A culture of risk and danger?

A culture of risk and danger?

Updated 10:21pm (Mla time) Sept 28, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A14 of the September 29, 2004 issue of the Philippine Daily Inquirer


WHY do we constantly take risks? In Tagalog we use the word "ligtas" to mean safe, but think hard now, how often do you actually use the word? Think, too, if you can translate "Is it safe to cross the street here?" into Tagalog. Or, would you ask, "Is this medicine safe?"

These were the questions I had to grapple with in my head as I prepared a talk for the national convention of the Philippine Society of Hospital Pharmacists, who decided that for this year, their theme should be "Establishing a Culture of Safety in Health Care." I shared some points about the cultural aspects of safety during that convention, but I thought it might be useful to use my column today to look into why we seem so cavalier and careless about safety issues in general.

Ignorant bliss?
Generally, people don't usually go around constantly thinking of safety issues as we eat, drive, cross the street or take medicines. In a way, that's a good thing because if we were so obsessed with safety issues, we'd end up paralyzed by fear.

On the other hand, people in developed countries are generally more conscious than those in developing countries of safety issues as these relate to food, medicines, our homes and offices and the natural environment in general.

Environmentalist and consumer groups are supported by mass membership and lobby constantly for stricter safety standards for everything from cars to toys.

The differences in attitudes toward safety issues boil down to the way we perceive risks. Obviously, we'd have to start first with whether we recognize risk situations in the first place. For example, many people are unaware that the medicinal cabinet in the toilet is one of the worst places to keep medicines. A recent report from England warns that under very warm and humid conditions, certain medicines might expire even before the date stamped on the package. Now if that risk exists in England, you can imagine what it's like for a tropical country like the Philippines. Yet, unaware of research findings about the effects of heat and humidity on medicines, Filipinos, British, Americans and many other nationalities still believe a toilet is the best place for a "medicinal cabinet."

Moving away from medicines, we see all kinds of other examples of blissful unawareness that put people at risk. We see kerosene stored in softdrink bottles, for example, and kept in the kitchen next to food items. Not surprisingly, the Poison Control Center at the Philippine General Hospital keeps getting cases of kerosene poisoning. Pesticides, too, are often kept and used carelessly. I've seen in rural areas pesticides kept next to infant formula!

Relative risks
Mass media and schools play important roles in bridging the information gap to help people become more safety conscious. On the other hand, not all of our risk-taking is caused by lack of information. We may be aware of the risks of doing something and yet continue to disregard warnings about those risks. I could name a thousand examples here, from not using pedestrian lanes to smoking.

One interesting explanation for this behavior is that people generally enjoy taking risks, with some people actually deriving a high from the most risky activities. Despite this enjoyment of risk, we do compare risks with benefits. Sometimes, the perceived "benefits" come from a no-choice situation. We know the pedestrian lanes are useless in places like the Quezon Memorial Circle and Commonwealth Avenue, given the Metro Manila Commission's flea-brained traffic scheme that has converted several of Manila's thoroughfares into racetracks. Sure, there are also pedestrian overpasses but these are built every two kilometers or so. Confronted with the risk of being run over and the hassle of having to walk several meters, for a Filipino, the "rational" choice is clear.

The relativity of risks gives rise to all kinds of forms of risk calculation. When we take medicines, we don't ask, "Is this medicine safe?" Instead, in English, Tagalog, Cebuano and whatever local languages we speak, we ask: "Is this medicine OK?"--with "OK" mainly referring to the expected benefits, relief from a headache, for example.

Another interesting example comes from the many interviews I've had with women who tell me natural family planning is not safe. Medically speaking, NFP is actually the safest, but the women explain it is "not safe" because it puts them at greater risk of pregnancy than, say, the pill.

Let's face it, given that the life of the average Filipino is already so fraught with risks, there's a greater tendency to trivialize even the most serious risks. When the government banned Filipinos from working in Iraq, there were vehement protests from those who wanted to go. I remember one applicant appearing on TV, quite agitated and angry, complaining that it is more unsafe to stay in the Philippines than in Iraq because here, their families were always in danger of starving.

Clearly, our notions of risks are based on the here and now. Many Filipinos, in fact, describe risk as "panganib" or danger, which isn't quite the same. Dangers are immediate, visible. For the Filipinos who want to go to Iraq, even the dangers in that country, so clear in the news, is still too distant, too invisible.

Modernity and risks
If underdevelopment and poverty seem to make risk-takers of us all, there's another interesting theory of risk, from Ulrich Beck: that modernity (and development) actually puts entire societies into risk situations. Here, it is a blind faith in "progress" and in technological advances that make us so uncritical in accepting technologies, from medicines to nuclear plants.

Ironically, it is now in the most developed countries where faith in science is being challenged. As societies modernize, they move on to an "interrogative mentality," a situation of "reflexive modernization" where you have more skeptical and critical individuals. A patient, for example, is no longer, well, a "patient" patient, passively accepting all that the doctors say. In developing countries, we rush to take the latest drugs on the market; in developed countries, people will be more cautious and ask their doctor, "It's so new. Are you sure it's safe?"

With the explosion of information sources, people can and should be taught to ask the right questions about risks and safety. Safety then becomes truly a matter of ligtas, which is not just "safe" but "saved from" particular risks.