February 6th, 2012

Fresh Air Matters... with Capt. Yaw

How much blindness do you suffer from? By keeping your gaze constant, even when there is a moving field of view, you are almost certainly blind to certain objects in front of you – I really mean it, you cannot see them – they disappear! Don’t believe me? Read on, and try an experiment later.

Pilots are taught to scan the horizon for other aircraft – never looking at the same spot for more than a second or two. Different patterns are favoured by different schools of thought. Personally I like a left to right and up and down scan, blinking occasionally if I am certain that I am looking in the right quadrant of the sky where an aircraft should be. I use a similar system when driving, especially when scanning for potholes on the rural roads, focusing near then far repeatedly! This helps to increase the information coming into our brains, but also to prevent the Troxler effect, sometimes called Troxler’s fading or ‘motion induced blindness’, meaning that motion and non-motion together can lead to ‘disappearance’ issues.

Imagine that you are flying and an aircraft is on a collision course with you. If you are staring at the same point out of the window (i.e. where you are going) that small approaching aircraft image is in the SAME position on your eye’s retina – and your mind will exclude it from the image you see – seriously! All you need to do is to keep your eye moving, scanning – and then your eye and your busy grey matter will keep you appraised of the danger. You can take five minutes in the office later to look at the Medicine on the Move website (www.medicineonthmove.org - under the INSCI tab) at a simple demo of how our minds cut out images if we do not keep on adjusting our gaze – or scan.

An amusing party trick or a life-saving piece of knowledge? I recently did a presentation where I showed in cockpit video footage of pilots flying small planes – and it is amazing how much their eyes and heads keep on moving. Scan the horizon, scan the instruments, scan the ground ahead (checking for emergency landing areas), scan the instruments, scan the horizon, scan the airframe… on and on and on – never ending. Keep on changing the focus points, keep on checking the available information and keep on ensuring that you are heading safely in the right direction, ready to respond should the need occur.

I look at the way so many people are fixedly focused on ‘middle-income-status’ or ‘low-inflation figures’ or some other policy related mantra, without adjusting their gaze and scanning the risks to that goal that are quickly ‘Troxler-ed’ out of view! Even within a particular practice we can become blind within a specialist area. Take health for instance. We are so focused on the sexy diseases, we are missing out the massive micro-collision courses that will simply prevent achievement of the goal, because we are not looking at the little bits of the image we have become accustomed to and are no longer even aware of.

So much focus, quite rightly, is made of Malaria and HIV, but at the same time much of Africa is affected by challenges that seem to be invisible. For example, did you know that Schistosomiasis (also called Bilharzia) is the second most socio-economic devastating parasitic infection in Ghana? With an estimated two hundred thousand deaths each year in sub-Saharan Africa alone, and yet the majority of the population has ‘motion induced blindness’ to it, its causes, cure and prevention...

Even those who focus on Schistosomiasis may have a tendency to fail to see the other challenges to the treatment and eradication of this hidden stumbling block to our regions development. Schistosomiasis is contracted from contact with infected water – and Ghana has over ten thousand kilometres of potentially infected Lake and river coastline at risk. One study estimated fifteen million cases in Ghana every year. Most of which are repeat infections. The way to cure the disease is a tablet. Simple, quick and efficient. But that does not stop you re-contracting the parasite again in a couple of weeks. The rules are simple, and easy to preach 1. Never drink from a lake or river, drink only clean water (filtered or boiled). 2. Never bathe in a lake or river, take the water out, filter it, and preferably leave it covered (to prevent mosquitoes) for 24 to 48 hours, the time for the parasite to die. 3. Do not urinate or defecate in the rivers or lakes or anywhere your ‘doings’ can wash into the water.

Simple. Simple. Simple. So simple that the majority of people are blind to reciting the mantra, or think that ‘one telling is enough’.

We all know that a woman who wants her man to tidy up his dirty socks has to ask him more than once – EVERY day of their marriage… Why then do we think that one poster, one advert campaign and one visit to a village to tell them to change their centuries old habits work like magic? Behavioural change need is easy to become blind to. Behavioural change need, once in your visual range, is a big headache – because it is incredibly hard to bring about. It requires a lot of time, energy and repetition.

Here is the most amazing part of the ‘behavioural change benefits’ covered in our three points above; it will reduce or even eradicate many other diseases and if you can couple ‘wash your hands with soap and clean water before your eat’, you can lift thousands out of poverty at a relatively low cost. But it is not sexy. It is not popular. It is not something people want to hear. AND there is another problem – a big one.

The vast majority of people living in Ghana who are at risk, are not easily accessible. Lack of roads and other infrastructure to the thousands of communities means that even getting a message to each of those communities is going to take man years, if conventional methods are used. Perhaps that is why it has been ‘allowed to enter our blind spots’. The good news is, such communities can easily be reached using innovative new aviation related techniques, developed and perfected in Ghana – making regular, repeatable contact and awareness campaigns a realistic possibility in the near term.

This will be a major topic of discussion at the First National Schistosomiasis Forum to be held in Akosombo in March of this year, and the organisers plan to shift some focus around and come out with the first Integrated National Schistosomiasis Control Initiative – a tough job, but one that can be done, if only we can move our heads around and see more than just a fixated look at the policy headlines.

Capt. Yaw is Chief Flying Instructor and Chief Engineer at WAASPS, and lead Pilot with Medicine on the Move, Humanitarian Aviation Logistics (www.waasps.com www.medicineonthemove.org e-mail capt.yaw@waasps.com)