Performing Prevention: The Construction of Risk and Its Consequences in Japan during H1N1 2009

Japanese policy makers and health care providers mirror American Centers for Disease Control (CDC) recommendations for most public health matters, frequently citing them as the gold standard for best practices.  In the case of influenza, however, standard Japanese recommendations and practices significantly diverge from the U.S.-based recommendations. While the CDC recommends that individuals wash their hands frequently and avoid contact with infected people, the Japanese medical associations add frequent gargling and the use of surgical-style masks. The order of priority groups for immunization have also historically differed.  Drawing on approximately 89 semi-structured interviews with patients and medical professionals in Japan and ethnographic fieldwork during the H1N1 outbreak of 2009, this article elaborates on the work of theorist Anthony Giddens to examine continuing differences in prevention practices in the face of communicable disease outbreaks like H1N1. The concept of risk creates the possibility for prevention—behaviors intended to “reorganize the future of suffering” (Frankenberg 1993); Giddens calls this the “colonization” of the future (Giddens 1991: 111).  But the risk society also necessitates the development of techniques for maintaining ontological security.  I argue that faith-like acceptance of recommendations produced by systems of expert knowledge such as medicine and public health is one way to maintain ontological security when normalcy is interrupted, as in the pandemic H1N1 influenza outbreak during 2009.