A | 이탈리아의 미슐랭 스타 요리사들이 한국 해녀들을 찾아간 적이 있다. 예능 프로그램 ‘어서와~ 한국은 처음이지?’에서다. 세계 최고의 요리사들은 오리발을 차고도 물 속에서 허우적대며 당황한다. 반면 할머니 해녀들은 아무렇지도 않게 깊은 바다로 내려가 멍게와 소라를 건져 올렸다. “바다는 거울 같아서, 욕심 내면 바로 사고납니다.” 이날 그들을 매혹시킨건 식재료의 싱싱함보다 해녀들이 바다를 대하는 태도였다.▶서양 역사에서 바다는 정복과 탐험의 대상이었다. 귀향에 10년 걸린 오디세우스부터 대항해시대의 선원들까지, 그들은 바다 건너 보물을 찾아 나섰다. 반면 동아시아의 바다는 삶과 생계의 터전이다. 그 최전선에 산소통 하나 없이 차가운 심해로 맨몸을 던지는 해녀가 있다. 한참 뒤 수면 위로 올라와 허파에 남은 마지막 숨을 내뱉는다. 그 생존의 소리를 ‘숨비 소리’라고 한다.▶맨몸 잠수의 어로 전통은 물론 세계 곳곳에 있다. 하지만 제주 해녀 문화만의 차별성이 있다. 가부장 사회에서 여성 주도로 단단한 경제 공동체를 이끌어왔다는 점이다. 무엇보다 탐욕을 경계한다. 장비의 힘을 빌리지 않고 바다가 회복할 수 있는 만큼만 채취한다. 또 숙련된 해녀는 몸 약해진 동료나 나이 든 선배를 위해 수심이 얕은 바다인 ‘할망 바당’을 흔쾌히 양보한다. 제주 해녀문화는 이 생태 친화와 공동체 연대의 가치를 인정받아 2016년 유네스코 무형문화유산으로 등재됐다.▶엊그제 미국 CNN은 한국의 외국인 해녀 카일리 젠터(36)의 사연을 집중 조명했다. 뉴욕 출신인 그는 원어민 강사로 한국에 들어왔다가 제주 바다와 해녀 문화에 반했다고 한다. 2024년 해녀학교를 거쳐 서귀포시의 한 어촌계에 정식으로 입단해 직업 해녀가 됐다. 해녀학교를 졸업한 외국인은 더러 있었지만, 현재 어촌계에 소속되어 직업 해녀로 있는 이는 젠터가 유일하다.▶한국인 남편과 결혼해 제주 정착 10년차를 맞은 그녀는 “제주에서 살고, 제주에서 죽고 싶다”고 했다. CNN이 주목한 지점은 단순히 ‘신기한 외국인’이 아니라, 고령화로 소멸 위기에 처한 전통 공동체가 외국인을 포용하는 ‘상생의 힘’이었다. 우리는 흔히 전통 유산을 박물관 유물처럼 여기곤 한다. 하지만 이 젊은 미국인 해녀가 주는 교훈이 있다. 단순히 박제된 유물이 아니라 살아있는 공동체이자 지속가능한 미래의 힌트가 될 수도 있다는 것. 미국인 해녀의 ‘숨비 소리’가 단절된 한국 어촌과 세계를 조심스레 잇고 있다. 일러스트=이철원。 Global consulting giant McKinsey & Company advised several painkillers producers for 15 years on how to "turbocharge" prescription drug sales largely to blame for starting the opioid epidemic in the US, The New York Times has revealed citing over 100,000 documents.,The docs emerged as a part of a settlement deal that McKinsey signed with several state attorneys that sued the company.,Apart from working with Endo, Purdue, and Mallinckrodt, the company also provided "in-depth experience in narcotics" for Johnson & Johnson subsidiaries producing controlled substances. Meanwhile, hundreds of thousands of US citizens died from overdose, often linked to these very drugs.,How It All Started,According to the disclosed documents, McKinsey helped both Endo and Purdue, the creators of two of the most widespread opioid-based drugs for severe chronic pain, to launch their products Opana and OxyContin in 2006-2008. The firm even advised one of the companies on how to overcome a Food and Drug Administration (FDA) block which it had encountered in 2008.,The FDA blocked Purdue's attempt to release an upgraded version of its OxyContin, which was more difficult to snort or dilute and inject in bloodstream – two methods of the prescription drug's abuse that already had been devised by some of its recipients. In order to help Purdue get the license, McKinsey interviewed an ex-drug dealer on the medication's abuse, prepared docs and even coached the drug firm's officials for meetings with the FDA as the pharmaceutical company knew its drug had been widely abused, the docs suggest.,Crack Pipes: Biden Administration's Handling of US Opioid Crisis Raising Questions, Journo Says15 February, 13:00 GMT,Purdue's main competitor, Endo, also released a new version of its painkiller and tried to get it marked as resistant to crushing (for snorting) and diluting (for injections), but the FDA did not allow the latter citing lack of such properties. Nonetheless, the drug's release was a success and coincided with a drop in abuse-resistant OxyContin's sales.,This came, however, at a cost of local epidemics of previously unseen blood disorders in several US states in 2012 – patients were found to be anemic and suffered from kidney failure. Many of them admitted to abusing updated Opana – the new formulae indeed discouraged from snorting it, but still allowed injection abuse. However, the same component that prevented crushing took a great toll on those who tried to inject the drug to get a better high, leading to red blood cells' destruction and organ damage.,Going on the 'Offensive',The consulting company's involvement in the opioid crisis did not stop at helping the companies to launch their products – it also helped them to boost the sales.,While the pills like the ones produced by Endo, Purdue and Mallinckrodt were originally advertised as not causing additions, US doctors were not always prone to prescribing them, especially when a patient's pain was neither severe nor chronic. According to the revealed documents, McKinsey's consultants helped Purdue, and several other companies, including two J&J subsidiaries, to overcome this "problem".,Starting in 2009, McKinsey developed a "segmentation" strategy for Purdue: its analysts divided the company's customers into groups based on their potential thoughts of the product and then formed distinct messages for each group. The customers in this case were doctors prescribing painkillers and the product was opioid drugs. The strategy targeted even doctors who resorted to opioids only in most extreme cases, ensuring them of OxyContin's safety and trying to convince them that there was no point in making their patients suffer.,The consulting company proposed to achieve this by "[raising] physician comfort levels through appropriate education and support". Purdue tried to convince these doctors that their colleagues had no issues prescribing OxyContin.,By 2014, the US government started to realize a nascent opioid drug problem was underway and introduced new labeling requirements for such drugs as well as instructions to use them only in cases of severe of chronic pain. Around the same time, OxyContin sales started to decline, prompting Purdue to ask for McKinsey's help once again – this time to overcome the government's policy and precautions.,The consultants identified the problem as the company promoting its drug as a less potent opioid amid rampant drug abuse and advised to shift to the "offense" instead, the documents show. They namely advised focusing the salesmen efforts on doctors, who were likely to prescribe OxyContin to a new client not previously taking opioid drugs.,"Physicians with higher OxyContin NBRx to Rx ratio may be more likely to initiate a patient on OxyContin", an extract from a McKinsey presentation for Purdue from January 2014 said.,Around the same time and amid the 2015 HIV concentrated outbreaks in several states linked to the opioid drugs abuse via injections, McKinsey consulted Endo on promoting its Opana. The company was not concerned about what the CDC named "explosive transmission" of HIV and the Opana's role in it, according to the documents. On the contrary, in summer 2015, it helped Endo rededicate most of its salesmen from other products into a "Sales Force Blitz" – the company almost solely dedicated to selling Opana to around 3,000 physicians in the US.,One of McKinsey's consultants was excited over the creation of the "Force", claiming in correspondence with the head of Endo’s painkiller unit that the "fun [begins] on Monday!" with the latter responding "agreed, the fun is just beginning".,Playing Both Sides,One of the strangest revelations in the documents uncovered by the New York Times is that McKinsey managed to play both sides of the opioid crisis tragedy – helping pharmaceutical companies sell more of "not-so-addiction-resistant" drugs, while also assisting the FDA, other government agencies and state governments, in the fight against the epidemic.,In 2017, the FDA finally decided to pull one of the drugs, the more potent Opana, from the market, but not until it made $844 million in revenue with help from McKinsey and played a role in the deaths of thousands of Americans, considered to be the victims of the opioid epidemic. Paradoxically, the same year, McKinsey Senior Partner Tom Latkovic lamented about doctors prescribing opioid painkillers left and right at a health care conference.,"Why do we continue to prescribe, dispense, pay for opioid prescriptions to people that we know, or at least we could know, have an incredibly high propensity to abuse them?" Latkovic wondered.,The bizarre divergence between what McKinsey was advising to the pharmaceutical companies and Latkovic's rhetoric is explained by the fact that he was not a member of the consulting company's pharmaceutical practice, which worked with pharma.,Instead, he and his team worked with state governments and health systems to pin down the ways of tackling the opioid crisis, The New York Times said citing two local officials, who used to work on the issue. Their work, however, was partly complicated by McKinsey's pharmaceutical wing, which wanted to greenlight their draft publications in case they could damage their clients.,North Carolina Rep. Claims Opioid Crisis 'Affects Every Community' in US Amid Drug Trafficking Surge19 December 2021, 01:36 GMT,Eventually in 2019, McKinsey finally stopped advising its top client, Perdue, but not until their ties became public during one of the litigations related to the opioid epidemic and initiated by US authorities. One such litigation eventually had McKinsey pay $600 million in settlement without admitting guilt, as well as release the documents related to its work with the pharmaceutical companies.。
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