Cultural Diplomacy During Epidemic Outbreaks. On the History of Epidemics in Diplomacy

Table of Contents

Introduction

Book outcomes

The Virus pandemic outbreak

A viral world war

Pandemics

Economic Considerations

Virus pandemic socioeconomic shock

International Health Regulations
Security Council

Social distancing

Diplomacy strained in the middle of Virus pandemic
Soft power
Culture as the explanation

The Role of Culture in Response to Epidemics

Culture in Managing Response to Pandemics

Socio-Cultural Factors Associated with Epidemics

Epidemic psychology
Epidemic
Transmission
History of Quarantine

Globalization and International relations
International Relations
International Relations and Globalization
Economic Globalization
Political Globalization
International Relations Theory
Levels of State Behavior
Levels of Analysis

Power

National interest

Polarity

Tools of international relations
Epistemology
Diplomacy
Informal diplomacy
Small state diplomacy
Globalization
Diplomacy
Purpose of Diplomacy
Public diplomacy
Cultural diplomacy
Goal of cultural diplomacy

International Relations
International Relations and Globalized Society
Culture in International Relations

Culture
Cultural resistance
Characteristics of Culture
Behaviour and Culture
Culture affects behaviour and interpretations of behaviour
Time and Diplomacy
Cross-cultural preparation points to consider
Cultural Diplomacy and Conflict
Expression and Cultural Diplomacy
Cultural diplomacy and Public diplomacy in action
Benefits from Successful cultural diplomacy
Forms of soft power
Appealing values
Cultural perceptions
Selecting activities

National identity
Reputation
Reputation capital
Creating reputation
Cross-cultural diplomatic strategies
Cultural assumptions
Cultural self-perception
Cultural fix points

Bibliography

Introduction

Although epidemic outbreaks pilot the general population, the country and consequently the diplomatic practices to an enhancement in cultural awareness the response to recent Virus epidemics show that there is still a lot to be learned.

The world has witnessed a number of epidemic outbreaks with shocking effects. While outbreaks are inevitable, their impact can be mitigated. Effective management of such events calls for better approaches encompassing all the different aspects that can influence the outcome, such as culture.

Through this book we will try to evaluate the lessons learned regarding culture in outbreaks of diseases and the diplomatic practices. We will come up with some of the ways in which culture and diplomacy can influence the response to epidemics and assesses the variety of approaches which have been developed to take those suggestions into account. We will discuss to which extend the lessons learned from the responses in the past have been implemented in the response to Virus outbreak and argues that within the international response culture was primarily confirmed a risk factor and fundamental structural aspects have been disregarded.

Communities’ response to outbreaks and their willingness to embrace the involvement devised and implemented by international experts in order to mitigate the effects of an outbreak can greatly influence the outcome.

International cooperation and coordination was blocked by the lack of agreement regarding the use of quarantine. The debate among scientists, health administrators, diplomatic bureaucracies, and governments demonstrated in the debates in the International Sanitary Conferences (Howard-Jones, 1975), particularly after the opening, in 1869, of the Suez Canal, which was perceived as a gate for the diseases of the Orient (Huber, 2006).

International relations referred to the study of foreign affairs and political interaction between countries and cover the complex of cultural, economic, legal, military, and political relations of all countries and their populations, actors and international organizations (Anderson, 2006). The goal of this book is to introduce some of the main issues of international politics, such as war and peace, development, regional integration and security, and to familiarize with different ways to conceptualise and analyse these issues (Appadurai, 1991). This should allow to make a more confident decision about your own attitude towards particular issues and to analyse these issues more thoroughly, but it should also make you question both your own as well as others’ representations of the world (Argyris, 1982).

Book outcomes

This book provides a broad introduction to the study of international relations and VIRUS and encompasses a diverse array of topics, from the causes of war to the politics of development, from international institutions to the environment, events, issues, and processes of international relations in order to provide the general knowledge and analytic tools necessary to understand, evaluate, and respond to a complex group of problems in the contemporary world. We will develop a broad understanding of some of the most important ideas, issues and events in international relations, and be able to better comprehend and articulate their thoughts on issues of major current significance (Applegate & Sypher, 1983).

Furthermore, the book will help the reader strengthen research and analytical skills by identifying the main actors in international politics regarding VIRUS and relate them to the contexts in which they operate. Although international relations is important due to the gradually interrelated world and historically, the establishment of treaties between nations served as the earliest form of international relations (Barkan, 2000).

The study and practice of international relations is valued due to these facts:

- promotes successful trade policies between nations during VIRUS outbreaks.
- encourages travel related to business, tourism, and immigration, providing people with opportunities to enhance their lives during VIRUS .
- allows nations to cooperate with one another, share information to face global issues include pandemics like during VIRUS , the environment etc.
- spreads human culture through cultural exchanges, diplomacy and policy development (Basu and Weibull, 2002).

The Virus pandemic outbreak

The VIRUS pandemic has exposed the weakness of many governments in managing emergency situations. The situation emerged cannot be treated with reverse-engineering, as this problem cannot be solved by money.

There exist diseases with unknown etiology. A viral origin has been suggested for many of these diseases, emphasizing the importance of a continuous search for new viruses (Stohlman & Hinton, 2001).

Recent viruses have been identified in mice, rats, chickens, turkeys, swine, dogs, cats, rabbits, horses, cattle and humans, and can cause a variety of severe diseases including gastroenteritis and respiratory tract diseases (Holmes & Lai, 1996). Three human viruses have been studied as HCoV-229E and HCoV-OC43 were identified in the mid-1960s, and are known to cause the common cold (Tyrrell & Bynoe, 1965). The recently identified SARS-CoV causes a life-threatening pneumonia, and is the most pathogenic human virus identified thus far (Lai, 2003).

SARS-CoV is likely to reside in an animal reservoir, and has recently initiated the epidemic in humans through zoonotic transmission (Peiris, et al. 2003).

A viral world war

Cholera struck Paris in 1832 in an epidemic that eventually killed nearly 19,000 people of Paris and the law enforcement officers were incapable to hold the violence that followed. Also, the interaction between wars and epidemics in shaping history has long been recognized. Napoleon Bonaparte’s nineteenth-century imperial expansion was halted by yellow fever, which his army encountered in France’s Caribbean colony of Saint-Domingue (Haiti). His eastern ambitions were thwarted by dysentery and typhus. The 1918 Spanish influenza pandemic, simultaneously with the First World War is estimated to have killed about 50 million people.

There was white blaming of black South Africans in 1918 precipitated the first legislative steps towards apartheid and by restricting the land available to people of color, apartheid accelerated the growth of a migrant labor system that divided black families.

Pandemics

There are various impacts from pandemic such as higher rates of underlying health conditions and larger socioeconomic and cultural barriers to adoption of pandemic interferences. The implementation of pandemic interferences could be optimized by a cultural alertness and response that address specific needs, social policies that minimize economic problems and improve compliance with isolation and quarantine, and relevant, practical, and culturally custom-made communications.

A pandemic strategy and implementation plans are designed to stop or slow pandemic virus transmission and mitigate the impact on the population and critical infrastructure (Santibañez, Fiore, Merlin and Redd, 2009). The essential elements of the pandemic strategy require complete community participation to achieve success and these elements include early detection of cases, rapid antiviral treatment and isolation of patients, antiviral prophylaxis and voluntary quarantine of patient contacts, and social distancing (Santibañez, Fiore, Merlin and Redd, 2009).

Some populations have lower ability to implement these pandemic interventions and to tolerate a pandemic because of socioeconomic disadvantages such as cultural, educational, and linguistic barriers (Blumenshine, Reingold, Egerter, Mockenhaupt, Braverman and Marks, 2008). If the needs of these populations are not successfully addressed through engagement of their communities in planning, response, and deployment of adequate resources, the national strategy could fail for all the population could fail to realize the benefit of timely pandemic prevention and control measures (Blendon, Koonin and Benson, 2008).

During and after natural disasters, some populations have higher rates of injuries, poor health conditions, adverse health outcomes, and lack of access to health care (Bouye, Truman and Hutchins, 2009).

Economic Considerations

Negative economic effects may occur in populations during and after a pandemic resulting in fewer financial resources, including economic assets to use during a extended pandemic (Groom and LaRoque, 2009). Members of the populations, are employed in the service industry, which is likely to be most affected by an economic downturn caused by a pandemic (Byrd and Clayton, 2000).

Cultures, social networks and low socioeconomic status of the populations is essential to preparing and responding to an influenza pandemic in these communities (Garrett, 2008). Some communities have many members who live below or near the federal poverty threshold; they may also have more crowded households, be uninsured, have no source of care, and lack access to new health care information (DeNavas, Proctor and Smith, 2007)

There are populations with barriers to adopting pandemic interventions such as limited financial resources, inadequate access to health care, variety of beliefs, restricted community partnerships, and limited inclusion of populations in planning for pandemics (Metzler, Jones, Pearson, Stevenson, Lewis, 2007).

To enable populations, service providers, and stakeholders to effectively undertake pandemic mitigation interventions: encourage full participation of racial/ethnic minority populations, their service providers, and trusted community leaders in all aspects of preparedness and response planning in a coordinated way, especially when planning for surveillance of ill persons and their contacts, isolation and quarantine, assessment of community needs and assets, and social distancing (Metzler, Jones, Pearson, Stevenson, Lewis, 2007). In order to strengthen public health and community health systems for ensuring provision of safety net services, minimizing economic burdens through social policies that address income and job loss, and maximizing access to food, water, and shelter (Garrett, 2008).

During the initial wave of a pandemic, the level of and loyalty to pandemic mitigation interventions determine the extent of transmission, morbidity, and mortality until a pandemic vaccine is widely available for the general population (Metzler, Jones, Pearson, Stevenson, Lewis, 2007). The vaccine plays an important role in containing the pandemic virus for all communities.

Virus and Asia Relations

The virus crisis management verified a local trend to be loyal to China to the point of risking human lives. China’s economic stoppage was quick disrupting trade, travel, and supply chains resulting into Singapore’s economy lowered by 2.1 % year to day, and Malaysia’s economy is lowered by 2.8 % while 2.4 million of job were lost. The virus exposed a diplomatic closeness leading toward an alignment with China’s practices and standards.

The Southeast Asian states anticipate China’s actions and adjust their reactions accordingly without the exertion of explicit power but by the acceptance of China’s soft power in a way of proactive diplomacy. At the same time, the same states did not want to irritate China in the course of a critical period during its efforts in attempting the deal with the virus and kept on complimenting the state for the ability to deal with the difficulty in highly creditable terms with advanced medical technology and decisive measures (Tonchev, 2020).

Simultaneously, the Southeast Asian states had a fear of potential revenge through the Chinese diplomacy approach with negative impact on investment and the economy. The friendly Southeast Asian states supporting China during the crisis will be granted advantages. China seemed as a hazard to the region by mismanaging the primary outbreak of the virus, no blame was expressed by any Southeast Asian state.

Virus pandemic socioeconomic shock

The Virus pandemic is increasingly looking like a crisis, and the world should change dramatically as a result of the virus and many of the assumptions that seem believable today may have to be reexamined in the near future, and all will depend on the brutality of the coming socioeconomic shock and the resilience of the world order (Tonchev, 2020).

The pandemic has uncovered the hazards and faults of global relationships, which disturb China. It’ll take a period before the influence of the Virus disaster can be evaluated with accuracy.

What will the socioeconomic shock results?

- Sensible economic disorder, which can be dealt with by the existing world setup and the recruitment of standing financial approaches. The consequences of this situation would seem as a gift from heaven.
- Severe economic destruction requiring a enormous demand for reform, even if resources are not available and by the insecure global setup.
- Shocking economic collapse leading to social and political chaos, drastic change the world order, and isolation. The consequences of this situation would seem as unbearable to understanding in its totality.

International Health Regulations

The global instrument for regulating public health diseases is the International Health Regulations of 2005 established under the patronage of WHO to prevent, protect against, control and provide a public health response to the international spread of disease.

The International Health Regulations places obligations on countries to provide adequate information to the World Health Organisation (WHO) to prevent the spread of pandemics by determining the nature of the virus.

The International Covenant on Economic Social and Cultural Rights (ICESCR) provides the most complete protection regarding Right to Health of individuals and recognizes the right of every human to the enjoyment of the highest attainable standard of physical and mental health. Violations of the Right to Health can occur through the direct action of countries and through omission or failure of the countries to take necessary measures arising from legal obligations.

Security Council

Pandemics have a security element so the Security Council is requested to strengthen the world’s response by addressing public health since it can be seen as a threat to international peace and security.

Social distancing

Work if apply the social distancing measures.

Go out if essential reasons such as to the doctor, pharmacist’s, bank, post office, supermarket, gas station or to help people in need.

For the diplomatic missions this means that distance-working is wanted for all activities for which physical presence of a human being is not necessary. Various meetings should be done through teleconference where receptions and other events are not included and elections must be postponed.

Diplomacy strained in the middle of Virus pandemic

The virus pandemic has severely distorted the international diplomacy at different levels. The disturbance may have considerable affect on matters of war and peace, arms control and human rights.

The countries are on lockdown situation, state visits are cancelled, and key meetings are postponed or hosted online. Diplomacy at the United Nations level has turned in to phones, emails and virtual meetings where diplomacy by teleconference and secure video has become the new norm, offering escape routes for the parts that are unwilling or unable to engage in fragile or hot negotiations resulting into a trigger of diplomatic atrophy. Peace talks and long-stalled negotiations are all diplomatic initiatives that have to wait due to the COVID-19, while simultaneously debates on human rights, global health issues, climate change and trade have been influenced.

In our days with virus crisis, humanity is facing a gigantic challenge. The crisis caused by virus has an impact in various dimensions such as:

- the public health,
- the labor systems,
- the social interaction,
- the political debate,
- the use of public spaces,
- the economy,
- the environment,
- the cultural life.

Soft power

Action of cities and local governments

- creating new possibilities to access heritage and knowledge and to participate in online cultural events
- providing new training and capacity-building programs to support the cultural circles
- supporting the presence of cultural institutions in internet and social media
- exploring new ways to organize the cultural work

During the crisis instead of social distancing we should practice physical distancing and social solidarity. It proves the need to increase the relationship as the cultural actors should promote commitment and protection of the cultural rights.

Culture as the explanation

Cultural practices that support the anti virus strategy are behind the pace of the epidemic such as the culture of wearing masks, little touching, washing of hands, hugging and hands shaking, walking without shoes in house, hygiene of public places, lack of speaking on public transportation, and clean water and air and foods are not eaten with bare hands. In cultures where there is often a tendency to blame people for getting sick, assuming that it was somehow their fault, people not to be discriminated after receiving a virus diagnosis, take better care of themselves not to catch the COVID-19, so they avoid going abroad, they wear a mask and wash the hands correctly. In these cultures there is a strong stigmatization of people with infection or conditions that are contagious or feared of bullying and isolation. This attitude is linked to ideals of purity and spiritual or physical pollution where people who get infected are thought as being receptive to immoral influences and people around them must be careful not to be polluted with their bad destiny.

Culture at the time of a pandemic

The effects of the virus pandemic on the cultural industry perceived the breaking of its regular touch with spectators who embraced the opportunity across websites and online platforms.

The Role of Culture in Response to Epidemics

Cultural aspects have a great influence on the processes of symptom recognition, labeling, help-seeking and the structure of health systems (Angel& Thoits, 1987). The decision to attend or ignore physical or psychological changes, their interpretation and evaluation of the change and their way of acting on the symptoms is influenced by culture (Angel& Thoits, 1987). Public health measures need to consider the cultural background, i.e. the social agreements and assumptions (Napier et al., 2014) and must be located at community level to enhance in-depth understanding of the individual context, participation and appropriateness of measures (Shaikh& Hatcher, 2005).

While epidemic outbreaks led to an increase in cultural awareness the response to recent epidemics show that there is still a lot to be taught (Orrego et al., 2018).

There is a huge number of definitions of culture but for the purpose of this book the complexity of the culture concept will not be limited by using a particular definition (Bond & Brough, 2007). However, culture refers to the way of life of a group of people and intersects with other sources of identity including age, gender, race and ethnicity, religion, lifestyle and occupation (Bond & Brough, 2007).

Through field research, the Culture has been revealed to affect the various ways that viruses have impacted the African population (Airhihenbuwa & Webster, 2004). This is because culture and culturally embedded beliefs and values can influence norms and stigmatization of certain groups (Mac Phail & Campbell, 2001).

Public health measures to stop epidemics in the past did not consider cultural aspects and a medical approach only is not adequate to attempt a multi-sided issue that involved a motivation for shift in terms of behavioral change and respect for local cultures (Bond & Brough, 2007), such as a restrained individual behavior change but also the ones which take care of the individual, thus stressing the positive aspects the specific culture has (Iwelunmor et al., 2014). The shift towards a cultural approach and the awareness of socioeconomic factors can be considered as a major lesson learned (Leclerc - Madlala et al., 2009). The cultural awareness in disease response includes qualitative research, community approaches, culturally competent personal to implement culturally appropriate strategies and cultural awareness in health communication (Jenkins, 2004).

There is the need to focus not exclusively on high risk groups (Kippax et al., 2013) to support community approaches and collective agency instead of approaches at individual level (Airhihenbuwa & Webster, 2004) and to undertake peer pressure and low perceived vulnerability (Mac Phail & Campbell, 2001). The focus on community approaches was implemented through an amplified use of community health workers and peer support systems and initiatives, however the need to involve community leaders is sometimes a challenging process (Simoni et al., 2011).

The dynamic and flexible nature of culture means the need to assess dissimilar collectives in which people participate to find ways for effective community approaches for example through public narratives (Rathje, 2009).

It is very important to have an awareness of the complexity of the specific culture and a careful use of the term culture in regard to diseases, because due to the excessive highlighting of the role of culture can lead to negative impacts, such as blaming societies for their high prevalence rate or stigmatizing certain groups so, the focus on broader social and structural factors as determinants of disease is needed (Sovran, 2013). It is still important to evaluate the impact of global differences in wealth and opportunity and their influence on health (Napier et al., 2014). Therefore the approach to virus which considers a multi dynamic relationship between political economy and culture is logical (Schoepf, 1991).

In most cases culture is mainly observed as behavior as hygiene practices, and individual approaches led to victim-blaming while structural forces were neglected (Abramowitz et al., 2015). The disease as well as the humanitarian response unsettled social accommodations regarding culture, customs, politics and interests and lack of political trust (Wilkinson& Fairhead, 2017). So, the focus on culture should not come at the expense of attention to sociopolitical and economic structures, obscuring the reality that global forces affect epidemics (Jones, 2014).

The understanding and the use of the term culture in regard to diseases lessons have hardly been implemented and within some organisations there was little awareness of culture being a complex system (Sastry& Lovari, 2017).

Lessons learned in the previous epidemic stressed the need of cultural awareness however, within the new virouses response the international response initially failed to consider cultural aspects apart from behaviour and community approaches were rather the exception than the rule. Neglecting culture in public health measures reduces the effectivity of those measures and can even lead to violence (Fairhead, 2016).

Understanding culture as a label can increase prejudice and culture being reduced to behaviour neglects underlying world views as well as structural forces (Bond& Brough, 2007). Therefore, understanding of the complexity of culture is necessary to avoid an separation without neglecting acknowledged differences (Fairhead, 2016).

This is achievable if culture is understood as a dynamic process which contains profits and obstacles (Bond& Brough, 2007). There is a danger of interpreting culture as stable and consistent (Sovran, 2013). A culture of listening must be developed to connect response efforts to the lived experiences of local people (Abramowitz et al., 2015). If there is a lack of cultural and background understanding the successful engagement of communities helped to overcome cultural barriers (Coltart et al., 2017).

There is the question of how culture matters for the people concerned and how diseases affect these cultures instead of only asking how it affects public health actions (Bond& Brough, 2007). We have to notice the effect of organizational culture can have on affected people (Kershaw, 2018). So, the vital importance of culture in understanding people, health behaviour and public health measures and the interacting with all those aspects must be acknowledged in future responses to epidemics (Komesaroff& Kerridge, 2014).

Culture in Managing Response to Pandemics

There is an effect of customs and traditional beliefs on the transmission dynamics of outbreak. In the early stages of a pandemic, cultural beliefs played an important role that contributed to the spreading of the disease. This suggests that an identification of the crucial cultural parameters of the epidemic is vital to the development of an efficient control strategy (Agusto, Teboh-Ewungkem and Gumel).

Other social factors were responsible for the spread of virous, such as a general lack of awareness and the poor state of health facilities and religious practices by communities are also found to have an adverse impact on the outbreak (Manguvo and Mafuvadze). Prevailing cultural beliefs are a test for healthcare providers in communicating the causes and nature of epidemics to local communities in a meaningful way because there is a heavy trust on traditional medical practices among communities through traditional healers that fail to understand viral infections. The inadequate understanding of the epidemic leads to unsafe handling of remains that become a source of contamination.

Failing to incorporate cultural and contextual factors may limit the degree of success in controlling the spread of diseases and during the outbreaks that there is an initial resistance to the evidence-based approaches to limiting the spread of thr virus..

The best approach to promote health in such disasters lies in understanding and, to a reasonable degree, embracing both traditional and religious practices.

Socio-Cultural Factors Associated with Epidemics

Public health behaviors frame suggests that poor health occurs because individuals are unable or unwilling to notice preventive messages or recommended treatment actions.

The role of cultural beliefs as well as the attitudes associated with prejudice and discrimination towards patients and healthcare workers has received less attention (Davtyan, Brown, & Folayan, 2014). Health-related stigma has had negative impacts on prevention efforts (Airhihenbuwa et al., 2009). Community members have also stigmatized the relatives of patients resulting in not being able to return home for having had contacts with patients (Kinsman, 2012). In some cultures, those who survive the disease also face stigma, rejection, violence, and rumors blaming them for spreading the disease (WHO, 2014b).

Culture is at the core of the development, implementation and evaluation of successful public health interventions and to centralize culture in health involvement, three domains of health beliefs and behavior should be taken into account where each domain includes three factors that form the acronym PEN:

- Cultural Identity
- Person,
- Extended Family,
- Neighborhood,
- Relationships and Expectations,
- Perceptions,
- Enablers,
- Nurturers and
- Cultural Empowerment
- Positive,
- Existential
- Negative (Airhihenbuwa, 2007).

Within the Cultural Empowerment domain, health issues are investigated first by identifying practices that are positive highlighting values that are existential and have no harmful health consequences before identifying negative practices that serve as barriers (Airhihenbuwa, 2007).

As a result, positive behaviors are attitudes or behaviors that are based on health and actions known to be beneficial to individual, family, and community (Airhihenbuwa, 1995). While virus can be spread through poor hygienic practices, numerous positive cultural practices have contributed to the efforts to stop the spread of the epidemic (Dogra, 2015). The sense of selflessness and duty to serve individual in the community, a common value in the high context culture of the afflicted areas was used in health messages (Appiah, 2012).

A sociocultural positive factor include the role played by the media due to the restriction of movement and on public gatherings imposed during the crisis (Nkanga, 2014). Journalists reported on the virus in order to inform the citizens of the dangers of the disease allowing individuals to use preventative measures and created an increase in awareness (Mark, 2015).

The wide spread emphasizes numerous sociocultural negative behaviors, which are defined as health beliefs and actions that are known to be harmful to health, or were triggering factors (Airhihenbuwa, 1995). These includes certain traditional burial practices, and beliefs regarding which contributed further to the spread of the virus (Alexander et al., 2015). Customs such as remaining close to the sick family member to nurse them have been identified as triggering factors in the spread of the disease due to a high viral load present in victims (Bah & Aljoudi, 2014).

Concerns, myths, and ideas of conspiracy have contributed to the spread as well (Bah & Aljoudi, 2014). An especially problematic negative behavior that added to the spread included conspiracy theories and this fueled a belief this had a role in creating the disease.(Jamal, 2014). These beliefs lead to health workers being met with suspicion and distrust. This, in turn, increase the likelihood of individuals resorting to home remedies or simply waiting to go to the doctor until only after the disease has progressed too substantially (Omonzejele, 2014). This delayed the ability of health care workers to treat the patient and stop the virus from infecting the people around them, effectively aiding in the spread (Thompson, 2014).

Epidemic psychology

The epidemic of fear have is also an epidemic of suspicion where there is the fear of catching the disease and the suspicion that one might already have it and might transmit it (Omonzejele, 2014). There is also a wide spread fear that the disease may be transmitted through any number of different routes, through sneezing and breathing, door-knobs, touching anything where the whole environment may be potentially infectious.

Also, the way that fear and suspicion may separate from the reality of the disease, so it is possible for great waves of panic and fear to spread among a population even when almost noone has actually been infected (Ohi et al 1988). Patients who were obsessed with the fear that they had the disease and could not be persuaded to the contrary and this panic is extended to those who are best informed about the disease, reinforced with stigmatization. (Weber and Goldmeier 1983). People may be unable to decide whether a new outbreak is important or not and they swing back and front and there is a collective disorientation. (Pettigrew, 1990). To those who find the outbreak as serious, then some psychological states occurs in because there are no routine collective ways of handling it, plan of action, strategy for containing and controlling the disease. Then the actions and strategies are matched by the epidemic of interpretation about the origins of the disease and its potential effects.

Many suggestions for limiting the contagion may cut across and threaten our conventional practice such as trade and travel which are disrupted, personal privacy and liberty is invaded, health education is enforced on matters that are normally never talked about (Brandt, 1987).

Due to the disturbance and confusion that such epidemics produce they are grounds for moral debate and moral challenge and an epidemic is a new opportunity for change and adaptation (Becker, 1963).

The individual social psychology produced by epidemics can result in a disintegrate of predictable social order where toxic effects may occur such as people feared of each other, sick people left unterated, infected people rejected or persecuted, those uninfected fear they are infected, violent moral disagreement are spread in a society, governments are in panic.

Epidemic psychology is unusual, powerful and extremely disturbing and is based, on the primitive, irrational emotions that are hidden within the dual nature of each human. In common days people stay rational, but in an epidemics crisis the unpleasant emotions govern such as horror, anger and panic (Collins 1985) .

Language role in the society can explain the collective possible for epidemic psychology. The epidemic of fear and suspicion is an unusually powerful pathology of social interaction. The social order can last when basic assumptions about interaction are disrupted, when people fears others or suspects that others fear them developing the potential to create a war of all against all and through language the fear of disease can rapidly, eveninstantly transmitted across people.

Strategies to control the virous and the psychology it produces, language creates the possibility of science and shapes both the means through which we can respond to epidemics and the diversity of such means.

Epidemic

An epidemic is the etymology of the Greek word "epi" upon or above and "demos", people is the rapid spread of disease to a large number of people in a given population within a short period of time. The term epidemic derives from a word form attributed to Homer's Odyssey, which later took its medical meaning from the Epidemics, an essay by Hippocrates. Thucydides' description of the Plague of Athens is considered one of the earliest accounts of a disease epidemic.

Epidemics of infectious disease are caused by a change in the ecology of the host population, a genetic change in the pathogen reservoir or the introduction of an emerging pathogen to a host population. An epidemic occurs when host immunity to either an established or emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium and the transmission threshold is exceeded. An epidemic may be constrained to a single location. If it spreads to other and affects a considerable number of people, it may be termed as a pandemic. The declaration of an epidemic requires an understanding of a baseline rate of incidence and they are defined as reaching some defined increase in incidence above this baseline. The term epidemic has become emotionally charged.

The terms epidemic and outbreak have often been used interchangeably. There are several changes that may occur in an infectious agent that may trigger an epidemic. These include:

- Increased virulence
- Introduction into a novel setting
- Changes in host susceptibility to the infectious agent

An epidemic disease is not required to be contagious (Green, Swartz, Mayshar, Lev, Leventhal, Slater, Shemer, 2002). The conditions which govern the outbreak of epidemics include infected food supplies such as contaminated drinking water and the migration of populations of certain animals, such as rats or mosquitoes, which can act as disease vectors (Martin, Granel, 2006).

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