In November 2017 all major newspapers ran a top story like this one: Some Brooklyn Children Have Blood Levels Higher Than Kids in Flint. Specifically, the Brooklyn children found to have such high blood levels were the Hasidic kids. As WNYC reported: “The highest rate was found in South Williamsburg, in the tight-knit, ultra-orthodox Jewish Satmar community.” The second highest rate came in in Borough Park, another Hasidic enclave.

When I read this news, I was totally surprised. Hasidic women are almost all stay-at-home mothers, and their kids are the center of their worlds. The kids we see in the community are dressed to the nines and seem quite alright. I didn’t understand why there should be such high rates of lead poisoning. I wondered if there was a cultural issue that might contribute to the lead poisoning rates, but this is all the explanation the media offered:

“Several factors contribute: Old housing, built long before the city’s 1960 lead paint ban, now has peeling paint. Poverty rates are high. And many residents speak Yiddish as a first language, which can make it more difficult for city health workers to do outreach. “

This simplistic story doesn’t satisfy me at all. Because with regards to old housing, New York city is replete with old housing and Hasidic kids are hardly the exception. With regards to poverty rates — I have heard a million times from the media that the poverty rate in the Hasidic community is high, but I don’t understand why they take the reported incomes at face value and don’t account any for the variables that make the community poverty rates seem so stark. There is a whole book to write on the complexities of the Hasidic economy, but I touched on some factors here. I hope to one day be able to write more on that, but don’t expect to have the time or energy anytime in the next decade. But for now, without going into the many reasons why I dispute this simplistic assessment, I’ll say that Hasidic kids are not growing up in impoverished situations. They all are well fed, dressed, housed and cared for. Medical care is widely available through medicaid doctors, and kids don’t go without treatment. I don’t see any relationship between high lead levels and Hasidic financial challenges.

And as for the language barrier – nah. Yes, Yiddish is a first language, but adults understand English full well and get by with various degrees of teeth breaking, but all in all, just fine.

Whenever the city decides that they will use Yiddish to reach the Hasidic community the results are either mildly comical or absurd or strange. But most of all, they give away that the gap between Hasidic Jews and westerners is not language, but culture.

I took this picture yesterday in Bushwick: a poster from the City department of health, hung upside down.

I love when the park translates the rules to Yiddish. It’s just bizarre. This sign before a Williamsburg park tells Hasidim exactly how to comport themselves with their dogs, even though none of the Hasidim have dogs.

Back to the story of the lead poisoning, I tried to ask around and do some of my sleuthing, but no one could explain why Hasidim have such high rates of lead poisoning. I spoke to some health reporters back then and hoped they could explain, but they were content with these superficial narratives of “poverty” and “yiddish”. Which, by the way, one walk down the full length of Lee Avenue and you’d have a hard time accepting this narrative.

So I didn’t find out. And I still don’t know.

I did cut this story out of the paper a few weeks ago, and it tells people about a campaign to raise awareness about lead poisoning that could result of paint, but that didn’t answer anything either.

But — yesterday on my tour we were discussing superstitions, and I mentioned blei gissen, the process of pouring lead to ward off the evil eye . The evil eye is generally considered to be a kind of bad omen or karma that comes from the envy and ill-will of others. The evil eye could often afflict those with striking beauty, money, smarts, etc. No one ever thought I was afflicted with the evil eye, so I don’t have personal experience with the various voodoo treatments like blei gissen, but I regularly see classified ads in the local papers for this service:

These ads are all for experts who proclaim they could help you “remove the evil eye and breathe easily” and “extinguish the evil eye by pouring lead”. Usually, the “expert” is Israeli, a travelling healer of sorts, who makes the rounds through US neighborhoods collecting fees for various opaque cures. My mother has insisted for years now that a birthmark I have on my face could easily be removed for the quick transaction of $400 between me and some Yerushaleymer miracle worker, and I’ve insisted that I’d very much like to hold on to my birth mark and my four hundred measly dollars. But I know my mother will fork over the moola to these itinerant wielders of Bubbe Maysos (sorry, I’m a cynic, it’s the truth) even as she knows full well there’s more than half a chance that it’s some kind of sharp sabra’s ruse. My mother is an intelligent woman and a part of her faith in this witchcraftery is the faith in the placebo effect: the simple belief that if this man will make me think I’m cured, then I will be cured.

In these magical men’s (or sometimes women’s) bags you’ll find various other treatments, like natural ointments or swinging pendants, palm reading and wrinkle reading, or reciting special prayers at specific sites. But the blei gissen seems to be especially popular, because not a week goes by that I don’t see an ad for it in the paper.

Here is a description of the procedure, which I found in a profile in the Jewish publication Five Towns:

To perform blei gissen, Rebbetzin Miller takes an ordinary looking pot, places a small bar of lead in it, and begins heating it on the kitchen stove. She gives out a laminated sheet with a tefilah on it to read while the lead melts. She does this in a typical kitchen with foods baking and children walking through. When the tefilah is finished and the lead has melted. Rebbetzin Miller casts a thick, off-white sheet of cloth like a tallis over the person. The molten lead is poured from the saucepan into a pot of cold water above the person’s head as the Rebbetzin speaks softly. The lead crackles and pops as it hits the cold water. The sheet is removed. The lead has fragmented into long pieces that look like silver twigs. If some of them have bulbous ends, the Rebbetzin explains, “Those are eyes. There is some ayin ha’ra. We have to do it over.”

Sometimes a curved piece can emerge that the Rebbetzin says is a “bird,” which signifies an imminent simcha. She repeats the process one more time to make sure all the ayin ha’ra is gone. Then, for good measure, she takes the names of a couple of the person’s family members and pours lead in their names. She concludes by pressing a few red strings from Kever Rachel on the subject along with a sprig of ruta in a tiny plastic bag.

Hmmm. Hum. I’m part intrigued, part scandalized– the entire procedure seems rather fascinating and I want to see a movie about it.

Well, I actually didn’t know any of how this Rebbetzin Miller or the other peddlers would do their work. I just mentioned blei gissen in conversation about unscientific “healing” and a German woman immediately offered to explain blei gissen – how it’s done and how you read the shape of the cooled lead as a way of diving what’s to come. Blei gissen is a very popular New Year’s custom in Germany. It’s written Bleigiessen but pronounced the same as in Yiddish. The full fancy word for the concept of pouring lead for learning special information is called Molybdomancy, a custom that can be found in “Finland, Germany, Austria, Switzerland, Turkey, and Bosnia and Herzegovina”.

The woman in our tour told us that one year, she hosted a New Years party in New York, and wanted to have a good time with the pouring of lead and the whole tradition. She couldn’t find the lead kits folks typically use (because it’s outlawed, I believe) so she ordered some lead pellets online. To their utter disappointment, the pellets wouldn’t melt. So we can assume the sign for their upcoming year to come was that of a pellet, which I assume is not a good prophecy. That’s just my thinking; I’m not an expert till someone offers to pay me $400 for my reading.

While I get a bitter kick out of the absurdity of such customs (they just don’t make sense to me, and border on exploitation), I also worry that this custom is simply not safe. On Wikipedia, you’ll see plainly in the first paragraph: “Some versions have been found to have potentially harmful effects on human health.” Specifically, the version that uses lead. There have been efforts in other cultures to replace the metal with tin, as described in the Telegraph:

Another charmingly suicidal German New Year’s tradition is molybdomancy – the posh word for divination using molten metal, or as the Germans call it, Bleigießen, pouring lead. Never heard of it? Quite rightly, since the British decided a long time ago that smelting was an activity best carried out in the open air – preferably somewhere very wet, like Wales. But in Germany, kits are sold with small burners and spoons and, in what looks to the untrained eye like a scene from Trainspotting, friends and families gather round to watch what form the molten metal makes as it hits the cold water, referring avidly to a checklist of shapes to see what the new year holds for the person who poured.

Given the toxicity of lead compounds, there have been efforts in recent years to convince the German Gypsy-Rose-Lee-wannabes of the virtues of tin, but largely in vain. 

I don’t know if the Rebbetzin Millers and Rav Teitelbaum’s of the Hasidic world use lead or tin, but odds are high that the earnest smelting and pouring and divining why a gorgeous little Hasidic boy is always sickly is happening with lead. I also do not know if this contributes, in any way, to the high rate of lead in the blood among the Hasidic population. Obviously I’m in no position to make such claims, but also obviously — the weekly arrival of a new lead-pouring guru can’t help.

I think the blei gissen industry should be a part of the investigation and education campaign on Lead Poisoning. But the larger point is that blei-gissen is but one example of a hazard found in the Hasidic community that doesn’t (mostly) exist for their New York City neighbors. If we try to diagnose and address problems afflicting Hasidim – ie the measles – we cannot expect an effective outcome if we don’t understand the holistic cultural situation from which the problems arise. A lot of the measles crisis could have been dealt with more effectively had they investigated beyond plugging words into Google Translate.

The measles virus continues to spread, and now the Mayor of New York City has ordered all Williamsburg kids to vaccinate or face a fine. I am set up to get Google Alerts for news about the Hasidic community, and I am getting floods of links to stories about the anti-vaxxers in the community. I am still trying to jive how the stories in the news, in which the measles epidemic seems to be fueled by anti-vaxxers, matches my on-the-ground experience of the Hasidic community.

Here is what I have come to understand. A community needs 95% vaccinated population in order for the community to have herd immunity and not to be vulnerable to the outbreak. In any community, you will have a population that is unable to vaccinate, either those too young or allergic or with compromised immune systems. But these unvaccinated people will be fine so long as there is herd immunity, which, for a very contagious disease like measles that can be spread by just coughing, needs to be very high. This leaves room for only about 5% to opt out before the her immunity is breached MMR. In a community where almost every home has a baby and many are too young for the vaccine, the 5% is much more easily reached. Herd immunity is so delicate.

It looks like the measles outbreak took off when the community dropped below herd immunity rates. It was the perfect recipe for disaster when a lot of scary information about vaccines made its way around the womenfolk, and people either hesitated or delayed vaccinations. On top of that, schools didn’t insist or stay on top of its students immunization status, and doctors and community leaders didn’t aggressively counter these scary ideas. I know my son would never be enrolled in Public School without being either up to date on his shots or an exemption, but Hasidic schools can be much more lax, especially when people already forgot how bad outbreaks can be.

While the community clearly dropped below immunity, we have to ask by what ratio. Notice that according to a pro-vaccine KJ publication titled “Tzim Gezint”, the main Satmar school has only 2% vaccine exemptions. In Williamsburg, where people consider themselves a bit more worldly and are more likely to deviate from community norms, there are probably more exemptions. According to CBS2, about 100 families in Williamsburg are against vaccines. Sure, the city estimated that 1,800 children in the Hasidic Williamsburg neighborhood hadn’t been vaccinated as of December 2018 – when we just started to hear about the measles outbreak. But there has been a huge uptick in vaccinations since.

In the news, the anti-vaxxers take center stage. Their continued absurd stance is painted as the key to the problem. For instance watch these two women, whose way of thinking and modeling for the Dunning Kruger effect makes me want to tear my hair out.

 

 

But do these women reflect mainstream views? Are they anomalies? Considering they showed up to the Brooklyn Library for the announcement by the mayor and were willing to be on camera, I’d say probably not. I am wondering if these folks are going to be the Naturei Karte of the measles issue. The Naturei Karte is a radical fringe anti-zionist group which loves media attention, and even though the people who subscribe to it are a minority, they are so vocal, they are lodged in the popular imagination as the example of a standard Hasidic Jew.

What’s important to realize that once herd immunity has been compromised, the virus can spread even if the population is now up to date. It spreads to the unvaccinated population. This from the Times: “Dr. Yakov Kiffel, a pediatrician in Monsey in Rockland County, said that he has both vaccinated children and treated about a half-dozen patients with measles since the fall. He said the majority of the sick were under 6 months old — the age at which a child can be given the first dose of the M.M.R. vaccine — and members of families that said they vaccinate.”

In other words, the cat is out of the bag. Now, even if the mayor gets everyone to comply, herd immunity is destroyed, and the 5% or so who shouldn’t be vaccinated are very, very vulnerable. Think a cancer patient. Think someone very ill. Think all those tiny babies coming down with measles. They are all now susceptible even if everyone complies after-the-fact. I think the community and health officials should learn, really learn, that if you don’t vaccinate before a problem comes to town, you can’t simply quickly run to get your shots and solve the problem. Contrary to what that lady proudly believes about the problems of vaccines, preventive measures like herd immunity do a lot of good. The old adage… an ounce of prevention is worth — a thousand dollar fine and terrible medical risks and babies with red splotchy rashes and a terrible health scare for everyone else.

Yesterday, while at the Hasidic medical center with my son, I picked up a magazine with a black cover and the title “Tzim Gezint“. It was free for patients to take, so I took it — of course! This was the formal, official, Hasidic publication on vaccines, and I’ve wanted to understand the measles outbreak ever since it has been all over the news. I wrote earlier this week that I’d check back in a year or two with more facts about what caused the measles epidemic. So guess what – it was kvitzes haderech; the Hasidic concept of magical speedy travel. I think I get it now.

This black mag was published by the Hudson Valley Health Coalition, a collaboration between Kiryas Joel health practitioners and the Orange County Department of Health. Kiryas Joel is in the New York suburbs, a bit far from the comparatively modern Borough Park, but also, it’s my home town. It’s where I lived the first twenty five years of my life. In fact, here’s a tangential piece of nostalgia:

Dr. Alan Werzberger, a pediatrician who is one of the primary voices in the publication, was my pediatrician all through my childhood. He started to practice the year I was born. My memories of him are mostly of the long, endless wait times in his waiting room. It could take five hours to see him. I never felt like I knew him at all, the doctor who rushed in and out. But when my son Seth was born, after I had a stillborn a year earlier, he showed up in my hospital room in Columbia and gave Seth his first check-up. I remember how surprised

I was when Dr. Werzberger walked in. I had been writing on the laptop, and he said “A woman from Kiryas Joel with a laptop. I’ve never seen that before.” And I acted so guilty, he mumbled something to the effect that he didn’t mean anything by it.

Anyway. There – Grandpa Simpson and I and long side-stories…

The book had some really interested insights into the issue with vaccines. It was an educational component of the Hasidic community’s efforts, and not surprisingly, the official stance is very pro-vaccine. But I also got to understand a little bit about how the secular anti-vaccine trends is affecting this demographic.

Here are my Cliff’s Notes:

1. First, the numbers: The heads of both major schools in Kiryas Joel wrote about what they see with regards to vaccines in schools. UTA reports that 2% of the students have religious exemptions, While V’Yoel Moshe says the school has 1,000 families and not one letter of exemption on file, with 95-98% compliance.

2. Religious exemptions doesn’t mean people are not vaccinating for religious reasons. Kornbluh from the UTA says that “A lot of parents are worried about confidentially They don’t want the community to be aware of their child’s illness, so they’ll bring a religious exemption instead of medical.” In other words, people are concerned about their reputation, about their children’s marriage prospects, and are getting religious exemptions to cover whatever booboo the child has that might prevent them, medically, from getting vaccinated.

3. Still, reluctance to vaccinate *is* a problem. This is where the anti-vaccine issue comes in. From reading the reports of doctors and administrators, I’ve seen that they are dealing with a new wave of parents who are afraid of vaccines. No, it’s not a whole community of fanatics rejecting modern science, but it seems to be a real trend. Kornbluh from UTA says that “two or three years ago, we had less than 1% [exemptions from vaccines]. I blame the rise on misinformation; it’s been a terrible influence. For example, a popular hotline listened to by many women, has been the source of a lot of negative and unsubstantiated claims about vaccines.”

4. A recent influx of anti-vaccine scaremongering: Dr. Werzberger says that “twenty-five years ago, there was no such thing as not giving vaccines on time! Except if someone had a cold.” Another doctor said that people are becoming more hands on. They are more invested, they question authority. They don’t just do as the doctor says. They’d come to the doctor and say “I’ve done my research” even if the research is from shabby sources.

5. Refusing vaccines on the basis of “health”, not religion. Per Dr. Werzberger, “Even in an insular culture, like Kiryas Yoel, the secular way of thinking will influence the community… Mothers think that vaccines negatively affect the immune system.” The irony here is terrific. Because of the small-town, insular ways of the Hasidic community, it is easier for babba maysos to spread. Yet of all the babba maysos to spread, it’s the ones from the secular nuts.

6. Why the Hasidic community is more susceptible to fears of vaccines: the takeaway is that a few things come together to make vaccine-refusal catch on. First, vaccines have been so successful, people forget how terrible the illness it curtails is, while they hear all about its side effects. Almost as if the crisis is over, no need for precautions anymore. Hasidim are not doctors or nurses, so misinformation is ripe for the spreading. The small-town feel means this yenta tells this friend and that person and it’s all confirmed: the cat was a spirit carrying news about the cancer the neighbor’s sister had because of vaccines. There is also that a few fringe people were peddling stories that scared people, and the community didn’t organize to respond to them and squelch people’s fears. You see this with other issues too — the proactive education isn’t there vis a vis health until things get really rough. My hunch is that this is why the lead problem affects the Hasidic community too; because the information about the dangers of lead paint and such doesn’t reach people. It’s clear from this publication that there is finally an effort to take mother’s fears seriously and explain to them what the issues are. There is also the aspect that, according to the administrator of V’Yoel Moshe school “Anti-vaccine movements catch up with these very, very overwhelmed mothers and provide an excuse not to vaccinate.” The V’Yoel Moshe school claims they had success by coordinating vaccines with the doctors office. In other words, when you have a lot on your plate it can be the path of least resistance.

7. It’s obviously not all anti-vaccines. Even though this magazine is primarily geared towards educating and encouraging those fearful of vaccines, it touches on some other issues that might make the Hasidic community vulnerable to an outbreak. This school principal writes that “we are so bonded together, so many kids in one classroom, so many bochurim sitting across from each other in Bais Medrash, we must be more vigilant than anyone else. He also writes that “since we are a frum mosad (a religious school), we must let all children in.” I won’t go into the hypocrisy of this rule being cut off for those who don’t comply with religious requirements… The point is that the children who are not vaccinated are not homeschooled, they are around to pass contagions around. The doctors offices also (most of them) will accept patients even if they refuse to vaccinate. So between those who can’t vaccinate and those who won’t and those too young, the risks are surely higher in the Hasidic community.

I like the publication. I like it a lot. Instead of screaming “anti-vaxxers!” and pointing fingers and making it as if anyone who has ever questioned vaccines is the enemy of vaccines, it takes Hasidic mothers seriously. It believes that education and community coordination can solve the problem. Which — I think it will. The question is if the community will learn for next time to be proactive, before the quacks and witch doctors return to town and again set up voodoo shop and sell their snake all to every woman’s deepest anxieties.

A year or two ago, New York City reported that the Hasidic community in Williamsburg had the highest rates of lead poisoning in the city. I heard it on WNYC radio, during a very early morning drive to my 5:30 spin class, back when I lived in the suburbs and did such suburban stuff as be on the open road at 5am. I thought to myself then, hm, I wonder why Hasidim were most affected. I’ll find out later. But I never did find out. Not for lack of trying. I did look at all the news stories published in mainstream sources, I asked anyone and everyone in the Hasidic community but got shrugs and ‘dunnos’, I even bought the Yiddish newspapers regularly and read the reports there too – but no one explained why the Hasidic community had higher rates of lead poisoning than other demographics.

Now there is a new story of a public health issue concerning disproportionately the Hasidic community. And again the obvious question of why is on my mind. It’s about the measles outbreak, of course. 153 cases have been reported in Rockland County, where County Executive Ed Day declared a countywide emergency. There have been cases in Hasidic Williamsburg too, where medical facilities too are on high alert.

A lot of things might cause a virus that was previously considered extinct to spread, but I don’t know what specific issues added up to make it happen here. The problem is that journalists covering this story are taking the easy route of just saying “well, must be because of that vicious anti-vaxxerism”. The Times and other NYC beat journalists find the few misfits in the community who are into health mishigasen and alternative healing and who don’t vaccinate, and they tell readers about it. The New Yorker interviews a nurse who meets with these vaccine-fearful women and explains the science to them, without asking how many women really are vaccine-fearful (although that nurse is laudable and seems lovely and to have a big, great heart) And the comments sections on reddit have it all diagnosed most succinctly: “Their religious refusal to vaccinate is putting me at risk.”

Wait. Why does the public walk away with the impression that Hasidim are against vaccines on religious grounds? Why are people acting like this is a religious rights issue?

In case it needs to be said again, let me be clear: Hasidism as a culture is pro-vaccines. They are not with vaccines the way that Jehova’s Witness is with blood transfusion. In fact, Hasidic culture as a whole loves modern medicine. That’s a whole other fascinating contradiction, but that’s the reality. Which mother of eight has time to deal with kids getting sick left and right? You give vaccines, thank goodness! There might be some or many misfits within the community who go their own way. That would be analogous to the Hasidim who have smartphones even though you are officially not really supposed to have one. So the individuals who are anti-vaccine are actually going against the cultural grain. And how many such people are there? How significant is their influence on the measles epidemic?

We have no idea. You won’t find the answers from reading the news.

The Times reported that the original carrier of the virus came from Israel and was unvaccinated, and that the virus spread to unvaccinated kids. That’s all the data you get. Based on that alone, they assume that this is mostly an anti-vaxxer story.

But there could be a number of other reasons for a child to be unvaccinated. Maybe because the child is too young for the vaccine. Or because the parents were neglectful of it. Or because the school the child went to didn’t remind the parents. Or because when a virus is considered extinct, people get sloppy. Maybe people get sloppy because they hear rumors about it being scary. If so, is that the same as anti-vaxxers? If the Hasidic community can be brought up to speed on vaccines with a bit of intervention, is it fair to put them in the same category as obstinate believers of fringe theories?

It is reasonable to guess that at the time of the outbreak, many kids were unvaccinated. But that doesn’t tell us why. If I tell you that I didn’t get my flu vaccine this year (I didn’t), would you automatically assume that it is because I am afraid that vaccines cause autism and I’m an anti-vaxxer now? Or would you ask the question journalists should be asking: Why didn’t you? How could we ensure you get it? What can we learn from this?

(the answer is because, em, um, I was neglectful and my doctor was out of it and CVS said I should come back the next day and… it didn’t happen.)

Even before the measles story was so big, I called my son’s old medical center in New Square for his records, and was surprised that the automated system now announced: “If you would like to find out if your kids are up to date on their MMR, press X”. Clearly, there is an element of just sloppiness here. What else caused the virus to spread? Was it only the unvaccinated? Was it the age the vaccine needs to be given? Is there something about how the vaccine is given that we can take away here?

Instead of answering any of this, secular anti-vaxxers have been conflated with the Hasidic community. Which causes everyone on the outside to gleefully finger-point and blame the Hasidic community for the outbreak. In the story in the Yiddish paper, one Hasidic family recounts being told that they are Jewish and therefore must have the measles. Ugh, that’s a lot of ignorance that we are allowing people to believe.

Why does it bother me so much? Because this bothers me in a very deep way: incuriosity about the other. Making the “OTHER” into a monster of its member’s worst. Making assumptions in place of investigating facts. Mistaking a small minor part of a story as the WHOLE story. I get so upset when people do that, because it’s de ja vu for me. That is what Hasidim do. I always had a hard time with it, and I encountered it. A lot

Once on a tour, some Hasidic man, clearly a douchebag, stopped me and started to yell at me and my group that “she hates us, don’t believe her, it’s all BS.” I was dumbfounded by how upset this person was based on what he made up in his own mind about what was happening on my tour. I asked him “how do you know what the tour is about?” but he was sure he knew. He was making assumptions, and then building towers of logic and debate on them. But the underlying assumptions are laughably pulled out of his own head, based on information he has and his logic. But I feel like for a Hasidic person, this is forgivable. Because Hasidim are raised in a pre-enlightenment worldview where you don’t have the resources or education in checking a premise.

In the secular world, I see the exact same tendency all the time. But not out of a poor capacity for evaluating the evidence. It comes out of the fast, intensive news cycle. Where journalists need to keep churning out stories. If you need to report on the measles outbreak in a day, you don’t have time for finding out why; you just talk to this attention loving clown and that (Gestetner, I’m looking at ou), get your quotes, and voila, the story is filed. Filed, but not told.

I ran into this ceremony on my way out of one of my Sunday tours. It was held in front of the Puppa Boy’s School, where our tour often passes. This was an inauguration of a newly completed Torah, the ceremony called Hachnuses Sefer Torah. Everyone looked all dressed up and festive!