
It was bound to come out sooner or later. The CIA/Navy SEAL raid that took out Osama bin Laden was just too good, just too clean. But the news that the CIA created a fake vaccination program in Abbottabad, Pakistan -- an effort to capture DNA from Osama bin Laden's children and plant a recording device in the bin Laden compound -- is an ugly smear on the high-water-mark mission of the U.S. fight against terrorism. To be fair, there's much that is still murky: We don't know for sure whether the CIA actually gathered any DNA, and we don't know whether it managed to plant the listening bug. We do know, however, that it paid a Pakistani doctor to start a fake vaccination program, administered the first dose of hepatitis B vaccine to poor children in Abbottabad, and hired an apparently unsuspecting nurse to enter the bin Laden compound.
Get ready for a lot of outrage over this. Doctors, health-care providers, and medical organizations in general get angry when their ability to care for patients is threatened. And using medicine for non-healing purposes -- in this case for killing -- really rubs them the wrong way. First off, hepatitis B is a real worry in Pakistan, and one dose in a three-dose series will only provide a tiny amount of protection to those children. There's almost no chance now that these kids will even finish the vaccination series -- and many, many thousands more will likely steer clear of future programs of this sort, no matter how legitimate.
Promoting vaccination in the Muslim world is hard enough already. As recently as 2007, visiting health workers in Afghanistan ran the risk of being beaten when they arrived to provide vaccines. Local leaders assumed they were spies; it took a formal letter from Taliban leadership to make vaccination possible. We can assume that kind of diplomacy will come to an end now. And the consequences are real: When Muslim leaders in Nigeria rejected the polio vaccine over fears that it would lead to sterility, it led to a polio outbreak in eight African countries.
There's good reason for the outrage. People's faith in their doctors is critical to the ability to provide health care, and it's unconscionable that the United States would use the single most delicate health issue in the Muslim world as its cover. But we do need to be realistic. It's not the first time health services have been a cover for a security operation, and it won't be the last. The most recent high-profile example was in 2008, when the Colombian military used the Red Cross emblem to disguise an army team engaged in a hostage rescue operation of 15 people held by the Revolutionary Armed Forces of Colombia (FARC).
But there's another narrative to this story, besides the outrage. Medical care gets used as a cover because it works. People persistently trust health-care providers to have their best interests at heart. That trust is broad and often blind. Sometimes stupidly so. In April this year, 86 homeowners in southeastern Turkey obediently swallowed a blood pressure pill given to them by police officers dressed as doctors. The "doctors" hadn't showed any kind of identification, and the pill turned out to be a piece of candy. The purpose of the exercise was apparently to get people to be more careful about checking IDs. Brilliant. (I'm glad I'm not a Turkish taxpayer.)
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