A wake up callThe coronavirus outbreak has laid bare the incapacity of the leaders to make their population feel secure.
Terms like ‘global village’ or ‘global society’ have existed to indicate interconnection and interdependency in our conversations for some time. But Covid-19 has truly exposed the actual intricacy of those connections. That perceived first world power and invincibility based on economic size and development is shaking in response to the crisis. Everyone thought that the first world countries had technology, resources and answers to address any health crisis; and epidemics and failure of health systems were reserved for the ‘third world’, a demeaning term in itself. The Covid-19 pandemic turned that idea on its head. The implied hierarchy based on race, culture, and economies, apparently, have proven epimeral. Also, it does not provide immunity to the rich and powerful.
The developed world is synonymous with innovation, cutting edge medical technologies and resources. Their healthcare systems are still more effective and advanced than that of the lower-income countries. However, this pandemic showed that even with emergency plans and policies in place, some crises can still expose vulnerabilities of the advanced healthcare systems.
Nepal has neither the authoritarian machinery like China’s nor the required resources and knowledge like the west to deal with the crisis of this potential. Despite being one of the countries closest to the epicentre, Wuhan, in China, the casual manner in which Covid-19 was initially addressed by foolishly claiming Nepal ‘Corona free’ weeks before it had taken any life outside of China; or discord in responses from various ministers demonstrated that the government failed to understand the gravity of the crisis. It was evident that the Nepal government had not thought about preparedness or prevention, and certainly did not demonstrate political leadership. Weeks into the crisis we still lack consistent and clear message or political fortitude to tackle the problem.
After almost 400,000 cases and more than 18,000 deaths worldwide, the authorities are finally scrambling to set up isolation beds, human resources and facilities. Failure to effectively and safely handle the exodus of residents at bus terminals prior to the lockdown that went into effect on March 24 exposed the government’s ill-preparation.
Covid-19 has certainly reiterated that the public health crisis is equally, if not more, about non-medical factors than the actual illness itself. Especially in a country like Nepal, social contexts matter when it comes to health and well being. Our health is determined by the individual, organisation, social, environmental, political and economic factors; and our policies have historically overlooked their influence. For effective implementation of prevention messages, especially when health literacy among rural masses is so low, they have to account for the public’s socioeconomic status, familial limitations, ability to comply or even comprehend, rather than just a checklist of prescribed instructions.
Dr Baburam Marasini, former Director of the Epidemiology and Disease Control Division has clearly stated in his many interviews in the media this week that public health planning and programs lack the ability to meet any public health crisis. This would be a shocking statement from the man once who was in charge, if it were in the west, but in Nepal, we are not surprised.
Early into the crisis WHO cautioned against ‘infodemic’, a term coined for the false information that was circulated on various media platforms. Unfortunately, some of those misleading information has inveigled Nepali minds, and surprisingly even the educated urbanites have digested such misinformation. There are many who actually believe the pandemic is just a media hype. Similarly, there are conspiracy theorists who think the government is purposely not reporting positive cases not to set panic in public.
Sometimes uncertainty and lack of succinct information from authority cause more anxiety than the crisis itself. Yet, the government has been lackadaisical in quashing falsehoods and presenting the true picture. At this critical juncture, public, private, and social entities have to move in lockstep to deliver an exact set of messages. Only after much hue and cry from all fronts just last week the cabinet specifically issued guidelines to the public to avoid crowds and congregations, close schools and postpone standardised exams; yet restaurants were still serving, and crowded transportation systems were still running.
A large portion of Kathmandu residents are rural to urban migrants who work in the informal economy and earn very little income. Most live in squalor like conditions. What happens to these folks who did not leave the city prior to the lockdown on March 24? If they were to be confined to their dwellings, that could prove to be more dangerous than the outside world. Still, if they demonstrate symptoms and require treatment; would they know what to do? Would they comply? We already dodged a bullet when travel restrictions were implemented in Covid-19 affected countries that prevented migrant workers from abroad coming back to Nepal as Coronavirus carriers in large numbers.
Similarly asking people to do what is not readily available to them also does not serve any purpose. According to the World Health Organization, the single most effective prevention step is periodically washing hands with soap and water; however, in places like Kathmandu where there is a chronic shortage of water and literally zero availability of water or soap in public places, such advice only makes a mockery of the situation.
Additionally, healthcare workers are expected to attend to the possible infected population with limited protection and resources. There is a severe shortage of protective equipment as well as other needed arrangements, especially if the outbreak overwhelms the healthcare system.
When the dust settles and post mortem is carried out, there will be a lot of discussion and actions to strengthen health systems, policies, readiness, response capabilities, and resources; not just of the developing countries but of the West as well. Covid-19 certainly reaffirmed the fact that our health systems are just as vulnerable as our personal health, and need constant monitoring and proactive actions to prevent failures.
What do you think?
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