Bill good evening. My name is bill leggett. I am a bookseller. On behalf of the entire staff welcome. , its a pleasure to have you here and a pleasure to be hosting sonia shah. And hearing her discuss her book, epidemic, trekking from cholera and beyond. If you have any noisemaking devices, take a moment to silence them now. Sonja will read for about half an hour and then take as many of your questions we can fit into 20 minutes. And then she will sign books afterwards. We encourage questions, but need you to use actually the one microphone thats here on the right by the pillar, so that everyone can be involved in the conversation and also for our cspan audience. After the event is over, if you great help if you fold up the chair and place it against a bookshelf, and it will be time for the book sailing book signing, and the books are for sale when you walked in. Sonia shaw is an investigative author whose work has appeared in the New York Times and scientific american, among others. Her books include crude, the story of oil, body hunters, testing new drugs on the worlds poorest patients and the fever, how malaria has ruled human kind for 5000 years. She discusses history including the outbreaks and responses to them as a reporter where it a pandemic still affects peoples lives and the futures what we now know and how we can use this to predict and contain the next outbreak. So please welcome sonia shah. [applause] sonia thank you, thank you, all, for coming. So this is my fourth book and it is my third time at this bookstore. Every time i come, i have some deepseated understanding i live closer to the store i that i actually do. I am always a little late. By my fifth book, i will be right on time. When it first started writing this book about six years ago, i certainly didnt expect that we would be living through a pandemic of a novel passage right when it came out. That is where we are with the zika virus washing over the americas. And i just heard the cdc report today that three out of the nine women who are infected with zika virus who came back to the , United States have had abnormalities in their babies, so it seems like this thing is actually might actually have some real barrel its, real virulence, not just in brazil. But the zika virus is just a good example of whats been generally over the past decades, and its the reason why i wrote this book, which is over the past 50 years, weve had over 300 infectious pathogens either reemerge or newly emerged. Zika virus is just the latest. We had ebola in west africa where it had never seen before, we had novel kinds of Avian Influenza including one that caused the biggest outbreak of animal disease in United States history. We have had Novel Coronavirus is , a new one coming out of the middle east, and then of course all of the antibiotic resistance resistant pathogens we have. We have chikungunya zika, west , nile virus, a whole number of things. What i wanted to look at as a journalist is how does a microbe that, you know, just a tiny little thing that has no how doesnt locomotion, it become this pandemic causing pathogen . I decided to answer that question. First i looked at the history of pandemics, and i picked on one to focus on, that is one of the most successful pathogens of all time, cholera. Pandemics but two seven. It killed half of the people infected with it. This can happen in a matter of hours unless they are rapidly treated. In the latest one is going on right now a couple hundred miles off the coast of florida in haiti. The historyscovered of cholera and i went to places where new pathogens are emerging. I went to south china, portauprince, elsewhere, to look at how the story of cholera can shed light on what is going to happen to these other new pathogen. What i found is the history of cholera is indicative of what is happening globally with all of these other emerging pathogens. Cholera came out of the environment. Like a lot of our new pathogens today. 60 are coming out of wildlife, animals and wildlife. Cholera did too. It is a marine bacteria. It lives in estuaries, places like a place in bangladesh which is where the major rivers of south asia drain into the bay of bengal. It is a huge wetland. The water is half fresh, half salty, quite warm, quite alkaline. It is perfect. It lives in conjunction with the zooplankton there. It helps recycle nutrients. It is an inhabitant in the environment. And people for a long time did not live in places like this. This is a giant mangrove swamp. Ly flooded twice a day. And cyclones. Rs that changed in the 19th century when the british raj decided to chop it down and turn it into rice farms. Quite suddenly over the course of a century, 90 of the area was settled. Suddenly people are in the close intimate contact with cholera in the environment. That allowed the cholera to spittle over spill over into human bodies and adapt. In our bodies it is different. The first pandemic started in this area in 1917 and spread into russia, the industrialized cities of europe. This is what is happening with our new pathogens. We are invading Wildlife Habitats or we are disrupting them. Either way we are allowing people and animals to come into intimate kinds of contact. When that happens, there microbes can jump over into our bodies and become pathogenic. From bats we have got you all a got ebola and marburg and sars. Usels are probably giving middle east respiratory syndrome. For monkeys we most likely got zika. From other nonhuman primates we got malaria, hiv. From birds we got influenza. This is how they are emerging and we are allowing them to amplify in cities and crowds. That started in the 19th century and cholera took advantage of that. People were flocking out of the farms to come into these new factory jobs. There was not a lot of room to scroll back then sprawl back then. They didnt have metros, so everyone lived near work with the possibility of it. Places like new york city had 77,000 people per square kilometer. This meant that they were breathing on each other, touching each other more, the waste was contaminating food and water. There was no sewages system in the 19th century industrial susies cities. They had out houses. There was no rule you had to empty any of that stuff out. People did what they did in the countryside. They tried to let it decompose. But that wouldnt happen before the waste ran into the streets, overflowed into peoples wells, contaminated. As an of cholera enters as soon as cholera enters an environment like that, it would explode. So the process of urbanization started in the 19th century but is only reaching its peak now. Half of humankind now lives in cities. That happened a few years ago. The majority of us will live in cities by 2030. They will be cities like washington, dc and san francisco. It will be like freetown and monrovia and mumbai. Ad hoc, lots of slums, poor infrastructure, chaotic. But 2 billion people will live in slums. That is the prediction. So there are new pathogen sticking advantage of this taking advantage of this. Ebola is a good example. Before we had outbreaks since the 1970s. Ebola never had infected a place of more than a few hundred thousand inhabitants before 2013. It was only in 2013 when it came up in guinea, within a few weeks it had infected three Capital Cities with a population of 3 million combined. That is really important why it was such a huge conflagration. Takingy the virus is advantage of urbanization. We have had this virus since the 1940s and maybe before. It was mostly in equatorial forests in asia and africa and it was carried by a forest mosquito. That mosquito mostly bit animals. It did not bite people much. People did not get a lot of zika virus. But now zika virus is being byried by 80s object i aedes egypti. They can breed in a drop of water in a bottle cap. All of the person plastic garbage we leave around, our person they are perfect environment. The only bite humans. Only bite humans. As an is a got into this mosquito, it expanded rapidly. Soon as it got into this mosquito, it expanded rapidly. We carry these around. That started in the 19th century in earnest with the steam engine. We started taking steamships quickly, often down our rivers. And then of course we collected those waterways by using steam engines to build canals. So the eerie canal opened. Just in time for cholera to come itr from london and purpose came down into the entire interior of north america. That happened again and again and again. We have not just a few Capital Cities with airports but tens of thousands of annexes between all of our airports. Connections between all of our airports. You can make a map of the cities of the world connected by direct flights. If you run a simulated flu pandemic on a map like that it is like a wave, a pebble dropped into a c. Intuio a sea. You can see where will happen because of the flights. That is how influential the Flight Network is. On the way epidemics spread today. Epidemics spread today. Modern life really increases the risk of these epidemics and is driving pathogens into human populations. The other part of the book is what we do about it. We dont take these things lying down. We have defenses, political, medical, all kinds of things we can do to fight back and contain these allergens. Pathogens. I spend a lot of time in the book trying to to select the outbreak in new york dissect the outbreak in new york in 1982. The governor of new york sent one of the top doctors to canada to do reconnaissance and see what was happening. Would this threaten your . He collected this data that had been mapped and the map appears in the book. It shows a clear picture, clusters of cases on the hudson erie, the eerie canal canal. Very clear picture. Nobody in new york wanted to quarantine the rivers or the canal. The canal is what turned new york city into a backwater port into the premier port of the country, the empire state. This is a huge part of the economy. Nobody wanted to close the waterway which would have been the obvious thing to do. So dr. Beck said while it might look like cholera is coming down the waterways and like it is contagious, actually it is caused by miasma. Miasma of course, this is a 2000yearold medical theory that diseases like cholera are spread through bad smell. That is what they thought. They decided to blame those bad poors on the drunks, the and the immigrants. Especially the irish. This was violent. This was not just badmouthing them in the press. There was epidemics in the 19th century. Thought. Rain of i think i am having a senior moment. [laughter] oh my god. Let me look at my notes here. Where was i . Yeah. The doctors. New york city, they didnt yes. It is funny that is where my mind went because this is my favorite part of the story. They didnt want to quarantine the waterways. Fact, there were companies at the time that were distributing cholera contaminated water and making money doing that. Ofre is a slum in the middle manhattan called five points. Has anyone seen gangs of new york . That is what it is about. That is the worst parts of the cholera epidemic affected that slum. It was really crowded and really filthy. The slum had been built on what was once a pond called the collect pond. It was the only source of fresh water on manhattan for a long time. It was filled up with garbage and the slum was built on top of that garbage filled landfill. The ground underneath the five points slum was really unstable, unlike the rest of manhattan which is bedrock. The contractor was easily contaminate ground water was easily contaminated. All of the outhouses, all of their material is sinking into the groundwater. The state of new york chartered a company to deliver Drinking Water to the people of new york. That company, instead of tapping upstream sources of water, the bronx river at the time which was fresh and clean, they thought that would be, that would cost too much money. So they made a decision like with flint, michigan, they decided not to tap the good water. They decided they would sink their wells in the middle of that slum. That water toed one third of the people of new york. This is through repeated cholera epidemics. This is the good part, the person who maneuvered all of this was aaron burr, Alexander Hamiltons nemesis and murderer. On top of that, the company that did this was called the manhattan company. The reason they want to disable this money is they wanted to start a bank which they did. It was the bank of the manhattan company. The bank still exists to this day. Do you know who it is . J. P. Morgan chase. That is their early history. When i tell that story in the book because i think we dont really look at the political and social drivers of contagion enough. And i think that is an interesting kind of turnaround from the past. My last book was on malaria. And you know, we had a lot of malaria in this country from the 1600s to the mid1900s and we really got rid of it before we had solid Biomedical Solutions by changing our landuse policy basically. Dams, but we had gists ons and malariolo the boards of these dams to make sure we would not extend the mosquito habitat. We changed housing practices. People put screens on windows and doors. Out of lifted people poverty in early areas, giving them electricity and mechanization. We built it out. Four this is well before we had ddt or drugs. But in the 1840s we started developing really specific chemical cures. We had an assailant, ddt penicillin, ddt and this created a new sen. Smith that became newrful and rated a establishment that became powerful and give help to the biomedical establishment. So what happens is that we have outbreaks of contagious disease, we dont look for the social and political routes. We look for epidemics, people get sick and then we hope we can throw sufficient vaccines and drugs at it to make it go away. That can work in some cases. But what im trying to say in this book is it is not sufficient for new diseases pathogens comeu up, we just knew pathogens come new pathogens come up we can deal with them. Talking about exponential growth of untreatable disease. This is theof dengue outbreak in florida in 2009. Dengue came out and it was. Entered in cap key west it had not been there in 70 years. It was immediately attacked as a biomedical problem, attack the insect, the virus. The mosquitoes have been effective for a long time. Florida has been surrounded by countries that have dengue. That is not new. There have not really been any invasion of virus or mosquitoes that needed to be attacked. What had happened in 2008 was we had the foreclosure crisis. And the foreclosure crisis meant we had a lot of abandoned homes. In florida that means a lot of empty swimming pools. When the rains came, the empty swimming pools filled up with water and became giant mosquito hatcheries and no one noticed and no one let the mosquito inspectors in. We had this unprecedented outbreak of mosquitoborne dengue virus. So i dont know if addressing the accusing the housing crisis would have helped contain the outbreak because nobody tried that. Is that thearguably biomedical model failed. We are continuing to have outbreaks in florida. It is considered a permanent part of the landscape there. What i want to say in this book is as great as the Biomedical Solutions are if we can start to pick prevent pandemics, if we engaged engage with the root causes, in which case it is not a question of meeting for the perfect cure but our own political will, think for listening. I will take questions. [applause] bill the microphone, thanks. Myhi, i am halfway through nook. I am really enjoying. I have a question about the zika virus because it came right after with your thoughts about Political Economic and every kind of treatment of the olympics and what, given your theories in the book, what would you suggest . Differentis a situation because the argument in brazil of why they should have the olympics and why they should come anyways because it is winter. It is true that when it is dry and cold, the mosquitoes either wont hatch as readily because you need standing water for at least a week or even if they do, they wont survive for long enough to transmit the virus because it takes seven to 10 days and it slows down if it is cool. That quite possible that is true, there will be less virus. At the same time we are living in a time of unstable weather patterns. All we would need is a good rainstorm, a week and a half before people started to come before the olympics and some of the water standing. Those eggs desiccated and can last desiccate and can last for months. They will come right along again. It is a risky endeavor but there is no stopping zika. It will come. It is probably here in far larger numbers than we know. 80 of people who get you dont have symptoms. Is the are counting tiniest tip of the iceberg. That is even counting, a lot of people who have symptoms, it is a rash or fever, they get better, it is selflimiting for most people. What we are counting is a tiny factor that is probably already here in a more widespread way. If you consider the fact we have 15 or so cases of sexual transmission in the u. S. , if there is 100 introductions, there is or so of the virus in the United States and 15 of those have transmitted sexually, the numbers dont match up because sexual transmission is a rare form. There is likely many more cases. Olympics or not it is coming, it will be here. It is a matter of time before we see it manifest itself in a more detectable way. D. C. So it is hard not to talk about our government. For 12 years i was one of the leaders in dealing with infectious disease, bioterrorism. Comments, under clinton and bush, there were large staffs at the National Security council focusing on bio security. Because there are 25 agencies and you got to have white house control or you have nothing obama comes in and wipes it out. Gone. It is not one of the 11 Top Priorities for the administration in terms of security. It is not even mentioned. Hadthen under bush we amazing efforts, tens of billions of dollars, trying to get development of vaccines, diagnostics, therapeutics. It wasnt very well designed. All of that has been dismantled by obama. Do you have any actually the explanation was, that we heard, cheney thought it was important and therefore we dont. Was what everybody widely quoted. What is your take of how it is possible given these are existential threats where a billion people could die, of avian flu epidemic, if it is roughly the same lithology of the one billion people. , youould have quarantines could have panic. How is it possible this administration has essentially zero interest in this issue . Think i think you have said it all. I dont think you really had a question. But i do think we need to do more than that. What i am trying to talk about is not just lets stockpile vaccines and have sort of experts we do need that as well. Ute really to get at the ro causes, Healthcare Infrastructure in the poor parts of the world, primary services to people who are vulnerable, what about the health of animals, however regulating land . We are breaking up pristine tracts of land. This is reservoirs and microbes that could spill over into our bodies. An all of the above approach. We need the expertise, but i would like it to be more multifaceted defense strategy. Know, d. C. U probably has the highest rate of hiv in the u. S. From like a global perspective, what lessons can be learned in approaching epidemics on a smaller scale . Sonia because d. C. Is like the epicenter of hiv. Sonia how does that translate into are there any correlations or what can you learn from the global spread of disease . Sonia we have seen this in the history of lots of contagions, marginalized communities. This is an interesting aspect of the 1832 epidemics of cholera is we had slums in the middle of the city. It was a driver of epidemics because there were these neglected communities in the middle of new york city and that was new. Usually in the past the poor people were a free on the referee of community the periphery of communities. In here the slums are in the middle of the city and that became kind of the epicenter that would slpark out. Would spark out. Even ebola is a great example where very simple interventions could have controlled that, but we didnt have anything on the ground, even soap and water could have helped control the spread of the virus but we dont have even the most rudimentary services for these remote communities and that puts everyone at risk. That is something i really it is a big lesson, the history of contagion. My name is scott and i work for a Global Health organization lobbying the government to focus on strengthening the developing world. I think it is not ridiculously hard when you take a given country and you know what is killing people like in kenya where hiv and malaria are big killers. It is not ridiculously hard to figure out what investments you can make that will make the greatest difference to saving lives and have the greatest impact. That gets harder when you are looking at pandemics. You dont know where will come from. This question of priority setting is important because we will never have all of the resources we want and so we need to set priorities we priorities. There is a time of things we could do about preventing pandemics but i dont have a lot of ability to say which things are going to have the biggest bang for our buck. Sonia i dont have an easy answer. We need all of it. The most glaring lack his primary health care, primary Health Services for poor people in remote places. I was in haiti during the cholera epidemic. It has been going on a few years. There a few years ago. We traveled maybe 50 miles from the capital but it took about eight hours because this place is so cut off. They were not so cut off they could not get cholera. Cholera had come into this village but they were cut off enough they could not get any resources to help them. That really struck me, this Uneven Development where they had one type of water coming down from the hills, the an aids have built as project and never gave them any support for maintaining it, there was no services or resources or know how to maintain this thing. When i came some of this pipe, that brought the sole Drinking Water, it was supposed to be on a and because supposed to be on a cliff, but because of erosion, it is near sea level. They had 32 holes in it and nothing to patch it up. They were using clock and wrapping it around cloth and wrapping it around for the had a tiny trickle of freshwater into the town. Around. They had a tiny trickle of fresh water coming into the town. With a bucket of water you dont give up eating and cooking, you give up washing. So this really simple things like clean water and aid that is not, that is sustainable over time, those are vague things. I am not a policy person. Im looking at how these things spread and what of the approaches we can take to help empower communities to come up with their own solutions . What is the biggest lesson of all. We ask them, what do you think we should do . I would really like 500 insecticide treated bed mats no, they said we would like better water into this town or whatever it is. I would like to thank you. I am from a part of the world where this problem started to develop first although i am part from a different part. Haiti has a huge problem because of the tremendous poverty and marginalization. I heard you talk about the fact Public Health issues and sanitation issues basically are more important and kind of medical issues for stopping a lot of stuff happening. Having said that, two questions. The first is, because we talked andt that but from europe, the United States of america and other developed countries, there are attempts to place people in in the tropics. Africa, for example, to figure how toing pandemics and track those things. That is the first thing maybe you want to talk about. The next thing is the complexity of zika spreading in the caribbean, happening of this point in time, not my island. A matter of time. Is a complexity coming out of brazil over this issue of consequences for kids. Yes,e are saying potentially for certain people with certain genetic profiles, this could be it is percent dont show anything. Dont show anything. But it is a problem no one is talking about. In these neighborhoods where a lot is happening, especially with the kids, the consequences for the kids, these neighborhoods have lots of pesticides and other stuff. Zika or is it zika plus these other things . These are the elements so have you heard about that . Sonia there has been lots of alternate theories about why we have had this rash of microcephaly in brazil. No, of them are easy to say that is not happening. The pesticide theory to me, there is a lot of evidence. Pesticide has been used in other parts of the world. It has not been spike in microcephaly. Would it have been used differently in these different places . Somehow because of cultural reasons or some other reasons, could those people have gotten a higher dose . I dont know. Tohink it is a mistake dismiss these alternative theories as conspiracy theories. What, that iss the conventional response especially from the Global Health establishment is to say stop spreading these, but there is a reason why these alternate theories come about. It is important to look at that. They come about because of a lack of trust in our biomedical establishment. Where does that come from . If you trace that back, and this is something i try to do in the book, i look at why were Health Workers during the ebola crisis attacked and slaughtered . This happened during cholera epidemics. Doctors were stoned in the streets, mobs, burned down quarantine hospitals area we see this again and again. Hospitals. We see this again and again. Transgressions have occurred between the biomedical establishment and local people and maybe through the best of intentions but it is still there and it needs to be addressed. The lack of trust israel. Peoplesismiss alternate theories we are dismissing the underlying feeling that they dont trust our Public Health messages. It makes it worst when we say you are stupid and ignorant. It is the same thing with the antivaccine arguments were people say they are so stupid and ignorant, they dont get the mmr, of course it doesnt have autism. We have evidence but where does the mistrust come from . People are frightened about industrial contaminants, chemical contaminants, secrecy and corporate secrecy. All of these things, corporate control of medicine. These are real issues worth addressing and wharf worth addressing what people feel they can trust. We need to do that work now because when some big pandemic comes, we need to trust our authorities. We need more of us to trust. We are not there yet. We have a lot of pockets of mistrust and conspiracy theories that come up almost immediately. Zika virus, within days there was the gm mosquito, the monsanto, all kinds of theories about why this is happening. Bill time for the last two questions. I am studying Public Health at George Washington and my concentration is in Environmental Health science and policy. I am taking a class called the social determinant of health. Wequestion is, how would work towards creating policy that would be effective in addressing Environmental Issues but also perhaps the root cause like social issues as you mentioned earlier . It is a huge issue how people experience disease and what does it mean about intervention that will make sense in their lives. This is a huge issue in malaria. We were hatching a lot of plans to help people in malaria countries that didnt match up with their own priorities. Bed mats were a good example. We created insecticide treated bed nets. It was going to be cheap and easy, you dont need refrigeration, clinicians, hospitals or roads. These people can be in the most poor, deprived settings and we can give them intervention and it will save them. Ok. We did that, spent hundreds of millions of insecticide that was a huge effort. A lot of good intentions and money and resources spent doing that. And then they were not used. 20 of them were being used. Really low uptake. And then they sent in anthropologist. People dont consider malaria a killer disease. They consider it a normal part of their lives. The nets are hot and square. They live in a round hunt. Hut it is the nicest material, so they are saving it for honored guests. All kinds of reasons. People on the ground who have the most malaria, they think of it in a totally different way than we do. Part of it is immunity. They have immunity to it. If you survive the gauntlet of the first two years of life and have your 12 episodes of malaria, you have immunity. Malaria comes and goes. It is the way you and i think of the flu. We had african scientists come over to the United States and so you people lose 40 billion a year from cold and flu. All you need to do is where this this little wear mask. It is so simple. Would we dont need we dont need anything fancy. Would we do it . We dont even wash our hands. I have sort of a contrast between this book and the book about massive power outages. What are your personal actions that you have done to prepare for pandemics, or what do you do in your daily life to avoid epidemic disease . Sonia i do common sense things. I keep up with vaccinations, wash my hands, try to stay informed. I believe we live in a micro real world. Microbial world and disease is part of our relationship to nature. This idea we should live in some kind of germfree environment and never have this is anomalous. If you think about the long history of humankinds interactions with microbes, we had the first antibiotics in the 1840s. Then we had hiv and lyme disease and new things we couldnt treat. , when we had the sense i am the daughter of two doctors, so i grew up with the feeling like infection, i will take antibiotics. It is simple. That is not going to be a part of my life. Maybe that was wrong. I think we will have to adjust to this new reality as our antibiotics stop working which is already happening. Bill thank you so much. Sonia thank you, all. [applause] bill thank you to sonia. You can fold up your chair and get your book signed right up here. Thanks. [captions Copyright National cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] announcer 1 history bookshelfannouncer 1 features the bestknown American History writers of the past decade talking about their books. You can watch a weekly series every saturday 4 00 p. M. Eastern here on American History tv on cspan3. Each week, American History tvs reel america things you context. Brings you context. We have been discussing the effect of this flu has covered a lot of territory. I would like to know how did it all get started . The exact point of origin of the influenza virus is of course not known. The current epidemic had its kong ands in hong singapore. Early april. By mid april the disease had become indeed epidemic in both of these cities. And remained so throughout the rest of the month. From hong kong and singapore the disease rapidly, in early may, formosa. The island of estimated half a Million People were attacked in a relatively short time. From formosa also during the month of may, the disease made its appearance in borneo and japan. And from the major shipping centers of these several areas, the disease very rapidly scattered into widely such widely separated places as , india, guam,sia and the philippines. Also in these is late may have the disease was reported as far away as australia and on board several ships on route from australia to san francisco. The first appearance of the disease in the United States was on june 2. This date is important because it means only a short six weeks from the time the first cases were reported in china, they occurred in the United States. This indicates the great rapidity with which influenza can spread over the world. June, this disease had practically circled the globe including southeast asia, southwest asia, the middle east, europe, australia, and north america. The june the of disease made its appearance in north africa, probably by the muslims returning from pilgrimages. July, the early disease made its appearance in chile, south america. Within three short months, every continent on the globe have been involved in this big pandemic. To sans on route francisco and several cases were diagnosed among our fleet. Wouldnt it have been simple to have isolated these known cases and prevented the spreading of them and kept them from coming in at all . It is not so simple for the reason that quarantine against influenza is not effective. Had it been possible for all of the cases on board these ships to have been isolated, it would have had little effect on the actual spread of the disease because undoubtedly there were many more people on board these same ships who by reason of a more recently acquired infection would have shown no symptoms of the disease and therefore they could not have been readily identified if they were passing through a quarantine station. Announcer 2 learn more this sunday 4 00 p. M. Eastern on American History tv. On june 8, 1972, an Associated Press photographer snapped a prizewinning image of nineyearold kim phuc who was severely injured in a friendly fire napalm attack by south vietnamese jets. The napalm girl is now a United Nations goodwill ambassador and author of the book fire road. Up next, Mark Boughton and , a jazz lokumbe composer who performs parts of a musical response to the image joined kim phuc on the National Constitution center stage to discuss the legacy of the war. [applause]