Prävention

In einem etwas langatmigen Artikel in der Onlineausgabe der NYTimes („Blocking the Transmission of Violence“ aus dem Magazin), den ich zugegeben teilweise nur überflogen habe, wird ein interessantes Konzept zur Gewaltprävention vorgestellt, das sich aus Konzepten zur Eindämmung von Infektionskrankheiten inspiriert — und auch über letztere einige Informationen bereithält, die für mich neu waren. Insgesamt ein überraschender und auf den zweiten Blick doch einleuchtender Ansatz, Gewalt ähnlich wie eine Infektionskrankheit zu betrachten.

There have long been two schools of thought on derailing violence. One focuses on environmental factors, specifically trying to limit gun purchases and making guns safer. The other tries to influence behavior by introducing school-based curricula like antidrug and safe-sex campaigns.

Slutkin is going after it in a third way — as if he were trying to contain an infectious disease. […]
In 1981, six years out of the University of Chicago Pritzker School of Medicine, Slutkin was asked to lead the TB program in San Francisco. With an influx of new refugees from Cambodia, Laos and Vietnam, the number of cases in the city had nearly doubled. Slutkin chose to concentrate on those who had the most active TB; on average, they were infecting 6 to 10 others a year. Slutkin hired Southeast Asian outreach workers who could not only locate the infected individuals but who could also stick with them for nine months, making sure they took the necessary medication. These outreach workers knew the communities and spoke the languages, and they were able to persuade family members of infected people to be tested. Slutkin also went after the toughest cases — 26 people with drug-resistant TB. The chance of curing those people was slim, but Slutkin reckoned that if they went untreated, the disease would continue to spread. […] Within two years, the number of TB cases, at least among these new immigrants, declined sharply.

Slutkin initially established an approach that exists in one form or another in many cities: outreach workers tried to get youth and young adults into school or to help them find jobs. These outreach workers were also doing dispute mediation. […] One of Slutkin’s colleagues, Tio Hardiman, brought up an uncomfortable truth: the program wasn’t reaching the most bellicose, those most likely to pull a trigger. So in 2004, Hardiman suggested that, in addition to outreach workers, they also hire men and women who had been deep into street life, and he began recruiting people even while they were still in prison. Hardiman told me he was looking for those “right there on the edge.” (The interrupters are paid roughly $15 an hour, and those working full time receive benefits from the University of Illinois at Chicago, where CeaseFire is housed.) The new recruits, with strong connections to the toughest communities, would focus solely on sniffing out clashes that had the potential to escalate. They would intervene in potential acts of retribution — as well as try to defuse seemingly minor spats that might erupt into something bigger, like disputes over women or insulting remarks.

As CeaseFire evolved, Slutkin says he started to realize how much it was drawing on his experiences fighting TB and AIDS. “Early intervention in TB is actually treatment of the most infectious people,” Slutkin told me recently. “They’re the ones who are infecting others. So treatment of the most infectious spreaders is the most effective strategy known and now accepted in the world.” And, he continued, you want to go after them with individuals who themselves were once either infectious spreaders or at high risk for the illness. In the case of violence, you use those who were once hard-core, once the most belligerent, once the most uncontrollable, once the angriest. They are the most convincing messengers. It’s why, for instance, Slutkin and his colleagues asked sex workers in Uganda and other nations to spread the word to other sex workers about safer sexual behavior. Then, Slutkin said, you train them, as you would paraprofessionals.

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Datum: Montag, 5. Mai 2008 14:57
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