That sounds pretty cool.
(Laughter)
You wake up one morning, however,
and you discover that the reason
there are no rules
is because there's no government,
and there are no laws.
In fact, all social institutions
have disappeared.
So there's no schools,
there's no hospitals,
there's no police,
there's no banks,
there's no athletic clubs,
there's no utilities.
Well, I know a little bit
about what this is like,
because when I was
a medical student in 1999,
I worked in a refugee camp
in the Balkans during the Kosovo War.
When the war was over,
I got permission — unbelievably —
from my medical school
to take some time off
and follow some of the families
that I had befriended in the camp
back to their village in Kosovo,
and understand how they navigated
life in this postwar setting.
Postwar Kosovo
was a very interesting place
because NATO troops were there,
mostly to make sure
the war didn't break out again.
But other than that,
it was actually a lawless place,
and almost every social institution,
both public and private,
had been destroyed.
So I can tell you
that when you go into one
of these situations and settings,
it is absolutely thrilling ...
for about 30 minutes,
because that's about how long it takes
before you run into a situation
where you realize
how incredibly vulnerable you are.
For me, that moment came
when I had to cross the first checkpoint,
and I realized as I drove up
that I would be negotiating passage
through this checkpoint
with a heavily armed individual
who, if he decided to shoot me
right then and there,
actually wouldn't be doing
anything illegal.
But the sense of vulnerability that I had
was absolutely nothing
in comparison to the vulnerability
of the families that I got to know
over that year.
You see, life in a society
where there are no social institutions
is riddled with danger and uncertainty,
and simple questions like,
"What are we going to eat tonight?"
are very complicated to answer.
Questions about security,
when you don't have any security systems,
are terrifying.
Is that altercation I had
with the neighbor down the block
going to turn into a violent episode
that will end my life
or my family's life?
Health concerns
when there is no health system
are also terrifying.
I listened as many families
had to sort through questions like,
"My infant has a fever.
What am I going to do?"
"My sister, who is pregnant,
is bleeding. What should I do?
Who should I turn to?"
"Where are the doctors,
where are the nurses?
If I could find one, are they trustworthy?
How will I pay them?
In what currency will I pay them?"
"If I need medications,
where will I find them?
If I take those medications,
are they actually counterfeits?"
And on and on.
So for life in these settings,
the dominant theme,
the dominant feature of life,
is the incredible vulnerability
that people have to manage
day in and day out,
because of the lack of social systems.
And it actually turns out
that this feature of life
is incredibly difficult to explain
and be understood by people
who are living outside of it.
I discovered this when I left Kosovo.
I came back to Boston,
I became a physician,
I became a global public
health policy researcher.
I joined the Harvard Medical School
and Brigham and Women's Hospital
Division of Global Health.
And I, as a researcher,
really wanted to get started
on this problem right away.
I was like, "How do we reduce
the crushing vulnerability
of people living in these types
of fragile settings?