CHB was found to be associated with Ro/ Individuals with SLE have an increased SS-A antibodies with the p200 epitope prevalence of high titers of Ro/SS-A and (Salomonsson, Sonesson et al. 2005). This La/SS-B autoantibodies. These antibod- highly specific antibody-antigen interac- ies have been found to be associated with tion has been associated with cases of third the development of CHB (Buyon, Rupel degree heart block and resulting in NLE- et al. 2004). This leads to a concern for associated CHB. Upon binding to the Ro/ pregnant SLE females because of the SS-A antigen on the cardiomyocytes, cal- potential of these antibodies to cross the cium dysregulation and intracellular ac- maternal-fetal barrier. The transmission cumulation is induced in the affected heart of autoantibodies occurs during the mid- cells (Salomonsson, Sonesson et al. 2005). dle of the second trimester (13-27 weeks). Calcium (Ca2+) is the leading regulator in When these proteins begin to circulate the heart’s development of pacemaking and through the fetal blood they can influence contractibility. An increased concentration inflammation of the atrioventricular node of Ca2+ in heart cells disrupts the function- and myocardial tissues in the neonate’s ality of these two processes. Furthermore, heart (Jaeggi, Fouron et al. 2004). On a the irregularity in calcium in the cells even- molecular scale, researchers are examin- tually leads to apoptosis of the cardiomyo- ing potential molecular mechanisms that cytes (Salomonsson, Sonesson et al. 2005). may regulate the transmission of autoan- This in turn can lead to a buildup of apop- tibodies and participate in the formation totic cells in the cardiac muscle tissue lead- of CHB. ing to potential scarring and fibrosis. It is

17 Explorations | Biological, Earth, and Physical Sciences this scarring and fibrosis that subsequently CHB addresses the glaring assumption results in the formation of CHB (Figure made in the previously described model, 2). However, this model does assume that that anti RO/SS-A antigens are released antigens necessary to elicit interaction with from intracellular components and made anti-RO/SS-A maternal antibodies are available to maternal autoantibodies. somehow released from their intracellular Typically during normal fetal heart de- components and made available as targets velopment, apoptosis is a normal physi- for the maternal autoantibodies. To date no ological event which functions in part as a literature exists to address this physiological “sweeping away” of unused cardiac cells assumption. (Pexieder 1975). This form of apoptosis occurs in the developing fetal heart in areas such as the endocardial cushion, developing conduction system and AV node. Physiological apoptosis during endocardial cushion formation permits the development of the septum between the atrium and ventricles. This alternative mechanism of NLE-associated CHB is thought to be regulated by a signal that utilizes apoptosis associated with the normal development of the heart and specifically cardiomyocytes. During fetal heart development, ex- Figure 2. Maternal Anti-SSA/Ro autoantibodies cross tra cardiomyocytes are made and are not the placental barrier and bind the SSA/Ro antigens on used. In order to remove these additional the surface of cardiomyocytes. The binding of the anti- cardiomyocytes, apoptosis occurs. It is this bodies signals apoptosis of the affected cardiomyocytes. apoptosis that is believed to promote cell degradation and release of anti-Ro/SS-A Alternative Model of the Development of NLE- antigens. After the release these antigens Associated Congenital Heart Block from intracellular compartments, these an- In the previous sections the widely accepted tigens are now free to interact with neigh- mechanism for the development of NLE- boring cardiac cells utilizing a paracrine associated CHB describes cardiomyocyte cell signaling mechanism. Once released apoptosis as a result of the anti-Ro/SS-A and attached to neighboring cells, these an- maternal autoantibodies attacking the de- tigens are presented to anti Ro/SS-A ma- veloping fetal heart and promoting calcium ternal autoantibodies that are circulating in dysregulation leading to an accumulation of the fetal blood system and this interaction calcium and apoptosis. However, the above promotes fetal cardiac apoptosis (Figure 3). mechanism assumes antigens necessary for This increase of apoptotic events leads to interaction with the maternal autoantibod- fibrosis, pathologic accumulation of con- ies are made available on the cell surface nective in the heart organ that can eventu- of developing fetal cardiac cells. However, ally lead to NLE-associated CHB. the alternative mechanism that opposes This model is supported by the work of this well accepted mechanism described Tran and colleagues, where they found previously, utilizes physiological apoptosis apoptosis in the fetal conduction system of the that occurs during normal fetal heart de- heart and tested for the presence of Ro/La (La, velopment to expose antigens to the mater- also referred to as SS-B, an alternate ver- nal autoantibodies. More importantly, this sion of the SS-A antigen) antigens on the alternative mechanism of NLE-associated surface of the cardiomyocytes once cells

18 Endya Frye underwent normal apoptosis during de- Treatmentof NLE-associated Congenital Heart Block velopment (2002). High levels of the anti- and Development of Diagnostic Markers gens were detected and the apoptotic cells Due to the complete irreversible nature presented intracellular La antibodies on of CHB, identifying at–risk mothers and the cell surface. Additionally, anti-Ro/La administering preventative treatment is maternal autoantibodies were found to be imperative in improving the survival of aggregated with human IgG in apoptotic the neonate and possibly preventing the cells in the areas such as the atrium, endo- progression of first–degree heart block cardial cushions and the AV node (Tran, to third–degree heart block (referred to Macardle et al. 2002; Tran, Ohlsson et al. as CHB). There are several methods of 2002). More importantly this study utilizes prophylactic treatment for CHB. These an In vivo model of anti-Ro/La antibody treatments can include fluorinated gluco- binding to the surface of apoptotic cells corticoids, immunosuppresants, intrave- (Tran, Ohlsson et al. 2002). Other groups nous immunoglobin, and plasmapheresis have proposed a similar model of NLE- (Yang, Chen et al. 2005). Ro/SS-A specific associated CHB (Miranda, Tseng et al. proteins are considered to be a potential 1998; Mazel, El-Sherif et al. 1999; Rosen marker of CHB in the fetus who progresses and Casciola-Rosen 1999; Miranda-Carus, to complete CHB. Identifying a marker for Askanase et al. 2000). NLE-associated CHB is important since

Figure 3. Alternative mechanism for the development of NLE-associated CHB. A. Cardiomyocytes with intracellular anti-Ro/SS-A anti-Ro/SS-B antigens surrounded by anti-Ro and anti-La antibodies, B. Physiological apoptosis occurs; intracellular antigens are translocated to the cell surface. C. Neighboring cells become apoptotic due to signals sent by initial apoptotic cell. Apoptosis is accelerated due to the antibody-antigen interaction.

19 Explorations | Biological, Earth, and Physical Sciences not all mothers with Ro/SS-A and La/ during pregnancy can lead to premature SS-B antibodies pass these antibodies to rupture of the membranes, intrauterine the fetus causing cardiac defects (Jaeggi, growth retardation, gestational diabetes, Fouron et al. 2004; Mevorach, Elchalal et hypertension, osteoporosis, and avascular al. 2009). bone necrosis (Mok and Wong 2001). A fetus with NLE-associated CHB, can After evaluating two possible models present with bradycardia, abnormally slow of CHB, I suggest a synthesis of the two heartbeat, typically less than 50 beats per midels that focuses on apoptosis as a target minute (Matsushita, Higashino et al. 2002). for possible therapy. In each model, either A normal fetal heart rate is between 110- by physiological occurrence or calcium 180 beats per minute. As a method of dysregulation, the end result is apoptosis of treatment to improve the fetus’ heart rate, the cardiomyocytes which exposes the in- researchers have studied administering dex- tracellular antigens that could be identified amethasone and β-sympathomimetic in- with antibodies in maternal circulation. A combination or individually to the mother possible pharmacological model for treat- (Jaeggi, Fouron et al. 2004). Jaeggi and col- ment would involve developing a drug that leagues concluded that the administration inhibits antibody binding to specific Ca++ of dexamethasone did not revert effects of channel which continues to be operation- CHB; however, it improved the outcome ally functional. This chemical could possi- of the fetus by circumventing other asso- bly bind to a specific region on the antibod- ciated diseases from manifesting (2004). ies which would prevent it from binding to Additionally, Jaeggi and colleagues pres- their appropriate antigens despite interact- ent evidence that demonstrates combining ing with these antigens. Because maternal dexamethasone with β-sympathomimetic Anti-Ro/SSA antibodies are innate to the treatment to treat CHB-associated brady- maternal circulatory system and are key cardia significantly improves the outcome factors in both models, pinpointing this im- of the fetus (2004). Additional studies munological structure would be pertinent support the finding that administration to discovery of a treatment. A hypotheti- of β-sympathomimetic increases the fe- cal drug would need to be administered to tal heart rate (Matsushita, Higashino et the gravid female during the critical phases al. 2002). In other case reports salbuta- of fetal cardiac development. Extensive mol, terbutaline (β-sympathomimetic), pharmacological research testing would be and ritodrine, respectively, were success- needed to investigate the possibility of tera- ful in managing CHB (Groves, Allan et al. tological effects on the fetus. In addition, 1995; Koike, Minakami et al. 1997; Chan, molecular and biochemical techniques Silverman et al. 1999). Further studies have such as electron microscopy and protein found beneficial effects of the utilization of analysis should be utilized to identify the corticosteroids in reducing the immune-ini- specific site the antibody that can be af- tiated damage to the developing fetal heart fected by the drug and to characterize the (Ostensen 2004; Hussain and Parke 2006; complete structural components of the an- Tincani, Danieli et al. 2006; Jazwinska- tibody, respectively. Tarnawska and Niewinski 2008). Although these treatments have favorable results to Co n c l u s i o n the fetal outcome, long-term side effects of the medications can increase morbidity Systemic lupus erythematosus is an autoim- (Tincani, Danieli et al. 2006). For example, mune disorder in which symptoms can be administration of high dose corticosteroids exacerbated in affected pregnant females.

20 Endya Frye

The increase in symptoms in the female can negatively affect the health of the fetus, and it is imperative to closely monitor these at-risk pregnancies. This risk is due to the ability of maternal autoantibodies to cross the placenta and initiate pathogenesis of the fetus. One of the most severe SLE- associated conditions is the formation of congenital heart block and can develop as a result of the passage of maternal autoantibodies. Research has been initiated to examine the mechanisms of SLE-associated congenital heart block, and generate potential therapies to prevent the affects of maternal autoantibodies. To date two differing models of NLE-associated exist, however, with the current information available it is difficult to determine which model more precisely describes the mechanism regulating the formation of NLE-associated CHB. Since both models describe the formation of NLE-associated CHB result in cardiac apoptosis, it is plausible that both models present a part of the entire mechanism(s) and thus do not preclude either model. Specifically, it is possible that the “alternative mechanisms” is a precursor to the widely accepted model of maternal autoantibodies attacking developing fetal cardiac tissue and vice versa. Understanding the molecular pathways of systemic lupus erythematosus, neonatal lupus erythematosus, and congenital heart block are all necessary in finding an effective treatment and possibly a cure. Research in these areas would be increasingly beneficial to the scientific community and helpful in improving the quality of life of individuals affected by SLE. Additionally, as CHB associated with maternal lupus status is highly correlated with the ethnic background of the mother, these studies also offer the opportunity to examine a developmental model of health disparities.

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Mevorach, D., U. Elchalal, et al. (2009). “Prevention of complete heart block in children of mothers with anti-SSA/Ro and anti-SSB/La autoantibodies: detection and treatment of first-degree atrioventricular block.”Current Opinion in Rheumatology 21(5): 478-482.

Michaelsson, M. and M. A. Engle (1972). “Congenital complete heart block: an international study of the natural history.” Cardiovasc Clin 4(3): 85-101.

Miranda-Carus, M. E., A. D. Askanase, et al. (2000). “Anti-SSA/Ro and anti-SSB/La autoantibodies bind the surface of apoptotic fetal cardiocytes and promote secre- tion of TNF-alpha by macrophages.” J Immunol 165(9): 5345-5351.

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24 Endya Frye

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26 Humanities

27 28 From Freedom to Bondage: The Jamaican Maroons, 1655–1770

Jonathan Brooks University of North Carolina Wilmington Faculty Mentor: Andrew Clark University of North Carolina Wilmington

Ab s t r a c t The Jamaican Maroons were not a small rebel community; instead, they were a complex polity that operated as such from 1655-1770. They created a favorable trade balance with Jamaica and the British. They created a network of villages that supported the growth of their collective identity through borrowed culture from Africa and Europe and through created culture unique to Maroons. They were self-sufficient and practiced sustainable agricultural practices. The British recognized the Maroons as a threat to their possession of Jamaica and embarked on multiple campaigns against the Maroons, utilizing both external military force, in the form of Jamaican mercenaries, and internal force in the form of British and Jamaican military regiments. Through a systematic breakdown of the power structure of the Maroons, the British were able to subject them through treaty. By addressing the nature of Maroon society and growth of the Maroon state, their agency can be recognized as a dominating factor in Jamaican politics and development of the country.

n 1509 t h e Sp a n i s h s e t t l e d Ja m a i c a the battle most slaves were separated from I and brought with them the institution of their masters and fled to the mountains. slavery. By 1655, when the British invaded Two major factions of Maroons established the island, there were 558 slaves.1 During themselves on opposite ends of the island, the Windward and Leeward Maroons. These two groups formed the first inde- 1 Bryan Edwards. “Observations on the Disposition, Character, Manner, and Habits of Life of the Maroon pendent polities from European colonial Negroes of the Island of Jamaica; and a Detail of the rule. The two groups formed independent Origin, Progress, and Termination of the Late War from each other and with very different po- Between Those People and the White Inhabitants.” In Maroon Societies: Rebel Slave Communities in the Americas, litical structures but similar economic and edited by Richard Price. (Baltimore: The Johns Hopkins social structures. Nevertheless both groups University, 1973), Pg. 231

29 Explorations | Humanities suffered from increased bondage by the gained from raiding included money, British under the guise of treaties promising weapons, women, and slaves; however, they autonomy.2 The British never recognized practiced a policy of isolationism. the Maroons as independent and did not The isolation policy adopted by the view the treaty as a document that would Jamaican Maroons allowed them to grow bring balance between the two nations. in political and social complexity. This al- The children of former slaves created a lowed for generations to be born not on unique collective identity and created a na- plantations but in Maroon villages. They tion. From 1655 to 1770 the Maroons were utilized land suitable for agriculture which integrated into the British bondage system allowed for self-sufficient agriculture pro- through external military force, internal duction. With population growth and the sabotage, and lack of political cohesion. expansion of hunting and agricultural In 1660 the British hired Capitan Juan ground the Maroons who had not been de Bolas to lead an army against fellow born on the plantation established a sense Maroons. The British gave him an indi- of identity that was unique and free from vidual land plot in exchange for his ser- bondage and identification with Britain. vices; four years later de Bolas had reduced The Maroons made extensive contact the number of Maroons from 558 to one almost on a daily basis with slaves on the hundred and eventually perished during a plantation—trading food product they had campaign against a remote village in the grown for tools, weapons, textiles, and pots Blue Mountains.3 The number of Maroons and pans that they were unable to manu- was a small fraction of the total popula- facture themselves. He argues that it was tion of the island and was not consoli- necessary in order to recruit new members dated or united, with each village having because the mortality rate of life in the 30 members or more. Maroons operated mountains was high.4 Even though mortal- independently from British interference for ity rates were high Maroons did not need the next 84 years. Their engagement was to be recruited. Slaves participated in petite initially limited with others on the island. marronage on a daily basis. It was not un- Contact was primarily through raiding and usual for slaves to go absent for a day or trading with slaves unwilling to leave their two and return. Slaves were given reign by plantation. the plantation overseers to participate in an Raiding took place mainly at night and urban environment that allowed them to without preemptive motives. Raiding was travel long distances away from the plan- an act of desperation as trading was more tation. Slaves sometimes migrated from the norm. Trading happened on a daily ba- plantation to plantation when they felt that sis. Maroons would go into towns and trade the master’s punishments were too grueling in the markets with free blacks and also de- or unjust. Seasoned slaves and slaves born velop relationships with slaves in order to on the plantation participated in this kind access goods only found on the plantation. of marronage, primarily because they had a Goods needed from the plantation and heritage on the plantation that included a market place included farming tools, tex- family unit. The increase in Maroon num- tiles, and iron and copper products. Goods bers was caused by grand marronage; mainly engaged in by slaves who had recently ar- 2 The word treaty was defined as a formal agreement rived in Jamaica and had not finished the between two or more states in favor of peace and trade.

3 Barbara Klamon Kopytoff.The Maroons of Jamaica: An 4 Vincent Bakpetu Thompson. The Making of the African Ethnohistorical Study of Incomplete Politics, 1655-1905. (Ann Diaspora in the Americas, 1441-1900. (NewYork: Longman, Arbor: University Microfilms Press), 1972 . Pg. 13 1993), p.273-292

30 Jonathan Brooks seasoning process, a five year process of pounds and the British death toll rose to working on the plantation. three thousand men.7 In 1734 the Governor Grand marronage was carried out by large of Jamaica stated: groups of slaves and their goals were to join a Maroon group or form their own We are not in a condition to defend ourselves… group, and most importantly never return and their success has had such influence on our to the bondage system which they had left. other slaves that they are continuously desert- Grand marronage was conducted through ing to them in great numbers…without your rebellion or organized fleeing. In 1673 a Majesties gracious aid and assistance must ren- Maroon–instigated rebellion on the Lobby der us a prey to them.8 Plantation set the precedent in Jamaica. The rebellion ultimately failed but it in- The Governors’ concerns were echoes spired other slaves to use the same orga- of the British crown which had written a nizational processes, utilizing knowledge letter claiming the conflicts with Maroons of the landscape and military skills to help were going to bankrupt the country. The them escape, for the next 50 years. Again in lack of labor on the island was threatening 1673, St. Anne Plantation revolted under sugar production as grand marronage was on its own population’s organization and three the rise, primarily due to lack of author- hundred slaves escaped into the Cockpits ity on the plantation. Most owners lived in occupied by the Leeward Maroons. In 1685 Britain rather than Jamaica, and their over- the Widow Grey Plantation experienced a seers participated in military campaigns revolt that allowed 150 slaves to escape. In against the Maroons only if the master had 1690 on the Sutton Plantation four hun- traveled to the island. The urgency of cor- dred slaves revolted and was heralded as respondence between Britain and Jamaica the manifestation of Maroon organization prompted the Governor to take a census of efforts. Only 40 managed to escape, but the Maroon population. the message had been understood by the In September 1734, an estimate on British.5 Upward of 1,500 slaves revolted Maroon population was released by across the island, but there is no evidence the British: “The Windward [eastern] that the majority of revolts were initiated Rebels…amount to 490 persons…Those by Maroons, unlike Brazil where rebellions to the Leeward [western]…about the same were decidedly organized by Maroons. in number…”9 The estimates were based From 1655 to 1690 the Maroons had grown in numbers and even though they had limited 7 The causalities were much higher than Maroon contactwith slavestheir presence was already mortality in battle. Maroon casualties reached at the that of legend.6 maximum two hundred men. The British reacted by financing cam- 8 Address of Governor, Council and Assembly of paigns against the Maroons beginning in Jamaica to the King, 21 February, 1734. This speech was 1700. The expenditures reached 250,000 published in Silvia W. De Groot, Catherine A. Christen, and Franklin W. Knight. “Maroon Communities in the Circum Caribbean.” In General History of the Caribbean: Volume III The Slave Societies of the Caribbean, edited by 5 Bev CareyThe Maroon Story: GordonTown, Jamaica:The Franklin W. Knight, 169-193. (London: UNESCO Authentic and Original History if the Maroons in the History of Publisher, 1997), Pg. 56-91 Jamaica, 1490-1880. (Agouti Press: A Maroon Publishing House, 1997). Pg. 145-152 9 Address of Governor, Council and Assembly of Jamaica to the King, 20 March, 1734. The speech was 6 After 1690 Maroon numbers stabilized as mortality provided abridged in Barbara Klamon Kopytoff. The rates provided equilibrium against new runaways, Maroons of Jamaica: An Ethnohistorical Study of Incomplete however, Maroon reproduction rates were high and Politics, 1655-1905. (Ann Arbor: University Microfilms helped population growth through 1734. Press), 1972

31 Explorations | Humanities on plantation owners who had submitted of settlements outlined during excavations forms claiming the number of slaves that of Accompong Town suggested they were had abandoned their plantation. The figure too small to be occupied by a large number was also based on the number of Maroons of people and that at the most around 30 they encountered on their military cam- people could occupy the settlements.12 The paigns. Based on the numbers of escapees outposts were not used for defense. Defenses in previous years through rebellions, this were built into the villages and the Maroon number was inadequate. The only record populations trained in combat. This num- from Maroons is that of Leeward Headman ber is too low to accommodate the number Cudjoe who recorded “231 men…women of men used for military protection and is and children are considerable and in pro- perfectly suited to fit the number of people portion to men.”10 Codjoe reported false allocated to conduct trade. Accompong of numbers in an attempt to soften tension the Leeward Maroon community was the with the British. The number of men was largest of the communities and built the greater than that of women and children largest outposts. The buildings had accom- because the proportion of men brought to modation of 30 people which proves that the Americas is much greater than that of they were used for storage and trade. They women; the number of women who par- were hidden so that new runaways would ticipated in marronage was small, as they not find and loot the buildings also, so that had established kinship or family ties on Europeans would not find and destroy the the plantation. Leeward and Windward surplus. If they were used for any other Maroon combined population reached well purpose than storage and trade then such over one thousand by 1735 and the com- measures would not have been made. munities had developed an independent The Windward Maroons built their out- economy and material culture. post on the rivers because fields suitable The Maroons grew cocoa, sugar cane, for agriculture were not in close proxim- plantains, melons, yams, corn, banana, wild ity and they relied more on fishing. They yams and roots, and cabbage. The villages also traded food products with slaves on traded with each other for food stuffs cul- the plantation and with free blacks in tivated in various parts of the mountains. the urban market. If they were unable Trade networks between villages made it to produce enough to be self-sufficient or possible for communities to build entire did not have enough surplus to engage in safe houses specifically for storage and trade they raided. Maroons hunted exten- house merchants traveling around to all the sively and raised hogs and birds for con- different villages.11 The size and location sumption. Salt was difficult to find for the Windward Maroons and relied on boiling 10 Cudjoe addressed the Governor of Jamaica in 1734 salt water, which meant they were in closer at the Governor’s request. The speech provided abridged in Kopytoff, Pg. 103 against the Maroons and then transformed into storage 11 Carey argued that these separate dwelling areas units. Kopytoff argued settlements were built in case of were built not for trade but in times of war during emergency relocation but they were much larger in scale European campaigns against them; surplus was kept and built not far from the original settlement, preferably their indefinitely and that it also was never used unless near a known productive agricultural field. She also that specific occasion rose. Michael Cranton “Resistance says that the large scale settlement functioned in similar to Slavery.” In General History of the Caribbean: Volume fashion to the small outposts when they were not used. III the Slave Societies of the Caribbean, edited by Franklin W. Knight, 222-270. (London: UNESCO Publisher, 12 Kofi E. Agorsah. “Background to Maroon Heritage.” 1997). He suggested they were not built independently InMaroon Heritage: Archaeological Ethnographical and Historical at all but rather they were old villages that had been Perspectives, edited by Kofi E. Agorsah, 1- 35. (Kingston, abandoned early during the European campaigns Jamaica: Canoe Press, 1994) Pg. 2-7

32 Jonathan Brooks proximity to the plantation complexes than his lineage; his father was the Maroon who the Leeward Maroons. Plantations were instigated the Sutton Plantation rebellion. located near the ocean so saltwater could Cudjoe claimed to be Nanny’s “brother” be easily gathered for local salt production; and claimed legitimacy through her lin- also, access to trading ports was greater. eage and his father’s lineage. Cudjoe was Their location gave them greater access able to consolidate the villages under his to trade with non-Maroons. The Leeward authority by taking power away from the Maroons relied heavily on wood ash for individual obeah women, further perpetuat- their salt needs. Salt was needed to preserve ing patriarchy in Leeward Maroon society. food products and was used medicinally for He did allow obeahs to control domestic cleaning wounds. Wood ash was the only matters but economic and military policies substance available that was comparable to were decided by Cudjoe. The Windward sea salt or desert salt. Maroons were more like a federation than The agriculturists of the Maroon com- a monarchy and it was more egalitarian munities formed a non-militant faction of than totalitarian. There was communal society. They were not armed on a continu- leadership, and hierarchy was based on age ous basis. The Maroons were able to build with elders at the top. Law and order was an artisan class which engaged in building conducted by society as a whole. Obeahs canoes, spears and various kinds of arrows were more influential and were advisors each designed for a specific purpose. They to the elders. Obeahs were considered to also made many musical instruments in- be in the second highest positioning soci- cluding the abeng, a horn like instrument, ety. They were described as “supernatural sometimes as rudimentary as a conch. technicians exercising their powers on be- They also made numerous variations of half of the group, and they might begin to the drum. With specialization and large take on political powers and apply ritual population, the Maroon settlements were sanctions on behalf of the group.”14 This complex and self-sustaining. The Leeward was especially true of Nanny, the founder Maroon Community of Old Nanny Town of the Windward Maroons. consisted of 120 separate huts with the She was one of the only obeahs to exer- village zoned for living and working quar- cise the full potential of her position. Most ters.13 Each village had a “Dancing Palace” obeahs never engaged in fighting and were where Headman conducted rituals and at odds with Headman over political con- ceremonies. The Headman functioned not trol.15 Nanny, on the contrary, carried a only as social leader but political leader, too. large knife belt with 12 knives at any given Political structures and Headman time. Her reputation was solidified as a roles varied between the Windward and fierce warrior when she returned from Leeward Maroons. The Leeward Maroons battle against the Europeans with bracelets were centralized and leadership was based on kinship. Succession of Windward 14 Kopytoff, pg. 83 Maroons was matrilineal and always went to a younger generation instead of a 15 This was evident when Windward Headman Quoha said: “When I consulted our Obeah woman, she opposed brother, sister, or older relative. Leeward the measure, and said him being beccara [whites] for Maroons were patriarchal instead of ma- take the town, so cut him head off.” This quote is found triarchal. By 1730 Cudjoe was the Leeward in Kopytoff, pg. 85. The larger text can be found in the Headman and claimed legitimacy based on Jamaican archives. The message had been recorded by an unknown soldier held captive by the Windward Maroons. The “measure” that was “opposed” by the Obeah was to keep the captive soldier as a slave. Also the 13 Agorsah, Pg. 20-25 term “beccara” can be found spelled “bakra.”

33 Explorations | Humanities made of British teeth wrapped around her the Maroons who had been born on the wrists and ankles.16 She had proven that the plantation in the Americas and those who Maroon nation had legitimatized itself as had been institutionalized for more than self-regulating political entity. She was said five years. As a result of closer proximity to to have taken on the “ . . . role of Queen Europeans over the years Maroons increas- Mother of Ashanti.”17 For most obeahs it ingly took titles such as Colonel, Captain, was difficult to maintain power, one wrong and Governor.19 prediction would dismantle their reputa- Proximity to plantation settlements was tion within the community and they would essential to Maroon communities and the be reduced to agriculturalist. The obeah is a importance increased as the British waged part of Maroon society that is directly linked campaigns against them, burning their to its African heritage. Most runaways that food crops and storage units. Proximity to joined through 1739 were African-born Amerindians increased in significance over and obeahs are only one of many cultural time, many of the agricultural techniques aspects incorporated. were developed by Amerindians and taught For Windward Maroons every aspect of to Maroons; however, relations diminished culture was inherently African; the nature as time progressed due to encroachment of authority, the belief in the supernatural, on Indian hunting territory. Amerindians kinship relations and obligations, division were also being contracted by the British to of labor among the sexes, Headman roles, besiege the Maroons. Military alliance and ritual leaders, and polygamy. Each village competency was essential in keeping inde- had its own medicine man and mid-wife. pendence. Constant warring put a strain on One of the strongest African influences was all inhabitants’ military capabilities. that of marriage and residence relations. Major General Sedgwick foresaw the es- Males could not settle in a new village indi- calated incidents in 1656: “[Spanish slaves] vidually while women could, and residency must be destroyed or brought in…or else status usually depended on economic they will prove a great discouragement to situations and hierarchy of lineage unlike the settling country.”20 These sentiments Leeward Maroons.18 Leeward Maroons were reiterated in a more acute form in amalgamated cultural influences, success- 1734 when the Governor of Jamaica said: fully combining African and European religion, agricultural practices, and a rigid We are not in a condition to defend ourselves, the class system. This was more prevalent by terror of them spreads itself everywhere and the ravages and barbarities they commit, have determined several planters to abandoned their settle- 16 Virginia R Dominguez. Leadership and the Exercise of ments, the evil is daily increasing and their success Authority in Maroon Societies. (New Haven:Yale University Press, 1990) Pg. 14 has had such influence on our slaves that they are continually deserting to them in great numbers 17 Ibid, Pg. 109 and the insolent behavior of others gives but too 18 Orlando Patterson “Slavery and Slave Revolts: A much cause to fear a general defection.21 Socio-historical Analysis of the First Maroon War, 1665-1740.” In Maroon Societies: Rebel Slave Communities in the Americas, edited by Richard Price, 246-292. (Baltimore: 19 Eugene Burt. “Runaway Slave Communities in the The Johns Hopkins University, 1973). He argued they New World: the Transportation of Africa to the Western were very much syncretic: “Marriage systems forged Hemisphere.” Seminar, March 15, 1977. Kenyatta in response and resistance to the dehumanization University College. of slavery drew on both underlying African culture values and a transformation of European marriage to 20 Edwards, pg. 232 create a Caribbean Creole system of conjugality and procreation.” 21 Address of Governor, Council and Assembly of

34 Jonathan Brooks

These concerns were coupled with increas- hands on one another, or surrender to the English ingly expensive campaigns. Major-General at discretion.23 Brooks remarks: Equally, the British were feeling the “hor- …to make a good mule road to the Negro rors of continual alarms, the hardships of town if practicable to be done and if not to military duty, and the intolerable burden of find another road that may be made so, as the maintaining an army on foot.”24 The British success of the present expedition will chiefly de- were unaware that one or two more cam- pend upon a constant supply of provisions and paigns would have permanently crippled the ammunition.22 Maroons. Before either side exterminated itself, the British offered a peace treaty in 1739. Distribution problems and casualties were not This treaty was the first step in assimilating only experienced by Europeans but Maroons the Maroons into Jamaican society; although, as well; however, the mortality for Maroons the assimilation was guised as recognition as was not from combat but rather starvation an autonomous nation for Maroons. and disease. The first draft of the treaty recognized only Prior to 1734 Maroons were not disrupting one town of the Leeward Maroons and none the plantation complex on a large scale and of Windward Maroons. Trelawney Town, the limited contact was neither hostile nor Accompong, Crawford Town, and Nanny repercussion-producing. After 1734 Maroon Town adhered to the treaty after Cudjoe re- activity in close proximity to the plantations ported it to each village; the British believed was viewed as a high threat, and militias were his lineage claim to both Windward and sent to destroy Maroon settlements and en- Leeward would give him the ability to repre- slave if not kill them. The Maroons increased sent all Maroons. The inability to recognize their isolation policies in order to keep the Cudjoes’ treachery incorporated Maroons threat of British military action low. In order that otherwise were self-governing and eco- to drive the Maroons out of the mountains, nomically sufficient. Many provisions and the British burned agricultural fields, barred stipulations were offered to the Maroons; in- trade in urban areas between blacks, and re- cluding returning new runaways and those in stricted movement of slaves on the plantation the community who had been members for and throughout Jamaica. The actions and re- two years or less. Since the first draft only actions of both the Maroons and the British recognized one town, Trelawney Town, the detrimentally exacerbated the incidents: land allotments were outlined exclusively for that town. The “ambiguity . . . of Maroon- The Maroons were not less anxious for an accom- Government relations allowed much flexibil- modation they were hemmed in and closely beset ity in the application and interpretation of on all sides; their provisions destroyed; and them- the treaties and eventually gave rise to seri- 25 selves reduced to miserable a condition by famous differences between the two parties,” ine and incessant attacks, that Cudjoe declared, the difference being in favor of the Maroons if peace had not been offered to them, they had who were largely still acting with limited restriction. The Maroon economy was still al- no choice left but either to be starved, lay violent lowed self-sufficiency through production of cash crops, except sugar cane. They could Jamaica to the King, 21 February, 1734. This speech was published in full text in Silvia W. De Groot, Catherine not, however, hunt within three miles of any A. Christen, and Franklin W. Knight. “Maroon Communities in the Circum Caribbean.” In General History of the Caribbean: Volume III The Slave Societies of 23 Kopytoff, pg. 106 the Caribbean, edited by Franklin W. Knight, 169-193. (London: UNESCO Publisher, 1997), Pg. 56-91 24 Ibid, pg. 107

22 Carey, pg. 279 25 Ibid, Pg. 118

35 Explorations | Humanities

British settlement. They were also required and frontier settlements. This culminated to build roads to their communities acces- in the purchase of the Peete Plantation sible by the British. This was a major process by Britain for Maroons. In exchange for that would inextricably link the downfall of the 610 acre allotment they had to police Maroon autonomy. surrounding plantations. Accompong was The British believed that all Maroons were given 1,500 acres of land it were to be di- highly centralized and gave full social au- vided by all Leeward Maroon settlements. thority to Cudjoe: “That Captain Cudjoe… Encroachment also led to the purchase and the Captains succeeding him shall have of one thousand acres of St. Elizabeth 26 full power.” The model was suited for the Plantation. By this time the Maroons com- Leeward political structure but undermined munities had been encompassed by whites. the Windward political structure by forcing This was strategically done by Britain to the egalitarian system into a patriarchal hi- keep land usage by Maroons as limited as erarchy. It also diminished the significance of possible and to restrict trade with one an- obeah in politics. The British replaced obeahs other and keep trade dominated European with white superintendents stationed in or near the villages. Cudjoes’ village was required sanctions. to have two and they were to be paid two hun- Under huge stress on the land, wide- dred pounds annual salary. Their main goal spread starvation occurred and the was to “…receive and communicate such or- Maroons rebelled. Trelawney Town and ders as shall be sent by his Excellency the gov- Crawford Town dissolved only to reestab- ernor to the said Negroes.”27 The mandate lish themselves as Scotts Hall and Charles transferred the political power of Headman Town. The agricultural variety plummeted to the Governor of Jamaica. The governor and production was regulated; Scotts Hill ordered all Maroons to declare war against was required to grow a certain amount the Spanish. The Maroons were stripped of arrowroot and Charles Town was re- of rank in the militias and all officers were quired to grow coffee and harvest lumber. British. If succession lines ran out in any hi- Cudjoe’s town was the only Maroon town erarchical structure the appointee would be after the treaty allowed to raise cattle. His placed there by the British not the Maroon town was also required to grow tobacco. consensus. Accompong was required to grow coffee In 1741 the treaty was revised in order and pimento. This caused large economic to support European feudal notions of sub- imbalances within the Maroon community jectship. Nanny Town received 500 acres causing Maroons to rely on grants from the in the parish of Portland. Maroons had an British. annual tax of one pound on the land and It was necessary to keep the economy owed 1/20th on profits made by commu- floating since Britain’s revision of the treaty nity. The town was required to have five in 1744 which stated slavery in Maroon white superintendents. Only a few towns communities was illegal. The breakdown had been given land outlines, and most of the slave labor system in the Maroon Maroons hunted and farmed far beyond communities was covered up as the Act their allotted territory. The expansion led for the Better Order and Government of to encroachment on British plantations the Maroon Communities. This measure tore apart the social system and economic 26 Ibid, Pg. 125 –The full text of Treaties is in systems began slowing. The constant pro- Barbara Klamon Kopytoff. The Maroons of Jamaica: An visions and enforced restriction on treaties Ethnohistorical Study of Incomplete Politics, 1655-1905. (Ann Arbor: University Microfilms Press, 1972) that were designed to enfranchise Maroons

27 Ibid, Pg. 127

36 Jonathan Brooks caused internal dissent. In 1749 Crawford Between 1655 and 1739 the Maroons Town rebelled and successfully murdered of Jamaica functioned as an independent their Headman Crawford and British su- polity and had total control over their own perintendents. Dissatisfaction with the economic, political, and social systems. Headman diminished their authority in the Competition over resources and trade Maroon community. caused conflict between the British and the The treaties restricted the Headman’s Maroons; internal sabotage exacerbated ability to organize a militia and to exercise hostile relations and caused disunity among the death penalty, which were the two main the Maroon groups and their leaders. In sources of fear induced power over the 1739 a treaty was signed promising rec- community. Their power was also limited ognition of the Maroon state in return for by restricting their access to the Jamaican menial regulations. The revisions eroded government. The intrusion of superinten- Maroon agency from 1739 to 1770 and dents on the villages further alienated the reached an apex when the superintendents Headman from the group as they took took over governing practices from the over the role of mediator between the obeahs and headmen, ultimately leading to British government and the Maroons. The total economic, social, and political control Headman’s ability and the group’s ability by Britain and ended Maroon autonomy. to appoint or elect their own leader was The utilization of documents written by the stripped from them: British, archaeological excavations of settlements, and the most recent ethno-histories A structure was erected—a group of were essential in analyzing Maroon hege- Government—appointed Maroon officers, su- mony. The Maroons established a complex pervised by White superintendents, complete society with distinct culture and identity; it with commissions, and badges to legitimize it, was through external and internal coercion but it never carried enough authority to satisfy that Maroon autonomy was stifled. other Maroon needs or British requirements.28

The British treaty put the Maroons in a cycle of perpetual regulation and oppression. The British government increasingly added more superintendents that would specifically control militias. Over time the responsibilities of all superintendents increased as the Headman’s responsibilities waned. In 1770 a superintendent-general was appointed to the Leeward Maroons and one was appointed to the Windward Maroons. It reduced the Headman’s role to figurehead and the British government had control over all aspects of Maroon life. This solidified the whites as the wholly recognized supreme authority. The British government had been able to reduce the once autonomous Maroons to petty subjects.

28 Ibid, Pg. 208

37 Explorations | Humanities

Bibliography

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Bastide, Roger. African Civilization in the New World. Translated by Peter Green. London: Harper and Row, 1971.

Besson, Jean. “The Creolization of African-American Slave Kinship in Jamaica Free Village and Maroon Communities.” In Slave Cultures and the Cultures of Slavery, edited by Stephan Palmie, 187-209. Knoxville: University of Tennessee Press, 1995.

Bilby, Kenneth. “Ethnogenesis in the Guiana and Jamaica: Two Maroon Cases.” In History, Power, and Identity: Ethnogenesis in the Americas, 1492-1992, edited by Jonathan D. Hill, 119-141. Iowa City: University of Iowa Press, 1996.

Burt, Eugene. “Runaway Slave Communities in the New World: the Transportation of Africa to the Western Hemisphere.” Seminar, March 15, 1977. Kenyatta University College.

Campbell, Christine Mavis. The Maroons of Jamaica, 1655-1796: A History of Resistance, Collaboration, and Betrayal. Granby, Massachusetts: Bergin and Garvey Publishers Incorporated, 2008.

Carey, Bev.The Maroon Story: GordonTown, Jamaica:The Authentic and Original History if the Maroons in the History of Jamaica, 1490-1880. Agouti Press: A Maroon Publishing House, 1997.

Craton, Michael. “Resistance to Slavery.” In General History of the Caribbean: Volume III The Slave Societies of the Caribbean, edited by Franklin W. Knight, 222-270. London: UNESCO Publisher, 1997.

De Groot, Silvia W, Catherine A. Christen, and Franklin W. Knight. “Maroon Communities in the Circum Caribbean.” In General History of the Caribbean: Volume III The Slave Societies of the Caribbean, edited by Franklin W. Knight, 169-193. London: UNESCO Publisher, 1997.

Dominquez, Virginia R. Leadership and the Exercise of Authority in Maroon Societies. New Haven: Yale University Press, 1990.

38 Jonathan Brooks

Edwards, Albert. “Maroon Warfare: The Jamaica Model.” In Maroon Heritage: Archaeological Ethnographical and Historical Perspectives, edited by Kofi E. Agorsah, 163-188. Kingston, Jamaica: Canoe Press, 1994.

Edwards, Bryan. “Observations on the Disposition, Character, Manner, and Habits of Life of the Maroon Negroes of the Island of Jamaica; and a Detail of the Origin, Progress, and Termination of the Late War Between Those People and theWhite Inhabitants.” In Maroon Societies: Rebel Slave Communities in the Americas, edited by Richard Price, 230-245. Baltimore: The Johns Hopkins University, 1973.

King, Johannes. “Guerilla Warfare: A Bush Negro View.” In Maroon Societies: Rebel SlaveCommunities in the Americas, edited by Richard Price, 298-304. Baltimore:The Johns Hopkins University, 1973.

Klein, Herbert S. African Slavery in Latin America and the Caribbean. Oxford: Oxford University Press, 1986.

Kobben, A.S.F. “Unity and Disunity: Cottica Djunka Society as a Kinship System.” In Maroon Societies: Rebel Slave Communities in the Americas, edited by Richard Price, 320-369. Baltimore: The Johns Hopkins University, 1973.

Kopytoff, Barbara Klamon.The Maroons of Jamaica: An Ethnohistorical Study of Incomplete Politics, 1655-1905. (Ann Arbor: University Microfilms Press), 1972.

Patteron, Orlando. “Slavery and Slave Revolts: A Sociohistorical Analysis of the First Maroon War, 1665-1740.” In Maroon Societies: Rebel Slave Communities in the Americas, edited byRichard Price, 246-292. Baltimore: The Johns Hopkins University, 1973.

Postma, Johannes. Slave Revolts. Westport, Connecticut: Greenwood Press, 2008.

Stedman, Captain J.G. “Guerilla Warfare: A European View.” In Maroon Societies: Rebel Slave Communities in the Americas, edited by Richard Price, 320-333. Baltimore:The Johns Hopkins University, 1973.

Thompson, Alvin O. Flight to Freedom: African Runaways and Maroons in the Americas. Kingston, Jamaica: University of the West Indies Press, 2006.

Thompson, Vincent Bakpetu. The Making of the African Diaspora in the Americas, 1441-1900. New York: Longman, 1993.

Thornton, John. Africa and Africans in the Making of the Atlantic World, 1400-1800. Cambridge: Cambridge Universtiy Press, 1998.

Wright, Colonel Martin-Luther. “Accompong Maroons of Jamaica,” In Maroon Heritage: Archaeological Ethnographical and Historical Perspectives, edited by Kofi E. Agorsah, 133-162. Kingston, Jamaica: Canoe Press, 1994.

39 America’s Changing Mirror: How Popular Music Reflects Public Opinion During Wartime

Christina Tomlinson Campbell University Faculty Mentor: Jaclyn Stanke Campbell University

Entertainment is always a national asset. Invaluable in times of peace, it is indispensable in wartime. All those who are working in the entertainment industry are building and maintaining national morale both on the battlefront and on the home front. *

~Franklin D. Roosevelt, June 12, 1943

h e t h e r o r n o t w e a d m i t it, War II, Vietnam, and the current wars in W societies change in wartime. It is safe the Middle East. These major conflicts cre- to say that after every war in America’s his- ate changes in society that are experienced tory, society undergoes large changes or in the long term, whether expressed in new embraces new mores, depending on the legislation, changed social customs, or new extent to which war has affected the na- ways of thinking about government. tion. Some of the “smaller wars” in our While some of these large social shifts history, such as the Mexican-American may be easy to spot, such as the GI Bill or War or the Spanish-American War, have the baby boom phenomenon in the 1940s left little traces of change that scarcely ven- and 1950s, it is also interesting to consider ture beyond some territorial adjustments the changed ways of thinking in modern and honorable mentions in our textbooks. societies as a result of war and the degree Other wars have had profound effects in to which information is filtered. Because their aftermaths or began as a result of a the thoughts of a nation’s citizens are sel- catastrophic event: World War I, World dom expressed explicitly, exploring pop

* Telegram to the National Conference of the Entertainment Industry for War Activities, quoted in John Bush Jones, The Songs that Fought the War: Popular Music and the Home Front, 1939-1945 (Lebanon, NH: University Press of New England, 2006), 31.

40 Christina Tomlinson culture during wartime may be a good way War I were developed and identify social to gauge America’s feelings about war. For opinions about war that may be reflected the sake of clarification, pop culture is de- through the music. World War II will be ex- fined as “commercial culture based on pop- amined in a similar fashion, but given the ular taste.”1 There are many aspects of pop greater number of US troops in the conflict culture that address the topic of war, but to and, by extension, a greater involvement of best understand how everyday citizens felt US citizens, it will be necessary to consider about wars of the twentieth century, music how music adapted to reflect the changing is one of the best media to consider. Music atmosphere. is readily available and abundant in both Coverage of Vietnam will reveal the shift amount and variety. In addition, given that in public opinion from pro-war to anti- participation in music is available to every- war, exposing growing divisions within one, it provides a means to look for themes American society. These are, of course, of continuity or change over time. generalizations, but this research will con- Music’s role during times of war has sider songs that address both sides of the changed throughout the twentieth and conflict. How the anti-war protestors ex- twenty-first centuries. The present research pressed their views in song (i.e., what lan- will consist of the four wars previously guage they employed) will also be studied. mentioned: World War I, World War II, The final portion of the paper will- ex Vietnam, and the wars in the Middle East plore music associated with the wars in the (including the Gulf War of the early nine- Middle East. Given that these wars are on- ties, the war in Afghanistan, and the war going, secondary research on the subject in Iraq). After studying the popular songs is very limited, but the songs available are of these wars, it is evident that how mu- abundant. By exploring songs that have sic is used has changed over time. Once been released in recent years and recog- used as a tool for military recruitment or nizing similar patterns from previous wars, a means to boost public support of world this paper will ultimately consider the cur- conflict, music’s role changed drastically rent direction of public opinion. during Vietnam to become the people’s The songs themselves will commonly be outlet for anti-war sentiment and criti- referred to as “war songs.” For the pur- cism of the government, a role which has, poses of this paper, to be considered a “war for the most part, persisted to the present. song” the song in question must be released These changes reflect a larger, changing during a war and the lyrics must address public opinion that became altered with a topic related to the conflict on the war- the advent of mass media in the war zone. front or “back home.” These topics vary As the media became more unfiltered, the greatly from war to war, but many prevail- music became more uncensored, willing to ing themes have been opinions concerning express more radical views from supporting the draft, separation of loved ones, fulfill- desertion to overthrowing the government. ing one’s duty, motivating the troops, and In a way, war, or at least the media’s depic- criticism of the conflict itself or the world tion of it, made culture more democratic. leader responsible. Those songs that may To show this change over time, it is nec- have been written during a war but address essary to explore the popular music of each alternate themes, such as the drug subcul- of these wars. The first step in the process ture or civil rights in the 1960s, will not be will be to examine how the songs of World considered in this research. To understand why this research is important, it is necessary to recognize the 1The Oxford Pocket Dictionary of Current English, 2009,“Pop culture.” link between music and society itself. The

41 Explorations | Humanities impact of music on society has been greatly were not ready to fight a war, and many debated as far back as Plato. In The Republic, citizens did not see a good reason to get in- he argued that music can influence not volved in what they believed was another only individuals, but also for whole societ- country’s fight; according to the song, they ies. For this reason he urged that some mu- supported Wilson’s role as a peacekeeping sical expressions be encouraged, but others mediator. banned because, as he stated,“when modes Public opinion experienced a shift fol- of music change…the State always changes lowing the sinking of the Lusitania in May with them.” 2 War songs in the World Wars 1915. When the story reached American operated with a similar point of view. It newspapers, the public was outraged at was commonly understood that music can Germany’s unrestricted submarine war- build morale or mobilize the masses. Music fare. As a result, titles such as “When the could be used as a vector for change to ease Lusitania Went Down,”7 written by Charles confusion during conflict. Furthermore, as McCarron and Nathaniel Vincent, were writer Les Cleveland asserts, music can be released. Nevertheless, even after the sink- “infused with a sense of individual worth ing of the ship many Americans were still and national urgency.”3 reluctant to join the fight. When the United States began to con- World War I: Reluctantly Going “Over There” sider mobilizing troops, several songs were During the early years of World War I, released that showed support and protest before the radio was available in every for the war.8 The common misconception household, the best way to gauge a song’s is the assumption that World War I songs popularity was by counting sheet music were all in support of the war, but this is not purchases, which Billboard charts reflect.4 the case. There was a presence of openly Many of the songs prior to the United pacifist sentiment reflected in song, mostly States’ involvement in World War I re- through the eyes of parenthood. According flected strong support for neutrality. Such to the Billboard charts, Al Bryan’s “I Didn’t melodies included Blanche Merrill’s “We Raise My Boy to Be a Soldier” was a very Take Our Hats Off to You, Mr. Wilson” popular song at its release in 1915. With sung by Nora Bayes and Fanny Brice in lines like “Who dares to place a musket on 1914. In the song, Wilson is hailed as “the his shoulder / To shoot some other moth- world’s great mediator” because his “pen is er’s darling boy,”9 the message of the song greater than the sword.”5 1914 was the first implies that war would be nonexistent if year of the Great War and under President more mothers spoke out in opposition.10 Wilson the United States remained neutral While this song was very popular in despite the conflict overseas.6 Americans 1915, it faded by April 1917 when the U.S. entered the war.11 Even Al Bryan later re-

2 Plato, The Republic, trans. Benjamin Jowett (Forgotten Books, 2008), 146, http://www.forgottenbooks.org/ the Great War (Berkeley: University of California Press, info/9781605064413. 2003), 245.

3 Les Cleveland, “Singing Warriors: Popular Songs in 7 Ibid., 246. Wartime,” Journal of Popular Culture 28, no. 3 (1994), 155. 8 Ibid., 251. 4 John Druesedow, “Popular Songs of the Great War: Background and Audio Resources,” Notes 65, no. 2 9 Alfred Bryan, “I Didn’t Raise My Boy to Be a Soldier,” (2008): 366. 1915.

5 Blanche Merrill, “We Take Our Hats Off to You, Mr. 10 Cleveland, “Singing Warriors: Popular Songs in Wilson,” 1914. Wartime,” 162.

6 Glenn Watkins, Proof Through the Night: Music and 11 Watkins, Proof Through the Night, 249.

42 Christina Tomlinson wrote his song, giving it the title “It’s Time Following the war, there was a growing for Every Boy to Be a Soldier.”12 The songs sense of inevitable change as a result of the considered “pro-war” during World War I world conflict. After having gone overseas used commonly recognized American sym- and being exposed to other cultures, many bols to arouse patriotism. Songs with titles soldiers returned home and desired a life like “We Shall Never Surrender Old Glory” outside of the small-town atmosphere they and “Uncle Sam Will Help You Win the were raised in. Such is the subject of the War” used this imagery as a means to en- popular 1919 hit, “How ‘Ya Gonna Keep courage participation in the military and ‘Em Down on the Farm (After They’ve industrial ventures for the war effort.13 The Seen Paree?),” which became one of the American flag became an icon in songwrit- top singles on the Billboard charts that ing and the focus of many war anthems. In year. The song is a conversation between fact, the national anthem “Star-Spangled a farmer named Reuben and his “wifey Banner” was made popular in 1914, even dear” who discuss the likelihood of their though it was penned by Francis Scott Key sons staying on the farm. The mother a century earlier. After it reemerged, it re- represents the voice of the past, with the mained an important rallying song and was desire to have her sons return to a life of used constantly at public events. 14 normalcy after the war: “. . . farmers always By far the most popular song of World stick to the hay.” Reuben, on the other War I was George M. Cohan’s “Over hand, represents the voice of reason that There.” Released about two months after reflected a growing realization that the war the United States entered the war, it be- had changed everything: came the number one song on the Billboard charts in 1917. Sung by Nora Bayes, the They’ll never want to see a rake or a plow song urges families and sweethearts to be And who the deuce can parley vous a cow?17 happy their loved ones are heading off to battle to “show the Hun [they’re] a son of a Although parts of the song are humorous gun.” The upbeat tempo and sound of the for the listener, there is a clear message drums in the song are reminiscent of troops that exposure to other cultures during war marching. Soldiers are urged to “hoist the have led to social change, and many who flag and let her fly / Yankee Doodle do or returned home desired to move into the die” and go into battle with the intention cities. of bringing pride to their country.15 The As the lyrics indicate, there were differ- song was an instant success, and remained ent views related to the war during World so until the end of the war. For his part in War I. Prior to the sinking of the Lusitania, contributing the lyrics, Cohan was actu- the songs released reflected the public sup- ally awarded the Congressional Medal of port for neutrality. It was only after the Honor in 1936.16 newspapers broke the story that the songs supported the war effort, and largely so; the most popular song “Over There” fa- 12 Alfred Bryan, “It’s Time for Every Boy to Be a vored involvement in the Great War. Still, Soldier,” 1917. there were voices of opposition, but these 13 Cleveland, “Singing Warriors: Popular Songs in popular songs resonated mostly with wor- Wartime,” 160. ried parents. When the war was finally 14 Watkins, Proof Through the Night, 289, 297. over, Americans understood that their 15 George Cohan, “Over There,” 1917.

16 Druesedow, “Popular Songs of the Great War: 17 Joe Young and Sam M. Lewis, “How ‘Ya Gonna Keep Background and Audio Resources,” 371. ‘Em Down on the Farm (After They’ve Seen Paree)?,” 1918.

43 Explorations | Humanities country was forever changed, as reflected regulate information coming in about the by “How ‘Ya Gonna Keep ‘Em Down on war. In their book Music of the World War the Farm.” II Era, authors William and Nancy Young described the institution as the following: World War II: Preferring Not to“Sit Under the Apple Tree” with the NWMC The OWI hired artists to create propaganda With roughly a million American troops posters on subjects as varied as rationing and killed and wounded, the reach of World saboteurs, put together several hundred news- War II was exponentially greater than the reels about both the war and the home front to previous one.18 The music industry conse- show in theaters…and utilized radio by produc- quently reflected an array of varied feelings ing numerous broadcast series that heightened about the conflict. The changes in society public awareness about current events.22 following the Great War were illustrated through several war songs and, as one his- Furthermore, the head of the OWI, Elmer torian states, mirrored a “corresponding Davis, created the NWMC, or the National shift away from homogeneity of America Wartime Music Committee. As the title during World War I.”19 implies, the committee’s purpose was to Technological changes during the inter- evaluate the appropriateness of war songs war years set the stage for the musical scene for the public. The committee identified of World War II. The radio became the songs that encouraged the citizens or mo- premier source of media and information tivated the troops, acting as national music during the 1920s and 1930s with the typi- arbiters and extending their governmental cal American citizen listening to it around influence into the music business. Their four and a half hours a day.20 Not only did quest for the perfect war melody, however, Americans listen to radio more frequently, proved to be a big disappointment, as only but there were more and more radios avail- a few songs attracted any attention. After able in the home; the percentage of homes the failures of the NWMC to boost morale with at least one radio rose from 67% in through music, the committee voted itself 1935 to 89% in 1945.21 While the main out of existence in April 1943.23 reason for owning a radio can be debated, Of all of the songs the NWMC released, it is not far-fetched to assume that more ra- only two were popular in the American dios would equate to more opportunities to mainstream. “Comin’ in on a Wing and a listen to music, hence the war songs hav- Prayer” and “Praise the Lord and Pass the ing a stronger influence on society, however Ammunition” both became big hits, with subtle. the latter going to number one on Billboard The federal government understood the in early 1943.24 “Praise the Lord” told a mobilizing potential that media could have story of a pilot who encouraged a group of on Americans. In June of 1942, the Office gunners to keep fighting the good fight: of War Information (OWI) was formed with the intent to maintain morale and Praise the Lord and pass the ammunition And we’ll all stay free.25

18 William H. Young and Nancy K. Young, Music of the World War II Era (Westport, C.T.: Greenwood Press, 22 Young, Music of the World War II Era, 11. 2008), 1. 23 Ibid. 19 Jones, The Songs that Fought the War, 16. 24 Ibid., 9. 20 Ibid., 22. 25 Frank Loesser, “Praise the Lord and Pass the 21 Young, Music of the World War II Era, 105. Ammunition,” 1942.

44 Christina Tomlinson

The catchiness of the song is undeniable, M. Cohan: “We Must Be Ready,” released and the NWMC managed to cleverly pass in 1939. It was nowhere near as popular on a message: the United States must fight as “Over There,” though both songs share this war in order to preserve democracy. similar themes.29 Other efforts were made to fuel the war Pearl Harbor changed America’s mind effort through songs outside of the NWMC. about the war. Following the attack, there Tin Pan Alley, a neighborhood in New were virtually no songs of isolationism, but York that was home to the music publish- a vast sea of them about going off to war ing business, hired lyricists and composers and its effects on soldiers and their families. to create war songs, many of which were Tunes like Hughie Charles’ “We’ll Meet big successes.26 It is not exactly clear why Again” may not have been popular in its Tin Pan Alley was more successful than the 1939 release, but its re-release following NWMC, but it can be expected that while Pearl Harbor became a hit and landed on the federal government’s main concern was the Billboard charts in spring of 1942.30 shaping public opinion and regulating in- Many of the songs released during World formation about the war, Tin Pan Alley’s War II were overtly pro-war in their mes- primary motivation was making money. sages. Cliff Friend and Charlie Tobias’ “We Thus, Tin Pan Alley followed public tastes Did It Before and We Can Do It Again” to profitable ends. Whether or not the song was one of the first militant songs of the was explicitly about war was of secondary war that reached a national audience with importance. Over the course of the war its soldiering reminiscent of the last con- it became more obvious that the majority flict. Other songs took a more nationalist of Americans did not want to hear songs approach with titles like “We’re Gonna about patriotism; they preferred ballads Have to Slap The Dirty Little Jap” and of romance or songs that were good num- “I’ve Got a Scrap with a Jap” that reveal bers at the dance halls,27 like “I’ll Be Seeing a popular shared opinion of the Japanese You” or “Rum and Coca–Cola.” following the Pearl Harbor attacks, albeit At the onset of World War II, the songs a racist one. 31 Songwriters from Tin Pan debuted seemed to have inherited the iso- Alley attempted to create music that gained lationist mindset from World War I. While support for the troops by encouraging all “Over There” had been an extremely sorts of participation from letter-writing popular song in the previous conflict, many to saying prayers, from giving financial isolationist anthems in the 1940s like “Go donations to planting Victory gardens.32 Back Over There,” released in 1940, used While their motivation was profit, it is clear Cohan’s classic to argue the nativist point that they were influenced by the powerful of view. Many messages in these songs en- National Wartime Music Committee. couraged dealing with “America first” be- The lyrics of many of World War II’s fore European affairs or were considered most popular tunes were simple with a soft anti-immigrant.28 Some songs of prepared- melody; the sentimental nature of the mes- ness did exist in the early years prior to sages of reuniting lovers led to many suc- the U.S. involvement, but not many. One cesses. These numbers became trendy dur- of the more popular songs on the subject ing the war as troops began to deploy. One of preparedness was actually from George 29 Ibid., 70.

26 Jones, The Songs that Fought the War, 42. 30 Jones, The Songs that Fought the War, 74.

27 Young, Music of the World War II Era, xiii. 31 Ibid., 125.

28 Jones, The Songs that Fought the War, 59. 32 Ibid., 184-186.

45 Explorations | Humanities such song, “Lili Marlene,” was originally a became clear that listeners demanded mu- poem written by a German soldier in World sic that reminded them of their families War I. It was set to music on the Axis side back home or loved ones overseas, com- and broadcast over German lines in 1941. monly referred to as “slush” songs. These The song became so popular among their melodies about affectionate relationships troops that an English version was released or the fear of separation, like “Don’t Sit in the United States in 1943, the most fa- Under the Apple Tree (With Anyone Else mous rendition of which was sung by the But Me),” recycle wartime romance sce- anti-Nazi songstress Marlene Dietrich, who narios. The majority of these “slush” songs was a German native. The song’s story of became very popular, as the focus was on Lili who waits for her loved one by the lan- the “girl back home” instead of the war. 38 tern’s light outside the barracks became Another category of music that was pop- a celebrated tale on both Axis and Allied ular was the upbeat dance songs featuring lines.33 servicemen. Referred to as “khaki-wacky” Songs about hope were also prevalent songs, these hits described middle and work- during the war following Pearl Harbor. ing class girls becoming infatuated with the “(There’ll Be Blue Birds Over) The White soldier persona. The phrase “every woman Cliffs of Dover,” released in 1941, spoke loves a man in uniform” comes to mind about everything returning to normal “to- with many of these songs.39 These melodies morrow when the world is free.”34 The ref- were rhythmic and equipped with positive erences to Dover and the use of English messages designed to distract the listeners, sweetheart Vera Lynn in its original version such as “The Boogie Woogie Bugle Boy tend to mislead audiences into believing (of Company B)” written in 1941 by Don the song was imported from England, but Raye and sung by the Andrews Sisters.40 it was actually written by Walter Kent and Other fun songs included “(There’ll Be a) Nat Burton, both native New Yorkers.35 It Hot Time in the Town of Berlin (When the struck a nerve with audiences and became Yanks Go Marching In)” and “Rum and immensely favored throughout the war.The Coca–Cola.” “Hot Time,” while upbeat lyrics are simple but come attached with an and catchy, reminded the listener of the emotional message, leading to the tune ris- mission at hand: quell German dominance ing to the number one spot on Billboard in in the region. “Rum and Coca–Cola” in- December 1941.36 cidentally would be considered inappro- Other popular songs of the war included priate in the 1940s if one read the original hits like “Sentimental Journey,” made fa- lyrics. With lines like “Both mother and mous by Doris Day, which describes the daughter / Workin’ for the Yankee dol- yearning to go home to loved ones and lar” and “They wear grass skirts, but that’s landed the number two spot on Billboard in okay / Yankee likes to ‘hit the hay’” the May 1945.37 Over the course of the war it subject of the song is clearly the good time to be had thanks to native girls in Trinidad. When the Andrews Sisters sang the song 33 Jones, The Songs that Fought the War, 77. with Bing Crosby, the lyrics were revised 34 Walter Kent and Nat Burton, “(There’ll Be Blue Birds slightly, and the song became the most Over) The White Cliffs of Dover,” 1941. popular hit of 1945.41 35 Young, Music of the World War II Era, 3. 38 Jones, The Songs that Fought the War, 215. 36 Paul Halsall, “There’ll Always Be An England and other War Music,” Modern History Sourcebook, 39 Ibid., 216. Fordham University, http://www.fordham.edu/halsall/ mod/ww2-music-uk.html. 40 Young, Music of the World War II Era, 15.

37 Jones, The Songs that Fought the War, 221. 41 Ibid., 48.

46 Christina Tomlinson

Many of the songs that have been dis- songs.45 This can be attributed to a more cussed to this point might be considered unfiltered media presence able to spread part of pop, but in 1942 we begin to see more information to the public. country music emerge as a national genre. The change in relationship between war “There’s a Star-Spangled Banner Flying and music and patriotism can be linked Somewhere,” written by Paul Roberts with the changing role of the media in Metivier, was the war song that brought the 1960s. The emergence of television country to a larger audience.42 The artist in particular provided more opportunities credited with singing the song, Elton Britt, to question events as they streamed into became the first country music artist to be America’s living rooms. Social unrest in the awarded a gold record from the Recording 1960s, particularly related to Civil Rights Industry Association of America.43 After its efforts and demonstrations, was broadcast debut to national recognition, country mu- frequently. In the past information spread sic has remained an integral part of war- through newspapers and radio reports, but time music. Americans had never actually seen the im- Few songs that dealt with the war directly ages beyond photographs and newsreels were considered successful. Most of the at the movies. Seeing the images tends to songs that were popular discussed war in- force participants to draw their own con- directly, as many of their characters were clusions, and Americans were questioning soldiers or “the woman left behind.” As authority long before Vietnam became Young and Young remarked, “The best- their concern. selling, most listened-to pop songs…existed It should be understood that many citi- outside of time and place. This situation zens were unaware of Vietnam until the frustrated many in government looking for spring of 1965 with Operation Rolling a stirring, chart-topping war song, but most Thunder. By then, it was too late for Americans, men and women, in civvies or Americans to experience the “neutral pe- uniform, preferred to stay with the tried- riod” that had existed in the World Wars and-true familiarity of the love song.”44 because they were already suspicious of This truth reflects the notion that the pub- the federal government’s decision-mak- lic may have supported the war, but they ing capabilities. When the images of war were ready for it to be over so life could re- streamed in, many questioned authority turn to normal. further, especially a government that constantly tried to convince citizens that fight- VietnamWar: “I-Feel-Like-I’m-Fixin” to Protest ing communism was a legitimate reason to The Vietnam War is the turning point in go to war in Vietnam. It is easy to see why the study of war music. While many of a large number of anti-war songs existed; the songs from wars in our past tended to many citizens were either upset or unable lean in favor, Vietnam presents a startling to understand the images they were seeing. shift in music. For the first time during a Prior to that time many musicians major conflict, the number of protest songs were silent about the war. It was not un- begins to outweigh the number of pro-war til Americans themselves began to change their opinion about their presence in

42 Louis Hatchett and W.K. McNeil, “‘There’s a Star Vietnam that many musicians in the record 46 Spangled Banner Waving Somewhere.’: The Story industry began to market protest. As the Behind Its Success,” in Country Music Goes to War, ed. by Charles K.Wolfe and James E. Akenson (Lexington, 45 Tony Palmer, All You Need is Love: The Story of K.Y.: The University Press of Kentucky, 2005) 34. Popular Music (New York: Penguin Books, 1977), 199. 43 Young, Music of the World War II Era, 197. 46 Kenneth J. Bindas and Craig Houston, “‘Takin’ Care 44 Ibid., 53. of Business’: Rock Music, Vietnam and the Protest

47 Explorations | Humanities music began to mirror American opinions Barry McGuire’s “Eve of Destruction,” re- more and more, the popularity of many of leased in the summer of 1965. At the time the anti-war songs soared. In fact, many of of its release it was criticized by several art- the tunes that are still remembered from ists for being a poor expression of protest, this time were released after 1965. and it was banned by several radio stations Lee Andresen, an authority on mu- in the United States. Still, it managed to sic during Vietnam, argues that music land the number one spot on the Billboard “shaped and articulated public opinion in Top 100 pop charts.50 unprecedented fashion.”47 Music played The protest songs begin to escalate with a significant role with lasting impressions, Tom Paxton’s “Lyndon Johnson Told the enough to the point that many Hollywood Nation,” released in 1965. In the song, movies about the war (e.g., Apocalypse Now, Paxton exhibits great criticism of the presi- Full Metal Jacket, Good MorningVietnam ) of- dent’s policy in the chorus: ten include music from the era to show its authenticity. Lyndon Johnson told the nation, With the Vietnam War escalating after “Have no fear of escalation. 1964, “folk music” reemerged, carrying I am trying everyone to please. the beacon of protest for the duration of Though it isn’t really war, the conflict. James E. Perone, author of We’re sending fifty thousand more, several books on music in the 1960s, de- To help save Vietnam from Vietnamese.”51 fines the renewed folk music’s leaders and characteristics: The lyrics demonstrate the frustration felt by Americans, many of whom were unable The new generation of folk revival musicians, to find a good reason to “save” Vietnam including Joan Baez and Bob Dylan, emerged in from their own people and were upset that the early 1960s. These musicians, which by 1964 so many lives were lost when war had not would include Phil Ochs and Tom Paxton, sang been formally declared. older left-wing protest music and composed songs One of the most easily recognized that were in the style of folk music, but that ad- anti-war songs of the Vietnam War was dressed the social issues of the 1960s, including Creedence Clearwater Revival’s “Fortunate racial integration, the threat of nuclear war, labor Son” released in 1969. The song’s opening strike, and the Vietnam conflict.48 riff is famous, along with the impassioned vocals criticizing the draft. The “fortunate Under the leadership of folk music, many ones,” according to the lyrics, are those became quickly involved in the anti-war that are from affluent families and have movement. Participants included mostly the means to avoid being drafted to serve young people, many of whom had already overseas. The song shows traces of popu- been influenced by the folk music revival on list tendencies with the haves vs. have-nots their college campuses.49 One of the early struggle being implied throughout. The protest songs of the war was P.F. Sloan and second verse is a good example of this:

Some folks are born silver spoon in hand, Myth,” Historian 52 (1989): 3. Lord, don’t they help themselves, oh. 47 Lee Andresen, Battle Notes…Music of the Vietnam But when the taxman comes to the door, War (Superior, W.I.: Savage Press, 2003), 16.

48 Ibid., 21. 50 Perone, Music of the Counterculture Era, 15. 49 Lydia M. Fish, “General Edward G. Lansdale and the Folksongs of Americans in the Vietnam War,” The 51 Tom Paxton, “Lyndon Johnson Told the Nation,” Journal of American Folklore 102, no. 406 (1989): 392. Ain’t That News, Elektra, 1965, CD.

48 Christina Tomlinson

Lord, the house looks like a rummage sale, yes. audiences in a rebellious exercise of free It ain’t me, it ain’t me, I ain’t no millionaire’s speech, an obvious deviation from the son, no. “Fish Cheer” on the album.55 His song’s It ain’t me, it ain’t me; I ain’t no fortunate one, use of profanity actually cost him a spot no.52 on the Ed Sullivan show, 56 but the song remains a memorable anthem that spoke The implication is that the “fortunate out against the war. Several verses find ones” have found ways to subvert the sys- jolly ways to protest what some considered tem and remain privileged; that is, they a meaningless venture in the jungle: use their wealth to protect themselves from being drafted in ways the poor are And it’s one, two, three, unable to do. The notion of Vietnam be- What are we fighting for? ing a war in which the poor men die was Don’t ask me, I don’t give a d*mn, a commonly held one, so the fact that the Next stop is Vietnam; “we-they” mentality emerges between the And it’s five, six, seven, rich and poor in these songs should not be Open up the pearly gates, surprising. Other songs criticizing the draft Well there ain’t no time to wonder why, can be found from several music groups. Whoopee! We’re all gonna die.57 Steppenwolf, remembered for “Born to Be Wild,” also wrote “Draft Resister,” consid- Beyond the sarcastic lyrics and fast-paced ered a tribute to men who left their families tempo of the song lies significance. The to avoid being drafted.53 number expresses discontent over the rea- With America becoming more and more sons for going overseas, and makes clear disenchanted as the war progressed, other that many who go will perish, evidence of bands came to the forefront with mes- which was streamed into American homes sages of revolution and protest. Jefferson on a daily basis. But all the songs during Airplane’s “Volunteers” calls for listeners Vietnam were not necessarily part of the to join the revolution in the streets, and anti-war movement. For those Americans the Rolling Stones recognized the sounds who saw the war as part of the larger of marching heard all around in “Street “domino theory,” or believed that Vietnam Fighting Man.” Other songs urged for an was a major battlefield in the war against end to the fighting; John Lennon’s Plastic Communism, songs that were pro-war or Ono Band gave the peace movement its an- acknowledged the importance of U.S. in- them with “Give Peace a Chance” during tervention were well-received.58 the Paris Peace talks in 1970. 54 The most well-known anthem of pa- The culmination of the peace movement triotism during Vietnam was “Ballad of was Woodstock in the summer of 1969. the Green Berets” by Staff Sergeant Barry Thousands gathered to hear the music and Sadler, released in 1966. Sadler himself many memorable songs surfaced, includ- was a Vietnam veteran in the Special ing the infamous “I-Feel-Like-I’m-Fixin’- Forces, although many of his fans were to-Die-Rag” by Country Joe and the Fish. probably unaware that he also worked as This upbeat song opened Woodstock with Country Joe shouting “f*ck” before the 55 Perone, Songs of the Vietnam Conflict, 40.

56 Andresen, Music of the Vietnam War, 63. 52 Creedence Clearwater Revival, “Fortunate Son,” Willy and the Poor Boys, Fantasy, 1969, CD. 57 Country Joe and the Fish, “I-Feel-Like-I’m-Fixin’- to-Die Rag,” I-Feel-Like-I’m-Fixin’-to-Die, Vanguard, 53 Perone, Songs of the Vietnam Conflict, 59. 1967, CD.

54 Andresen, Music of the Vietnam War, 53. 58 Perone, Songs of the Vietnam Conflict, 72.

49 Explorations | Humanities a mercenary.59 The song’s pro-government and more pro-war tunes out of Nashville.63 leanings were not heavy-handed; rather, It is not entirely clear why this is the case, the song focused on the Green Berets but there is a likely connection between the as a stellar fighting unit. The fighting in prevalence of country music and the in- Vietnam was not glorified to a large extent. creasing numbers of soldiers drafted from These little tweaks helped “Ballad of the the South. Green Berets” become number one on the One of country’s most renowned art- Billboard top 100 chart in 1966, making it ists during the 1960s was Merle Haggard. arguably the most popular war song in the Remembered for contributing several coun- sixties.60 Had the song been more evident try hits, he also wrote war songs. His song of Vietnam support, it definitely would not “The Fightin’ Side of Me,” was released in have sold so well. 1969 and is considered an anti-protester Moreover, with the debut of country anthem, and the lyrics show an upset side music in World War II, we find that many of some Americans: country music artists were also in support of the U.S. presence in Vietnam and Let this song I’m singin’ be a warnin’ expressed those views musically. Johnny If you’re runnin’ down my country, man Wright’s “Hello Vietnam” was one of coun- You’re walkin’ on the fightin’ side of me.64 try’s first songs of support during the war. Released in August 1965, it came onto the As the words express, there was a bit of a scene closely after the first major buildup of social backlash in the face of the protesters troops had been deployed on the ground.61 that we commonly associate with the peace Lines from the song reflect the belief in the movement, and a great number of them domino theory: were represented through country music. After looking over several songs of the America has trouble to be stopped Vietnam War, one can notice some long- We must stop communism in that land term social themes that have carried over Or freedom will start slipping through our hands.62 from previous wars. One dominating theme is the fear of losing a son. Like the This recognizes the idea that America— World War I classic “I Didn’t Raise My Boy and democracy—will be at risk should to Be a Soldier,” this war also addressed the Vietnam fall under Communist control. apprehension of having loved ones over- When considering which areas of the seas. Several songs in the 1960s communi- United States were more likely to be “pro- cate the heartache of losing a son, such as war,” it should be made clear that if any Dorothy Gorman’s “Happy Birthday Son,” part of the country remained steadfastly Jan Howard’s “My Son,” Bonnie Guitar’s supportive of the United States’ involve- “The Tallest Tree,” and, of course, Loretta ment in the war, it was the South. Even Lynn’s “Dear Uncle Sam.”65 after 1965 when a large portion of the While we have been looking over war country grew angrier about the conflict, songs on the home front, music also changed the listeners considered part of the “coun- overseas in the jungles of Vietnam. During try music audience” were receiving more the war there was some censorship of music from the Armed Forces Radio (AFR), but it did not prevent protest music from 59 Andresen, Music of the Vietnam War, 65.

60 Ibid., 132. 63 Andresen, Music of the Vietnam War, 105.

61 Perone, Songs of the Vietnam Conflict, 75-76. 64 Merle Haggard, “The Fightin’ Side of Me,” The Fightin’ Side of Me, Capitol, 1970, CD. 62 Johnny Wright, “Hello Vietnam,” Full Metal Jacket, 1965. 65 Andresen, Music of the Vietnam War, 125-126. 50 Christina Tomlinson making it overseas. Many of the hits from Vietnam. As more citizens grew upset, the back home were played in the AFR, but music reflected a greater lack of support not many that were anti-war in nature or for the war. As many recall, the Vietnam any music that was considered to have a soldiers were not well received when they “French flavor.” Any music that was- un returned home. Given the popularity and deniably against the war could be heard messages behind many of the hits of the from the tape players of the soldiers, who time, it should be no surprise that public frequented shops that sold the music.66 opinion shifted in that direction, especially Pirate radio stations existed overseas, and if one belongs to the school of thought many of the popular ones actually operated where music is believed to be a major re- out of major U.S. military bases.67 These flection of public opinion. If the majority stations sought to counter the influence of popular war songs were against the war, of the Armed Forces Radio in the minds then it can be inferred that a large number of soldiers. One station, Underground of Americans, especially the young baby Saigon, made frequent use of profanity and boomers, held this view. was quick to tell its listeners where to find the best marijuana and massage parlors in Wars in the Middle East: America Still Divided, Vietnam.68 The prevalence of a demoral- “Courtesy of the Red, White, and Blue” and ized armed force could then be linked to “American Idiot” the military’s inability to control the me- The music describing the Wars in the dia influences on the warfront, especially Middle East is the latest chapter in the pres- those linked with the protesting voices back ent discussion of war songs. This is essen- home. tially uncharted territory for several reasons, Some songs produced back in the United the first of which is the question: When did States were used for other purposes in the these wars really begin and when will they jungle. One use of war songs was to dis- end? For the sake of exploring the music orient the enemy at nighttime. Soldiers re- of the present, it is necessary to go back to turned home with tales of using Creedence music from the Gulf War in the early 1990s Clearwater Revival’s “Run Through the and continue to the songs of the War on Jungle” on night guard duty to warn Viet Terror in Afghanistan and the War in Iraq, Cong fighters that all troops nearby were both of which are still ongoing. awake and alert. If captured, American The fact that these wars are still ongoing prisoners of war were played music as a means that any conclusions are highly de- means of being psychologically broken. batable. Without seeing the bigger picture Music used for these purposes ranged from the outcomes and results have not yet been Johnny Cash to Christmas carols, all for the realized in their entirety, and consequently purpose of making soldiers more emotion- there has been very little discussion about ally vulnerable.69 the role of music in wartime post-Vietnam. The images of war on television gave Although the outcome of these later wars battle a new face that many were not ready is uncertain, the music remains, and there to see or understand, and it likely contrib- are lots of songs that discuss the wars in uted to why public opinion shifted during the Middle East. There are enough present to recognize common themes and draw conclusions. Given what is already known 66 Ibid., 177. about the relationship between music and 67 Cleveland, “Singing Warriors: Popular Songs in previous wars, it can be inferred that mu- Wartime,” 172. sic will continue to be a reflection of public 68 Andresen, Music of the Vietnam War, 180. opinion during wartime.

69 Ibid., 184-185. 51 Explorations | Humanities

Some marked themes permeate many The implication is that the price of oil is of the songs pertaining to the Middle East. blood, yet Americans are lulled by the me- Similar to the Vietnam War, the majority of dia into believing that the U.S. are commit- tunes that would be categorized as war songs ting good acts: contain negative messages that criticize the government or find fault with the presence Mister anchor assure me of American troops in other countries. The That Baghdad is burning lyrics become more metaphorical, yet more Your voice is so soothing explicit and angry. It should be noted that That cunning mantra of killing the lyrics from the current wars are more I need you my witness extreme than their predecessors, indicating To dress this up so bloodless a large lack of support. To numb me and purge me now73 Songs that express disdain for the government were present during the Gulf War, The lyrics describe the news networks as but there were not many. Several of these soothsayers that can influence public opin- numbers were released by bands that are ion with their eloquent news reports. The commonly associated with subversive mes- destruction of Baghdad mentioned is made sages. One such song, “Guerilla Radio” by a “bloodless” event, one that will have little Rage Against the Machine, paints elected effect on society because they are “numb” officials as villains: to the stories. This definitely supports the notion that the media can have a profound Was [the ballot] cast for the mass who burn and toil impact on the opinions of Americans be- Or for the vultures who thirst for blood and oil?70 cause they can manipulate the images on television. “Testify” asks that the media The elected representatives are the “vul- continue on their job well done. tures” and as many anti-government songs Following the attacks on September 11, will illustrate, a commonly held belief 2001, music returned to familiar ground. is that the United States is present in the During times of war the character of Middle East only to benefit from its oil in- the “heroic, male, blue-collar American dustry. This song was very popular within worker, the man of few words but strong its genre, gaining the number seven spot of deeds” returned to the forefront.74 The the Billboard Alternative charts in 1999.71 television bombarded us for weeks with im- Other Rage Against the Machine songs ages of smoke and fire and New Yorkers have similar messages. “Testify” from The running away while the police and firefight- Battle of Los Angeles album equates the deaths ers rushed into the chaos to rescue lives. overseas with the oil industry: It brought new reality to major events, as many of the images were not recorded Mass graves for the pump and the price is set by news stations, but captured by regular And the price is set.72 people who uploaded their videos online. September 11 was one of the first major events in American history where media 70 Rage Against the Machine, “Guerilla Radio,” The Battle of Los Angeles, Epic, 1999, CD.

71 “Alternative Songs,” Billboard, http://www. 73 Ibid. billboard.com/charts/alternative-songs?chartDate= 1999-12-04#/charts/alternative-songs?chartDate= 74 Aaron A. Fox, “Alternative to What? O Brother, 1999-12-04. September 11, and the Politics of Country Music,” in Country Music Goes to War, ed. Charles K.Wolfe and 72 Rage Against the Machine, “Testify,” The Battle of James E. Akenson (Lexington, KY: The University Press Los Angeles, Epic, 1999, CD. of Kentucky, 2005), 172.

52 Christina Tomlinson images were seen completely unfiltered and is “Courtesy of the Red, White, and Blue were contributed by regular citizens. (The Angry American),” which describes a Not unlike the reaction America had af- very impassioned response to the attacks as ter Pearl Harbor, the attack on American stated in the song title. The portion of the soil prompted patriotic feelings. It did not song that prompted the largest reaction was matter what one’s opinion of the United the fifth stanza: States had been before; now that so many Americans had suffered and survived the Justice will be served and the battle will rage same catastrophe, many tended to pull This big dog will fight when you rattle his cage together and acknowledge that they are And you’ll be sorry you messed with all Americans and they are all “in this to- The U.S. of A. gether.” That mentality was carried through ‘Cause we’ll put a boot in your *ss to music, and given what is already known It’s the American way 79 about patriotism and music, it should be no surprise that country led the charge. Obviously, when a songwriter says that One of the earliest and certainly the “putting boot to *ss” is the American thing most successful song that directly addressed to do, he is clearly not looking for a dip- 9/11 was Alan Jackson’s “Where Were You lomatic solution. The lyrics even sparked (When the World Stopped Turning).”75 The opposition from other country musicians, somber melody of the song and the“simple notably Natalie Maines from the Dixie man” perspective allowed the message to Chicks, who stated that the song made reach a number of people. It also identi- county music appear “ignorant.” 80 Shortly fied the various reactions that Americans after the controversy surrounding the song, had to the event, including “dust[ing] off Keith put out another potentially offensive that Bible at home,” spending more time number. with loved ones, watching I Love Lucy, and Sung from the point of view of a “mid- purchasing firearms.76 At the time of its re- dle-aged, Middle-Eastern, camel-herdin’ lease, it became the fastest single to reach man” Keith attempts to describe the impact the top of the Billboard country charts since that the Taliban have had on communities 1997.77 in Afghanistan with “The Taliban Song.” Other memorable country songs in the The song may be humorous for many lis- wake of 9/11 came from Toby Keith, who teners, but the song also acknowledges lots presented an angrier response to the at- of commonly held beliefs of the time, the tacks. Some of the controversy caused by primary one being that Saddam Hussein his lyrics actually led to his exclusion from a was linked with the Taliban and partially 9/11 memorial broadcast that was set to air responsible for the events of 9/11: on national television,78 but he gained lots of fame and sold many albums during the Mr. Bush got on the phone with Iraq and Iran war. His most recognized musical tribute and said, ‘Now you sons-of-b*tches you better not be doin’ any business with the Taliban.’81

75 Ibid. 79 Toby Keith, “Courtesy of the Red, White, and Blue 76 Alan Jackson, “Where Were You (When the World (The Angry American),” Unleashed, DreamWorks, Stopped Turning),” Drive, Arista Nashville, 2002, CD. 2002, CD.

77 “Alan Jackson earns fastest #1 of any country artist in 80 Calvin Gilbert, “CMT News Special Explores Maines- 4 years,” ThatsCountry.com, December 18, 2001, http:// Keith Controversy,” CMT.com, June 6, 2003, http:// www.thatscountry.com/artman/publish/printer_54.shtml. www.cmt.com/news/feat/tkeith.nmaines.062003.jhtml.

78 Fox, “Alternative to What? O Brother, September 11, 81 Toby Keith, “The Taliban Song,” Shock’n Y’all, and the Politics of Country Music,” 172. DreamWorks, 2003, CD.

53 Explorations | Humanities

The extent to which Hussein was or was Don’t look at me not involved with the Taliban was hotly de- I ain’t callin’ for no assassination bated at the time of the song, and these lyr- I’m just sayin’ “Who voted for this a**hole of ics recognize that the link between the two the nation? 83 was thought to have existed, although later events indicated its falsehood. The members of Public Enemy must have While “The Taliban Song” was not assumed that Gore would be elected in played on the radio, likely because of the 2000, and expressed their unhappiness at potentially offensive lyrics, it was sung in the results given their memories of the el- public venues and before fans at every con- der Bush’s administration. This could be cert. In fact, the only version of the song seen as a reflection of the public outrage of that is available anywhere is the concert the election results, whereby Gore won the version. While the song as a whole could popular vote but lost the election. be seen as an expression of patriotic fer- As the Wars in the Middle East pro- vor, natives of the Middle East may find gressed, the images of war streamed some lines offensive, like the referral of the through American televisions as they did homestead as a “two-bedroom cave” or a during Vietnam. This reality of war was burqa as a “scarf.” Probably the most in- also amplified thanks to new technology sulting part of the song is when the United that allowed for war participants to record States entered Afghanistan: the war unfiltered and upload their findings on the internet without any censorship from They dropped little bombs all over their holy land the authorities. The debate on whether or And man you should have seen ‘em run like not this kind of amateur journalism should rabbits, they ran (the Taliban)82 be allowed is for another time, but the important thing to understand is that the me- It is doubtful that members of the Muslim dia presence, however unofficial, has a pro- community would celebrate the bomb- found influence on what we see at home. ing of their homes, regardless of whether If the presence of video cameras and tele- or not they were associated with terrorist vision in Vietnam was any indication of groups. the future, then the presence of unfiltered Other musical trends outside of coun- Internet footage can be even more influen- try with regards to the Wars in the Middle tial on the public opinion of the war. As the East should also be recognized. Rap and public’s opinion changes, the music produced other genres from the urban areas have will continue to realign itself to reflect it. become the frequent communicators of Other rappers were more explicit with anti-government messages in recent years. their outrage at President Bush than Public President George W. Bush is often a target Enemy, in part because they too had seen of ridicule for his foreign policy decisions the war footage unfiltered. Prior to the 2004 during his presidency. In one song “Son of presidential election, Eminem recorded a a Bush” by Public Enemy, the election of protest song and music video called“Mosh” George W. Bush is critiqued: that was made available online. Although it was not an official single, it does carry on I been through the first term of the rotten the revolution spirit of Jefferson Airplane The father, the son, and the holy Bush and the Rolling Stones from the Vietnam It we all in

83 Public Enemy, “Son of a Bush,” Son of a Bush, Koch 82 Ibid. Records, 2003, CD single.

54 Christina Tomlinson era. Eminem portrays himself as a leader about the scene, whether or not they un- of a movement in the United States that derstand what they see. would prevent Bush from continuing his The last musical genre that must be ad- presidency and continuing the War in dressed is rock, simply because it has ef- Iraq. In the third verse, he considers an- fectively carried the anti-war tradition of archy as an effective solution for the Bush Vietnam with the least amount of change administration: over time and produced the majority of popular protest songs for the wars in the Let the President answer a higher anarchy Middle East. One of the most comprehen- Strap him with an AK-47, let him go fight his sive protest songs of the Middle East must own war be “Hands Held High” by Linkin Park. It Let him impress Daddy that way addresses several aspects of the war, from No more blood for oil the opinions of the people watching tele- We got our own battles to fight on our own soil84 vision in the United States, to the actions of the soldiers, to the perspectives of the The lyrics speak for themselves. He later children in Iraq. raps that what America needs to do is “to This song is also reminiscent of disarm, THIS weapon of mass destruction “Fortunate Son” in its message of the “rich that we call our President,” a jab at the al- man’s war,” which presents frustration at legation that Saddam Hussein was keeping the continuing social stratification: “weapons of mass destruction” from UN inspectors. ‘Cause I’m sick of bein’ treated like I have Enimem’s lyrics reflected a commonly before . . . held opinion that can be seen as a repeat Like this war’s really just a different brand of war of Vietnam: the reasons why the United Like it doesn’t cater to rich and abandon poor States are involved in war are not shared by Like they understand you in the back of the jet the American people. It also recognizes the When you put gas in your tank idea that our presence in the Middle East These f*ckers are laughin’ their way to the bank may be linked with our dependence on oil, and cashin’ the check85 a theme pointed out by Rage Against the Machine in the late 1990s. As these opin- Like the “rummage sale” in “Fortunate ions can be considered highly subjective, Son,” the rich in this song have also man- it is nonetheless important to understand aged to find ways to stay wealthy at the that the public opinion on any event can poor’s expense. Linkin Park also implies change based on what it sees on television that the wealth was derived from oil com- or online. This is especially true when the panies, which for many were thought to be information Americans receive is more un- linked with the wealth of the Bush family. filtered. By the time “Mosh” was released, Perhaps the most vocal rock band in terms Americans were able to download daily of their protest of the U.S. presence in the any missile strikes footage or videos of im- Middle East is Green Day. Since the inva- provised exploding devices (IEDs) in ac- sion of Iraq in 2003, they have been writing tion from the comfort of their home office. protest songs, two of which became big hits This degree of digital freedom is significant and led to their receiving the Grammy for for its ability to present images that force Americans to draw their own conclusions

85 Linkin Park, “Hands Held High,” Minutes to 84 Eminem, “Mosh,” Encore, Aftermath, 2004, CD. Midnight, Warner Bros, 2007, CD.

55 Explorations | Humanities

Best Rock Album for both 2004 and 2009.86 East and the previous success of “American The first, “American Idiot,” off their album Idiot,” it is safe to assume that they at least bearing the same name finds an upbeat implied protest by having these words in way to say that America is brainwashed by the chorus. paranoia and hysteria. Lines from the song are very catchy, yet still criticize the Bush Co n c l u s i o n administration for stirring fear in the minds By examining the war songs of the twen- of Americans: tieth and twenty-first centuries, there are several conclusions that we can draw based I’m not part of a redneck agenda on the research available. The most impor- Now everybody do the propaganda tant conclusion is that music during times And sing along in the age of paranoia.87 of war is a reflection of the opinions of Americans at that moment, or at least the The “redneck” agenda is an allusion to songwriters that claim to represent them, Bush’s plan for the country, as many con- but they are subject to change based on the sidered him nothing more than a redneck information available through media out- from Texas. The encouragement to “do lets and the degree to which they are un- the propaganda” implies that the “propa- filtered. The public opinion of World War ganda” is a group dance to which everyone I prior to the sinking of the Lusitania was would know the steps. that of neutrality, and the music reflects Presently heard on the radio is their most that. Only when Americans read about the recent protest song of consequence, “21 tragedy in the newspaper did their opinions Guns.” It is not overtly anti-war and while begin to change. Some still clung to neu- the jury is still out on the true meaning of trality, but many were affected by the news the song, many listeners have interpreted of death, and so altered their perception the number as an anti-war anthem because about America’s role in the conflict. of the frequent references to the twenty- World War II followed a similar pattern one gun salute performed at the funerals with the neutrality songs at the forefront. of fallen soldiers. The salute is repeated for The attack on Pearl Harbor changed ev- every chorus: erything. Soon after, the songwriters were churning out songs that called for war and One, twenty-one guns support of the troops at home. The radio Lay down your arms, give up the fight replaced the newspaper as the primary One, twenty-one guns source of war news, and provided a greater Throw up your arms into the sky outlet for the music industry. As World War You and I 88 II carried on, it became more and more obvious that music was not only a reflec- This song does not spell out its anti-war tion of opinion, but perhaps an influence stance, but given Green Day’s reputation as well. For this reason the government and as protestors of the wars in the Middle record companies went to great lengths to create the perfect war song, but the truth is 86 “Grammy Award Winners,” Grammy.com, http:// that most people in the forties wanted a love www2.grammy.com/GRAMMY_Awards/Winners/ song that reminded them of better times, as Results.aspx?title=&winner=u2&year=0&genreID=0& these were the best-sellers of their time. hp=1 The major shift from predominately pro- 87 Green Day, “American Idiot,” American Idiot, war attitudes to those that were anti-war Reprise, 2004, CD. came with Vietnam. A stark difference be- 88 Green Day, “21 Guns,” 21st Century Breakdown, tween that war and the World Wars was the Reprise, 2009, CD.

56 Christina Tomlinson lack of an American attack that the public for many that are living through this war would take seriously, like the Lusitania or seems to be the desire to end the war soon Pearl Harbor. If that event had occurred, and to bring the troops home. more pro-war songs would likely have been made. The lack of that event meant that the only pro-war songs would have come from the school of thought that considered Vietnam a pivotal link in the “domino theory.” The large following of the anti-war sentiment came from Americans exposed to the war through their television, the new technological medium for media and information. The events they witnessed from their screens affected many of their beliefs and fears, and their music reflects an outlook of anger and frustration over war in a country that many Americans felt needed to be left alone. The wars in the Middle East, as of 2010, seem to be following the tradition of Vietnam, although they began like the World Wars because of the events of September 11. Most of the pro-war songs that were popular were country songs like they had been for Vietnam, but occurred very soon after the attacks on the United States. After the U.S. became involved with the war and the images began pouring into American homes again, the music shifted to mirror the feelings of Vietnam. Many of these anti-war messages were further fueled by the presence of the internet and more sophisticated digital equipment that allowed for users to record footage and share it with the world without being censored by the government. Perhaps the lesson here is that many Americans cannot comprehensively understand the images of war; obviously no one would want to see their loved ones in battle on television, but how can the United States, or any modern nation, ever have lasting support for the war effort with such graphic images streaming in daily? It would be nearly impossible, based on the war songs that are continuing to emerge from musical artists. The current public opinion

57 Explorations | Humanities

Wo r k s Ci t e d

Pr i m a r y So u r c e s

Wa r So n g Da t a b a s e s a n d On l i n e Pr i m a r y So u r c e Co l l e c t i o n s (Songs found in each collection are listed alphabetically by songwriter or performer’s last name.)

Cochrane, Colin. Halcyon Days Music. http://www.halcyondaysmusic.com/ww1music.htm. Bryan, Alfred. “I Didn’t Raise My Boy to Be a Soldier.” 1915. Cohan, George. “Over There.” 1917. Hart, Will. “When Yankee Doodle Learns to Parlez Vous Francais.” 1917. John, Howard and Percy Wenrich. “Where Do We Go From Here.” 1917. Merrill, Blanche. “We Take Our Hats Off to You, Mr. Wilson.” 1914.

Duffy, Michael.Firstworldwar.com : A multimedia history of World War One. http://www.firstworldwar.com/index.htm. Asaf, George. “Pack Up Your Troubles in Your Old Kit Bag and Smile, Smile, Smile.” 1915. Carlton, Harry and Joe Tunbridge. “Mademoiselle from Armentieres.” 1915. Judge, Jack. “It’s a Long, Long Way to Tipperary.” 1912. Long, J. P. and M. Scott. “Oh! It’s a Lovely War!” 1917. O’Hara, Geoffrey. “K-K-K-Katy.” 1918. Rose, Ed. “Oh Johnny, Oh Johnny, Oh!” 1917. Young, Joe and Sam M. Lewis. “How ‘Ya Gonna Keep ‘Em Down on the Farm (After They’ve Seen Paree)?” 1918.

Masetti, Lorenzo. Antiwar Songs (AWS). http://www.antiwarsongs.org/index.php?lang=en. Country Joe and the Fish. “I-Feel-Like-I’m-Fixin’-to-Die Rag.” I-Feel-Like-I’m- Fixin’-to-Die. CD. Vanguard, 1967. Creedence Clearwater Revival. “Fortunate Son.” Willy and the Poor Boys. CD. Fantasy, 1969. Dixie Chicks. “Travelin’ Soldier.” Home. CD. Columbia, 2002. Dylan, Bob. “The Times They Are A’Changin’.” The Times They Are A’Changin’. CD. Columbia, 1964. Eminem. “Mosh.” Encore. CD. Aftermath, 2004. Green Day. “21 Guns.” 21st Century Breakdown. CD. Reprise, 2009. “American Idiot.” American Idiot. CD. Reprise, 2004. Linkin Park. “Hands Held High.” Minutes to Midnight. CD. Warner Bros, 2007. Public Enemy. “Son of a Bush.” Son of a Bush. CD Single. Koch Records, 2003. Rage Against the Machine. “Guerilla Radio.” The Battle of Los Angeles. CD. Epic, 1999. “Testify.” The Battle of Los Angeles. CD. Epic, 1999. System of a Down. “B.Y.O.B.” Mesmerize. CD. American, 2005.

58 Christina Tomlinson

Pu b l i s h e d Pr i m a r y So u r c e s

Vogel, Frederick G. World War I Songs. Jefferson, North Carolina: McFarland and Company, Inc., 1995.

Ot h e r Pr i m a r y So u r c e s –So n g s

Bryan, Alfred. “It’s Time for Every Boy to Be a Soldier.” 1917.

Haggard, Merle. “Okie from Muskogee.” Okie from Muskogee. CD. Capitol, 1969. “The Fightin’ Side of Me.” The Fightin’ Side of Me. CD. Capitol, 1970.

Jackson, Alan. “Where Were You (When the World Stopped Turning).” Drive. CD. Arista Nashville, 2002.

Keith, Toby. “Courtesy of the Red, White, and Blue (The Angry American).” Unleashed. CD. DreamWorks, 2002. “The Taliban Song.” Shock’n Y’all. CD. DreamWorks, 2003.

Kent, Walter and Nat Burton. “(There’ll Be Blue Birds Over) The White Cliffs of Dover.” 1941.

Loesser, Frank. “Praise the Lord and Pass the Ammunition.” 1942.

Paxton, Tom. “Lyndon Johnson Told the Nation.” Ain’t That News. CD. Elektra, 1965.

Sadler, Barry. “Ballad of the Green Berets.” Ballads of the Green Berets. CD. RCA Victor, 1966.

Seeger, Pete. “Where Have All the Flowers Gone?” Sing Out. 1961.

Wright, Johnnie. “Hello Vietnam.” Full Metal Jacket. 1965.

Se c o n d a r y So u r c e s

Bo o k s

Andresen, Lee. Battle Notes…Music of the Vietnam War. 2nd ed. Superior, WI: Savage Press, 2003.

Fox, Aaron A. “Alternative to What? O Brother, September 11, and the Politics of Country Music.” In Country Music Goes to War, edited by Charles K. Wolfe and James E. Akenson, 164-191. Lexington, K.Y.: The University Press of Kentucky, 2005.

Gitlin, Todd. The Sixties: Years of Hope, Days of Rage. New York: Bantham, 1987.

Hatchett, Louis and W.K. McNeil. “‘There’s a Star Spangled Banner Waving Somewhere.’: The Story Behind Its Success.” In Country Music Goes to War, edited by Charles K. Wolfe and James E. Akenson, 33-42. Lexington, K.Y.: The University Press of Kentucky, 2005.

59 Explorations | Humanities

Jones, John Bush.The Songs that Fought theWar: Popular Music and the Home Front, 1939-1945. Lebanon, N.H.: University Press of New England, 2006.

Palmer, Tony. All You Need is Love: The Story of Popular Music. New York: Penguin Books, 1977.

Perone, James E. Music of the Counterculture Era. Westport, C.T.: Greenwood Press, 2004. Songs of the Vietnam Conflict. Westport, C.T.: Greenwood Press, 2001.

Plato. The Republic. Translated By Benjamin Jowett. ForgottenBooks.Org, 2008.

Rudder, Randy. “In Whose Name? Country Artists Speak Out on Gulf War II.” In Country Music Goes to War, edited by Charles K.Wolfe and James E. Akenson, 208-226. Lexington, K.Y.: The University Press of Kentucky, 2005.

Taruskin, Richard. Music in the Late Twentieth Century. Oxford: Oxford University Press. 2005.

Watkins, Glenn. Proof Through the Night: Music and the Great War. Berkeley: University of California Press, 2003.

Young, William H., and Nancy K. Young. Music of the World War II Era. Westport, C.T.: Greenwood Press, 2008.

Jo u r n a l s

Bindas, Kenneth J. and Craig Houston. “‘Takin’ Care of Business’: Rock Music, Vietnam and the Protest Myth.” Historian 52 (1989): 1-23.

Cleveland, Les. “Singing Warriors: Popular Songs in Wartime.” Journal of Popular Culture 28, no. 3 (1994): 155-175. http://search.ebscohost.com.proxy.campbell.edu/ login.aspx?direct=true&db=aph&AN=9511200661&site=ehost-live.

Druesdow, John. “Popular Songs of the Great War: Background and Audio Resources.” Notes 65, no. 2 (2008): 364-378. http://search.ebscohost.com.proxy.campbell. edu/login.aspx?direct=true&db=aph&AN=34874936&site=ehost-live.

Fish, Lydia M. “General Edward G. Lansdale and the Folksongs of Americans in the Vietnam War.” The Journal of American Folklore 102, no. 406 (1989): 390-411. http://www.jstor.org/stable/541780.

James, David. “The Vietnam War and American Music.” Social Text, no. 23 (1989): 122-143. http://www.jstor.org/stable/466424.

Rikard, Dorlea. “Patriotism, Propaganda, Parody, and Protest: The Music of Three AmericanWars.” War, Literature & the Arts: An International Journal of the Humanities 16, no. 1/2 (2004): 129-144. http://search.ebscohost.com.proxy.campbell.edu/ login.aspx?direct=true&db=aph&AN=16360202&site=ehost-live.

60 Christina Tomlinson

On l i n e So u r c e s

“Alan Jackson earns fastest #1 of any country artist in 4 years”. ThatsCountry.com. December 18, 2001. http://www..thatscountry.com/artman/publish/printer_54. shtml.

“Alternative Songs.” Billboard. December, 1999. http://www.billboard.com/ charts/alternative-songs?chartDate=1999-12-04#/charts/alternative- songs?chartDate=1999-12-04.

Farley, Christopher John. “Music During Wartime.” Time, October 2, 2001. http://www. time.com/time/arts/article/0,8599,177836,00.html.

Ganzel, Bill. “Pop Culture Goes to War.” Wessels Living History Farm. http://www.livinghis- toryfarm.org/farminginthe40s/life_07.html.

Gilbert, Calvin. “CMT News Special Explores Maines-Keith Controversy.” CMT.com, June 6, 2003. http://www.cmt.com/news/feat/tkeith.nmaines.062003.jhtml.

“Grammy Award Winners.” Grammy.com. http://www2.grammy.com/GRAMMY_ Awards/Winners/Results.aspx?title=&winner+u2&year=0&genreID=0&hp=1.

Halsall, Paul. “There’ll Always Be An England and other War Music.” Modern History Sourcebook. Fordham University. http://www.fordham.edu/halsall/mod/ww2- music-uk.html.

Wells, K. A. Music as War Propaganda: Did Music Help Win the First World War?” Parlor Songs. The Parlor Songs Association. http://parlorsongs.com/index.php.

61 62 Social Sciences 64 Forms of Social Support by Non-Relatives in Emergency Situations: Ecuador

Brittany Burke University of North Carolina Greensboro Faculty Mentors: Eric Jones and Arthur Murphy University of North Carolina Greensboro

Ab s t r a c t The primary focus of this study relates to the various types of informal support received by people who have been relocated due to a disaster, in this case in a town near Mt. Tungurahua, Ecuador, as a result of its eruptions in 2006. More specifically, since it is well-known that family plays the strongest role in providing informal types of support, I chose to focus on the settings in which non-familial informal support was provided in this time of need, while controlling for other factors such as gender and relationship type. The types of support studied were grouped into four categories: tangible, informational, emotional, and job-opportunity. In conducting interviews designed to highlight these instances of non-familial support, it was then possible to note patterns the respondents shared. The results indicate that acquaintances considered to be ‘friends’ or ‘neighbors’ are the most likely non-relatives to offer support, and that emotional support was the most common form of informal support received by respondents, followed by informational. Results also suggest that males, contrary to other similar studies, were more responsible for both receiving and reciprocating these various types of support.

h i s s t u d y c o n c e r n s t h e v a r i o u s assistance. This type of help—institutional T types of non-institutional and non- or formal—is responsible for supplying familial support received by victims of a considerable tangible, or material, aid to natural disaster—these people have been many victims of disaster, but does not pro- relocated to a small town, Penipe, near vide all the forms of support that people Mt. Tungurahua as a result of its erup- need. More specifically, research suggests tions in 2006. In many disaster settings, the that family often plays a strong role in pro- government and other specialized organi- viding the other forms of support not pro- zations are available for various forms of vided by institutions. However, beyond the

65 Explorations | Social Sciences support of family, less is known systemati- organizations have had a large impact on cally about the importance of non-family the resettlement in my study site of Penipe. in supporting in disaster settings. Thus, it These forms of support are relatively easily is the goal of this study to focus on non-kin measured. Less easy to measure is support social support in a time of need. Perhaps provided by friends and neighbors. I inves- by reviewing circumstances in which in- tigated these more personal, or informal, formal support is most commonly utilized, instances of support in order to understand institutional methods could be improved non-kin sources of informal assistance in to better handle cases similar to those of recovery following disaster. Penipe. Factors such as relationship type What are the instances, then, in which and gender were also considered to assess people tend to receive non-family infor- the possible influences they bear on support mal support? Degree of urbanization is results in an emergency situation. Utilizing one factor. Scott and Roberto (1987) con- both closed and open-ended questions in ducted research on support involving older my interviews with 26 people, I was able adults and concluded that persons living to analyze circumstances under which non- in rural areas are more likely to both give familial, informal support is provided to di- and receive informal support compared saster victims. to those living in urban areas (448). This suggests that populations living outside the Incidence and Importance of Informal city depend more upon personal relation- Support ships than institutions for help. As Penipe Ample research has been conducted in the is a very small community, I considered it a fields of both formal and informal types rural area and so I expected to find ample of social support. Many of these studies situations in which support was exchanged are aimed at evaluating under which cir- on a more personal/informal basis. Because cumstances one can expect to receive or transportation in the area is limited to those give support. In a broad study conducted who can handle it physically and afford it, on stress and support in various situations, distance (and thus neighbors) became a rel- Unger and Powell (1980:567) conclude that evant aspect to consider for these sparsely “When families needed advice in emergen- scattered populations in central Andean cies, they typically went to relatives, the lo- Ecuador. cal druggist, bartender, or priest. Formal It makes sense that those situated far- agencies were not utilized by families in ther away would be less dependable than trouble.” Unger and Powell cite some in- the people living in closer proximity in stances in which formal agencies were re- the event of an emergency, unless longer- lied upon for support following an emer- term assistance is offered. However, stud- gency, but the overall trend tended to be ies involving support and distance are that “informal sources were utilized just as limited. One study conducted in a rural often, or more frequently, than agencies” area of Thailand showed that construc- (1980:568). A number of informal venues tion of schools and temples linked villages were listed as sources of informal support and citizens in ways that would have oth- in Unger and Powell’s report, including erwise not existed because of the relatively personal ties to relatives, friends, pastors, long distances (Faust et. al. 2000). Events teachers, and physicians; although some involving the exchange of machinery and/ of these might be considered formal sup- or labor, such as tractor sharing, happened port if serving in their official capacity on over shorter distances, thus strengthening behalf of an institution. Formal support more proximate social networks. In a study

66 Brittany Burke conducted on distance and types of support replace the role a child would presumably pre-Internet era, “tangible” and “emo- fill. In these instances, non-kin become the tional” support were most often received most likely candidates for support following from those residing within close proximity a disastrous event. to the respondent—in this particular case, Gender also seems to be a factor that within a 10-mile radius (Mok and Wellman limits or creates opportunities for informal 2007). I expect to find similar results due to support following a unexpected destructive the lack of telecomunication devices, such event. A study conducted by Drabek (1986) as computers and Internet, throughout the in Topeka, Kansas, analyzed the influ- community. ences of relatives and non-kin on support A study conducted on African-American patterns after the touch-down of a large social networks for cases of need through- Tornado. It appears that in response to out the United States focused on a number the disaster, men were more inclined than of different variables that determined the women to help individuals outside their types of informal support givers (Taylor families (Drabek 1986), but were gener- et al. 1998). Specifically, as family - mem ally less likely to receive support from oth- bers are more commonly situated in more ers. According to the same study, women remote areas from one another, non-kin are much more likely than men to utilize instances of support (20.6%) increase in a a range of relationships to ensure support time of need (Taylor et al. 1998). Although in a time of need. Beggs et al. (1996:207) family and kin may still be the more per- also report this trend, noting that following ferred choice overall, friends and neighbors Hurricane Andrew, “individuals who are are the more likely candidates in situations embedded in networks with high propor- where relatives live further than is comfort- tions of men should have better access to able to travel on a regular basis. In these in- informal recovery support.” In their find- stances, neighbors and friends become the ings, Beggs and colleagues conclude that best alternatives for help in an emergency although men were more likely to offer aid situation. Common characteristics, as well, to acquaintances, they were less likely to re- do play a role not only in strengthening so- ceive support than women were. cial ties but in increasing likelihood of re- Finally, concerning the type of support ceiving support. that people receive in post-disaster set- Demographics are another important tings, Kaniasty & Norris (2000) found that factor in disaster and informal support Caucasian, African American and Hispanic studies. By analyzing characteristics of Americans in the US were equally comfort- African Americans, such as marital status, able asking for emotional and informational gender, age, and location, (Taylor et al. support, but somewhat less so for tangible 1988) studied the contributions of both rel- support. In terms of receiving support, atives and non-relatives in a time of need. emotional support was most common, fol- Those authors discovered that “Both fam- lowed by informational support, and then ily and non-kin were found to be important tangible support. No comparable study has sources of emergency assistance” and con- been done on support in the form of work cluded that adults ages 25–45 report the opportunity in a disaster setting. highest instances in which friends would be of service in a time of need. In the same Hy p o t h e s e s study, they reported that black seniors without children rely on non-relatives not In order to account for these findings on only for maintaining social networks, but to informal support, I formulated hypotheses

67 Explorations | Social Sciences to test in Penipe, Tungurahua Province, finding someone a job whether short-term Ecuador. To begin, I expected to have or long-term). I developed a question- many well-documented instances of varied naire (see Appendix A) and asked people support to work with utilizing socio-demo- whether they received each of these kinds graphic data from an on-going project in of support, from whom, and how often. I the same area. By using these data I could also included a hypothetical situation at the better narrow my sample-size and create a end of the interview to give the respondent group of qualified respondents with whom a chance to give an example of a non-rel- to conduct this project. Thus, I expect that, ative that they could rely on for day to day from within this sample, people who expe- support (for males—borrowing work tools; rienced non-familial informal support since and for females—seeking child care). the 2006 eruptions of Mt. Tungurahua would (a) have experienced emotional sup- Nature of the Sample port as the most common type of support, The sampling frame consisted of an al- (b) be helped mostly by males, and (c) be ready existing random sample of 150 females with dependent children. households taken from the several hundred pre-existing and resettled households Me t h o d s in Penipe. Requirements for participation were as follows: Measures To capture variation in received informal 1. Must be 18 years of age or older support, I considered numerous types of 2. Must have already completed the survey inter support a person can receive, and then cat- view from the on-going NSF project in Penipe egorized these into four broad groups: tan- (Collaborative Research: Social Networks in gible, emotional, informational, and work Chronic Disasters – Exposure, Evacuation, support. The first three are commonly and Resettlement; PIs-Eric Jones, Linda identified in research on social support (e.g., Whiteford, Arthur Murphy, Graham Tobin), Kaniasty and Norris 2000), and the last was and must have reported receiving at least one a specific kind of support commonly men- type of informal support from non-kin tioned while I was in the field so I felt it 3. Must agree to be tape recorded for the inter would be important to include. Tangible or view, because my Spanish is an intermediate instrumental support is commonly consid- level and also because data may be lost in in- ered the giving/receiving of any physical terviews due to speed of speech. item or assistance that can be used to better one’s situation, and includes unpaid labor, Once I had conducted pilot tests, it was food and shelter in addition to other mate- clear that lack of trust in non-family was rials. Emotional support refers to cases in a major hurdle in receiving non-familial which the respondent confides within an- support, which suggested it might by diffi- other person for the purpose of self-relief cult to obtain sufficient cases for this study. or problem solving. Informational support Many of the respondents admitted they is defined as an instance in which the re- don’t receive nor welcome help from any- spondent has an opportunity to become one to whom they are not related. I decided more knowledgeable of an event or of re- to eliminate from the sample people who covery resources by means of verbal and/ had received no informal help from non- or written communication. Work support kin. This information was available from includes the exchange of physical labor the on-going project already underway in for monetary compensation (i.e., giving of the same area. Thus, I reviewed the survey

68 Brittany Burke interviews from the larger research project receiving any type of non-familial support, and selected only people who had received despite answers given for the previous sur- some form of support from non-relatives vey, thus this survey was omitted. Twelve of in their post-eruption recovery process. My the 26 respondents were males and 14 were next complication dealt with trust yet again. females. Ages varied from 19 to 84 years Oftentimes, informants were not comfort- old. All of the respondents lived in Penipe, able relying on their current neighbors for and all but one of them lived in a resettled support in a time of need. In most cases, section of the town occupied by families the resettled part of Penipe from which I whose housing near the volcano put them drew my sample had complete strangers at risk and/or families that have suffered moving in next door to each other. Because various property losses due to eruptions trust is such an important aspect of these and ash fall from Mt. Tungurahua in 1999 people’s lives, I decided to allow neighbors or 2006. reported living in other areas (i.e., previous neighbors before resettlement) to be listed Conduct of Interviews the same as those living within Penipe. This Once in the field, I spent my first two approach worked well and the rest of my weeks exploring Penipe, with special atten- interviews produced sufficient variation in tion paid to the resettled area of the com- types of informal support from non-kin. munity, or New Penipe. Due to the lack of Because I had available only one month trust and relationships between neighbors in the field, my goal was to interview 25 in New Penipe, it was important to develop people out of the 150 people previously a questionnaire that addressed this unique interviewed by the larger project. I ran- situation. To make up for the probable domly selected 30 individuals who had lack of responses citing current neighbors already completed their survey is with the as sources of support, I allowed for previ- larger project and who had also reported ous neighbors (neighbors from before the at least one instance of support from some- disaster and resettlement) to be classified one other than a relative from the overall the same as ‘neighbor’. Following the ini- sample of 150. Overall, I was success- tial two week period, I finalized the inter- ful in completing 26 interviews; for 25 of view questions (see Appendix A) by doing them, I noted one or more cases in which a few practice sessions of questioning three informal support from non-relatives follow- other project field workers. Although each ing the eruptions of Mt. Tungurahua was question asked for specific information, received. One interviewee denied having there was flexibility to record unstructured

Tangible Informational Emotional Work (n=12) (n=33) (n=49) (n=27) Neighbors 42 15 24 19 Friends 26 45 57 41 Work-mates 16 15 10 37 Mix 16 24 4 4 Other 0 0 4 0 Total 100 100 100 100

Table 1. Percentage of different types of support offered by different relationship types.

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Type of support vs. Friend Neighbor Work-mate Mix Relationship type vs. Other vs. Other vs. Other vs. Other Relations Relations Realtions Relations Tangible vs. 3.010 2.878 0.004 0.338.561 Other Support Informational vs. 0.198 1.343 0.154 7.122* Other Support Emotional vs. 5.120 0.225 2.936 4.513 Other Support Job Opportunity vs. 0.895 0.289 6.186* 0.589 Other Support Table 2. Chi-Square values for relationship type and support type. responses that would add ethnographic understanding of the results. For each type of Type of Support Percentage support I included in my questions a brief Tangible 27 description for the interviewees including Informational 62 some generic examples in order to lessen Emotional 81 the chance that a participant would con- fuse one type of support with another (e.g., Work 54 emotional for informational). Table 3. Percentage who reported having received different types of support. Re s u l t s

Relationship Type New Penipe is comprised of people origi- nating from a number of smaller villages within theTungurahua region and, because of this, direct neighbors in New Penipe do not necessarily have strong bonds and, in some cases, actually lack mutual trust. Out of the 42 instances of support from Figure 1. Proportions of people receiving high, medium, neighbors, only 22 were from neighbors and low frequencies of support. currently living in Penipe. Of those 22, six had resided in the same community from this exemplified the notion that relation- which the respondent relocated. Therefore ships throughout New Penipe are depen- a possible 26 of the total 42 cases of sup- dent upon trust. In other words, as shown port from neighbors were more likely due in Table 1, friends alone are very impor- to trust and the relationship itself, rather tant sources of emotional support; how- than locality. ever, when that strong bond with a friend Table 1 shows that informational and is further strengthened by close proximity emotional support were the most common (neighbor) or constant interaction (work- forms of support for the relationship cat- mate), friends become even more depend- egory “Mix.” This mix category was com- able—not only for emotional but also in- posed of people who had been described as formational support. both work-mate and friend, or, more com- Table 2 presentes the results of the chi monly, both friend and neighbor. Because square analysis of the data considering re- every mix categorization included a friend, lationship type and support type. For each

70 Brittany Burke analysis, one relationship was compared (Table 3), as predicted by my hypothesis. to the total of the rest of the relationships, Informational was the second most com- and one type of support was differentiated mon form of support received, followed from the all the rest of the types of support closely by work-related support. Tangible together. The differences are significant support was received by less than half as for friends vs. others (other categories all many interviewees as were the other three lumped together) as well as mix vs. others support types. as being a greater source of emotional support. The mix category also provided more Frequency of Support Received information vs. other kinds of support than Responses were first categorized into: did other relations, and workmates pro- “high,” “medium,” or “low” levels of sup- vided more job opportunities (as opposed to port based on the reported frequencies of other kinds of support) than did the other each type of support. If respondents an- relationship categories. Other categories of swered yes to having received support, they potential importance, but not significant at were then asked how frequently they had the .05 level, were tangible support from received that support. Specifically, high neighbors or friends and emotional support frequency was defined as receiving sup- from workmates. Interestingly, the neighbor port ranging anywhere between daily and category by itself, when compared to the weekly. Anything reported as every weekend other relationships together (neighbors vs. or monthly (and everything between that others), did not provide more of any type time-range) was scored as medium. The re- of informal support (p=.090), as shown in sponse “when needed” was included in the Table 2. medium category. Low frequency was defined as support occuring less than once per Types of Support month. These responses were graphed to The four types of support (job opportunity, better understand the relationship between emotional, informational, and tangible) type of relstionship and the frequency of yielded both expected and unexpected support. In comparing/contrasting the fre- results in relation to support and relation- quencies of instances in which support had ship type. Out of the 26 interviewees, emo- been offered to respondent (Figure 1), emotional support was most often reported tional support was rated highest.

Level of Tangible Informational Emotional Work Support (n=12) (n=29) (n=51) (n=27) High 25% 41% 59% 22% Medium 58% 52% 35% 48% Low 17% 7% 6% 30% Total 100% 100% 100% 100% Table 4. Proportions of people receiving high, medium, and low frequencies according to type of support.

Type of Support High Low Total Tangible (n=12) 33% 67% 100% Informational (n=29) 45% 55% 100% Emotional (n=51) 75% 25% 100% Work (n=27) 48% 52% 100% Table 5. Rates of support grouped into high and low frequencies.

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Emotional support was the most common men received more overall support than type of support received by those resettled women received. In fact, for every type in Penipe since the volcanic eruptions. The of support, men experienced more aid. other three types of support were most com- However, as predicted, males were also monly offered in medium frequencies (i.e., noted as offering support more frequently between every weekend to every month). than females. Percentages can be viewed below in Table 4. I further investigated the gap between Di s c u s s i o n a n d Co n c l u s i o n frequencies of support by grouping all instances into “High” and “Low” categories. Access to informal social support varies High was defined as any instance falling from case to case depending on a num- into a daily to monthly occurrence, and all ber of different factors. Every person in else was considered low. As Table 5 shows, this sample had been affected in one way high frequencies of emotional support are or another by the disaster, though some much more common than are low frequen- were theoretically better equipped to man- cies of emotional support; high frequencies age an unexpected event. This was due to of tangible support are much less common their social networks consisting of not only than are low frequencies of tangible sup- family but also non-kin. Persons, especially port; and reporting of both informational men, with a variety of friends, neighbors and work support cannot be predicted by and work-mates appeared most able to recency of last support received. deal with the aftermath of this emergency situation. Gender By researching the aspects of social sup- Contrary to my hypothesis, women were port typical of peasant farmers, it may be actually less likely to receive support in this possible to craft a more effective plan to as- study. Women made up the larger part of sist communities similar to Penipe following the sample (54%), though they reported a natural disaster. More importantly, by un- fewer instances of having given or received derstanding the relationship types of those support, thus reporting lower per capita in need, we can better predict the types of support (Table 6). In descriptive analysis of support that will already be available from the data, men reported higher frequencies citizen to citizen. The lack of trust between of actually having received support from citizens of New Penipe can be expected, people named as part of their support net- for instance, as it is predicted in Asthana’s work. To determine the reasoning for this (1996) research. By creating a disaster man- unexpected finding, I removed the “work” agement program that is prepared to han- column from Table 1. Perhaps males expe- dle obstacles such as these, formal support rience many more job opportunities than can be utilizing more effectively. women? Even with this revised analysis, According to my hypothesis, I expected to Interviewee Percentage of times that Percentage of times that Total Gender support was received support was received from non-family males from non-family females Men 81% 19% 100% (n=12) (n=61) (n=14) Women (n=29) 40% 60% 100% (n=18) (n=27) Total (n=) 41 79 25 124 Table 6. Support received by men and women.

72 Brittany Buke see proportionately more instances of sup- inhabitants of Penipe are of meager finan- port offered by men and proportionately cial means and do not have private trans- more instances being received by women. portation. Instead, the only transportation However, men were the more common re- available for a relatively low expense is the ceivers of support following the eruptions buses. They make interval runs to many of of Mt. Tungurahua. Though this pattern the local villages on a daily basis, though supports Drabek’s (1986) claim that help constant stops along the way even make would be recipients most from men, it does short distance travel quite an effort. not follow predictions that women would be Although the relocation process solved the most common receivers of disaster sup- the lack of housing issue, it failed to ease port (Taylor et al. 1988). The other predic- stresses in other areas. The lives of the tion, that men were the more likely venues relocated people were much improved of support, was supported. This might be due to the efforts of housing projects and because of the nature of the resettlement various formal organizations, but it seems and/or the social norms common the the other aspects of the relocation have been area. Men have many more opportunities less positive. Specifically, lack of trust was than women to meet, bond, and just hang- a major consequence of the relocation pro- out. Child raising and cooking are consid- cess. Neighbors of New Penipe were often ered the jobs of women of the household. from different communities throughout the Throughout my experience in the field, I Chimborazo province. Property loss was noticed men out of the house after dark yet another negative effect that stemmed and interacting with one another in various from not only the eruptions themselves, but bars and open shops while women were from relocation as well. Transportation was expected to stay indoors. Following dinner, necessary to get to one’s property, which it is expected that women stay inside while presented a new expense should farmers men are more often walking about the decide to continue working what land was community, visiting the local pool hall or still productive. General dissatisfaction was drinking in small gathering places. I would also a common comment of respondents. suggest the possibility that the higher in- Most interviewees stressed their desire to stance of support offered to men is directly return back to their native communities. related to their ability to build and main- Possible interventions are based on my tain more social connections particularly in analysis: this resettlement setting since previous ties have been disrupted. A strong emphasis on increasing access of a broad Also, I proposed that emotional support range of help to females would also benefit the would be the most common type of sup- whole community. port witnessed, as it was common in the literature. This prediction was supported. Regularly scheduled neighborhood meetings/cel- Distance as well seemed to play a role in ebrations could be a start to compensate for the this study, as alternate types named were lack of communication and/or trust between relo- rarely situated more than a comfortable cated households in new communities. day’s travel from the interviewee. Faust et al. (2000) conducted a similar study in a Some respondents have free time on their small village in Thailand and found that hands—now having no land to work or hav- certain institutional facilities led to the rela- ing no means of securing transportation to tionships of individuals living more than a get to their land. Village projects could pro- comfortable day’s travel apart. Most of the vide monetary income to those willing to

73 Explorations | Social Sciences work, as well as help to strengthen relationships, and even improve quality of life in newly relocated locations. These building projects would also likely help with the issue of dissatisfaction among resettled families and instill a sense of pride and belonging to the community they now live. Many communities in the Tungurahua area already meet to perform labor projects in their communities. I believe the best example of this is the traditional mingas–community projects organized by male leaders in some villages—which are so prevalent throughout the Andean region (Korovkin, 1992; Thurner, 1993; Whitten, 1969). Programs such as these can be used as models for resettlement and disaster management. Results from this project might be useful for generating models for post-disaster relocation sites, but generalization from the data is not warranted due to the small sample size. It is also important to note that this study was conducted using a sample that had been offered, accepted, and received the above mentioned types of aid, so overall rates of support are exaggerated—I attempted only to interview people I knew had reported in another study having received social support. Further research would be necessary to compare these results with those of the entire town of Penipe (or elsewhere), as well as add support by family members into the study to understand the relative importance of non-kin aid for each of the four types of support.

74 Brittany Burke

Ac k n o w l e d g m e n t s

This research was supported by a Research Experience for Undergraduates supplement to NSF BCS-0751265 (EC Jones-PI, AD Murphy CoPI). I am thankful for the support in the field I received from Fabiola Juarez Guevara and AJ Faas, as well as my fellow REU researcher Audrey Schuyler. AJ Faas, Adam Boseman, and six anonymous reviewers provided invaluable comments helping clarify the meaning of the results and improving the presentation of the manuscript. Most of all, I am indebted to several dozen people in Penipe who extended themselves to me as I asked them about their struggles and their help-seeking strategies.

Wo r k s Ci t e d

Asthana, Roli. 1996. Involuntary Resettlement: Survey of International Experiences. Economic and Political Weekly. 31(24):1468-1475.

Beggs, J.J., V.A. Haines, And J.S. Hurlbert. 1996. Situational Contingencies Surrounding the Receipt of Informal Support. Social Forces. 75(1):201-222.

Bradfield, C., M.L. Wylie and L.G. Echterling. 1989. After the Flood: The Response of Ministers to a Natural Disaster. Sociological Analysis 49(4):397-407.

Drabek,T.E. 1986. Human System Responses to Disaster: An Inventory of Sociological Findings. Springer-Verlag.

Faust, K., B. Entwisle, R.R. Rindfuss, S.J. Walsh, and Y. Sawangdee. 2000. Spatial ar- rangement of social and economic networks among villages in Nang Rong District, Thailand. Social Networks 21(4):311-337.

Jacobson, D. 1987. The Cultural Context of Social Support and Support Networks. Medical Anthropology Quarterly 1(1):42-67.

Kaniasty, K., & F. Norris. 2000. Help-seeking comfort and the receipt of help: The roles of context and ethnicity. American Journal of Community Psychology 28:545–582.

Korovkin, T. 1992. Indians, Peasants, and the State: The Growth of a Community Movement in the Ecuadorian Andes. Occasional paper for the Centre for Research on Latin American and the Caribbean (CERLAC).

Mok, D. and B. Wellman. 2007. Did distance matter before the Internet?: Interpersonal contact and support in the 1970s. Social Networks 29 (3):430-461.

Scott, J.P., and K.A. Roberto. 1987. Informal Support of Older Adults: A Rural-Urban Comparison. Family Relations 36(4):444-449.

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Taylor, R.J., L.M. Chatters, and V.M. Mays. 1988. Parents, Children, Siblings, In-Laws, and Non-Kin as Sources of Emergency Assistance to Black Americans. National Council on Family Relations 37(3):298-304.

Thurner, M. 1993. Peasant Politics and Andean Haciendas in the Transition to Capitalism: An Ethnographic History. Latin American Research Review 28(3):41-82. Unger, D.G., and D.R. Powell. 1980 Supporting Families under Stress: The Role of Social Networks. Family Relations. 29(4):566-574.

Whitten Jr., N. 1969. Strategies of Adaptive Mobility in the Colombian-Ecuadorian Littoral. American Anthropologist 71(2):228-242.

76 Brittany Burke

Ap p e n d i x A: In t e r v i e w

Questionnaire Used in Penipe

Introduction t o In t e r v i e w e e : Greetings, I’m a student and I’m working with AJ, Fabiola, and Eric on their study involving the social effects of the volcano. I’m studying for a smaller project for my university. I know that sometimes the family is best for helping with whatever necesity, but sometimes it’s not possible to ask family members, and I’m interested in knowing more about the mo- ments in which other people are asked for assistance and why. Would you be able to answer a few questions for me? The interview is short, about 10 or 15 minutes long, it’s not as long as the last interview you answered.

Is it okay if I tape record this conversation?

Name:

As k :

A1: I see that you’ve received support (like tangible/information/emotional/work) from people whom are not relatives of yours, correct? Ye s No Tangible: Loaned items, money, food, gifts, etc… Information: That can help to better or ease your situation (like information about organizations that can help). Emotional: Like sharing emotions, worries, sadnesses, experiences, etc… Work: Have offered chores of some sort to you in exchange for monetary compensation.

A2: Tangible: Has there been a time that you’ve received tangible support from someone that is not a relative of yours? Ye s No

A3: What was/were their name(s)? (Up to 3 names)

A4: Who is to you? And where do they live?

A5: What tangible support did give to you? And when was the last time?

A6: With what frequency did give this support? And how much did they give?

A7: Have you also given tangible support to ? And what was it?

A8: Information: Has there been a time that you’ve received informational support from someone that is not a relative of yours?

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Ye s No

A9: What was/were their name(s)? (Up to 3 names)

A10: Who is to you? And where do they live?

A11: What information did give to you? And when was the last time?

A12: With what frequency did give this support?

A13: Have you also given informational support to ? And what type of information was it?

A14: Emotion: Has there been a time that you’ve received emotional support from someone that is not a relative of yours? Ye s No

A15: What was/were their name(s)? (Up to 3 names)

A16: Who is to you? And where do they live?

A17: What emotional support did they share? And when was the last time?

A18: With what frequency did give this support?

A19: Have you also given emotional support to ? And what was it?

A20: Work: Has there been a time that you’ve received a job opprotunity from someone that is not a relative of yours? Ye s No

A21: What was/were their name(s)? (Up to 3 names)

A22: Who is to you? And where do they live?

A23: What type of work did they offer you? And with what frequency did they offer you work?

A24: Have you also offered a job to ? What type of work was it?

78 Brittany Burke

Now I’m going to read a hypothetical situation.

Fo r Ma l e s : A25: Say your family members cannot help you, from whom would you ask to borrow a pickax and/or hoe and why?

Fo r Fe m a l e s : A25: Say your family members cannot help you, to whom would you go to to watch your children and why?

A26: Who is ______to you? And where do they live? ______

A27: Have you already received some things like this from ______? Like what? ______

A28: When was the last time? ______

Observations :

79 Defining Barriers to Acceptance of Westernized Medicine Among Montagnard Refugees

Margeaux Corby Elon University Faculty Mentor: Donald Wooley Elon University

Ab s t r a c t As culture is a primary component in shaping an individual’s perception of illness, this research attempts to discover the cultural barriers to displaced populations’ acceptance of “Western” medicine and observance of prescribed medical regimens. In this ethnographic study, evidence-based cross-cultural health knowledge of the Montagnard community in Greensboro, North Carolina, was collected via snowball sampling. Subjective narratives, investigator observations and review of previous research were used to evaluate the overall patterns observed in both first- and second-hand accounts of health- related activities and health care utilization by the Montagnard community. Patterns found included misunderstandings between patient and provider due to differences in defining illness and the use of passive obedience to avoid revealing ignorance. Such findings appeared to encourage patient noncompliance and explained ignorance of clinical appointment and health care systems.

hat are the cultural barriers to dis- Southeast Asian refugee populations’ cul- W placed populations’ acceptance of tural tenets and ideologies, especially in “Western” medicine and compliance to establishing patient-doctor relationships its tenets? How can medical practitioners and ensuring successful provision of care, overcome potential barriers to improve the has been documented in both scientific health of displaced populations? Culture is studies and practitioner observations (Ito, primary in shaping an individual’s percep- 1999; Stephenson, 1995; Uba, 1992). These tion of illness and compliance with pre- refugee populations, typically the poorest scribed medical regimens. The importance and lowest educated members of mod- of health care providers understanding ern society, are more likely to suffer from

80 Margeaux Corby significantly higher levels of death and dis- immigration of Hmong, Cambodian, ease than other population segments when Laotian, Vietnamese and Montagnard acceptance and accessibility toWesternized communities following the end of the medicine is lacking (Kreps & Sparks, 2008). VietnamWar (Southeast 2009). Montagnards Identification of health-related cultural el- are not Vietnamese, a distinction that has ements is critical for providers and health steered the course of these peoples’ history educators wanting to establish appropri- and future in Vietnam, as their religious ate health care programs and materials and ethnic differences have been the cata- for culturally diverse populations. Respect lyst for much of their persecution. Raleigh for cultural factors, such as familial roles, Bailey, director of the Center for New spirituality and communication patterns, North Carolinians and a senior research are essential to the acceptance of recom- scientist at University of North Carolina mended care regimens and preventative at Greensboro was heavily involved in the programs (Kreuter et al., 2002). first Montagnard immigration waves in Refugee populations are at greater health the 1980s. His experiences and study of risk than other segments of the population the uniquely tragic history of these people (Kreps & Sparks, 2008) because they are from the time of their involvement in the the most likely to experience dissonance Vietnam War was a significant source of the with Western medical culture. In order for following historical information. According the target population to accept the medi- to R. Bailey, although some live in urban cal notions of their new nation, a bridge areas, the majority of Montagnards are ru- must be created between cultural axioms ral, farm people from Vietnam, very ethni- and the foreign, yet effective interventions cally different from Vietnamese. The U.S. that Western medicine provides. In this Special Forces recruited them as frontline paper, I present findings from an ethno- allies to fight in the highlands of Vietnam graphic study of Southeast Asian refugees, during the Vietnam War, another reason a Montagnard population in particular, the Vietnamese government continues to residing in Greensboro, North Carolina, harass the Montagnards (R. Bailey, per- to fully demonstrate the need for cultural sonal communication, April 30, 2009). awareness in a clinical and public health The life of Montagnards in Vietnam setting. Some of the key cultural barriers and their relationship with the ruling for this population that will be examined in Vietnamese government eerily parallels the the article are Montagnards’ varying defi- calamitous history of the Native Americans nition of illness that may limit health-seek- in the United States, according to R. Bailey. ing behavior, the use of passive obedience Land treaties between Montagnard leaders to avoid shame or revealing ignorance, and the ruling Vietnamese government reliance on traditional medicine and false were struck and subsequently broken. perceptions of Western medicine. Before Montagnard Christian churches, espe- the stories of these cultural groups can be cially the evangelical churches in Vietnam told, it is necessary to introduce the popu- that had become the organizing place for lations examined in this study and briefly Montagnards in terms of social change, discuss the reasons behind their exodus to were made targets of governmental oppres- the United States. sion; many were burned. Stories of physical Over the past 35 years, 1.3 million refu- violence, mysterious imprisonment of fam- gees have arrived from Southeast Asia. ily members and forbiddance of church Cambodia, Laos and Vietnam are the attendance were common amongst inter- three major countries represented by the viewees—many fled to the jungle between

81 Explorations | Social Sciences

Vietnam and Cambodia to escape persecu- Li t e r a t u r e Re v i e w tion (R. Bailey, personal communication, April 30, 2009). Modeling health messages in a cultur- “They’re always like ‘You came from ally appropriate framework is primary for Vietnam’ and we’re like ‘No, we’re running health communication to be effective be- away from Vietnam,’” one interviewee tween health provider and patient or health said. The distrust Montagnards have of agency and target community. The impor- the Vietnamese is truly pervasive through- tance of culturally appropriate care has out the majority of the community, stem- been explored by public health and com- ming from the violence inflicted on these munication scholars via 1) examining the Christian people attempting to worship significance of cultural awareness in health in a communist country. Human rights communication, 2) the special need for cul- violations continue today and Montagnard turally appropriate health care for refugee churches both in the United States and populations, and 3) the role of health pro- Vietnam continue to petition Congress and viders in establishing culturally appropriate the United Nations for help. communication. Such issues have proven The very first large group of Montagnard to be forefront in the struggle to overcome refugees came in 1986 and subsequent im- cultural barriers to appropriate health care migrant waves and natural born genera- (Barr & Wanat, 2005; Paez et al., 2008; tions have led to the 7,000 or so that reside Kreps & Sparks, 2008). in North Carolina. Montagnard refugees, made to flee because of their beliefs, hold Significance of Cultural Awareness in Health tightly to such values in America, and these Communication traditions and principles directly influence Examining cultural issues that impact and health care decisions, compliance and influence the way in which members of vul- pursuance. nerable populations respond to health com- Southeast Asian refugees in the United munication and care is crucial for successful States, despite many cultural, linguistic and disease prevention and health management national differences, share common pre- (Kreps & Sparks, 2008). The necessary cus- emigration experiences of war and flight tomization of health communication pro- from oppressive governments and common grams and health services to better meet governmental benefits once in America the needs of minority consumers is ac- (Ito, 1999). As such, information about complished by recognizing and practicing Montagnard normative cultural values culturally relevant modes of appropriating and their direct and indirect influence on knowledge (Kreuter & McClure, 2004). health care will be supplemented by find- Healthy People 2010 is a set of health pro- ings of other Southeast Asian refugee ex- motion and disease prevention initiatives periences and cultural patterns observed by meant to help health organizations develop various health care providers, all of which programs to improve the overall health of have been documented in anthropological the nation during the first decade of the studies. The influence of culture on health- new century (U.S. Department of Health related activities, provider responsibility and Human Services & Office of Disease and the need for health professional-tar- Prevention and Health Promotion, 2010). geted interventions will also be examined It was established by several federal agen- extensively, in addition to an exploration of cies, health departments, businesses and suggested approaches to improving cultural community partners working to increase competency of patient care providers. life expectancy and quality, as well as

82 Margeaux Corby eliminate health disparities. The program’s emotional and physical demands of flight objectives, which include increased access and uncertainties encountered in an alien to quality health services and establishment country. These numerous potential sources of more educational and community-based of stress refugees face make them prime programs, acknowledge the significance of candidates for health problems, but be- maintaining a focus on culture when devel- cause of the cultural and linguistic barriers oping intervention strategies (Kreuter et al., before them, the least likely population to 2002). It charged health practitioners to ex- take advantage of necessary and available plore not only the unique concerns of dif- health care systems. ferent cultural groups, but investigate how such needs can be met when conventional Health Providers’ Role in Establishing Cul- services have failed (Kreuter et al., 2002). turally Appropriate Communication Health care providers play a critical role in It is because of these emotional, educa- the interaction with patients from diverse tional and economic obstacles faced by populations and their improved cultural refugees that public health activists and ed- competency would yield improved commu- ucators should not attempt to add the addi- nication with patients and potentially re- tional burdens of changing refugee etiolo- duce disparities in health and health care gies of illness and require conformation to utilization (Horner et al., 2004). Western health care models. Cultural barriers experienced by refugees in relation to Necessity of Culturally Appropriate Health their health care are expansive and result in Care for Refugee Populations increased stress on an already overstressed Consequently, non-native and refugee community. Ultimately, health programs populations are especially vulnerable to and interventions targeted at refugee pop- significant discrepancies in health care ulations require greater expense for and access and are in great need of culturally demands upon local health care systems relevant, accurate and timely health infor- (Kemp, 1985). Interventions and programs mation (Kreps & Sparks, 2008). Reaching aimed at health care professionals are con- immigrant populations is a tremendously sidered most likely to effect change since it complex but acute need in the United is providers that exert more primary control States, as these groups are the most vul- over the health provision and care process nerable health care consumers (Kreps & (Horner et al., 2004). Approaching patients Sparks, 2008). Traditional culture and ac- within a relevant cultural framework will companying values are highly esteemed by actually aid the process of diagnosis and populations who, because of violent and treatment, since symptomology and treat- horrific circumstance, are forced to live ment regimens can be better understood without the basic comforts of a familiar by patients, who must describe and comply language, nationality and political struc- with such measures, and practitioners, who ture (Frye & D’Avanzo, 1994). Often these must interpret such symptoms and pro- belief structures have been threatened in vide treatment (Hamilton, 1996; Kreps & their native country and refugees have suf- Sparks, 2008). It has been argued that more fered violence from the governing bodies effort should be put into provider-focused who forced their exodus (Frye & D’Avanzo, interventions than focusing on change in 1994). Refugees are leaving one volatile patients for these reasons (Horner et al., and violent environment for a potentially 2004). Providers who obtain detailed infor- safer but more unpredictable and foreign mation about patients’ cultural perspectives one. They are subject to the additional will have a greater insight into patients’

83 Explorations | Social Sciences health beliefs than if they only identify a pa- Interviews, which ranged from 45 to 90 min- tient by ethnicity (Andrulis & Brach, 2007). utes in length, were conducted individually, Because failure to consider patient cultural although family members were sometimes issues can result in incorrect medical histo- present, and participant narratives were re- ries, non-compliance, and low likelihood of corded and transcribed. Interviewees were effective treatment (Flores, 2000), cultur- asked questions that covered a variety of ally appropriate health communication tar- topics, including inquiries about their health geted at health care providers or agencies is histories, personal experiences with health thus necessary to limit health disparities in care in the United States and Vietnam, non-native and refugee populations. challenges they faced during the resettlement process, religious beliefs, Montagnard Me t h o d s traditions and health experiences related to them by friends and family members. This ethnographic study focused on the Visual material (photographs and video subsection of Montagnard refugees in of some informant interviews) and audio the Greensboro area, as well as commu- material from taped conversations were nity members who have worked exten- collected. These subjective narratives, in sively with the population and took place combination with investigator observations from September 2008 to February 2010. and review of previous research, were used Snowball sampling was used to locate and to analyze the overall patterns observed in interview subjects since organizations famil- both first- and second-hand accounts of iar with the community mainly work exclu- health-related activities and health-care sively with the local Montagnard religious utilization by the Montagnard community. leaders and are not in contact with other Interviewees are not identified in the pa- individuals except on a case-by-case basis. per, unless their position is relevant to the The sensitive nature of my questioning, quoted information. Analyzing techniques as it regarded health-related information, I used involved 1) the identification of in- made introductions through acquaintances digenous themes that appeared to char- beneficial in securing source confidence. acterize the health care experience of an Because there is very little current literature interviewee and 2) the comparison of these about the Montagnards in general, much themes to other interviewee accounts and less about those living in North Carolina, I current scholarly research. Use of these began the process of contacting members types of scrutiny-based techniques have of the Montagnard community by con- been deemed more appropriate for longer, tacting refugee resettlement agencies and richer narratives and the contrast-compare requesting referrals for community leaders. methods allow a broader exploration of a By attending regular Sunday worship ser- previously unexplored health culture (Ryan vices at the United Montagnard Church, & Bernard, 2003). Such comparisons were I established a familiarity with the com- made after the interviews by identifying key munity and recruited interviewees, most concepts discussed by informants and then of who suggested other family members or matching these patterns to other intervie- friends as potential interviewees. wee statements and relevant literature. Eleven female and three male Seven primary motifs were identified and Montagnards were interviewed, all be- further literature was sought to expand spe- tween the ages of 20 and 60. Interviewees cific themes not fully described in the initial had been born in Vietnam but now lived literature review. in the United States for at least three years and were proficient English speakers.

84 Margeaux Corby

Re s u l t s a n d Di s c u s s i o n such as circumcision or tonsillectomies, which are considered routine in the United Patterns found among Montagnard refu- States, are frightening to many Southeast gees included misunderstandings between Asian refugees. Some groups believe such patient and provider due to differences in invasive procedures have long lasting and defining illness, passive obedience, reliance multiple effects that outweigh the benefits on traditional medicine and false percep- of surgical relief or cures (Muecke, 1983). tions of Western medicine. In addition, the Religious beliefs can also play a role in introduction of American fast food is lead- the refusal of many routine procedures by ing to the formation of new dietary habits Montagnard patients. “Circumcision [the by refugees, forecasting the possibility of doctors] explain is cleanliness, for a better new health concerns brought on by an un- health,” one interviewee said. “But in our balanced diet. These patterns were devised culture and belief you shouldn’t take off a posteriori by separating observations, in- anything that’s given, you go against God’s terviews and applicable literature analyses will, and those are the things that are so into comparable thematic categories. sensitive because once it’s done you can’t sew it back.” Defining Sickness Southeast Asians who decide to seek Modern health care is highly regarded by health care are often apprehensive about many Southeast Asian groups. Problems the treatments and diagnostic tools used related to these groups’ utilization of in Western medicine because of their lack health care are due more often to misun- of familiarity with and misinterpretation derstandings rather than a lack of accep- of the functions of such procedures, no tance (Kemp, 1985). Because health culture matter how non-invasive or simple they shapes the way in which sickness is defined may seem to Westerners (Uba, 1992).One and the interpretation of its severity, it also Montagnard woman gave birth to a son influences the actions necessary to treat it with a malfunctioning liver and, although and the way in which it is described to oth- the doctors’ suggested a transplant, she re- ers. Ideas concerning the source of sickness fused to give permission for such an opera- and disease, something many mistakenly tion. “They keep him two months and they believe are universally understood and ac- said they want change for him, change his cepted, are susceptible to varying explana- liver,” she said. “I say he still little, I’m scary tions. For instance, the idea of preventative for him. At the meeting they say ‘Why you care is not a familiar mode of thinking for say no?’ I say no, I can’t do it, they want me many Montagnards. “[The Montagnards] to sign the paper, and I say no I just speak work until they get hurt or are too sick to to God I pray to God.” This Montagnard go into work,” said one interviewee. “If mother’s lack of knowledge about the tech- someone gets them to a medical provider, nology, process and safety measures taken then they get care, and if they don’t they before, during and after organ transplants don’t.” in the United States led her to refuse a po- An individual’s understanding of illness tentially health-improving, even life-saving, etiologies is created well before a clinical surgery for her son. encounter (Ito, 1999). Such interpretations of symptoms and causation of sickness are Seeking Health Care conceived through interactions with people Health-seeking behavior is constrained in within important social networks and can in- many refugee Southeast Asian populations fluence behavior both before and after doc- due to beliefs in the naturalness of suffering tors visits (Ito, 1999). Moreover, procedures and reticence about seeking treatment for

85 Explorations | Social Sciences asymptomatic diseases. Southeast Asians governmental persecution and spent years beliefs concerning the inevitability of suf- treating injuries and sicknesses with herbal fering and acceptance of the time of death remedies since qualified health care was not as predetermined inhibit some from seek- an option. Even though professional health ing medical services (Uba, 1992). Members services are now available to Montagnards of a Vietnamese population of rural origin in the United States, many do not take ad- studied in Victoria, British Columbia ap- vantage of them because they are not used peared to base many decisions around the to the idea of seeking out such services. traditional concept of causation, and the notion of individual destiny (Stephenson, Collectivism and Importance of Family 1995). Stigmas associated with disease and Although collectivism and kinship are not illness can lead many to not seek care for inherently health related, these factors have serious conditions out of fear of family or a significant influence on health behaviors community judgment. “They can’t afford and outcomes (Kreuter & McClure, 2004; to be here and to be an outcast from their Ito, 1999). Because family and peers are society, their community because they have often the source of accepted and trusted no one, nothing, this is it and they can’t information, inclusion of family, especially go back to their homeland,” said one in- decision-makers within the family who may terviewee from the county health board. not be actual blood relatives, is an impor- “So what do they do? They just accept it tant factor in facilitating compliance (Ito, and die.” This belief is still very strong in 1999). Montagnard refugees rely on elders, older generations of Montagnard refugees. husbands and most importantly, their com- “It’s so hard to get them to go see a doc- munity’s religious leader to assist in or make tor because they always believe if you have the actual decision about care and the ac- cancer it’s a curse because your mom did ceptance of treatment plans.“The oldest, bad things or your dad owe me 50 cents,” normally one person makes a decision for said one Montagnard refugee, who also you. If that person were not around in an works as a hospital translator.” Just to face urgent situation that you need to make a de- the community alone is not easy. People cision in five minutes then religious leader start looking at you like ‘Your mom is a bad is the second person that make a decision mom.’ For a certain symptom of a disease on your spouse behalf. It normally whether that you have [the thought] is you deserve you should have any more baby or not, it.” Similarly, Cambodians are slow to seek whether you should go on birth control or help because some accept symptoms as fate, not,” said an interviewee. “A lot of health which is related to certain religious beliefs care providers ask, ‘What is your relation- and varying definitions of what it means to ship with the patient?’ and the preacher will be healthy (Kemp, 1985). say ‘I’m her pastor’ and they still won’t get it Southeast Asian populations also can because they have no idea. We honor God have different standards than Americans and we honor the person who delivers the about how significant a health threat has to message who is the preacher or the pastor.” be to seek professional care. For example, The grouping of Montagnard communi- the majority of Cambodian refugees are ties and the many extended and immediate unaware of basic hygiene, principles of family members that crowd households il- disease transmissions and many have lived lustrate the importance of “togetherness” under conditions in which high levels of many feel. “[Montagnards] don’t seek out disease are tolerated (Kemp, 1985). Many the private space that [Americans] do,” Montagnards lived in the jungle to escape one interviewee said. “You want to be with

86 Margeaux Corby your family, you don’t want to be separated, given diagnosis or the reason for a prescrip- in a way.” If Montagnards are willing to tion regimen, many will not express their sacrifice personal boundaries and comfort disquiet. Many Southeast Asian cultural to be with family members, they will cer- traditions emphasize that authority figures tainly reject health professionals and insti- or experts should not be questioned or op- tutions that don’t understand or allow fam- posed directly but only discreetly disobeyed ily members to be included in the medical later on (Muecke, 1983). This passive obe- decision-making process. dience also leads to non-compliance for The impact of specific family members Montagnard patients. “The trick is they (usually a husband or other male figure) are so polite they wouldn’t respond, they and their importance as decision-makers is wouldn’t say no, they hardly say no be- essential in gaining client cooperation and cause health care provider is like the god- aiding in effective treatment and diagnosis dess or something to them but they won’t (Ito, 1999). “The culture is always the hus- do it when they go home,” said one hospital band make decisions. The problem like…to translator. This type of passive obedience give birth control they have to ask husband is culturally adaptive and Southeast Asian to decide,” said one interviewee. Many refugee patients use this strategy to cope Southeast Asians find being alone fright- with uncertainty and authority as well as ening. One woman did not want to leave avoidance of shame (Muecke, 1983). The Vietnam but came to America to be with cultural values that emphasize this unmiti- her father who was living all by himself. gated politeness and obedience to author- “When I came here the first time I think ity figures is frustrating and confusing for I don’t want to come here,” she said. “My medical personnel who do not understand dad call my family in Vietnam on the phone why patients fail to return for medical ser- and I feel so sad for my Dad, he can’t speak vices after a seemingly smooth encounter English and work hard and I just feel sorry (Uba, 1992). “That is the culture itself,” for him. I miss him too [so because of] that said a hospital translator. “Whether they I just come over too.” Involving a patient’s like you or not they won’t let you know, the family as much as possible during a doctor’s only way you know is if you never see them visit, even possibly simultaneously schedul- come back for their follow up, that’s when ing an entire family to be seen can put pa- you know something was wrong.” Cultural tients at ease (Muecke, 1983).“Over there in norms regarding respect of clinicians’ au- Vietnamese or Montagnard culture, family thority may prevent patients from being ac- is to be honored, you got to respect that,” tive in their care (Andrulis & Brach, 2007). one interviewee said. “Rather listen to par- Winning a patient’s confidence is difficult ents than listen to yourself.” Inviting family for doctors who must contend with the members and friends to participate in the many cultural variations in attitudes to- clinical encounter and even assist with ask- ward medical professionals. ing questions and recalling instructions is essential since many Southeast Asian cul- Unfamiliarity and Misunderstandings of tures require family member approval or Western Health Care Systems participation in the decision-making pro- United States citizens familiar with the cess (Andrulis & Brach 2007). Western medical system often consider intake procedures routine but these same Passive Obedience situations are often confusing to Southeast Even though a Southeast Asian refugee pa- Asian refugees new to the process. tient may not understand or agree with a Members of minority groups may try to

87 Explorations | Social Sciences hide or mask their limited health literacy or one day we come home and after meal she unfamiliarity with Western systems of care die. It’s hard for [doctor] to acknowledge by not asking questions or simply feigning that.” Thus knowledge of past diagnostic comprehension (Andrulis & Brach, 2007). procedures and the results of such tests are The American appointment system is often rarely known (Muecke, 1983). misunderstood both in terms of needing Any foreign-born person’s first contact an appointment and the fact that once an with Western health services requires them appointment is made, patients still must of- to fill out questionnaires. These situations re- ten wait past the scheduled time (Muecke, veal unfamiliarity with Western medicine’s 1983). According to one Montagnard in- typical instructions such as checkboxes and terviewee, the concept of needing to make rating scores of symptoms, and require an appointment time, arriving at the doc- the patient to reveal private and possibly tor’s office or clinic at that specified time embarrassing health-related information and then have to wait several minutes past (Zanchetta & Poureslami, 2006). “They ask that time is unusual and frustrating. “It’s you how many partners you have,” one fe- different from Vietnam and here. When I male interviewee said. “We don’t ask that was in Vietnam when I got to doctor, when back home or are you active and things like we go there, it’s like they working when we that, we don’t ask those things. When they get hurt but over here we have to wait. No, asked me for the first time I was like ‘What in Vietnam when you get hurt just go, you do you mean? I’m single.’ You didn’t un- don’t need to make an appointment or any- derstand the question to be honest.” Such thing.” The appointment system continues misunderstandings of important medical to be a source of confusion and sometimes questions have the potential to lead to in- a reason behind a lack of health care seek- accurate health histories, which may cause ing behavior, according to community clinicians to order unnecessary, expensive leaders. “They keep say ‘Why doctor make and time-consuming diagnostic procedures appointment for me and I have to come or misdiagnose a patient. on time but, I wait over thirty minutes or The roles of hospital or clinical person- one hour how is that?’” Frustration felt by nel differ from country to country, and the Montagnard patients already dealing with breadth of responsibility exercised by a stresses of relocation can lead to bitter- nurse versus a doctor or a receptionist may ness toward Western health services, a dim be unfamiliar to a patient. A Montagnard prospect for the resolution of future medi- woman who was a nurse in her native cal conditions. country continually seemed confused by The purpose behind physical examina- how little nurses seemed to influence care tions and the listing of health histories is not regimens. “Everybody know the nurse in understood by many refugees. Indochinese Vietnam not same as here,” she said. “Here groups tend to focus on treatment of symp- somebody sew they only sew, somebody take toms rather than discovering the underlying out baby they only take out baby and over causes (Kemp, 1985). In addition, obtain- there I do everything. I take out baby, I can ing medical histories from many Southeast see ear, can see jaw, can see everything. I Asian patients tends to be unproductive give the medicine. I don’t need the doctor.” because they are rarely told the names of The idea of specialization or different fields previous illnesses or medicines given to of medicine is also a hard idea to grasp for them. “Many time when they do a family some Montagnards used to a more gen- health history, we don’t know,” an intervie- eralized system of care. “In Vietnam they wee said. “We know our folks died, but we have a general doctor,” one interviewee don’t know what they die from. We just say said. “One doctor he can make decision to

88 Margeaux Corby do things. Here you go to primary doctor, believe there are limitations to even what and he cannot do the family practice he herbal remedies can cure so Western medi- sent you to specialist and that is different cines are still sought out. “Herb medicine the way of treatment.” Montagnards want- to treat one only [symptom],” one inter- ing to see a physician must find some form viewee said. “The body only one diagnosis of transportation and potentially secure a and symptom can be gone only one and translator, in addition to the regular sched- if you have two or three you can’t have uling steps taken by most Americans need- herb medicine.” When medication is dis- ing to use health services. After putting so pensed, dosing instructions are often mis- much effort into seeing one doctor, it can understood or not received at all. “We have be incredibly disheartening for a patient to make sure they understand medicines, how realize the process must be repeated. The to take it,” said one Montagnard commu- prospect of repeating such a daunting task nity leader. “They said okay one day I take may lead to an abandonment of efforts all three times a day. Three time how much? together. How many hour?” When a prescription or medication is received, a lack of knowledge Reliance on Traditional Medicine about medicines in pill form still can lead to The perception that Western medicine is confusion.“The concept of needles they’ve inappropriate for non-Westerners can con- heard of because they have experience be- tribute to Southeast Asian patients’ refusal cause of the flu shot annually but they’re to seek Western healthcare or, once being not really a big fan of pills because nor- prescribed a medication, not taking it (Uba, mally when you go to the doctor you usually 1992). “I guess like my family have used the get out with a shot. [In Vietnam] whether root of the tree but I don’t know what that you have stomach ache they give you shot. called,” one interviewee said. “My brother Over here they expecting [a shot] but all sent it over here but we don’t keep it no you have is prescription you can’t even buy more we use it all.” When asked about anti- there,” said one hospital translator. “That’s biotics many interviewees seemed confused when it gets lost, the pills never get taken. and asked what antibiotics were. Many did The prescription is ended up in their wallet admit using Tylenol and Aleve but couldn’t for many years.” In this case, even though think of any American medicine besides the patient does receive care from a physi- those name brands. cian, the necessary steps to begin effective Southeast Asians put more emphasis on treatment (i.e., filling the prescription) are self-care and self-medication and both are never taken. often practiced longer than with Western patients before professional care is sought Changes in Diet and Lifestyle (Muecke, 1983). “In Vietnam only if the The “bigness” of American lifestyle, in- life’s threat, then you go to hospital,” one cluding the availability of high calorie, interviewee said. “If you flu you try to use large proportioned food not available in herb medicine. We treat flu from earth, Vietnam has contributed to the forma- from mother earth medicine. They give tion of new health concerns for Southeast birth also we have herb medicine. And vita- Asian populations. According to one inter- min we take from the jungle. I been 17 year viewee, the Montagnards have adopted all in jungle I learn myself, I do all that I learn of the bad American dietary habits. “Over and use in the jungle 17 years. If you have here it’s like it’s kind of easy,” according wounded you put honey inside and clean to one interviewee. “It’s like hamburg- all pus and clean pus go fast to heal. That ers, in Vietnam it’s tree leaves and what is what we used to do.” Montagnards do we found in jungle just eat something we

89 Explorations | Social Sciences found in jungle. In America it’s like kind of “Western” medicine and compliance to its get bigger, in Vietnam it’s not get big.” The tenets have been examined. The findings vast selection of food and its availability point to the need for greater acceptance in America appears to be in stark contrast and understanding of Montagnards’ defi- with what many Montagnards experienced nition of illness, use of passive obedience, in their native country. “In Vietnam no reliance on traditional medicine and false food, no anything,” one interviewee said. perceptions of Western medicine by health “In America you have salt, you have food, care professionals to improve the quality you have anything.” Another interviewee and accessibility of information and treat- emphasized the people’s dependence on ments. A clinician seeking to learn about the natural environment for sustenance in the Montagnard needs to know about how Vietnam. “I told Montagnard one word in these cultural factors can negatively influ- the beginning Montagnard have never die ence a clinical encounter. For instance, pa- by food. Many people surprise when I say tient ignorance, due to distrust of Western that. But when we are in Vietnam we are medicine and misunderstandings about starving, we don’t have food enough, and its functions, is not always apparent since we eat nature; we not eat meat too much Montagnard cultural values emphasize because we don’t have.” This new selec- feigning understanding rather than question of food and its unhealthiness is com- tioning authority figures or admitting a lack pounded by the sedentary lifestyle propa- of knowledge. Culturally aware clinicians gated by Western luxuries such as public can navigate such cultural nuances through transportation and factory jobs that don’t engagement and implementation of tai- involve manual labor. “I never exercise,” lored communication techniques. one interviewee said.“Because they used to Future studies looking at the ways work a lot so they don’t need exercise and in which second and third generation they all skinny. When they get here they are Montagnards are experiencing dissonance kind of big. Even me when I was in Vietnam with Western medicine are needed as the I was so skinny.” High blood pressure and population continues to grow. Studying other diseases associated with weight gain Montagnard communities outside of one are very plausible future medical concerns specific geographic area and in other re- for these populations not used to having to gions of North Carolina such as Raleigh compensate for lack of everyday exercise and Charlotte could provide information and the accessibility of cheap, unhealthy about how location impacts health barriers, fare. “In America many people get wrong in terms of access and cultural incongrui- food, high blood pressure, cholesterol, dia- ties. A more quantitative study using mea- betes and often if you not careful with nu- surable data like that achieved by surveys trition you get because of that,” said the could also be employed in future research. leader of a local Montagnard congrega- Such findings could potentially determine tion. “I have over history 30 Montagnard the significance of one barrier compared to die in America. Same cause from stroke another and establish a more detailed plan because of high blood pressure, and they by which providers and educators could de- never heard that in Vietnam.” velop cultural competency. Because it is the engaged, non-judg- Co n c l u s i o n mental clinicians who can learn about a patients’ belief system and practices, they In this study, cultural barriers to the Montag- are also the ones who can replace harmful nard refugee populations’ acceptance of or ineffective remedies with harmless ones

90 Margeaux Corby that are consistent with individual beliefs are willing to adapt their own approaches (Flores, 2000). This can be accomplished in to accommodate multiple needs of cultur- several ways, on both a micro and macro ally diverse minority community members scale. At a provider-patient level, physicians (Andrulis & Brach, 2007). and nurses can modify their messages so It is important to remember that health they are more digestible to refugee patients communicators, providers and allied pro- unfamiliar with health care commonali- fessionals are all at an early age of under- ties. Allowing patients use their own words standing the scope of health literacy and to describe their culture and language and culture as it relates to minority popula- adopting less formal assessment strategies tions, especially those isolated from ma- will also limit misunderstandings between jority populations by cultural boundaries patient and provider (Andrulis & Brach, (Andrulis & Brach, 2007). The scope of 2007). Clear communication can be fa- methods employed to evoke positive health cilitated by providers that deliver simple change can be as large as instituting new messages to patients and are taking an ac- training programs or as small as assuring tive interest in a patient’s understanding understanding in a single patient encoun- of their instruction. Providers that do not ter. On a grander scale, establishing cul- bombard patients with several messages at tural competency training in collaboration once, speak in uncomplicated and jargon- with local resettlement agencies or building free language often have more success with relationships with community leaders who patient compliance and improved trust can communicate the needs and cultural (Andrulis & Brach, 2007). The teach-back nuances of their group to medical profes- or teach-to-goal method is also another sionals and health educators can help ad- successful strategy of having patients ex- dress certain health barriers. Studies have plain what they have been told. Patients suggested training in cultural competence should be asked to repeat information to when dealing with such multicultural and make sure comprehension has occurred. diverse patient perspectives, but this train- Clinicians can learn more about their pa- ing is a complex mix of specific types of tients’ health culture and beliefs by asking knowledge and self-awareness (Horner questions that explore patients own unique et al., 2004). Furthermore, creativity and concept of health, such as: What do you flexibility is needed to apply these cultural think has caused the illness? What do you competencies to the treatment and clini- think the illness does? (Andrulis & Brach, cal decision-making and it is unlikely to be 2007) Providers who accommodate folk ill- achieved by a one-time-only study course ness beliefs and practices and who are able (Horner et al., 2004). to integrate them into suggestions for ap- A merger of programs that seek to im- propriate care will be better able to explain prove health professionals’ communica- the rationale behind a particular condition tion skills across culture and language and and treatment plan (Flores, 2000). Cross- training to improve provider ability to serve cultural exploration by providers will better low-health literacy populations is necessary allow them to appropriately diagnose and (Andrulis & Brach, 2007). Training pro- treat culturally diverse, minority patients. grams should take advantage of known An understanding and culturally appro- effective learning methods such as role- priate approach must be taken by provid- playing, specific case presentations and the ers to support their patients’ self-manage- inclusion of outside consultants such as ment efforts (Andrulis & Brach, 2007). indigenous healers and community lead- Accomplishing this is possible if clinicians ers (Horner et al., 2004). Opportunities to

91 Explorations | Social Sciences include cultural training in health provider education may include courses offered in medical schools, lecture series during residency and continuing medical education courses (Flores, 2000). Patient and clinical care, however, are not just between physician and patient—the receptionists taking appointments and hospital administrators who make their facilities more or less accessible to minority populations are also involved in the health care process (Horner et al., 2004). If such advances are made and those working in a patient-care, health provider setting are able to move beyond their own personal perceptions of lack of care coordination, racial and ethnic preju- dices and assumed patient ignorance, the cultural competency process can begin and the length and quality of refugee lives can be improved and brought up to par with majority members of the population (Paez et al., 2008). No matter the extent of these accom- modation efforts, an increase of cultural awareness and knowledge by providers and educators can bring refugees one step closer to real understanding and effective care that continues outside the hospital or clinic. This progress is sorely needed by refugee communities, especially the Montagnards, whose want for comprehensive health care is great because of intense pre- and post– immigration experiences but ability to access and understand such beneficial health services is limited by cultural barriers.

92 Margeaux Corby

Wo r k s Ci t e d

Andrulis, D. P., & Brach, C. B. (2007). Integrating literacy, culture, and language to improve health care quality for diverse populations. American Journal of Health Behavior, 31, S122-S133.

Barr, D. A. & Wanat, S. F. (2005). Listening to patients: Cultural and linguistic barriers to health care access. Clinical Research and Methods, 37(3), 199-204.

Flores, G. (2000). Culture and the patient-physician relationship: Achieving cultural competency in health care. The Journal of Pediatrics, 136(1), 14-23.

Flores, G., Gee, D., & Kastner, B. (2000). The teaching of cultural issues in US and Canadian medical schools. Academic Medicine, 75, 451-455.

Freimuth, V. S. & Quinn, S. C. (2004). The contributions of health communication to eliminating health disparities, editorial. American Journal of Public Health, 94(12), 439-455.

Frye, B. A. & D’Avanzo, C. (1994). Themes in managing culturally defined illness in the Cambodian refugee family. Journal of Community Health Nursing, 11(2), 89-98.

Hamilton, J. (1996). Multicultural health care requires adjustments by doctors and patients. Canadian Medical Association Journal, 155(5), 585-587.

Horner, R. D., Salazar, W., Geiger, H. J., Bullock, K., Corbie-Smith G., Cornog M., & Flores G. (2004). Changing healthcare professionals’ behaviors to eliminate disparities in healthcare: What do we know? How might we proceed? The American Journal of Managed Care, 10, SP12-SP19.

Institute of Medicine of the National Academies. (2002). Speaking of health: Assessing health communication strategies for diverse populations.Washington, D.C.: National Academy of Sciences.

Ito, K. L. (1999). Health culture and clinical encounter: Vietnamese refugees’ responses to preventive drug treatment of inactive tuberculosis. Medical Anthropology Quarterly, 13(3), 338-364.

Kemp, C. (1985). Cambodian refugee health care beliefs and practices. Journal of Community Health Nursing, 2(1), 41-52.

Kreps, G. L. & Sparks, L. (2008). Meeting the health literacy needs of immigrant populations. Patient Education and Counseling, 71, 328-332.

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Kreuter, M. W. & McClure, S. M. (2004). The role of culture in health communication. Annual Review of Public Health, 25, 439-455.

Kreuter, M. W., Lukwago, S. N., Bucholtz, D. C., Clark, E. M., & Sanders-Thompson, V. (2002). Achieving cultural appropriateness in health promotion programs: Targeted and tailored approaches. Health Education & Behavior, 30(2), 133-146.

Muecke, M. A. (1983). Caring for Southeast Asian refugee patients in the USA. American Journal of Public Health, 73(4), 431-438.

Paez, K. A., Allen, J. K., Carson, K. A., & Cooper, L. A. (2008). Provider and clinic cultural competence in a primary care setting. Social Science and Medicine, 66, 1204-1216.

Ryan, G.W., Bernard, R.H. (2003). Techniques to Identify Themes. Field Methods, 15(1), 85-109.

Southeast Asian Communities (2009). Retrieved Mar. 29, 2003, from Southeast Asia Resource Action Center, Washington, DC. Web site: http://www.searac.org/commun. html.

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94 Ocular Health Knowledge Modifications

Diana Gliga East Carolina University, Faculty Mentors: Michael Bassman and Annette G. Greer East Carolina University

Ab s t r a c t The purpose of the project was to investigate ocular health knowledge modifications in subjects of the former communist country Romania. Accessible, high-quality eye health care in Romania remains a primary challenge to be overcome. Because for many Romanians eye care is difficult to obtain, the intention of this research was to raise awareness about preventive eye care versus costly treatment. NEI (National Eye Institute) recognizes that an increasing occurrence of eye afflictions is becoming a major public health problem worldwide. NEI also underlines the importance of public education through health-promotion workshops, and it encourages community leaders and local efforts to foster vision health education and research. Voluntarily-participating subjects were asked to complete a pre-seminar interview assessing basic knowledge of proper eye care. General qualitative questions included: what are effective ways to protect one’s eyesight, why do we need to take care of our vision, and how can eye exercises be effectively used to maintain healthy vision. Additionally, information was collected about subjects’ socio-economic backgrounds via individual surveys. Post-seminar interviews, using a format identical to that of the pre-seminar interviews, were conducted within a two-week timeframe. Changes in participants’ knowledge were gauged via comparison of the two sets of interviews. The population distribution was assessed in terms of gender, age, medical (mainly ocular) family history, ocular health, economic status, and education level. Final evaluations of educational outcomes showed retention and application of information.

95 Explorations | Social Sciences

Preliminar y Re s e a r c h Da t a Li t e r a t u r e Re v i e w

y e c a r e h e a l t h disparities h a v e Addressing Health Disparities E long been the subject of debate and Approximately 250 million people world- deliberation, both locally and nationally, in wide cannot see, or they have trouble with organizations such as National Eye Health their eyesight. Yet it is estimated that 75% Education Program (NEHEP). The need for of blindness cases could be treated and a greater number of ocular health care pro- that 90% of cases of blindness could be viders is undeniable. The issue has gained prevented (National Eye Health Education interest and has started to be addressed in Program). A lack of access to eye care and third world countries such as India. In fact, a lack of funding are the main obstacles. the National Eye Institute (NEI) endowed “Optometry Giving Sight” is an interna- seven research grants in 2005 to expand vi- tional initiative which, in cooperation with sion research in India. However, more work CIBA Vision, raises funds to help cover the in ocular research is still needed in many costs of ophthalmologic care for inhabitants other developing countries. of impoverished countries. Forty countries Upon approval of the University and receive funding through the project, includ- Medical Center Institutional Review ing Sri Lanka, Kenya, Tanzania, Uganda, Board (UMCIRB), I gathered pilot data South Africa, and Zambia (National Eye over the last two years in a project titled Health Education Program). Unfortunately, “Eye-care health disparities: International and Romania has not yet received such support Rural United States Comparison.” This 2007 despite its status as a third world country self-designed research was conducted in with a modest economic profile and limited Bihor County, Romania and Pitt County, access to ocular care. And although the NC, under the supervision of two family National Eye Institute (NEI) has collabo- practitioners, Dr. Aurelia Marti and Dr. rated with populations-based visual im- Tom Irons. Educational seminars and vi- pairment surveys in Nepal, China, Chile, sion acuity examinations provided oppor- India, South Africa, Malaysia, and Brazil, tunities to explore and compare the basis Romania has not yet been included. of health disparities among subjects at both An unstable economy and a poorly research sites. Preliminary data indicated funded health care system make medi- that a high percentage of the populations cal care in Romania very nearly a luxury studied (55.19% in Oradea, Romania and item. Nationally, an average of only six 68.90% in Belvoir Elementary School, Pitt hospital beds are available for every thou- County, NC) had vision-related problems. sand patients. Currently, in this country of These problems included poor to very poor more than two million people, only about vision acuity, frequently combined with a thousand ophthalmologists and residents the usage of inappropriate glasses. The are in practice. There are no optometrists; findings, recently published inExplorations routine vision examinations are performed (Gliga) underlined the urgency of provid- by family practitioners. However, these ing proper eye care and health education. physicians are mostly unable to offer ef- In the research of ocular health knowledge fective services as they are expected to at- modifications reported in this paper, I ad- tend daily to more than 40 patients within dress the need for health education and test a four-hour time span. Additionally, people its impact on targeted populations. in greatest need of vision care tend to be geographically isolated in villages scattered throughout the country. The availability of

96 Diana Gliga technology is also very limited in the field. a four-hour schedule between eye exams As Dr. Benone Cârstocea stated in an inter- (for out-patients and in-patients), hospital view, there are locations where machines as rounds, surgery, and administrative tasks. old as one hundred years are being used as Patients wait between one and two hours ocular diagnostic tools (In Romania). to be seen (first come, first serve basis) and once inside the doctor’s office, they are Ba r r i e r s t o He a l t h y Vision rushed through the exam—an arrange- ment which leaves no time for educating Limited Professional Advice the patient. In Romania there is limited information This raises the question of whether phar- regarding ocular prophylaxis. A few infor- macists might provide an educational link mative pamphlets are available at private between doctors and patients. Recently, ophthalmologic practices, but this means more emphasis has been placed on explor- that only patients to such practices are ing this idea, but as with all things new, it able to access them. Because of the high takes time to implement. As of now, the private health care cost, not many people government-funded medical system gives can afford such services. As of 2010, the the appearance of being staffed with per- average consult in Oradea, Romania, costs sonnel who, to some degree or another, 700 RON, which is the equivalent of $24. lack adequate preparation. There are vari- Average monthly salaries in Oradea are ous reasons for this lacuna, including a lack only 1940 RON ($646) as of February 2010 of materials and access to too-few faculty. (Salarii mai mici). It is also alarming that in the Transylvanian system of universities, 74% of people re- Corruption in the Healthcare Field port having heard from others about cases There is also a pressing issue of corrup- of professional dishonesty, and 36% know tion in the Romanian medical field. It is of such cases from their personal experience known that there are still doctors who do (Coruptia din Mediul Universitar). not give the proper (or any) medical care unless the patient pays bribes beyond the Impact of the Internet standard fee. Statistics show that 29.72% A key to disease prevention is education of of doctors receive bribes and 36.58% re- the public. Educational materials concern- ceive “Thank You” awards (Craciunas). It ing the importance of drinking water, eye- can thus be said more bluntly that 29.72% relaxation, wearing eye glasses, and sleep- of doctors can rightly be accused of cor- ing sufficiently exist on the Internet, but ruption. However, the benefits of Western such materials written in Romanian are advances in ophthalmic care are available limited (Spune din Priviri). for those who can afford to pay. These include lenses such as Air Optix Aqua and Cu r r e n t Mo v e m e n t s t o De c r e a s e DAILIES, exams with expert machinery Vision He a l t h Pr o b l e m s such as PlusoptiX A09, and eye-care solutions such as AOSept Plus and SoloCare The popular “Did you know…” articles Aqua (Spune din Priviri). have been adapted by Romanian online magazines. New mothers, for example, can Government-FundedHospitals and Universities find articles that answer concerns or state Because of the financial crisis, most patients facts regarding the care of newborns. This seek help at government-funded hospitals. information includes how newborns see In such locations the doctor must divide most clearly within a 25 cm range, and how

97 Explorations | Social Sciences the size of an eyeball does not substantially The importance of lutein and Vitamins A, change through the years (Stiati ca…). The E, and C are mentioned (Mihailan). There particular set of facts conveyed through is a downside to this otherwise helpful ar- such materials is not especially critical in- ticle. For instance, because it is featured in sofar as they do at least help stimulate peo- an online magazine sponsored by pharma- ple’s inquisitiveness, inducing them to seek cological funds, a particular drug (Vizual more (and more instructive) information. Aktiv) is recommended for a particular One can also find online advice on vari- ocular condition (Mihailan). It is left to the ous blogs. This decidedly western idea is reader to discern meaning from the busi- gaining currency in Romanian culture, too. ness propaganda when choosing which One can find information pertinent to vari- products to purchase. ous eye-care topics and concerns, such as Advice regarding the vision of children “ways to alleviate ocular discomfort from can also be found on the Internet. In a excessive computer usage (Raspunsuri de la 2009 poll of 232,700 students in Bucharest, cititori). One reader, Vasile Niculescu, an- it was found that ophthalmologic problems swers this question with good advice. Such were the most commonly encountered networking helps break down geographic health problems (Chirileanu). These diffi- barriers to information exchange. (The culties interfered with students’ academic reader is from Bucharest and the inquirer is life, introducing further complications such from Oradea.) However, it bears noting that as depression, even from a kindergarten Internet advice must be taken cautiously, as level. “Organizatia Mondiala a Sanatatii” the persons giving advice may not be pro- reported in 2002 that more than 161 mil- fessionals or experts in the subject. lion people worldwide suffer a vision defi- Many of the online educational mate- cit, out of which 37 million are blind—1.4 rials available in Romanian concern the million of them being younger than 15 importance of beautiful, healthy eyes, and years (Lentilele de contact). Dr. Gina explain medical terminology and condi- Tanase, Bucharest medical center direc- tions “in plain language” that the average tor, states that positive vision rehabilitation reader can understand. Besides stating the (up to 20% of vision acuity) is attainable in problem, such articles often suggest solu- patients older than five years of age, with tions, whether this be something that can treatment ranging from 10 sessions to a be accomplished at home or purchased off full six-month recovery period (Lentilele the shelf. Romanian doctors in specialized de contact). Dr. Marinela Gheorghe echoes fields can be found on the Internet writing her colleague, suggesting that eye diseases articles or reviewing others’ writings prior in children should be identified early be- to publication. Thus, Dr. Ionut Costache cause otherwise they can bring worse com- advises pregnant women to check with their plications (Gheorghe). These problems can ophthalmologists, especially during the last be further exacerbated by an overuse of trimester, since retina formation exerts a computer screens and TV viewing. A list of nutritive effort, and contractions during la- symptoms, possible causes, and treatment bor can sometimes rupture the retina and options are provided. It is nationally rec- lead to blindness (La varsta de 3 ani). Dr. ommended that the first eye exam be done Mircea Filip makes available to the public a at three years of age, which is equivalent to list of expected costs related to eye care. the Western standard. Dr. Mircea Moraru Another example is the article “Ochi from Oculus Clinic, underlines this critical Frumosi si Sanatosi” (Mihailan) wherein idea since the eyes can be best “educated” several ophthalmologists discuss macular up to five or six years of age (Bendelic). As degeneration and ocular disease prevention. for the older population, an experiment

98 Diana Gliga conducted by Dr. Johanna Seddon on 935 impressive thesis projects. One example people between 67 and 71 years of age re- is Dr. Tomina Popescu’s dissertation on vealed the unhealthy effects of excessive correlation between diabetic retinopathy smoking, obesity, or unwise eating habits and subclinical arterosclerosis (Popescu). (Maresan). The subject pool consisted of 100 patients It must be noted that while useful in- from Spitalul Clinic C.F. Craiova. They formation exists online in Romanian, the were screened for a year (2008), regularly majority of the Romanian population does given check-ups and evaluations (Popescu). not possess the financial or educational Strong correlating factors were proven to resources to access the Internet, so this in- be hypertensive stress, smoking history, and formation remains out of reach to most. presence of plaques. Unfortunately, those lacking Internet access Other research is noted on various top- are precisely the people in greatest need of ics, ranging beyond dry-eye syndrome medical attention: they are primarily of studies to one project investigating minute, median to old age with limited educational, genetic details. For example, an investiga- medical, and socio-economic status. tion of Dr. Lilia Dumbrăveanu from the ophthalmology department at USMF Va r i o u s Ophthalmological “N.Testemiţanu” (Dumbrăveanu) resear- Re s e a r c h Ef f o r t s in Ro m a n i a ched the role of major histocompatibility complex HLA in the diagnostics of uveit A number of research projects are ongo- associated with seronegative ankylosing ing in Romania in various specialized ar- spondylitis. Dr. Iulia Lopata, from the same eas within the field of ophthalmology. department, investigated the critical role of Examples include “Modern treatment of the structure of the tear film in the interac- Dry Eye Syndrome (DES)”, a study con- tion between contact lenses and the ante- ducted by a team of doctors/researchers rior surface of the eye (Lopata). in Chişinău, Moldova (Lopata). The study It is notable that these studies addressed was based on 78 patients with DES of vari- ways to alleviate ongoing ophthalmologic ous etiology and moderate severity. Three conditions, but none of them focused on different, inoffensive, non- or mini-invasive prophylaxis and its probable positive effects treatments were judged fruitful (Lopata). in ocular disease prevention. While cer- Another group from the USMF “Nicolae tain diseases “come with age,” with proper Testemiţanu” and “Spitalul Clinic home-based, sanitary habits, the age at Republican” focused on the comparative which these conditions appear could be study of different imagistic modalities in or- pushed back. bital trauma complicated with intraorbital foreign body (Lopata). With conventional Vision He a l t h Disparities in Ro m a n i a and radiological techniques they determined efficiency in diagnosis and localiza- International collaborations are symbolic tion of the roentgen-positive intraorbital of the linking elements between developed foreign body in 145 patients with orbital and developing countries. They empha- trauma. The group identified strong and size that accessible, high-quality care is the weak points of different imaging methods main challenge to be overcome. NEI, in its as well as the preferred diagnostic sequence support for international research, has co- depending on the foreign body characteris- operated for more than 25 years with popu- tics and possible localization (Lopata). lations-based visual impairment surveys in Even at the University of Medicine and Nepal, China, Chile, India, South Africa, Pharmacy in Oradea there exist some Malaysia, and Brazil (Bridbord). However,

99 Explorations | Social Sciences many more European developing coun- that discromatopsies are among the medi- tries such as Romania remain underserved cal maladies deemed incompatible with when it comes to ameliorating visual health driving a vehicle. This law was modified on disparities. The need for research and pro- 12/4/2003, leaving it to the ophthalmolo- motion of proper health care in such places gist to decide how the condition can affect remains critical. driving. If the doctor considers it to be an Romania thus provides an interesting issue, a stamp of “INAPT SOFER” (inapt venue for reviewing visual health dispari- driver) is placed upon the medical record ties. An October 2006 survey reports that (Hurbea). This of course creates disparities there are a total of 40 Romanian national in how this group of patients is evaluated ophthalmology residences divided among and regarded. the principal municipalities—and con- comitantly main medical centers—such Me t h o d o l o g y as Oradea, Arad, Iasi, Timisoara, and Bucharest. It must also be taken into ac- My plan of action in the research project count that the 2,740 total national resi- focused on the effectiveness of educational dency seats in the medical field include, but seminars promoting preventive ocular are not limited to, ENT, family practitio- health practices. Data collection and analy- ners, radiologists, urologists, dentists, phar- sis consisted of three main components: a macists, even legal medicine practitioners pre-seminar interview to assess the knowl- (Numarul de locuri). These numbers fur- edge pertaining to potential ocular health ther reflect the deficits in ophthalmologic implications, an educational workshop on care in Romania. The “Capital” newspa- ocular preventive care, and a post-seminar per reported that in Bucharest, more than interview (format identical to the first). The 5% of people wearing eyeglasses did not second interview was distributed within receive a prior eye checkup, whereas 19% two weeks of the first. Thus, individual of them had not had an eye exam in more personal knowledge modification was as- than three years (Jumatate din Romani). sessed and measured. Close observation, Additionally aggravating the situation is recording, and analysis were avenues of that the population most critically in need data collection. of vision care is geographically isolated in Seven hundred twenty-three subjects villages throughout the country. They lack were recruited on a voluntary basis and transportation, and none of the practicing without incentive offered. Cooperation ophthalmologists engage in house calls. It with local family practitioners, medical must also be noted that there is no notion university professors, and middle/high of optometrists in most European countries school directors allowed me access to a such as Romania (“In Romania”). Thus, large subject pool. UMCIRB approval was the research and educational interventions obtained prior to start of research, and that would be most beneficial to these indi- this approval was subsequently renewed viduals must be brought to them. in February 2010. UMCIRB approved Legislation itself creates a gray area informed-consent documentation for par- for treatment of ocular conditions such ticipants (and for parents of those under as dicromatism (Toma). In Romania, ap- 18 years of age) was given to participants. proximately 0.4% of the male population Students tested were from a pool of vari- is affected (Hurbea). In the ordain Nr. 87 ous schools in metropolitan Oradea, such from 03/02/2003, Anex 1, paragraph as Scoala Generala Oltea Doamna, Scoala “Oftalmologie”, number 4, it is stipulated Dacia, Liceul Emanuel Gojdu, and Liceul

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Lucian Blaga. Rural areas represented in Educational Seminars the study include: Alparea, Baile Felix, Bors, Eye health concepts were presented to 541 Capalna, Gepiu, Ineu de Cris, Osorhei, fifth, sixth, seventh, and eighth grade stu- Paleu, Sacadat, Sanmartin, Santandrei, dents at various schools in Bihor County, and Sarand—all villages in Bihor County. Romania, and to 182 Romanian subjects at the university level and beyond. Goals included eye safety, preventative care, and

Pre-Seminar Interview Information was gathered regarding birthplace, age, gender, and employment.

The questionnaire was divided into two sections, one pertaining to ocular medical history, and the other addressing personal knowledge about eye care. The first section included the following:

1 Have you ever been told that you have an eye problem or disease? What and when? 2 Does anyone in your family suffer eye problems? Who and what? 3 Have you ever had eye-related surgical interventions or special treatments? Describe. 4 Whom do you seek when you experience personal eye-related pain/discomfort? 5 How often do you have eye exams? What’s covered by the eye exam and/or treatment? 6 Do you wear eyeglasses and/or contact lenses? Since when? 7 When was your last eye prescription changed? Is the prescription from the last exam adequate now? 8 Who wears eyeglasses and/or contact lenses in your family? 9 Do you have health insurance?

The second section was designed in a Tr u e /Fa l s e format. The subject had to distinguish between eye-care truths and myths, and to circle an answer. The following statements were included:

1 “Reading in dim light is hurtful to your eyes.” 2 “Using computers can hurt your eyes.” 3 “Wearing the wrong kind of eyeglasses damages your eyes.” 4 “Children outgrow crossed or misaligned eyes.” 5 “Eating carrots improves your vision.” 6 “People with weak eyes should avoid reading fine print.” 7 “Wearing eyeglasses will cause you to become dependent on them.” 8 “A cataract must be ‘ripe’ before it is removed.” 9 “Contact lenses can prevent nearsightedness from getting worse.” 10 “Eyes can be transplanted.”

101 Explorations | Social Sciences internalization of knowledge presented. was 10/10 (10 questions answered cor- Students received comprehensive individ- rectly out of 10 possible questions). Thus, ual brochures. The colorful and informa- for example, if a subject initially scored tive handouts kept the students engaged 3/10 (three correct answers) and then 9/10 and interested. Other concepts included (nine correct answers), an overall increase verbally in the presentations were: in retained knowledge was indicated.

Why do we have eyes—purpose? Da t a An a l y s i s a n d Di s c u s s i o n Why do we need blinking, eyelashes, eyelids, and tears? Although the research history was already What are glasses and contacts for? built at several primary and secondary What are good ways to protect our eyes? schools in Oradea and at the medical of- (e.g., nutrition, eye exercises, avoiding bright fice of Dr. Aurelia Marti, my goal was to lights, no sharing of glasses, makeup, etc.) reach a larger population in this city and in Eye structure and communication with the the surrounding villages (e.g., Santandrei, brain. Ineu de Cris, and Paleu). The initial proposed sample size for the research was 500 Brochures people, but the final tally amounted to 723 The informational brochure included two participants. With invitations from several parts. One listed the answers to the Eye-Care family practitioners (Dr. Aurelia Marti, Dr. TRUE/FALSE section of the questionnaire, Olimpia Perez) and from Dr. Straciuc— along with the reasoning behind each answer. University of Medicine and Pharmacology The second part gave information regard- in Oradea, along with access to various ing eye-injury prevention in various settings academic settings (e.g., Health Classes such as the home, in the workshop, around at Liceul Oltea Doamna, Liceul Lucian children, in the garden, around cars, dur- Blaga, and Liceul Emanuel Gojdu, second- ing sports, and while using fireworks. First- ary schools in Oradea), I was able to access aid tips for eye injuries were also listed, cat- the resulting participant pool. egorized by the various types of injury such as foreign objects in the eye, cuts to the eye Examination Results and eyelid, blows to the eye, and chemical Data were analyzed on the basis of regional burns. differences (rural vs. municipal), gender, age, The brochure information and question- education level (fifth through eighth grades naire were offered in both Romanian and vs. university and beyond), economic level English so that participants could answer in (having state insurance vs. having no state whichever language they knew or felt more insurance), social influence (having family comfortable with. history of ocular issues or not), personal ocular health (having problems with vision Post-Seminar Questionnaire and Interview or not), and socio-medical status (how often Within two weeks, a questionnaire iden- an eye exam was received). tical to the pre-seminar one was given to Subjects from both municipal and rural participants. Final evaluations of the col- settings showed a positive increase in ocu- lected data gauged the retention and the lar health knowledge from pre to post in- application of the information presented in terview. Initial interview scoring averages the seminars. Subjects with affected vision were 37.57% and 39.57% respectively. were encouraged to visit ophthalmologists. Post-educational seminar interventions The maximum score on the questionnaire revealed average scores of 74.55% and

102 Diana Gliga

75.35% respectively. This shows a 37.69% business or because the participant was overall increase in knowledge accumulation able to afford an additional private policy), regarding proper eye-care. not necessarily that the participant carries Similar results were observed in other no insurance at all. For subjects with state categories as well. For female subjects in insurance, initial interview scoring averages municipal and rural settings, initial scores of correct answers were 37.90%, and for were 37.66% and 36.92% respectively. those with no state insurance were 37.48%. Post-educational scores were 75.64% and Post-educational seminar interventions re- 87.69% respectively. This shows a 39% vealed an effective ocular prophylaxis, with overall increase. For male subjects in mu- average scores of 75.26% and 76.53% re- nicipal and rural settings, initial scores spectively. This shows that subjects with no were 38.03% and 42% respectively. Post- state insurance (and thus with a better eco- educational scores were 73.31% and nomic level) scored with 0.27% higher than 82.44% respectively. This shows a 36.12% those with state insurance. Because the dif- overall increase. When comparing female ference was small, economic level might to male subjects, the former had a higher not play a part in the change of health overall increase. knowledge. Additional research could shed Education level plays a part in the effec- more light on this. tiveness of information assimilation. Thus, Social influence could also play a part in when comparing fifth through eighth grade a person’s degree of information assimi- students with university level/beyond sub- lation. This parameter was examined via jects, these findings were noted: initial in- family history of ocular issues, whether this terview scoring averages of correct answers may be ocular disease (e.g., astigmatism, were 35.54% and 44.61% respectively. conjunctivitis), ocular surgical interventions Post-educational seminar interventions re- (e.g., cataract surgery), or affected visual vealed an effective ocular prophylaxis, with acuity. If a subject’s family member had average scores of 68.53% and 95.93% re- such a history, then by association, the sub- spectively. This shows that prophylaxis is ject could have heard of and learned about observed to be effective in classes as early various eye conditions, causes, and treat- as fifth grade. A higher maturity level for ments. For subjects with a medical family subjects at university-type settings shows history of ocular issues, initial interview greater information assimilation. A similar scoring averages of correct answers were trend holds true for ascending age groups. 38%, whereas those without such a history Positive health knowledge retention was scored 37.47%. Post-educational seminar thus observed in subjects with various edu- interventions revealed an effective ocular cational backgrounds. prophylaxis, with average scores of 75.83% In order to analyze the effectiveness of and 74.82% respectively. The difference of the seminars for subjects with different eco- 1.01% between groups shows that there is a nomic levels, I had to define the economic social influence for how much information parameter.The defining factor was whether one can internalize. the subject carried state insurance or not. The socio-medical category relates how Having state insurance implies that one is one’s behavior in seeking prophylactic employed by the state, or is the child, 18 medical care can vary based on social- years or younger, of one employed by the circle influences. The various categories state. Having no state medical insurance are based on frequency of seeking eye ex- implies that the subject might have private ams. Subjects were divided on the basis of insurance (perhaps due to owning a private whether they had never had an eye exam,

103 Explorations |Social Sciences had one exam in their lifetime, had two to the country to seek better opportunities five exams total, had one exam or more ev- has increased considerably. Availability ery year, or had an exam every two years. of needed technology in the field is also a The initial interview scoring averages of huge limitation. correct answers for the above mentioned The cost of any ophthalmologic inter- categories were 36.16%, 37.96%, 38.93, vention is considerable and can lead people 39.83, and 44.37% respectively. Post- not to seek treatment. For example, the cost educational seminar interventions revealed of cataract surgery in Romania is approxi- an effective ocular prophylaxis, with aver- mately 12 million lei (with $1=23000lei, age scores of 75.28%, 75.47%, 71.19%, the cost is approximately $522 dollars), of 80.33%, and 80.31% respectively. This which insurance covers no more than 2.4 shows that effectiveness is to a certain de- million lei (approximately $104) (40.000 gree positively influenced by an increase in de cazuri de cataracta operate anual in personal outreach for ocular care. Romania). It must also be noted that the average monthly income for a middle-aged Limitations worker is $270.

General Research Limitations Further Questions A primary concern is the fact that there was The investigation showed that there is a considerable restriction on the time frame positive educational impact in rural groups during which research was conducted, par- and in municipal subjects. Investigations in ticularly with trying to organize travel in rural settings should be conducted which Romania. Obtaining prior UMCIRB ap- adjusts for any influencing factors such as proval was somewhat time-consuming and an education in the city, social ties to city constraining. Because there were no other subjects, etc. principal or secondary investigators, it was To further assess the effectiveness of the considerably harder to examine and to ed- ophthalmologic prophylaxis seminars it ucate a larger subject pool. This reveals the would be necessary to re-examine the sub- need for constant research and for support jects. This would include completion of the of current researchers who are gathering prophylaxis questionnaire and the conduc- information to be made available as future tion of comprehensive eye exams. It could references and implementations toward the be thus established whether healthy ocular- betterment of society. Partnerships with care habits are followed, and whether they more schools in Romania would have also are in correlation with good results in the furthered the current studies. examination. This subject reevaluation should be at an interval of every two years Regional Research Limitations for a duration of at least 20 years. The rea- A significant limitation in hopes for im- son for such a timeframe is that eye exams proving the vision health of Romanians are recommended every one to two years is the healthcare system, which lacks the and the time in which an ocular condition needed workforce. Currently, the national can appear is faster in younger subjects. combined number of practicing ophthal- This screening would determine the suc- mologists and residents is approximately cess rate of subject education. At the mo- one thousand (“Numarul de locuri”). ment we can show that people have a posi- Additionally, Romania became part of the tive education growth, but we have yet to European Union in 2007. Consequently, correlate it to disease prevention and/or the number of young Romanians leaving postponement.

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Co n c l u s i o n s

The research conducted in Oradea has shown a great success in regards to the educational interventions. There was a significant rate of information retention as evi- denced in final assessments. With Romania just entering the EU, the working, middle- class population is leaving the country in greater numbers, in hopes of finding better-paying jobs in neighboring European countries. In the process, they leave behind those who need the most medical attention. These people are the ones who need to be reached, and the sooner the better. Of course, because over half of the tested subjects in Oradea are in “need of ophthalmologic attention” category, there is an obvious need for further research, for implementation of efficient educational interventions promoting preventive care, and for assistance to individuals requiring immediate medical attention. Upon my return from Romania I plan to adapt the research to rural eastern North Carolina, USA. I will identify high-risk groups in local communities through regular vision screenings. Afterwards I will be able to apply my experience, my broader understanding of the subject, and my cultural sensitivity to the promotion of ocular preventive care. Meanwhile, I will assess the individual knowledge modification and information retention change with respect to each participant’s personal ocular health behavior. My future goal is to promote a healthier vision status in the at-risk identified population.

105 Explorations | Social Sciences

Ac k n o w l e d g m e n t s

The author would like to give a special thanks to all of the contributors to the paper: Dr. Annette Greer, PhD, Assistant Clinical Professor, Office of Interdisciplinary Health Sciences Education; Dr. Michael Bassman, PhD, Assistant Vice Chancellor & Director of the University Honors Program, EC Scholars & Undergraduate Research The US Fulbright Organization; The Romanian Fulbright Commission; Ocular Health Behavior Modifications, Fulbright Research 2009-2010; Fulbright assisting advisor Dr. Conf. Mihaela Coroi, Facultatea de Medicina si Farmacie din Oradea—Sectia Oftalmologie.

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108 A Game-Theory Analysis of US Efforts to Curb the Colombian Cocaine Trade

Saumil Jariwala North Carolina School of Mathematics Faculty Mentor: Virginia Wilson North Carolina School of Mathematics

Ab s t r a c t In the United States, efforts to disrupt the cocaine trade have centered on coca eradication in nations such as Colombia. In spite of funding increases for eradication initiatives, cocaine production levels in Colombia did not decrease between 2004 and 2009. Current US intervention strategy involves fumigating coca fields with herbicidal spray; the most herbicide is dispensed to the areas with the most coca cultivation. While this approach seems valid from a conventional viewpoint, it does not consider the motivations of individual farmers and thus results in an improper allocation of funding. By approaching the scenario from the level of the farmer as opposed to a nationwide perspective, this problem can be solved using game theory, a branch of mathematics that can be used to determine the optimal choice for rational actors in a given competitive scenario. For this analysis, Colombia was broken down into smaller regions called departments, and regional data on coca production from the UN Office on Drugs and Crime was utilized to determine estimated payoffs to Colombian farmers by region for coca and a licit alternative, coffee. The results of the analysis suggest that coca production levels in Colombia can be significantly decreased with only modest increases to herbicidal spraying: fumigating approximately 4,000 more hectares could eradicate almost 19,000 hectares of coca. More precise figures on coca cultivation and more accessible information on the export value of licit crops could yield a more accurate analysis.

n 2007, t h e n u m b e r o f Am e r i c a n s mentioned in a US survey that they had I 12 years and older addicted to co- “fairly easy” to “very easy” access to cocaine reached 2.1 million, a little under caine.2 These alarming numbers only be- 1% of the population.1 Every day, 2,500 gin to reveal the growing cocaine crisis in Americans use cocaine for the first time.1 the United States. The US—which is re- Approximately 42% of 12th graders sponsible for approximately 60% of the

109 Explorations | Social Sciences world’s illegal drug consumption1—has spray to the area that grows the most coca. taken the lead in efforts to curb the cocaine While this may be the best approach by trade, both domestically and abroad. Of conventional wisdom, this course of action the two possible ways to reduce the amount makes one major and invalid assumption: of cocaine consumption—reduction in de- that the only way to stop coca production mand and reduction in supply—the United is by destroying as much of it as possible. States has primarily targeted the latter, spe- Colombian farmers grow the coca crop not cifically through intervention in Colombia, because they want to create large amounts the world’s largest producer of the coca of illegal cocaine but rather because it is crop since the 1990s. During the Clinton the most profitable economic decision for administration, the United States gave their livelhood. If growing licit crops be- Colombia 860 million dollars worth of came more lucrative than growing illegal aid—three-quarters of which was used by alternatives like coca, then Colombian the government for Colombian military de- farmers would gradually defect to the more velopment—in a program known as “Plan profitable crops: the licit ones. By under- Colombia.”3 4 By equipping the Colombian standing that each Colombian farmer police force and military with drug eradica- is self-interested and not necessarily in- tion equipment, the United States hoped to terested in the success of all Colombian stop coca production at its source by tar- farmers, the scenario can be reduced to a geting cocaine-selling guerrilla groups and game that pits an individual Colombian coca-growing communities. Since then, the coca farmer—representative of the group US has loaned Colombia growing sums of as a whole—against the US and its drug money to combat the cultivation of coca, eradication efforts. Thus, a game-theory with a large percentage of funds still de- approach lends itself well to this situation, voted to improving Colombia’s security as it is a strategic interaction between two forces.5 Although the US government has or more parties that want to maximize their been partially successful in reducing the own gains, sometimes at the expense of cultivation of coca in Colombia, produc- other players. Because both the Colombian tion figures from 2001 through 2006 still farmer and the Colombian government hovered at 1997 levels, despite increased want to maximize payoffs, game theory is funding and greater efforts to eliminate the applicable to the analysis of the Colombian coca crop.6 As a result, UN Office on Drugs coca scenario. and Crime Executive Director Antonio Maria Costa claims that even greater fund- Ba c k g r o u n d ing is what is needed to solve the coca problem.6 Through a game-theory analysis of Coca cultivation in the Andes is rooted in the Colombian farmer, this paper attempts tradition. Primarily in the region around to explain how the United States can bet- Bolivia, the coca leaf is an integral part of ter use its resources in Colombia. With a the Andean life, whether chewed for cul- greater understanding of the Colombian tural, religious or simply recreational pur- farmer’s choices and relative payoffs, the poses.7 8 9 10 11 In Colombia, however, the UN, United States, and Colombia can bet- growth of the coca bush is a rather novel ter allocate their resources to greatly reduce occurrence that has its origins in the rise the illegal coca trade. of the illegal cocaine trade.12 After it is har- Currently, the United States allocates its vested, coca leaf can be transformed into funds in Colombia from a “top-down” per- coca paste with the addition of sulfuric spective: it distributes the most herbicidal acid and certain combustibles. Following

110 Saumil Jariwala a variety of chemical reactions—including of an herbicide—usually a variant of the acidification, oxidation, and neutraliza- Monsanto product Roundup—in a tar- tion with a base—the coca paste becomes geted region to kill any coca crops grow- cocaine base. The illegal drug known as ing in a particular area. Aerial fumiga- powder cocaine is actually cocaine hydro- tion is useful as it inexpensively destroys chloride, a compound that can be easily large swaths of coca with little effort, but synthesized from cocaine base.6 13 By the the process often acts as a sword in places end of this transformation process, the where a scalpel is needed: aerial fumiga- value of the cocaine has risen from one dol- tion removes both illicit and licit crops in lar per kilogram of raw coca leaf to 1,762 an area, and it simply destroys one har- dollars per kilogram of wholesale powder vest of the coca plant instead of the en- cocaine.6 The source of this highly addic- tire bush.6 Because it is inexpensive and tive drug is the plant Erythroxylum coca, relatively simple to apply, aerial spraying which is generally grown in the lower alti- is the premier method used by the United tudes of the Andes and matures within 18 Nations, the United States, and Colombia months of planting.7 14 13 After this growth to curb coca cultivation in Colombia. period, the coca bush averages about In this model, we have assumed that three to six harvests a year and produces every farmer is faced with the decision to approximately 1,446 kilograms of coca grow either the illicit coca crop or the com- leaf per harvest.6 Compared to other lu- mon licit alternative coffee. In Colombia, crative alternatives, such as coffee, coca growing illicit crops can be nine to ten is a rather high-yielding and fast-growing times as lucrative as growing legal alterna- crop. This further complicates US inter- tives such as coffee. However, because coca vention efforts, as only a few bushes are is such a labor-intensive crop, coca cultiva- needed to produce a substantial amount tion requires about three times as much of cocaine.15 labor as coffee cultivation.17 Thus, the deci- The Colombian police and armed sion to grow coca over other licit alterna- forces have reduced the coca supply pri- tives is ultimately a financial decision and marily through two direct methods of in- not one based off of lack of expertise or volvement: aerial fumigation and manual convenience of labor. eradication. Manual eradication involves the deployment of troops into coca-rich regions and the uprooting of all coca bushes in the area. This process is only efficient on a small-scale, can be used only in easily-accessible locations, and puts the troops in danger; for these reasons, manual eradication is limited to a small scope.6 However, manual eradication is very effective: after coca bushes are removed by manual eradication, it takes approximately eighteen months until another set of illicit crops can fully mature.16 In addition, manual eradication specifically removes drug-producing crops, not legal crops.6 Aerial fumigation, also known as aerial spraying, involves the dispensing

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Introduction t o Ga m e -Th e o r e t i c An a l y s i s

Game theory allows a mathematical analysis of interactions between two ideally rational groups with distinct interests, whether cooperative or diametrically opposed. Put simply, game theory is a branch of mathematics that allows two agents to optimally obtain resources in a given competition or scenario. Whenever two parties are concerned with maxi- mizing their gains and minimizing their losses, a general branch of game theory known as minimax game theory is often applied. The major stipulation of this theory is fulfilled in this simulation: that the payoffs used must have constant values and be independent of any particular strategy. While the created game has overarching similarities to a minimax game, some of the underlying assumptions for minimax game theory do not apply to this model, rendering some of the tools of this subfield of game theory inapplicable.18 Mathematics has previously been used to analyze the Colombian cocaine trade. Research—in particular much work by Daniel Mejia—focuses on all stages of the problem, from coca cultivation through interdiction, trafficking, and ultimately consumption.19 20 One paper by Mejia et. al in particular utilized game theory to analyze drug production and trafficking—a separate phase of the cocaine trade—through an advanced game with multiple stages and rational actors.21 Much of the current research involves using mathematics to analyze the economic effects of certain policies: for example, how crop subsidies would affect supply and demand. Our research is distinct in that it proposes a new outlook on the situation, a reassessment of the roles of individual Colombian farmers. As a preliminary approach to the problem, a two-player, two-strategy game was created in which a single Colombian farmer is interacting with a coalition of the UN, the United States government, and the Colombian government. See figures 1-3. The Colombian farmer has two choices: either to grow the coca crop on his plot of land or to grow a licit alternative, simulated here as coffee, Colombia’s largest licit agricultural export.15 The farmer is limited to playing only these two pure strategies. The government coalition is also limited to two pure strategies: to either aerially fumigate only coca crops or do nothing. The payoff for the farmer is crop revenue, evaluated as US dollars per hectare for the sake of universality. The payoff for the government, however, is the number of coca plants, evaluated as coca leaf revenue per hectare. By minimizing the amount of coca grown, the United States is limiting the supply of cocaine which is its ultimate goal in giving foreign aid to Colombia. In this model, the game is played under idealized conditions, as both the farmer and the government coalition have more strategies and the opportunity to use mixed strategies in real life. Minimax game theory cannot be applied here because one player is aware of the other’s moves and payoffs. In the game, the government coalition is aware of the farmer’s actions, as the government can aerially survey the farmer’s lands, and it acts after the farmer does. Since one player is aware of the other’s actions, certain techniques from minimax game theory cannot be used, as that player could take advantage of the greater information he has to improve his payoff.18 If the coalition of governments knows that the farmer is going to grow coca—perhaps from conducting an aerial survey— then it will aerially fumigate his crops, but otherwise it won’t bother. This preliminary game uses data that are too nonspecific to provide specialized and actionable results, but nonetheless it is useful as an introduction to this game-theory analysis and as a generalized simulation of the scenario. The values payoffs used in the normal form of the game are as follows:

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Revenue = kg US Dollars Coca (AverageYield in hectare* year )(AverageColombian Price in kg ) Revenue = kg US Dollars Coffee (AverageYield in hectare* year )(AverageColombian Price in kg ) Expenses = kg Coffee lb Coffee US Dollars Coffee (AverageYield in hectare* year )(kg Coffee )(Production Cost in lb Coffee ) Expenses = kg Coca US Dollars Coca (AverageYield in hectare* year )(Production Cost inkg Coca ) Other mentioned values include EffectivnessAF, the average effectiveness of aerial fumigation in destroying coca fields. When fields are aerially fumigated, farmers only profit and incur cost from the crops that survive, so RevenueCoca and ExpensesCoca become the following. With proper data, the game can be evaluated to provide a meaningful solution. In 2006, coca leaf was sold for an average of $1 per kilogram, and the average annual yield was 6300 kilograms per hectare per year.6 The coffee crop’s price was set at $199.22 for 125 kilogram bags, and the average yield in Colombia was 450 kilograms per hectare per year.22 23 The values marked as expenses in the matrix are the cost of production of these crops,

RevenueCoca= (1 – EffectivenessAF)(Average Yield)(Average Colombian Price)

ExpensesCoca= (1 – EffectivenessAF)(Average Yield)(Production Cost)

Coalition of United Nations, US Government, and Colombia All Colombian Aerial Fumigaion Do Nothing Farmers Grow (Revenue - Expenses , 0) (Revenue - Expenses ,0) Coffee Coffee Coffee Coffee Coffee

(1-EffectivenessAF)(RevenueCoca - Grow (Revenue - Expenses Expenses ) Coca Coca Coca Coca -RevenueCoca) -(1-EffectivenessAF)(RevenueCoca) Figure 1. This is the normal form game between the coalition of nations involved with aerial fumigation and collectively all the Colombian farmers. which includes cost of seeds, herbicides, pesticides, fertilizers and wages.6 Literature values place the average production cost per pound of coffee at $0.80.24 Not enough information was available to generate a specific dollar value for coca leaf production expenses, but data from Bolivia suggest that, on average, production costs expend 30% to 35% of coca leaf revenue.17 For this analysis, we use 30% as our benchmark. The government coalition’s strategy of not aerially fumigating is iteratively dominated by the aerial fumigation strategy, leaving a 1x2 matrix. When we eliminate the lower payoff for the farmer, there remains only one solution: aerially fumigate and grow coffee. This value from the model is counter to what actually occurs in Colombia, as the results suggest that coffee is slightly more lucrative than coca. If this were true across the board in Colombia,

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kg US Dollars US Dollars Revenue = 6,300 1.0 = 6,300 Coca ( hectare* year )( kg ) hectare * year

kg 199.22 US Dollars US Dollars RevenueCoffee = (450 hectare* year )( 125 kg ) = 717.192 hectare* year

Expenses = 0.30 Revenue US Dollars Coca * Coca hectare* year

kg Coffee lbCoffee US Dollars US Dollars Expenses =(450 0.45359237 0.80 =163.293 Coffee hectare* year )( kgCoffee )( lb Coffee ) hectare* year

Coalition of United Nations, US Government, and Colombia All Colombian Aerial Fumigaion Do Nothing Farmers Grow (717.192 - 163.293, 0) (717.192 - 163.293, 0) Coffee Grow (1 - 0.88) (6300 - 0.30*6300) (6300 - 0.30*6300,) Coca -(1 - 0.88) (6300) Figure 2. This is the normal form game included in Figure 1 wih calculations included.

Coalition of United Nations, US Government, and Colombia All Colombian Aerial Fumigaion Do Nothing Farmers Grow (553.899, 0) (553.899, 0) Coffee Grow (529.20, -756) (4410, -6300) Coca Figure 3. This is the normal form game included in Figure 1 with values included. this would mean that it does not make rational sense for farmers to grow coca in Colombia. If we suppose the model is valid, the question is then raised of why some Colombian farmers do indeed cultivate coca. We propose a simple explanation. To simulate this game over time, it is simply played for every year in the simulation. Using the solution we found earlier, the result is a payoff of 553.899*t to the farmer, where t is equal to the number of years. However, if the government coalition does not always choose the optimum payoff—if it makes a mistake one year—the resulting total payoff for the farmer would be different. If the government does not aerially fumigate the crops one time in 100 years, then the average expected payoff for growing coca is 568.008, a value higher than 553.899. While it is unlikely that the government coalition would make a mistake if it monitored only one farmer, the likelihood of this error becomes more pronounced as the analysis is extended to a greater and greater number of farmers. In addition, the analysis becomes more relevant: the actual scenario in Colombia involves the monitoring of thousands and thousands of farms, not just a single plot of land. The analysis becomes even more useful when the values used are more specialized. The values used thus far have been Colombian

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national averages. By centering games around specific regions, this analysis can take advantage of more precise values that take the geographic and economic differences between each region into account.

Re g i o n -b y -Re g i o n An a l y s i s

As the simulation is limited to regions of Colombia, however, the information states of each player change. In larger regions, the coalition becomes less informed about what crops are

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planted where, and limited resources prevent the conducting of unlimited aerial surveys. In larger regions, the single Colombian farmer from the initial simulation is replaced with a group of Colombian farmers. While each farmer may be aware of what the government is doing to his particular plot, each farmer makes a decision independent of what is happen- ing to other farmers and their respective plots. As a result, each player is unaware of the specific actions of the other, although knowledge of the other players’ motivations remains. Once the game is extended to this level, it is necessary to allow players to employ a mixed strategy. It is unlikely that the farmers would collectively decide to grow either coca or coffee: crop cultivation will be divided among the farmers in percentages. In addition, limiting the coalition of governments to two moves—aerially fumigating all coca or none of it—is a simplification of its capacity to act. By allowing mixed strategies, the game allows the farmers to make independent decisions and grants the government coalition a greater capacity to act. In expanding the game, an additional assumption is made that the farmers will want to maximize their collective payoffs rather than their individual ones. However, because the game is expanded and not entirely revamped, the collective payoff is analogous to the payoffs of the individual farmer in the initial analysis. The regions used in this study merged 21 of Colombia’s 33 departments into seven regions: these departments were selected if there was any evidence of coca cultivation. Because of the large amount of data available from the United Nations’ Office on Drugs and Crime’s 2006 Colombia Coca Cultivation Survey, the regions were combined in the same manner as in that report. The regions are demonstrated on the maps of Colombia in Figure 5.1

Figure 5a. Figure 5c.

1 Please note that, for parts of the paper, the Central region is mentioned, which is a combination of Sur de Bolivar and Catatumbo

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Figure 5b. Figure 5d.

The values used in the simulation for Average coca are depicted below in the table in Region Annual Yield Figure 6.6 The nationally regulated price (Kg/Ha/Year) of Colombian coffee was used, $199.22 for Meta-Guaviare 9,900 125 kilograms of coffee.22 Information on Orinoco 8,552 the annual yield of coffee by department Sur de Bolivar 6,288 or region was not available, so the national Putumayo-Caqueta 5,559 average value was used. In five of the seven games in Figure 7, Catatumbo 5,510 the payoff to the farmer of coca cultiva- Sierra Nevada 4,840 tion under aerial fumigation was less than Pacific 2,705 the payoff for growing coffee. This means All regions 6,343 that, in most regions, farmers would gener- Figure 6. ally choose to grow coffee instead of coca if the United States were aerially fumigating all fields. However, this is clearly not the case, as the region with the lowest average payoff for growing coca actually produces the second most coca in Colombia.6 To find out exactly why payoffs differed so markedly from actual conditions in Colombia, the probabilityP of how much the government coalition aerial fumigates has been derived.6 By inserting these payoffs into the regional matrices, the average payoffs for growing coca and growing coffee for every farmer can be determined. These values are available in Figure 7. As the values above show for every region, it is (on average) in the farmer’s interest to grow coca, as the payoff over multiple years from growing coca would be higher than that from growing coffee. The margin is smallest in the Pacific region, the department second in total coca cultivation. Therefore, in order to find out how much more the government coalition needs to aerially fumigate to make it more lucrative on average to grow coffee, the probability P of aerial fumigation was derived in each regional matrix. This value of P reveals what percentage of coca fields the government coalition needs to aerially fumigate in order to make the average payoff for growing coca lower than that for growing coffee.

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Coalition of United Nations, US Government, and Colombia Regional Colombian Aerial Fumigaion Do Nothing Farmers Grow (Revenue - Expenses , 0) (Revenue - Expenses ,0) Coffee Coffee Coffee Coffee Coffee (q) Grow (1-Effectiveness )(Revenue - AF Coca (Revenue - Expenses Coca Coca Coca ExpensesCoca) (1-q) -RevenueCoca) -(1-EffectivenessAF)(RevenueCoca) Figure 7. General form for each region. This is the normal form game that will be used to evaluate payoffs for each region in Colombia.

Coalition of United Nations, US Government, and Colombia Meta- Guaviare Aerial Fumigaion (p) Do Nothing (1-p) Farmers Grow Coffee (553.899, 0) (553.899, 0) (q) Grow Coca (831.6, -1188) (6930, -9900) (1-q) Figure 7. This is the normal form game that contains values for the Meta-Guaviare region in Colombia.

Coalition of United Nations, US Government, and Colombia Orinoco Aerial Fumigaion (p) Do Nothing (1-p) Farmers Grow Coffee (553.899, 0) (553.899, 0) (q) Grow Coca (718.768, -1026.24) (5986.4, -8552) (1-q) Figure 7. This is the normal form game that contains the values for the Orinoco region in Colombia.

Coalition of United Nations, US Government, and Colombia Sur de Bolivar Aerial Fumigaion (p) Do Nothing (1-p) Farmers Grow Coffee (553.899, 0) (553.899, 0) (q) Grow Coca (528.192, -754.56) (4401.6, -6288) (1-q) Figure 7. This is the normal form game that contains the values for the Sur de Bolivar region in Colombia.

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Coalition of United Nations, US Government, and Colombia Putumayo- Caqueta Aerial Fumigaion (p) Do Nothing (1-p) Farmers Grow Coffee (553.899, 0) (553.899, 0) (q) Grow Coca (466.956, -667.08) (3891.3, -5559) (1-q) Figure 7. This is the normal form game that contains the values for the Putomayo-Caqueta region in Colombia. Coalition of United Nations, US Government, and Colombia Catatumbo Aerial Fumigaion (p) Do Nothing (1-p) Farmers Grow Coffee (553.899, 0) (553.899, 0) (q) Grow Coca (462.84, -661.2) (3857, -5510) (1-q) Figure 7. This is the normal form game that contains the values for the Catatumbo region in Colombia.

Coalition of United Nations, US Government, and Colombia Sierra Nevada Aerial Fumigaion (p) Do Nothing (1-p) Farmers Grow Coffee (553.899, 0) (553.899, 0) (q) Grow Coca (406.56, -580.8) (3388, -4840) (1-q) Figure 7. This is the normal form game that contains the values for the Sierra Nevada region in Colombia.

Coalition of United Nations, US Government, and Colombia Pacific Aerial Fumigaion (p) Do Nothing (1-p) Farmers Grow Coffee (553.899, 0) (553.899, 0) (q) Grow Coca (227.22, -324.6) (1893.5, -2705) (1-q) Figure 7. This is the normal form game that contains the values for the Pacific region in Colombia.

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By inputting this derived P, the simulation reveals how the economic situation in Colombia needs to change for coca production to be unprofitable.

PayoffCoca < PayoffCoffee = 553.899

P= Sum of Hectares of Coca Aerially Fumigated (by Department) Total Hectares of Coca Grown

P= Sum of Hectares of Coca Aerially Fumigated (by Department) Sum of Hectares of Coca Aerially Fumigated (by Department) + Hectares of Coca Cultivated

Meta-Guaviare P= 14714+25915 =0.6642 14714+25915+20540 Orinoco P= 5485+1400 =0.5020 5485+1400+6829 Sur de Bolivar P= 18022+2662+5588+2146+831+1068+41 =0.7228 18022+2662+5588+2146+831+1068+41+11643 Putumayo-Caqueta P= 4575+26491 =0.6434 4575+26491+17221 Catatumbo P= 1687 =0.7756 187+488 Sierra Nevada P= 0+0+0 =0 0+0+0+437 Pacific P= 59865+1536+0+0 =0.7655 59865+1536+0+0+18807

553.899 > P * PayoffAerial Fumigation + (1 - P) * PayoffDo Nothing

PayoffCoffee = P * PayoffAerial Fumigation + (1 – P) * PayoffDo Nothing

PayoffCoca = P * PayoffAerial Fumigation + (1 – P) * PayoffDo Nothing

The values above reveal that, on average, the government coalition needs to fumigate about 97% of fields in order to make coffee cultivation the more lucrative of the two options. There are exceptions however: in Meta-Guaviare and Orinoco, no P value will make coffee cultivation more lucrative, and in the Pacific region, only about 80% of fields need to be aerially fumigated. The figures for Orinoco and Meta-Guaviare are somewhat misleading, as this analysis assumes that fields can be sprayed only once per harvest. If we allow fields to be sprayed twice per season, the equations and payoffs change.

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Meta-Guaviare P > 1 (Not Possible) Orinoco P > 1 (Not Possible) Sur de Bolivar P > 0.9934 Putumayo-Caqueta P > 0.9746 Catatumbo P > 0.9732 Sierra Nevada P > 0.9506 Pacific P > 0.8039

By plugging in N = 2, the average yields, and the average Colombian price for Meta- Guaviare and Orinoco, the following results appear:

N RevenueCoffee= (1 – EffectivenessAF) * ( AverageYield )(Average Colombian Price)

ExpensesCoca = 0.3 * RevenueCoffee where N is equal to the number of times a field is aerially fumigated per harvest

Inputting the profit values as the payoffs in the equations used for solving for P, the following P values are revealed:

Meta-Guaviare 2 RevenueCoca = (1 – 0.88) * (9900) = 142.56

ExpensesCoca = 0.3 * RevenueCoffee = 42.768

RevenueCoca – ExpensesCoca = 99.792 = ProfitCoca

Orinoco 2 RevenueCoca = (1 – 0.88) * (8552) = 123.149

ExpensesCoca = 0.3 * RevenueCoffee = 36.945

RevenueCoca – ExpensesCoca = 86.204 = ProfitCoca

PayoffCoca < PayoffCoffee = 553.899

553.899 > P * PayoffAerial Fumigation + (1 - P) * PayoffDo Nothing

Meta-Guaviare 553.899 > P * 99.792 + (1 - P) * 9900 P > 0.9537 Orinoco 553.899 > P * 86.204 + (1 - P) * 8552 P > 0.9448

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These data suggest that if the government coalition sprays about 95% of fields in Meta- Guaviare and 95% of fields in Orinoco two times per season, the coffee cultivation will be more profitable than coca cultivation there. While the data for Orinoco and Meta-Guaviare are intriguing, the data from the Pacific region reveal insight into more efficient eradication methods. For coca cultivation to be less lucrative than coffee on average in the Pacific region,P needs to be in the PCalculated range.

P > 0.8039 P = 59865+1536+0+0 = 0.7655 Calculated 59865+1536+0+0+18807 ΔP > 0.0384

Base Coca Production = 18,807 hectares of coca annually in the Pacific region.

(59865 + 1536) * 0.8039 = 76378.9 Hectares (Theoretical) 0.7655

59865 + 1536 + 18807 = 80208 Hectares (Current)

Needed Reduction = Current – Theoretical = 3829 Hectares of Coca annually

P is a percentage calculation. Thus, if aerial fumigation is increased by 3.84% or more in the Pacific region, then policymakers should see Colombian farmers in that region gradually defect to other, licit crops. Defections could reduce coca production by up to 18,807 hectares annually with as little as 3,829 Hectares of increased fumigation. In contrast, if the United States maintains its current approach, it would require the full 18,807 hectares to be fumigated.

Di s c u s s i o n o f Re s u l t s if the payoff is lowered to a level below that of coffee cultivation. Another way to The framework reveals ways that the gov- decrease coca cultivation would be to in- ernment coalition can discourage farmers crease the efficiency of aerial fumigation. from growing coca. The solution appears While using a more effective herbicide is to be—as UNODC Executive Director one solution, another would be to spray Costa mentioned—greater funding for all regions twice per harvest: this would aerial fumigation efforts. Although the change the effectiveness of aerial fumiga- pure strategy payoffs for coca cultivation tion from 88% to over 98.5%, reducing are lower than coffee cultivation under the the percentage of coca fields that need right conditions, not enough aerial fumi- to be sprayed. However, this statistic is gation is occurring to yield this result. For somewhat misleading, as it means that the UNODC to have increased success the United States would have to spray combating coca cultivation, the amount around 90% of fields twice instead of of aerial fumigation will have to increase. about 100% of fields once, thereby lead- To allocate this extra funding most effi- ing to a tremendous increase in aerial fu- ciently, this study suggests that aerial fumigation. Such a large increase in spray- migation increases need to be restricted to ing herbicides poses environmental and one region at a time, as reducing the pay- ethical concerns. Another purported op- off of coca cultivation is only worthwhile tion—subsidizing farmers to encourage

122 Saumil Jariwala licit crop growth—is shown by this model other non-quantitative motivations and to be a very expensive solution. Without consequences. In this particular scenario, greater aerial fumigation efforts, the gov- there are two sets of implications—moral ernment coalition would have to subsidize and environmental—that are not consid- farmers multiple times the market selling ered in this analysis. The first to be con- price of the licit alternatives they grow. sidered, moral, involves the livelihood of Therefore, the model suggests that aerial Colombian farmers. Those farmers who fumigation is considerably less expen- decide to grow coca do not always do so sive—provides “more bang for the buck” for selfish reasons; it can be impossible to so to speak—than crop subsidies, which make enough money growing other, less explains why the use of aerial spraying by lucrative crops, and although the coalition intervening bodies is currently so preva- of governments does want to eradicate lent in Colombia. the coca trade, doing so might destroy a This analysis not only advises the way of life and force thousands of farm- Colombian government to fund more ers to seek a new way to make a living. In aerial fumigation, but it also reveals the addition, greater aerial fumigation could best regions to increase aerial fumigation have an untold environmental impact. in. If the government coalition aerially Information is available that indicates fumigated about 4% more land in the that current levels of aerial fumigation Pacific region—the region with the sec- are having a detrimental impact on the ond most coca cultivation— then the av- environment, and increasing the amount erage coca payoff would be less than the of herbicide dispensed in Colombia will average coffee payoff, which should result only lead to greater environmental dam- in widespread abandonment of the coca age.25 While the government coalition crop. The government coalition should could potentially eradicate coca cultivation target its efforts in that particular region, in Colombia by increasing the aerial fumi- as large gains are possible there with only gation levels, a decision needs to be made a modest increase in activity. The eradi- about whether or not it is environmentally cation of approximately 3,829 hectares worthwhile to move in this direction; if the of coca in the Pacific region should re- UN, USA, and Colombia decide they do sult in the eradication of approximately not want to pursue this action, perhaps 18,807 total hectares of coca. To put this they should decide whether or not aerial potential change in perspective, the gov- fumigation and foreign intervention is the ernment coalition would have to triple proper response to the cocaine trade at all. the current amount of aerial fumigation in the Meta-Guaviare region, the region Limitations with the highest amount of coca cultivation, in order to achieve comparable re- It is necessary to briefly mention the limi- sults with the Pacific region. tations of this model. With any game- Before the United Nations, United theory model, one of the underlying States, and Colombia decide to pursue assumptions is that all parties must act greater aerial fumigation efforts, the rationally and always choose greater pay- ramifications of current coca eradica- offs, which is not always the case in the tion methods need to be mentioned. real world. In addition, while this model Although game theory allows research- takes many of the economic incentives ers to follow the rational decision-making for growing coca into consideration, other process of two players, it does not reveal non-financial (and often non-quantifiable)

123 Explorations | Social Sciences motivations do exist. In some cases, farmers grow coca not necessarily because it is more financially lucrative but rather because of the pressure and threats from narco-terrorist or guerrilla organizations, such as the Revolutionary Armed Forces of Colombia (FARC). However, we posit that this kind of scenario should be considered an exception rather than the norm. Because the major reason is essentially economic in nature, economic frameworks are directly applicable to model this scenario.

124 Saumil Jariwala

Co n c l u s i o n

This study involves the analysis of coca cultivation in Colombia for the purpose of developing strategies that can improve the efficiency of aerial fumigation efforts in Colombia. The game theory framework reveals that, with enough aerial fumigation, the government coalition can make licit crop growing more profitable than coca cultivation, thereby reducing the amount of coca cultivation in Colombia. However, the government’s current levels of aerial fumigation are insufficient to make coca cultivation uneconomical on a widespread level. Most of the viable solutions to the problem of coca cultivation in Colombia involve aerial fumigating the coca crop to a greater degree, by either spraying fields twice or spraying more coca fields. This report discusses an approach to reducing the coca trade in Colombia by assessing coca cultivation from a behavioral standpoint. By specifically tar- geting modest increases in eradication, large decreases in coca cultivation can be attained. Ultimately, the government coalition can make more educated decisions about where coca eradication efforts should be increased by considering the economic perspective of individual farmers.

Ac k n o w l e d g m e n t s

I would like to thank Dr. Virginia Wilson and Dr. Myra Halpin for invaluable support as my mentors through the research process. I would also like to acknowledge Mr. Jim Litle, William Condon, and Akhil Jariwala for assisting me through the paper writing process. Further acknowledgements go to Mr. John Woodmansee, Dr. Gerald Wilson, Dr. Robin Kirk, and Dr. Guillermo Trejo for reviewing my research and providing valuable insight.

125 Explorations | Social Sceinces

Wo r k s Ci t e d

1 Results from the 2007 National Survey on Drug Use and Health: National Findings, Rockville, MD: Substance Abuse and Mental Health Services Administration, 2008.

2 L.D. Johnston, P.M. O’Malley, J.G. Bachman, and J.E. Schulenberg, Monitoring the Future, National Results on Adolescent Drug Use: Overview of Key Findings, 2008, Bethesda, MD: National Institute on Drug Abuse, 2009.

3 C.P. Rydell, J.P. Caulkins, and S.S. Everingham, “Enforcement or Treatment? Modeling the Relative Efficacy of Alternatives for Controlling Cocaine,” Operations Research, vol. 44, Oct. 1996, pp. 687-695.

4 “Alternative Development in the Andean Area: The UNDCP Experience,” 2001.

5 I. Vaicius and A. Isacson, “The ‘War on Drugs’ meets the ‘War on Terror’,” The Center for International Policy, Feb. 2003.

6 “Colombia Coca Survey for 2006,” Jun. 2007.

7 “Colombia Coca Trade,” Trade and Environment Database, Jan. 1997.

8 C.J. Allen, The Hold Life Has: Coca and Cultural Identity in an Andean Community, Washington DC: Smithsonian Institution Press, 1988.

9 R.B. South, “Coca in Bolivia,” Geographical Review, vol. 67, Jan. 1977, pp. 22-33.

10 C. Gutierrez-Noriega and V.W.V. Hagen, “Coca: The Mainstay of an Arduous Native Life in the Andes,” Economic Botany, vol. 5, Jun. 1951, pp. 145-152.

11 R. Martin, “The Role of Coca in the History, Religion, and Medicine of South American Indians,” Economic Botany, vol. 24, Oct. 1970, pp. 422-438.

12 F.E. Thoumi, “Illegal Drugs in Colombia: From Illegal Economic Boom to Social Crisis,” Annals of the American Academy of Political and Social Science, vol. 582, Jul. 2002, pp. 102-116. 13 G.D. Lee, Global Drug Enforcement, Boca Raton, FL: CRC Press, 2003.

14 “Cocaine Production’s Effect on the Environment in Colombia,” Schaffer Library of Drug Policy.

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15 “CIA—The World Factbook—Colombia,” The CIA World Factbook, May 2009.

16 P.M. Franko, The Puzzle of Latin American Economic Development, Lanham, MD: Rowman & Littlefield, 2007.

17 H. Sanabria, The Coca Boom and Rural Social Change in Bolivia, Ann Arbor, MI: University of Michigan Press, 1993.

18 D.W. Read and C.E. Read, “A Critique of Davenport’s Game Theory Analysis,” American Anthropologist, vol. 72, Apr. 1970, pp. 351-355.

19 Herschel I. Grossman and Daniel Mejia, “The War Against Drug Producers,” NBER Working Papers 11141, National Bureau of Economic Research, Inc., 2005.

20 Daniel Mejia and Carlos Esteban Posada, “Cocaine Production and Trafficking: What Do We Know?”, World Bank Policy Research Working Paper 4618, May 2008.

21 Daniel Mejia and Pascual Restrepo, “The War on Illegal Drug Production and Trafficking: an Economic Evaluation of Plan Colombia,” Documentos CEDE 005123, Oct. 2008.

22 L. Pinzon and E. Mello, Colombia Coffee Semi-Annual 2008, USDA Agricultural Service, 2008.

23 J.A. Duke, CRC Handbook of Alternative Cash Crops, 1993: CRC Press.

24 B. Ruiz, “Colombia’s Coffee and Oil Crisis,” Colombia Journal Online, Nov. 2001.

25 K.R. Solomon, A. Anadon, A.L. Cerdeira, J. Marshall, and L. Sanin, Environmental and Human Health Assessment of the Aerial Spray Program for Coca and Poppy Control in Colombia, Washington, DC: Inter-American Drug Abuse Control Commission, 2005.

127 Building Community Capacity in Resource Poor Neighborhoods: Community-University Partnerships

Kimberly Lancaster Amanda Smith with Lindsey Carrier, Joanna Dick, Elizabeth Dodson Hillary Geen, Jessica Glovas, Lacey Hancock, Erin O'Donnell, and Allison Whitley University of North Carolina Wilmington Faculty Mentor: Leslie Hossfield University of North Carolina Wilmington

Ab s t r a c t Community based research, service learning opportunities, and community university partnerships give university students the opportunity to work directly in the community with real life situations. The Public Sociology program of the University of North Carolina at Wilmington has partnered with the Wilmington Housing Authority, a local public housing agency, to create the Community Campus at Hillcrest. The Community Campus at Hillcrest provides a resource-rich environment in a resource-poor community. Public Sociology students complete research and service learning projects at the Community Campus. The following paper discusses three research projects that were completed. Each project’s goal was to assist in building community capacity within the surrounding community.

o m m u n i t y c a p a c i t y is d e f i n e d a s capacity. Four core strategies to building C the relationship between human capi- community capacity include 1) leadership tal, organizational resources, and social development; 2) organizational develop- capital used to solve problems and improve ment; 3) community organizing; 4) foster- a community (Chaskin 2001). Chaskin ing collaborative relations among organiza- (2001) identifies four elemental character- tions (Chaskin 2001). istics in building community capacity: 1) The University of North Carolina a sense of community; 2) a level of com- Wilmington (UNCW) Public Sociology mitment; 3) the ability to solve problems; 4) Program working in partnership with the and access to resources. Social agency, the Wilmington Housing Authority (WHA) independent ability to act on one’s will, is a has created the WHA UNCW Community critical component in building community Campus at Hillcrest. The Community

128 Kimberly Lancaster, Amanda Smith, et al.

Campus is located in a public housing problem solvers. Partners need to be cre- community. The Community Campus at ative and flexible when problems arise. Each Hillcrest provides a resource-rich environ- must work to come up with initial planning ment within a resource-poor community. A as well as when unexpected problems arise variety of programs for people of all ages (Marullo et al 2009; Strand et al 2003). are provided free of charge to members of 2) Partnerships must commit to avoiding the the surrounding community. Programming temptation to take shortcuts. Each partner has been implemented through mul- must be willing to work together to cre- tiple UNCW departments, Cape Fear ate best practices for their project. Once Community College, and a variety of other the best practices are decided upon, they local non-profit organizations. Each pro- should be adhered to. When decisions are gram that takes place at the Community made early in the relationship it is easier to Campus is designed to meet the needs of create task lists and time lines. Many col- the community based on prior research laborations find the creation of memoran- and needs assessments. Programs that are dums of understanding helpful (Marullo et provided through UNCW also allow for al 2009; Strand et al 2003). 3) It is impor- service learning opportunities for the stu- tant that partnerships do not end up with dents that assist with these programs. The hierarchical structures. Collaborations are UNCW Public Sociology program is based most beneficial when all participants have at the Community Campus. Students work equal value and respect for one another. each semester to address critical issues iden- Partners should keep in mind that each tified by residents of Wilmington Housing member is bringing their own strengths Authority. The overarching goal of the and weaknesses to the project. The vary- Community Campus is to build community ing skills and experiences of each partici- capacity in a resource-poor community us- pant help to make the collaboration strong. ing Chaskin’s (2001) model for the creation 4) The sharing of resources is an impor- of community capacity. tant aspect of collaboration. Each partner Service learning should be focused on brings a variety of resources; whether they empathy and empowerment (Marullo, be knowledge, experience, enthusiasm or Moayedi, Cooke 2009, and Stoecker 2005). financial; all are important and necessary. A well designed program will provide re- 5) All participants should have a role in ciprocal rewards for both the students and the production of results. Collaborations the community. Community based service are formed to meet the needs of the com- learning and research is most effective when munity it is serving. Each partner in the done in collaboration with the community. collaboration must make a concerted ef- Service learning and community based fort to produce the results that will help to research is an excellent way to improve meet the needs and goals set forth at the campus and community relationships and beginning of the project. Once the project allows both the university and the commu- is completed, partners must work together nity to be more productive (Marrullo et al to disseminate the findings and implement 2009; Strand, Marullo, Cuforth, Stoecker, changes (Marullo et al 2009). and Donohue 2003; Ward and Wolf- Community-university partnerships need Wendel 2000). to have similar directives in order to be There are five key practices that must be successful (Strand et al 2003). At the begin- considered in order to create an effective ning of the partnership, partners should collaboration. 1) Collaborative partners share a worldview and common mission. must work together to become effective They should agree upon their goals and

129 Explorations | Social Sciences strategies. Each should have mutual trust 2009, 372 residents live in the Hillcrest and respect. While participating in the Community. The majority are females project, each partner should have equal (69%), who are more likely to be the heads power and control. Communication is of households (77%) than males. The racial very important and each should make an composition of the Hillcrest Community is effort to listen to the views, thoughts and mostly African American (97%), with 1% concerns of others. Partners need to be White, and 1% unspecified race, and less understanding and flexible enough to meet than 1% American Indian. Among these to needs of the collaboration. Partnerships residents, 4% are also of Hispanic descent. should be satisfying, organized and able to Over one-third of the population is dis- create long-range social change (Strand et abled. Hillcrest Community housing units al 2003). range from one to three bedrooms. Most According to Chaskin (2001), the best families consist of only one person (66%); way to empower a community is to help thirty-three (33%) percent of families have build community capacity. Chaskin im- between two to four persons and only 1% plied the meaning of community capacity of families have five persons; the average to be “the interaction of human capital, family size is two persons. None of the fam- organization resources, and social capital ilies have more than five persons. Members existing within a given community that can of over half of all households (52%) have be leveraged to solve collective problems lived in the Hillcrest community for more and improve or maintain the well-being of than 10 years; 35% have lived in Hillcrest a given community. It may operate through for over 20 years and 28% of households informal social processes and/or orga- have lived in the community for five years nized effort “(Chaskin 2001:295).” Social or less. Thirty percent (30%) of the fami- capital comes in the form of relationships lies living in the Hillcrest Community have between people. As community members earned income from employment. Families build relationships, they build social capi- receive assistance from Social Security, tal (Coleman 1988). Human capital is the Pensions, Temporary Assistance for Needy knowledge and skills that a person has. Families (TANF), and general assistance. Social capital assists with the growth of hu- Some families receive assistance from more man capital. People with strong relation- than one source. Some families with earned ships and strong networks have more op- incomes also receive some form of assis- portunity to gain human capital (Coleman tance as well. The average annual income 1988). Community-based service learning per family is $9,893. and research can lead to advocacy which Over the course of two semesters, UNCW in turn may empower the community and Public Sociology students identified critical build community capacity (Mooney & social issues, designed a research protocol Edwards 2001). to investigate these issues and carried out research. Each student completed IRB Co n t e x t o f Re s e a r c h training and the research protocol was submitted and approved by the UNCW IRB. The Hillcrest Community—Wilmington, The first semester consisted of on-site class North Carolina meetings where the students determined According to statistics provided through needs for research and became familiar a personal communication with the faces in the community. The second semes- Wilmington Housing Authority on site ter consisted of both on-site class meetings property manager at Hillcrest in September and a 160-hour internship experience that

130 Kimberly Lancaster, Amanda Smith, et al. gave the students not only hands-on expe- spend more of their money on foods that rience in the community by allowing them will sustain them but not necessarily pro- to work with one or more of the programs vide them with the nutrients that they need that take place at the Community Campus, (Metallinos-Katsaras et al 2009). but also an opportunity to complete com- Prior research (Metallinos-Katsaras et al munity based research to address the is- 2009; Gundersen & Kreider 2009) shows sues that were previously determined. In that children in low income families who the sections below, three distinct research have not received proper nutrition often agendas are described in which applied become obese.This tendency towards obe- research projects have been created—all sity later leads to long term health prob- to help build community capacity among lems such as diabetes and other chronic Resource-Poor residents in Wilmington, diseases (Metallinos-Katsaras et al. 2009; North Carolina. These research agendas Gundersen & Kreider 2009). Poor prenatal are not listed in any ranked order and are nutrition can also be detrimental to a child’s considered of equal importance. health (Gundersen & Kreider 2009). Nord, Andrews, and Carlson (2009) found that I. Nu t r i t i o n a n d Fo o d Se c u r i t y in about two-thirds of food insecure house- Re s o u r c e -Po o r Co m m u n i t i e s holds use coping strategies to deal with their predicament. Common coping strate- Prior Literature gies are eating a less varied diets, participat- Food insecurity is defined as being “a lack ing in federal food and nutrition assistance of access to enough food for an active programs, and obtaining emergency food healthy life, which results from limited or from community food pantries or emer- uncertain access to nutritionally adequate gency kitchens to make up for the lack of and safe foods in socially acceptable ways” food. Nord, Andrews, and Carlson (2009) (Metallinos-Katsaras, Sherry, and Kallio found that only a little more than half of 2009:1790). Nutritional food insecurity all food insecure households in the United happens not only in developing countries States participate in federal food and nutri- but in the United States, as well. It affects tion assistance programs. Research suggests mostly low income, minority families in that the best way to combat this epidemic both urban and rural areas (Huddleston- is to provide more access and availability Casas, Charnigo, and Simmons 2008). to food stamps for those families that are Over 17 million households in the United eligible (Huddleston-Casas et al 2008; Jha States were considered food insecure in 2009). The high price of foods also needs 2008 (Nord, Andrews, and Carlson 2009). to be addressed in order to help impover- Findings suggest a cycle of food insecu- ished families take advantage of a larger rity; food being the main source of energy variety of healthy choices (Jha 2009). that provides nutrients which give the ability to provide quality labor that can help St a t e m e n t o f Pr o b l e m secure work which in turn provides a person the ability to earn money so that they The focus of this component of the research may buy food (Jha 2009; Gersovitz 1983; project was to determine the community’s Yngve, Margetts, Hughes, and Tseng access to and use of affordable, nutritious 2009). Research (Yngve et al 2009) shows food in two ways: 1) assessment of food in- that nutritious foods such as fruits and veg- security through a modified USDA survey; etables are more expensive than processed and 2) measurement of established and filler foods. Low income families usually increased nutrition knowledge revolving

131 Explorations | Social Sciences around a children’s after-school nutrition lies in a resource-poor community, a modi- program called Friends, Food, and Fun fied USDA survey on food security was sent that includes participation in the upkeep home to guardians of the children that were of a community garden in the Hillcrest participating in the WHA/UNCW Com- Community. The Friends, Food and Fun munity Campus at Hillcrest nutritional pro- program was created and implemented gram, Friends, Food & Fun. Fifteen surveys at the Community Campus through com- were sent home with a request to be community partners and two Public Sociology pleted by a guardian and returned. Eight interns. Guest speakers, such as local chefs, surveys were completed and returned. The farmers, and other community volunteers, survey consisted of 17 questions regarding worked with the children to plant, harvest at home food security and accessibility to and prepare foods from the garden. The healthy food (see Appendix 1). program included a nutrition lesson that In order to understand the access to and gave the children information regarding the knowledge of nutritious foods in children in nutritional facts about the foods that were resource-poor communities, The Friends, planted in the garden and later cooked and Food and Fun pre- and post- survey (see tasted. Appendix 2) was administered on the first The big-picture goal of this aspect of and last days of the Hillcrest after-school the research project was to increase com- program Friends, Food, and Fun. The ten- munity capacity and social agency in the week program consisted of various nutri- resource-poor community of Hillcrest in tion-based events and lessons surrounding Wilmington, North Carolina. The plan was fruits and vegetables planted in the exist- to build community capacity in four ways: 1) ing community garden. Fourteen questions build a sense of community through involv- regarding the children’s knowledge of the ing resident children in Friends, Food, and food pyramid, the basic logistics of garden- Fun; 2) secure a level of commitment from ing, and the foods they chose to eat most interns, local businesses and volunteers to frequently at home and at school were assist in the creation and implementation asked. Sixteen surveys were completed on of the program; 3) identify and solve ex- the first day, and 23 were completed on the isting problems specific to the community’s last day. The individual and cumulative food insecurity issues; and 4) increase ac- averages were calculated from the data to cess to resources through utilization of the determine the participants increase or de- community garden. Additionally, four core crease in nutritious food decision making. strategies to building social agency were exercised: 1) leadership development in teach- Fi n d i n g s ing residents how to utilize the community garden; 2) organizational development Food Security Findings in the construction of Friends, Food, and The data collected from the modified USDA Fun; 3) community organization surround- food security surveys showed that seven of ing the community garden by increasing the responding families receive some sort community participation; and 4) fostering of food assistance from the government, collaborative relations with local organiza- such as WIC, food stamps, and/or free or tions, businesses, and volunteers. reduced school lunch. Some participants receive one of these services while others Me t h o d s a n d Da t a An a l y s i s receive two or even all three to provide food for their families. In addition to this, find- To understand food security levels in fami- ings also show that among the participants

132 Kimberly Lancaster, Amanda Smith, et al. who utilize food assistance programs, one suggest that by bringing in community ties family relies on the use emergency food to increase nutrition knowledge, a greater assistance programs, such as soup kitchens, interest in and preference for nutritious food banks, food pantries, or other “free” foods, like fruits and vegetables, can develop food resources on a monthly basis in order within children. The current research im- to be sufficiently food secure. Three of par- plies that the relationship between human ticipants surveyed indicated that they have capital, organizational resources, and so- changed or reduced essential healthy foods cial capital may be used to assist with food from their diets. Reasons given for reduc- insecurity problems and build community ing essential healthy foods were the cost of capacity. By increasing community connec- the food, lack of transportation to purchase tions and the level of community partici- food or the availability of these foods where pation around the community garden, the they are able to shop. Of the five basic food residents can increase their sense of com- groups, participants were more likely to munity, which in turn will help to build so- eliminate fruits, protein and dairy products cial capital. By working together to reduce from their diet. the food insecurity in the neighborhood by using the community garden as a resource, Nutrition Knowledge Findings the community can work together to build Following the close of the ten-week pro- community capacity. All four of Chaskin’s gram and the administering of the post sur- (2001) elemental characteristics in build- vey, cumulative averages were compared. ing community capacity will be met when Findings show that the average knowledge a committed community works together to of the children’s food pyramid and ba- build relationships while solving problems sic gardening increased between the pre- and gaining access to resources. and post- surveys by three percent (70% to 73%). Additionally, when asked about II. Nu t r i t i o n a l Ac c e s s o f food eaten most frequently at school and at Re s o u r c e -Po o r Co m m u n i t i e s home, as well as favorite foods, the average Th r o u g h EBT Us a g e a t t h e amount of fruits and vegetables names in Fa r m e r 's Ma r k e t these categories increased from 1.18 times per child to 2.46 times per child between St a t e m e n t o f Pr o b l e m the pre- and post- survey. Statistical testing was not completed due to the small sample Nord et al. (2009) reported that over half size. of all food-insecure households participate in federal food and nutrition assistance Di s c u s s i o n a n d Implications programs. Information from the Modified USDA Food Insecurity survey shows that The Modified USDA Food Insecurity sur- the resident participants of Hillcrest have vey findings indicate that the absence of nu- at times changed or reduced essential tritious foods in resource-poor communities healthy foods from their diet because of can be attributed to high costs, lack of trans- cost, transportation, or availability. Food portation, and lack of availability. These and nutrition benefits distributed by the findings suggest that adding resources, such state of North Carolina are accessed by us- as the presence, maintenance, and use of ing an EBT (Electronic Benefits Transfer) the community garden, may help to reduce Food Stamp card to purchase food items the expensive costs and aid in the access to at grocery stores (New Hanover County nutritious foods. Additionally, the findings Department of Social Services 2010). This

133 Explorations | Social Sciences aspect of the research project measured Wilmington’s Riverfront Farmers’ Market the interest level of Hillcrest residents in began participating in the 21st Century participating in the new debit, credit and Farmers’ Market program near the end of EBT Food Stamp card acceptance pro- the fall of 2009. gram that is currently available at the According to the organization Leaf Riverfront Farmers’ Market, which could Light Inc., the process in which custom- increase access to nutritious food alterna- ers use their EBT Food Stamp cards at the tives. This project also sought to establish Farmers’ Market is simple. Local farmers transportation from Wilmington Housing bring their produce or product to the mar- Authority for those who are unable to uti- ket. The customer starts at a stand where lize the Farmer’s Market due to limited a market representative will use a standard transportation. point of service (POS) machine to run their EBT Food Stamp card. The customer is EBT Use at the Farmer’s Market then given wooden tokens equaling the In North Carolina, Electronic Banking purchase value. The wooden tokens are Transfer (EBT) Food Stamp cards usage at given in $1 increments that can be used the Farmers’ Market is a fairly new process. on Supplemental Nutrition Assistance In 2004, the North Carolina 21st Century Program (SNAP) eligible foods. According Farmers’ Markets was developed through to the United States Department of LeafLight Inc. in cooperation with the Agriculture Food and Nutrition Service, USDA Food and Nutrition Service, and funds may be used to purchase breads, ce- Supplemental Nutritional Assistance reals, fruits, vegetables, meats, fish, poultry, Program (LeafLight 2010). Leaflight, Inc. and dairy products as well as seeds and administers the program in partnership plants that will produce food for the fam- with the North Carolina Department of ily to eat (USDA 2010). Customers using Agriculture & Consumer Services, Got their debit or credit card are given tokens to Be NC Agriculture, North Carolina in $5 increments that can be used to pur- Department of Health and Human chase anything. The tokens can be used at Services, North Carolina Division of Social any participating vendor and are treated Services, Food and Nutrition Services pro- like money in the transaction. At the end gram, and the Physical Activity & Nutrition of the business day, the farmers turn in the Branch of the North Carolina Division of tokens they received and complete paper- Public Health (Leaflight 2010). The North work for redemption. LeafLight, Inc. then Carolina 21st Century Farmers’ Markets p r o - processes the transactions and the farmers gram developed a way to implement a receive a check or deposit for the value of more convenient payment system for tokens received. The processing is typically North Carolina residents who are purchas- completed in less than a week. ing items from agricultural retailers such as farmer’s markets and farm stores. The Me t h o d s new payment system offers an electronic form of payment for purchasers, which A convenience sample of 42 residents in the includes EBT Food Stamp cards as well as Hillcrest community was used to measure debit and credit (LeafLight 2010). By 2010, the level of interest in gaining transporta- farmer’s markets in eighteen counties in tion from Wilmington Housing Authority North Carolina currently accept EBT (WHA) to the downtown Riverfront Food Stamp cards and the number of mar- Farmers’ Market and interest in tak- kets is consistently increasing nationwide. ing advantage of the newly implemented

134 Kimberly Lancaster, Amanda Smith, et al.

EBT Food Stamp card acceptance pro- appointments. Based on the Wave Transit gram. Thirty-five residents were contacted bus routes in place at the time of the study, through door to door canvassing and were if a Hillcrest resident were to take the bus given a qualitative verbal survey to better to the Riverfront Farmers’ Market, they understand their feelings concerning the would spend at least an extra hour of their subject while the remaining seven were day on the bus going to and coming home asked to complete a quantitative written from the farmers’ market not including the survey while attending a program taking time waiting for the bus to arrive at the place at the Community Campus. Three stop. Residents who were surveyed indi- questions regarding the participant’s use cated that they would be interested in go- of EBT cards, knowledge of the Farmer’s ing to the farmers market if transportation Market and interest in transportation to outside of the local bus transit system were the Farmer’s Market were asked of all readily available to them. Several indicated participants: that the benefits of shopping at the farm- 1) Do you use EBT cards? ers market were not worth the extra time 2) Do you know about the Downtown needed to take the bus. Farmers Market? 3) If transportation through WHA were Di s c u s s i o n a n d Implications available to the downtown farmers market once a week, would you take This research indicates that if transporta- advantage of it? tion was more readily available to public housing residents, there might be more in- Fi n d i n g s terest to use the local farmers’ market as an EBT food source. A meeting was held with The data collected show that 83.3% of Wilmington Housing Authority transporta- survey participants were interested in using tion officials to discuss the research find- their EBT cards at the Riverfront Farmers’ ings and the possibility of them providing Market if transportation were made avail- transportation to the residents. Although able to them. Of the 11.9% who said they the Wilmington Housing Authority rep- would not use this program, reasons were resentatives believed that it is an excellent mostly because they were not interested idea for residents of the public housing in the Farmers’ Market or had their own community, they feel there would be too transportation. many scheduling and cost concerns for While surveying residents, it became ap- the Wilmington Housing Authority. At the parent that many residents were displeased completion of this research a final deci- with the current public transportation sys- sion had not been made by the Wilmington tem, Wave Transit, in Wilmington. Upon Housing Authority. Additional discussion reviewing the Wave Transit bus routes, it took place regarding the limited access was found that there were a limited num- of public transportation to public hous- ber of buses stopping near Hillcrest and ing communities. Through the discussions they were not easily accessible. Previous with Wilmington Housing Authority repre- studies by UNCW Public Sociology stu- sentatives, it was determined that Hillcrest dents (2009) also found that Wave Transit is not the only community experiencing bus routes make it difficult for residents transportation difficulties. Many -resi to use public transportation to meet their dents of Hillcrest and other public hous- daily needs such as looking for and/or going communities are senior citizens. Age ing to work, trips to the store and doctor’s and health related conditions make it even

135 Explorations | Social Sciences more difficult to make use of the available relations among organizations (Chaskin Wave transit system. By gaining access to 2001). Through the incorporation of the Riverfront Farmer’s Market and the the strategies designed to build commu- opportunity to use EBT Food Stamp cards, nity capacity within its programming, the residents have increased access to fresh, lo- Community Campus’ primary goal is to cal nutritious foods that may not be avail- foster an environment that enables the able at the most convenient grocer. This four characteristics of community capac- research is consistent with Huddleston- ity to thrive. The goal of this research was Casas et al.’s (2008) findings regarding low to assess participants’ attitudes about the income minority families in urban areas community campus, identify any need for having food insecurity issues. As previous future programs that incorporate commu- research (Nord et al. 2009) suggests a com- nity building strategies, and ultimately de- mon coping strategy for food insecurity is termine the impact the community campus the use of Federal food and nutrition assis- has had on the community and on building tance programs, such as EBT Food Stamps. community capacity. This research suggests that members of the Hillcrest community have an interest in us- Me t h o d a n d Da t a An a l y s i s ing EBT at the farmer’s market to gain additional “access to nutritionally adequate This project measures participants’ atti- and safe foods” (Metallinos-Katsaras et al. tudes about the Community Campus and 2009:1790). However, this research implies the programs it offers, while assessing how the ability to utilize the Riverfront Farmer’s participants utilize the facilities available at Market may be hindered due to inadequate the Community Campus. The data were transportation. from a sample (n=9) of residents in the resource-poor community of Hillcrest in III. Co m m u n i t y -Un i v e r s i t y Wilmington, North Carolina that houses Partnerships a n d Building the Community Campus. The sample Co m m u n i t y Ca p a c i t y : was obtained through snowball sampling An Ev a l u a t i o n o f t h e Co m m u n i t y techniques that included each strata repre- Ca m p u s a t Hi l l c r e s t sented in the population of the surrounding community. Snowball sampling was chosen St a t e m e n t o f Pr o b l e m due to the link between networks and connections and community—the primary fo- This research evaluates the Community cus of this research. As community leaders Campus at Hillcrest, established through and decision makers, two resident council a community–university partnership and members were also included in the sample designed to build and foster community to assess their attitudes about the progress capacity and social agency in a resource- of the Community Campus. In order to poor area. Four fundamental characteris- best evaluate and explore each participant’s tics of community capacity include a sense experiences, attitudes and feelings about of community, a level of commitment, the the Community Campus and its perceived ability to solve problems, and access to re- impact on the community, a qualitative ap- sources (Chaskin 2001). Additionally, there proach was chosen. In depth, face-to-face are four main strategies for building com- interviews were conducted consisting of 10 munity capacity: leadership development, open ended and probing questions designed organizational development, community to measure participants’ attitudes about the organizing, and fostering collaborative Community Campus and the programs it

136 Kimberly Lancaster, Amanda Smith, et al. offers. Questions (see Appendix 3) were in- program and include opportunities for ed- cluded to measure how and how often each ucational development such as homework participant utilizes the programs and facili- help, tutoring, arts and crafts classes, dance ties at the Community Campus, knowledge classes, gardening, nutrition programs, po- of the Community Campus, thoughts and etry and literature exercises, and time to feelings about the Community Campus and utilize the computers. its perceived impact within the community. While greater impacts may be noted in Additional questions that were designed to the areas of educational development, it gather data about what types of future pro- is also important to note that the children gramming residents would find beneficial to have made the community campus very their community were also included in the much a part of their daily lives and com- interview process. All respondents, includ- munity life, developing and encouraging ing resident council members, were asked their sense of community. According to the same set of interview questions. Each the WHA UNCW Community Campus interview was recorded, transcribed and Afterschool Attendance Report provided the data were coded for thematic patterns. by the on site coordinator in April 2010, an average of 17 children visit the Community Fi n d i n g s Campus daily to participate in some form of programming, while 27 of the 42 The following three themes emerged from school-aged children who live in Hillcrest the interviews conducted with the sample have visited the Community Campus at of Hillcrest residents described in the pre- least once. Many of the children that visit vious section. the Community Campus are regular participants in the children’s programming Theme One: Positive Impact on Children in that is offered. Additionally, the parents of the Community in the Areas of Education children who are involved with programs at and Mentoring the Community Campus are more likely to utilize programming and become involved “When the kids leave school they continue to themselves through volunteering. Of the learn at the center.” –Resident and parent residents interviewed, two were parents of children who attended programming at the “If I have an impact on just one child, I know I Community Campus and both parents had have done my job.” –Resident and volunteer utilized programming and volunteered at the Community Campus. Of the residents interviewed, eight reported the largest impact of the Community Theme Two: Access to Resources Builds Campus within the community has been Human Capital, Social Capital, and Social with the children/youth in the areas of ed- Agency ucational development and positive mentoring. Of the programs currently offered, “I was using the computers here one day and half are geared towards children/youths happened to put my resume up on one of the with primary focuses being on aspects of job boards, and that is how I got my current educational development.The Community job. There are some of us that don’t have the re- Campus offers a range of programs that sources to go to the unemployment office or the are designed to be both fun and academic, library on a daily basis to get online to look for These programs typically take place dur- work. Having access to the computers is helpful ing the Community Campus’ after school when you’re seeking work.” –Resident

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members. Two participants reported work- Residents use the computer lab facilities to ing closely in the past with the Community build human and social capital by gaining Campus organizing community events or access to a wider job market and thereby volunteering with a program, one of whom increasing their chances of becoming was a resident council member. The other employed. Of the adults interviewed, six two respondents reported feeling they could said that they were more likely to use the rely on the partnership with the univer- computer lab and attend computer classes sity to aid them if and when they needed more frequently than any other program or help organizing an event, reaching a par- facility. The number one use of the com- ticular goal, or solving a problem within puters was to find employment and apply the community. By aiding the community for jobs. Residents cited a lack of access with “translating commitment into ac- to computers in the home and/or the dif- tion,” (Chaskin 2001:297) the Community ficulty with transportation systems to the Campus has improved the community’s public library or Employment Security ability to solve problems. Residents’ com- Commission to use job-seeking resources, mitment to community goals and projects such as computers, as the largest obstacles can be realized more greatly by working in while seeking employment. Additionally, partnership with the Community Campus. the close proximity and easy access to computers with no time limits were cited as pri- Di s c u s s i o n a n d Implications mary reasons for using the computer labs on site. It was also noted that on several This research suggests that the Community occasions interview participants referred to Campus has made notable progress in the the Community Campus as the “resource area of building community capacity in the center.” Because access to resources is one two years since its establishment by imple- of the four fundamental characteristics of menting capacity-building strategies within community capacity, the computer lab fa- its programming. These capacity-building cilities work as a strategy towards this goal strategies include fostering leadership de- by providing a needed resource within the velopment, organizational development, Hillcrest community. community organizing, and collaborative relations among organizations (Chaskin Theme Three: Strengthens Community’s 2001). Because the Community Campus Ability to Solve Problems thrives on the organizing within both the community and the university, as well as “Anything that needs to be done as a whole the organization and collaboration between for the community, I can go to the community the two, these strategies are paramount campus and ask someone for their help and to the goals of the Community Campus. they have no problems helping.” –Resident and Among the resident children of Hillcrest, resident council member a positive impact in the areas of education and mentoring is additionally noted It was noted that four of the residents as promoting a sense of community and interviewed felt they could turn to the building community capacity. In the areas Community Campus for help with com- of providing access to resources, building a munity-based events, organization, or pro- sense of community, and building problem- grams. Of the four of respondents who said solving abilities, the Community Campus they felt they could turn to the Community has made significant advances towards Campus, two were resident council promoting these particular fundamental

138 Kimberly Lancaster, Amanda Smith, et al. characteristics of community capacity Additionally, community involvement will within the Hillcrest community. produce stronger ties between the commu- However, frequent evaluations should nity and university, thereby continuing to be conducted by future public sociology foster the collaborative relations between interns and Community Campus coordi- the two groups and strengthening the com- nators to ensure that programming is con- munity-university partnership. By continu- tinuing to meet community needs and resi- ing to utilize these strategies to include all dent input is part of program formation. aspects of program formation, community By talking with residents about individual capacity will continue to grow to include all and community need, programs can be characteristics. more efficiently designed with a particular community need in mind. By address- Future Programming Suggestions ing community needs directly expressed by Of the working-aged residents interviewed residents, the Community Campus will be (those under the age of 65 and/or not re- better equipped to provide access to appro- tired), 71.4% said they would like to see priate resources needed in the community. some form of career services and/or skills Additionally, consistent resident input will building classes. The implementation of increase the level of community commit- career services program that included in- ment to the growth and progress of the struction of resume writing, job search community. techniques, and interview skills would fur- Further, in order to continue to work ther increase human and social capital, as towards its intended goal of building com- work-seeking adults would increase their munity capacity, the Community Campus chances of becoming successfully em- at Hillcrest must promote individual levels ployed, while making important contacts of commitment from residents through and forming networks. An increase in so- promoting resident volunteerism and in- cial and human capital would also result in volvement at the Community Campus an increase in social agency. Additionally, and within the community. The organi- the high demand noted for a career services zational level of commitment from the and skill-building program indicates a need university, as well as local business and within the community for this particular organizations outside of the community, resource. is strong. However, the individual level of Another noted demand was for some commitment of residents has yet to reach form of athletic team for the youth within a threshold, as only a portion of current the community. The implementation of programming has included resident input a community-based team would create a during formation. Increasing the level of sense of community amongst team mem- commitment from community members bers and coaches, while utilizing existing must be made a priority, as it is a large part resources (ball fields and courts) within the one of the four fundamental characteristics community. Additionally, a community of community capacity. Increased resident team would help promote a level of com- involvement in all aspects of programming mitment amongst team members, parents, and program development will build a level and residents to the community. By devel- of commitment by building individual oping leadership skills and building social level social agency for residents, increasing agency, residents would be a part of the or- leadership development amongst residents, ganizational development of the team and and fostering community involvement with events. Moreover, the university commu- organizing of the Community Campus. nity based team would foster collaborative

139 Explorations | Social Sciences relations with other communities, the university, city, and local businesses.

Co n c l u s i o n

The Community Campus at Hillcrest is still a new community and university collaboration. It is a work in progress and is continuously working to improve the relationships between the community and the university. The collaboration offers excellent opportunity for community based research project as described earlier in this article. However, there is still not as large a level of community participation and commitment as one would hope. The experiences that are available allow for empowerment within the community for the residents as well as the students involved. Community and university collaborations are beneficial to all people involved. Community service learning is an excellent way for students to become involved in a variety of forms of social research. It is imperative that universities work with the community to grow partnerships that can be effective. As the Community Campus collaboration continues, lessons are learned and improve- ments are needed and made to reduce the gap between the community and the university. By continuing to strive to produce programs and research issues that are relevant and needed by the community, the Community Campus will continue to work to build Community Capacity in the Hillcrest community.

140 Kimberly Lancaster, Amanda Smith, et al.

Re f e r e n c e s

Chaskin, Robert J. 2001. “Building Community Capacity: A Definitional Framework and Case Studies from a Comprehensive Community Initiative,” Urban Affairs Review 36:291-323.

Coleman, James S. 1988. “Social Capital in the Creation of Human Capital.” American Journal of Sociology: 94.

Gersovitz, M. 1983. “Savings and Nutrition at Low Incomes.” The Journal of Political Economy 91(5): 841-855.

Gundersen, C., and B. Kreider. 2009. “Bounding the Effects of Food Insecurity on Children’s Health Outcomes.” Journal of Health Economics 28:971-983.

Harrison, D., Case, A., Fiederlein, L., Lancaster, K., Ridenour, K., Sellers, W., Vestal, A., Whitley, A. 2009. “Transportation in Resource-Poor Areas In Wilmington, NC” Public Sociology Program, University of North Carolina Wilmington, Wilmington, NC. Unpublished Report.

Huddleston-Casas, C., R. Charnigo, and L.A. Simmons. 2008. “Food Insecurity and Maternal Depression in Rural, Low-Income Families: A Longitudinal Investigation.” Public Health Nutrition 12(8): 1133-1140.

Jha, M. 2009. “Food Security in Perspective: the Significance of Social Action.”Community Development Journal 44(3): 351-366.

LeafLight, “21st Century Farmer’s Market”, Retrieved September 7, 2010 .

Metallinos-Katsaras, E., B. Sherry, and J. Kallio. 2009. “Food Insecurity Is Associated with Overweight in Children Younger than 5 Years of Age.” Journal of the American Dietetic Association 109(10): 1790-1794.

Marullo, Sam, Roxanna Moayedi, and Deanna Cooke. 2009. “C. Wright Mills’s Friendly Critique of Service Learning and an Innovative Response: Cross-Institutional Collaborations for Community-Based Research.” Teaching Sociology 37:61-75.

New Hanover County Department of Social Services. “Food and Nutrition Services,” Retrieved September 7,2010 .

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Nord, M., M. Andrews, and S. Carlson. 2009. “Household Food Security in the United States, 2008.” Economic Research Service Report Summary. U.S. Department of Agriculture.

Sanders, Trecie, WHA Public Housing Manager. 2009. Interviewed by author, Wilmington, NC, September 30.

Stoecker, Randy 2005. Research Methods for Community Change: A Project-Based Approach. Thousand Oaks, CA: Sage Publications, Inc.

Strand, Kerry, Sam Marullo, Nick Cutforth, Randy Stoecker, and Patrick Donohue. 2003. Community-Based Research and Higher Education. San Francisco, CA: Jossey-Bass.

USDA Food and Nutrition Services “Supplemental Nutrition Assistance Program” Retrieved September 7, 2010 .

WHA/UNCW Community Campus. 2010. 2009/2010 Afterschool Attendance Report. Wilmington, NC.

Yngve, A., B. Margetts, R. Hughes, and M. Tseng. 2009. “Food Insecurity- Not Just About Rural Communities in Africa and Asia.” Public Health Nutrition 12(11): 1971-1972.

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Ap p e n d i x 1

Modified USDA Survey on Food Security

Introduction We are interested in learning more about access to affordable food for Housing Authority residents.

The questions below are about food and your family’s needs.

1. Circle the line below that describes you and your family: When I shop, I am able to choose from a variety of foods that are high in quality When I shop, I am able to choose from a variety of foods that are not high in quality When I shop, I am usually limited by the variety of foods carried in the store

2. Circle the line below that best matches you: I eat healthy foods from all food groups daily or almost daily I eat healthy foods from all food groups a few times a week I eat healthy foods from all food groups at least once a week I rarely eat healthy foods from all food groups

3. What are you most concerned about when buying food? Rank these with 1 being the most important and 5 being the least important. Food Price Quality of Food Nutritional Value of Food Food Taste Food Convenience

4. Circle the line below that describes you: I eat 2-3 servings of both fruits and vegetables most days I eat 2-3 servings of fruits, but less or no servings of vegetables most days I eat 2-3 servings of vegetables but less or no serving of fruits most days I do not eat 2-3 serving of fruits or vegetables most days

5. Where do you buy the majority of your groceries? Rank these with 1 being where you buy the majority of your groceries to 5 being where you buy the least. Supermarket (Food Lion, Harris Teeter) Superstore (Wal-Mart) Small Grocery Store Convenience store without gas Convenience store with gas

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6. What do you consider when deciding where to buy groceries? Rank these with 1 being the most important factor and 5 being the least. Nearness to the store Transportation Food Variety and Quality Offered at the Store Prices at the Store Other (what are they?)

7. Do you rely on any food assistance programs like Food Stamps, WIC, or the school lunch program to help supply food for you and your household? Check the box below that describes your household: Yes No

If you checked Yes, please check which ones below: Food Stamps WIC School Lunch Program Other (please list)

8. Do you rely on any emergency food assistance programs like soup kitchens, food banks, food pantries or any other “free” food resources? Check the box below: Yes No

If you checked Yes, please check which ones below: Soup Kitchens Food Banks Food Pantry Other Free Food Resources (please list)

9. If you do use emergency food assistance programs, please tell us how often. Circle the line below that describes your household: Daily Weekly Monthly Occasionally throughout the year Less than once a year

144 Kimberly Lancaster, Amanda Smith, et al.

10. How often do you utilize fast food restaurants as a source of food? Check the box that describes you: Daily or almost daily More than once a week At least once a week A few times a month Less than once a month

11. What are your reasons for buying fast food? Rank these with 1 being the most important reason to 4 being the least important reason. Fast food restaurants are near by Fast food restaurants are easier to access than the grocery store Fast food is cheap I would rather eat fast food than prepare food from the grocery store

12. How do you feel about the nutritional value of your daily food intake? Circle the line that describes you: The food I eat is very nutritious Sometimes the food I eat is nutritious The food I eat is not always nutritious I rarely eat nutritious foods

13. How interested would you be in learning about how to include nutritious food in your diet and learning to cook with these foods? Circle the line that describes you: Very interested Somewhat interested Not very interested Not interested at all

14. Here are some reasons why people don’t always have enough or the kinds of the foods they want to eat. Please indicate if any of the following is a reason why YOU don’t always have enough or the kinds of food you want. Not enough money for food Kinds of food I want are not available Not enough time for shopping or cooking Too hard to get to the store On a diet No working stove available Not able to cook or eat because of health problems Don’t know or not applicable Other: (please list)

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15. People have made several statements about their food situation. For these statements, please indicate whether the statement was often true, sometimes true, or never true for your household in the past 12 months.

The first statement is “I worried whether our food would run out before wegot money to buy more.” This was: Often true Sometimes true Never true Don’t know

The second statement is “Someone in my household has had to cut the size of a meal or skip a meal because we did not have enough food” This was: Often true Sometimes true Never true Don’t know

16. If Food Stamps and/or WIC benefits were accepted at the local Farmers Market, how likely would you be to shop at the Farmers Market? Check that box that applies to you: Very likely Somewhat likely Not likely at all

17. Are there any foods that you have omitted from your diet or have gone without on a consistent basis because of cost, transportation, or availability? Yes No

If yes, indicate the food group/s that these foods are from? Grains Fruits Vegetables Protein Dairy Fatty Foods

Thank you for helping us understand more about food security!

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Ap p e n d i x 2

Friends, Food, and Fun Spring 2010

What is your name? Are you: Male or Female How old are you? Are you allergic to any foods?

1. Which of the following foods should you eat the least of?

2. Which snack will you give you the most energy?

3. Which snack is best for your eyes and skin?

4. Which snack gives you strong bones?

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5. What are the three things that our garden needs to grow? a. A bowl, milk, and spoon b. Sunlight, water, and dirt c. Air, hard work, and love

6. Which is healthier?

7. Which is healthier?

8. Which is healthier?

9. Which is healthier?

148 Kimberly Lancaster, Amanda Smith, et al.

How many meals do you eat a day?

How many snacks do you have at home in a week?

What are two things you usually eat for dinner?

What are two things you usually eat for lunch at school?

If you could choose anything, which are your three favorite foods?

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Ap p e n d i x 3

Community Campus Evaluation Interview Schedule

1. Do you know about the Community Campus/center in the Hillcrest community? If so, how did you hear about it?

2. Have you ever been to the Community Campus? If not, is there any reason why? If so, how often do you visit the Community Campus?

3. Do you know what programs are offered?

4. What programs/facilities do you use most often?

5. If you do not currently participate/use any of the programs/facilities, what program would you most likely participate in?

6. Are there any programs you would like to see started at the center that you feel the community would benefit from?

7. What existing program would you say you benefit from the most? If none, what kind of program do you feel you would benefit from?

8. What are your thoughts and feeling about the Community Campus?

9. What would make the Community Campus more meaningful for you?

10. Do you think the Community Campus has had an impact on your neighborhood? If so, what?

150 About the Student Authors

Hannah C. Ainsworth Since arriving back, she has compiled a graduated from Salem College in 2010 manuscript of her own project involving with a Bachelor’s of Science degree in social support and disaster management. Chemistry. She has worked on the Salem Traveling the east coast, she has presented College American Ginseng Project since her findings at various research expos and February of 2008. During that time, she anthropology club meetings. She hopes to has presented this research at a Regional continue her studies at graduate school in and National Meeting of the American the upcoming future. Chemical Society. In addition to this project, she conducted Physical Chemistry Margeaux Corby research at Kent State University’s graduated summa cum laude and Phi Beta Liquid Crystal Institute, sponsored by Kappa from Elon University in May 2010. the National Science Foundation’s REU She majored in biology and journalism, summer program. She is currently doing held three different editor positions at the research at Wake Forest University’s school school paper, The Pendulum, and partici- of Medicine while applying to graduate pated in several volunteer projects serv- schools for the coming year. ing minority and displaced populations. Margeaux’s research was funded through Jonathan Brooks the $15,000 Lumen Prize, awarded to is from Charlotte, North Carolina. He re- select Elon University students following ceived a BA in history with a minor in an- submitted research proposal and rigorous thropology from the University of North interview process. She currently works Carolina – Wilmington in May 2010. The with disabled clients by providing reha- article presented is part of an ongoing re- bilitative and respite services. Margeaux search project. The research was presented is applying to medical school and hopes at the UNCW undergraduate research to continue her health communication showcase. He is currently enrolled in the research as a physician. graduate program at UNCW, pursuing a MA in global history, concentrating on Endya L. Frye West Africa and the trans-Atlantic world. is a senior biology at North Carolina Agricultural and Technical State Brittany Autumn Burke University, and is an active member of the is a recent graduate from the University of University’s Honors Program where she North Carolina at Greensboro majoring holds various leadership positions. In ad- in Anthropology and double minoring in dition to her academic endeavors and at- Sociology and Spanish. She was given the taining recognition by the College of Arts opportunity to live and conduct research and Sciences as Undergraduate Student in the Andean highlands of Ecuador in of the Year, Endya is a member of sev- the months of July and August, 2009. eral honors societies. She is the current

151 Explorations president of the Minority Association of in TaeKwonDo. At the end of his senior Pre-Medical Students at NC A&T. Upon year, Saumil was honored to be named a graduation Endya intends to pursue a United States Presidential Scholar. In his career in medicine. Her research interests free time, Saumil enjoys singing and read- include understanding various aspects of ing about international affairs. the autoimmune disease Systemic Lupus Erythematosus. Kimberly Lancaster is a graduate of the University of North Diana Gliga Carolina Wilmington with a BA in Public is a graduate of East Carolina University. Sociology with a concentration in Human She received a Fulbright Scholarship Resources and Inequalities. She received to study eye conditions of her native the Sociology Academic Excellence Romanians. She is currently enrolled as award for her graduating class. She is a medical student at Brody School of currently enrolled as a graduate student Medicine. She conducted biological and in the Criminology and Public Sociology health science research during her under- Masters Program at the University of graduate terms. North Carolina Wilmington. Her current research is focusing on community univer- Rachana Gyawali sity partnerships and the organizational came from Nepal to Winston-Salem, collaborations that take place specifically North Carolina in 2006 for her under- at the Community Campus at Hillcrest graduate. She received her B.S. degree where she is working as the Campus in biology from Salem College in 2010. Coordinator. During her undergraduate, she got an opportunity to participate in the ongo- L. Tiara Murphy ing American Ginseng project at Salem graduated from Salem College in May College. She was actively involved in this 2010 with a B.S. in Biology. She spent project for the last two years. In addition, three of four undergraduate years as a she has done a couple of internships at member of the American ginseng inde- Wake Forest University Baptist Medical pendent research team, and thoroughly Center and at Targacept. Currently, she enjoyed the experience. She is currently a is pursuing her graduate studies in the first-year medical student at the University department of Biology at Texas A & M of South Alabamas College of Medicine University. in Mobile, AL. Undergraduate research has provided a solid basis both for research Saumil Jariwala at the graduate level and has given ad- currently attends the University of ditional insight into the process of clinical Pennsylvania under the Huntsman testing.” Program. As a senior at the North Carolina School of Science and Smriti Sharma Mathematics, Saumil completed his game- is originally from Kathmandu, Nepal. theory research and also served as Student She received her undergraduate degree Body President. Saumil’s other activities from Salem College in May 2010 with a included Quizbowl and Model United major in Chemistry. She was involved in Nations. Outside of school, Saumil is an Ginseng project for 2 years while her years Eagle Scout from Boy Scout Troop 374 at Salem. During the time, in addition to and a First Degree Decided Black Belt presenting the research in Salem College,

152 About the Student Authors she had presented the research in different national and regional conferences. She currently works at an Environmental Chemistry labs in Nicholas School of Environment at Duke University. She plans to pursue her graduate education in Environmental Chemistry in Fall 2011. Amanda Smith is currently senior at University of North Carolina Wilmington. She will graduate in December 2010 with a BA in Public Sociology with a minor in Journalism. She is a member of Alpha Kappa Delta, the international sociology honors society. Amanda has presented this research at the 5th annual UNCW Undergraduate Research and Creativity Showcase, as well as the 8th annual Colonial Academic Alliance Undergraduate Research Conference. She will also be a panelist at the upcoming North Carolina Governors Conference for Women in November 2010. After graduation, she plans to pursue her MA in Sociology and is considering a PhD thereafter. Christina Tomlinson is currently a graduate student at University of Missouri-Kansas City, where she is pursuing a Master’s degree in history. She graduated summa cum laude in 2010 and received her BA in history from Campbell University in Buies Creek, NC. Presently, she is part of a museum consult- ing team that is aiding in the relocation of the Black Archives of Mid-America in Kansas City, MO. She hopes to continue in higher education and plans to pursue a PhD specializing in medieval social history and gender studies. Her research interests include early medieval German history, the Migration Period, and women in the Middle Ages.

153 About the Faculty Mentors

Dr. Michael F. Bassman Dr. Nita A. Eskew is the first Distinguished Honors Professor is an Associate Professor of Chemistry at in the new Honors College at East Salem College. She is collaborating with Carolina University. Previously, Dr. Dr. Jeanine Davis of North Carolina State Bassman was Associate Vice Chancellor University and Dr. Jennifer Cruse-Sanders and Director of the Honors and of the Atlanta Botanical Garden on an ECScholars Programs. In addition, he interdisciplinary research project focusing founded the ECU undergraduate research on the bioactive molecules in American program and initiated Explorations for the ginseng, a medicinal plant native to North state of North Carolina. Dr. Bassman Carolina. Nita received both her BS was a co-founder of the Ethnic Studies and PhD degrees in chemistry from the Program and served as Coordinator University of North Carolina at Chapel for ten years . His area of expertise is Hill. Prior to joining the Salem faculty, Holocaust Studies and he serves on the she worked in the chemical industry on North Carolina Council on the Holocaust. various products including polyurethane, organic dyestuffs and pigments, and span- Dr. Andrew F. Clark dex fiber. is Professor of African and Global History at UNC Wilmington. He received his Dr. Annette G. Greer Ph.D. from Michigan State in African is Co-Director, Office of Interdisciplinary History, with a focus on West Africa, in Health Sciences Education where she 1990. He has published extensively on teaches Interdisciplinary Rural Health African history and society, and teaches a courses primarily in online environments. variety of courses in African and global In addition to rural health, Dr. Greer history. He has published numerous teaches public health and adult educa- book reviews in Africanist journals, has tion. She collaborates with faculty from presented many papers to professional the College of Human Ecology to teach conferences and gives public lectures on an Honors Seminar that combines art a number of topics related to Africa and and health. Dr. Greer has been involved international affairs. Since his Peace Corps in interdisciplinary education for over service (1978-1981) in Senegal, he has twelve years. Along with her advanced traveled extensively in West Africa and is degrees in nursing, Dr. Greer has as- currently completing a manuscript on slav- sociate degrees in Agriculture Science ery, Islam and independence in Senegal and Agricultural Business. She serves and Mali. He is a past president of the on the NIH/NCI National Advisory Association of Third World Studies and is Board of the Agricultural Health Study currently the Country Specialist for Senegal and represents farm spouses. She has and Guinea with Amnesty International. published on interdisciplinary education

154 About the Faculty Mentors and service-learning in allied health and colonists in ‘‘Wealth-Based Trust and the nursing journals. Dr. Greer’s dissertation Development of Collective Action’’ (2004) research in learner-centered pedagogy has in the journal World Development. been published internationally in journal articles, a book chapter, and as a book. Dr. Patrick M. Martin Dr. Leslie Hossfeld serves as an assistant professor at North is Director of Public Sociology Carolina A&T State University. Before Undergraduate and Graduate Programs joining North Carolina A&T State at UNCW. She received the 2005 Faculty University, he graduated from Virginia Fellow in Public Policy and Public Union University with a BS in Biology Engagement at the Institute for Emerging and then earned a Ph. D. in Cell and Issues at North Carolina State University. Molecular Biology from the University Her research focuses on poverty and job of Virginia. He is currently a member loss in rural North Carolina. She has of the Wake Forest University, School of made presentations to the United States Medicine, Comprehensive Cancer Center Congress and to the North Carolina and maintains an active research labora- Legislature on the subject of job loss and tory that focuses on the molecular regu- rural economic decline and recovery. Dr. lation of aggressive cancers and health Hossfeld is co-founder of the Southeastern disparities in cancer. He is also very inter- North Carolina Food Systems program, an ested in developing new curriculum and economic development project focused on has developed a biotechnology certificate keeping food dollars within the local economy. program, new courses involving cancer pathogenesis and cancer health disparities. Dr. Eric Jones a research scientist, University of North Dr. Arthur Murphy Carolina at Greensboro, has focused his head and professor of anthropol- recent work on understanding how the ogy, University of North Carolina at structuring of social relations following Greensboro, has been very involved in extreme events (e.g., natural disasters, research in urban economic systems and pioneer colonization, and immigration) in cultural dynamics of disaster recovery. impacts individual outcomes and recovery. His disaster research has covered floods, His general research interests concern volcanic eruptions, and hurricanes in the cross-cultural vulnerability and resilience United States, Mexico, and Ecuador. He under conditions of environmental and/ is the coauthor of Social Inequality in or social change. He recently coauthored Oaxaca (1991, Temple University Press), the edited volume The Political Economy The Mexican Urban Household (1990, of Hazards and Disasters (2009, AltaMira University of Texas Press), and coeditor Press), published the innovative method- of The Political Economy of Hazards and ological piece ‘‘Extreme Events, Tipping Disasters (2010, AltaMira Press). Points and Vulnerability: Methods in the Political Economy of Environment’’ in Dr. Jaclyn Stanke Environmental Social Sciences: Methods is Associate Professor of History at and Research Design (in press, 2010, Campbell University, where she has taught Cambridge University Press), and per- since 1999. She received her PhD in formed the application of social network History from Emory University in 2001. analysis to cooperation among pioneer A specialist in the Cold War, she has

155 Explorations written and published articles on Anglo- American relations following Stalin’s death in 1953, the Cold War and the American South, and American popular perspectives of the Solidarity movement in Poland. She is currently working on a larger project documenting American popular culture and popular perspectives of the 1980s as the Cold War went from a deep freeze to a sudden end.

Dr. Virginia (Ginger) S. Wilson taught history for thirty years at the NC School of Science and Mathematics and served as Dean of Humanities. She retired in 2010, but hopes to do some part-time teaching. She received the NCSSM Outstanding Teacher Award and the UNC Board of Governors Award for Excellence in Teaching. She was awarded the National Council for the Social Studies Service and Outstanding Secondary Teacher Awards. She is an Adjunct Associate/Assistant Professor for Duke’s Undergraduate and MAT Teacher Education Programs. She serves on the Board of Directors of the North Carolina Council for the Social Studies.

Dr. Donald Woolley is a researcher in the Department of Psychiatry at Duke University studying Post Traumatic Shock Disorder in children. He is also an adjunct assistant professor in the Department of Sociology at Elon University and is unclear about when he accidentially became a Socio-Biologist.

156 Submission Process Who is eligible? The primary author or authors must be undergraduates at a 2 or 4 year college or university in the state of North Carolina working on original research under the direction of a faculty mentor. Works may be co-authored. What to Submit? We are seeking research papers, critical essays (literature/research reviews, articles written on a particular topic), or media submissions of performing/fine art endeavors.

Explorations,the Journal of Undergraduate Research and Creative Activities for the State of North Carolina , will be published primarily online, providing opportunities for a variety of text and media submissions in the following disciplines:

Biological, Earth, and Physcial Sciences Performing Arts Business and Legal Social Sciences Creative Writing and Discourse Technology and Engineering Humanities Visual Arts and Design Mathematics How to Submit? Guidelines for publication:

1. Submit all articles (without images) in Word documents (.doc) only, and indicate where images, graphs, maps, or charts should appear. 2. Submit images, graphs, maps, and charts as separate files. For creating graphs and charts (in Excel, Illustrator, or Paint): make the image as LARGE as possible. This will ensure its visibility in the publication. 3. Images need to be saved as .jpegs, preferably at high resolution (300dpi). 4. If images are not yours, please obtain permission in writing and cite the copyright owner. 5. Use grayscale (no colors) on all charts, tables, graphs. 6. Submit everything in its original file. (Example: article as Word doc, image as .jpeg.) Do not convert files. Do not embed images into your article. Create an Appendix to indicate image placement.

Please attach your submissions and all additional forms in an email addresed to: [email protected].

Deadline: February 1, 2011 and June 1, 2011

(Continued on page 158.)

157 Explorations Suggestions for Success 1. Make sure your name is on everything you submit

2. Use your initials and submission title as the title of your paper and/or any other email attachments, this way everything can be easily identified.

3. Turn in your required forms with your submission. Submissions sent without all required forms will not be accepted. Detailed information at www.explorationsjournal.com.

4. Once your work has been blind reviewed, you may submit your work yourself or your faculty mentor may submit it. If you are a single author, you will be the main contact. If you are one of multiple authors, decide who will be the main contact and have him/her submit on behalf of all.

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