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On Revolutionary Medicine

Internationalist Che wrote the following essay in 1960. We thought this is important reading to shapeup our lifestyle as we are passing one of the most difficult times of our time due to COVID-19 outbreak. - Edts 

by Ernesto Che Guevara
Translated: Beth Kurti

This simple celebration, another among the hundreds of public functions with which the Cuban people daily celebrate their liberty, the progress of all their revolutionary laws, and their advances along the road to complete independence, is of special interest to me.

Almost everyone knows that years ago I began my career as a doctor. And when I began as a doctor, when I began to study medicine, the majority of the concepts I have today, as a revolutionary, were absent from my store of ideals.

Like everyone, I wanted to succeed. I dreamed of becoming a famous medical research scientist; I dreamed of working indefatigably to discover something which would be used to help humanity, but which signified a personal triumph for me. I was, as we all are, a child of my environment.

After graduation, due to special circumstances and perhaps also to my character, I began to travel throughout America, and I became acquainted with all of it. Except for Haiti and Santo Domingo, I have visited, to some extent, all the other Latin American countries. Because of the circumstances in which I traveled, first as a student and later as a doctor, I came into close contact with poverty, hunger and disease; with the inability to treat a child because of lack of money; with the stupefaction provoked by the continual hunger and punishment, to the point that a father can accept the loss of a son as an unimportant accident, as occurs often in the downtrodden classes of our American homeland. And I began to realize at that time that there were things that were almost as important to me as becoming a famous or making a significant contribution to medical science: I wanted to help those people.

But I continued to be, as we all continue to be always, a child of my environment, and I wanted to help those people with my own personal efforts. I had already traveled a great deal - I was in Guatemala at the time, the Guatemala of Arbenz- and I had begun to make some notes to guide the conduct of the revolutionary doctor. I began to investigate what was needed to be a revolutionary doctor.

However, aggression broke out, the aggression unleaded by the United Fruit Company, the Department of State, Foster Dulles- in reality the same thing- and their puppet, called Castillo Armas. The aggression was successful, since the people had not achieved the level of maturity of the other Cuban people of today. One fine day, a day like any other, I took the road of exile, or at least, I took the road of flight from Guatemala, since that was not my country.

Then I realized a fundamental thing: For one to be a revolutionary doctor or to be a revolutionary at all, there must first be a revolution. Isolated individual endeavour, for all its purity of ideals, is of no use, and the desire to sacrifice an entire lifetime to the noblest of ideals serves no purpose if one works alone, solitarily, in some corner of America, fighting against adverse governments and social conditions which prevent progress. To create a revolution, one must have what there is in Cuba - the mobilization of a whole people, who learn by the use of arms and the exercise of militant unity to understand the value of arms and the value of unity.

And now we have come to the nucleus of the problem we have before us at this time. Today one finally has the right and even the duty to be, above all things, a revolutionary doctor, that is to say a man who utilizes the technical knowledge of his profession in the service of the revolution and the people. But now old questions reappear: How does one actually carry out a work of social welfare? How does one unite individual endeavour with the needs of society?

We must review again each of our lives, what we did and thought as doctors, or in any function of public health before the revolution. We must do this with profound critical zeal and arrive finally at the conclusion that almost everything we thought and felt in that past period ought to be deposited in an archive, and a new type of human being created. If each one of us expends his maximum effort towards the perfection of that new human type, it will be much easier for the people to create him and let him be the example of the new Cuba.

It is good that I emphasize for you, the inhabitants of Havana who are present here, this idea; in Cuba a new type of man is being created, whom we cannot fully appreciate here in the capital, but who is found in every corner of the country. Those of you who went to the Sierra Maestra on the twenty-sixth of July must have seen two completely unknown things. First, an army with hoes and pickaxes, an army whose greatest pride is to parade in the patriotic festivals of Oreinte with hoes and axes raised, while their military comrades march with rifles. But you must have seen something even more important. You must have seen children whose physical constitutions appeared to be those of eight or nine-year-olds, yet almost all of whom are thirteen or fourteen. They are the most authentic children of the Sierra Maestra, the most authentic offspring of hunger and misery. They are the creatures of malnutrition.

In this tiny Cuba, with its four or five television channels and hundred of radio stations, with all the advances of modern science, when those children arrived at school for the first time at night and saw the electric light bulbs, they exclaimed that the stars were very low that night. And those children, some of whom you must have seen, are learning in collective schools skills ranging from reading to trades, and even the very difficult science of becoming revolutionaries.

Those are the new humans being born in Cuba. They are being born in isolated areas, in different parts of the Sierra Maestra, and also in the cooperatives and work centres. All this has a lot to do with the theme of our talk today, the integration of the physician or any other medical worker, into the revolutionary movement. The task of educating and feeding youngsters, the task of educating the army, the task of distributing the lands of the former absentee landlords to those who laboured every day upon that same land without receiving its benefits, are accomplishments of social medicine which have been performed in Cuba.

The principle upon which the fight against disease should be based is the creation of a robust body; but not the creation of a robust body by the artistic work of a doctor upon a weak organism; rather, the creation of a robust body with the work of the whole collectivity, upon the entire social collectivity.

Some day, therefore, medicine will have to convert itself into a science that serves to prevent disease and orients the public toward carrying out its medical duties. Medicine should only intervene in cases of extreme urgency, to perform surgery or something else which lies outside the skills of the people of the new society we are creating.

The work that today is entrusted to the Ministry of Health and similar organizations is to provide public health services for the greatest possible number of persons, institute a program of preventive medicine, and orient the public to the performance of hygienic practices.

But for this task of organization, as for all the revolutionary tasks, fundamentally it is the individual who is needed. The revolution does not, as some claim, standardize the collective will and the collective initiative. On the contrary, it liberates man's individual talent. What the revolution does is orient that talent. And our task now is to orient the creative abilities of all medical professionals toward the tasks of social medicine.

We are at the end of an era, and not only here in Cuba. No matter what is hoped or said to the contrary, the form of capitalism we have known, in which we were raised, and under which we have suffered, is being defeated all over the world. The monopolies are being overthrown; collective science is coring new and important triumphs daily. In the Americas we have had the proud and devoted duty to be the vanguard of a movement of liberation which began a long time ago on the other subjugated continents, Africa and Asia. Such a profound social change demands equally profound changes in the mental structure of the people.

Individualism, in the form of the individual action of a person alone in a social milieu, must disappear in Cuba. In the future individualism ought to be the efficient utilization of the whole individual for the absolute benefit of a collectivity. It is not enough that this idea is understood today, that you all comprehend the things I am saying and are ready to think a little about the present and the past and what the future ought to be. In order to change a way of thinking, it is necessary to undergo profound internal changes and to witness profound external changes, especially in the performance of our duties and obligations to society.

Those external changes are happening in Cuba every day. One way of getting to know the Revolution and becoming aware of the energies held in reserve, so long asleep within the people, is to visit all Cuba and see the cooperatives and the work centres which are now being created. And one way of getting to the heart of the medical question is not only to visit and become acquainted with the people who make up these cooperatives and work centres, but to find out what diseases they have, what their sufferings are, what have been their chronic miseries for years, and what has been the inheritance of centuries of repression and total submission. The doctor, the medical worker, must go to the core of his new work, which is the man within the mass, the man within the collectivity.

Always, no matter what happens in the world, the doctor is extremely close to his patient and knows the innermost depths of his psyche. Because he is the one who attacks pain and mitigates it, he performs and invaluable labour of much responsibility in society.

A few months ago, here in Havana, it happened that a group of newly graduated doctors did not want to go into the country's rural areas, and demanded remuneration before they would agree to go. From the point of view of the past it is the most logical thing in the world for this to occur; at least, so it seems to me, for I can understand it perfectly. The situation brings back to me the memory of what I was and what I thought a few years ago. [My case is the] story all over again of the gladiator who rebels, the solitary fighter who wants to assure a better future, better conditions, and to make valid the need people have of him.

But what would have happened if instead of these boys, whose families generally were able to pay for their years of study, others of less fortunate means had just finished their schooling and were beginning the exercise of their profession? What would have occurred if two or three hundred peasants had emerged, let us say by magic, from the university halls?

What would have happened, simply, is that the peasants would have run, immediately and with unreserved enthusiasm, to help their brothers. They would have requested the most difficult and responsible jobs in order to demonstrate that the years of study they had received had not been given in vain. What would have happened is what will happen in six or seven years, when the new students, children of workers and peasants, receive professional degrees of all kinds.

But we must not view the future with fatalism and separate all men into either children of the working and peasant classes or counter-revolutionaries, because it is simplistic, because it is not true, and because there is nothing which educates an honorable man more than living in a revolution. None of us, none of the first group which arrived in the Granma, who settled in the Sierra Maestra, and learned to respect the peasant and the worker living with him, had a peasant or working-class background. Naturally, there were those who had had to work, who had known certain privations in childhood; but hunger, what is called real hunger, was something none of us had experienced. But we began to know it in the two long years in the Sierra Maestra. And then many things became very clear.

We, who at first punished severely anyone who touched the property of even a rich peasant or a landowner, brought ten thousand head of cattle to the Sierra one day and said to the peasants, simply, 'Eat'. And the peasants, for the first time in years and years, some for the first time in their lives, ate beef.

The respect which we had had for the sacrosanct property right to those ten thousand head of cattle was lost in the course of armed battle, and we understood perfectly that the life of a single human being is worth a million time more than all the property of the richest man on earth. And we learned it; we, who were not of the working class nor of the peasant class. And are we going to tell the four winds, we who were the privileged ones, that the rest of the people in Cuba cannot learn it also? Yes, they can learn it, and besides, the Revolution today demands that they learn it, demands that it be well understood that far more important than a good remuneration is the pride of serving one's neighbor; that much more definitive and much more lasting than all the gold that one can accumulate is the gratitude of a people. And each doctor, within the circle of his activities, can and must accumulate that valuable treasure, the gratitude of his people.

We must, then, begin to erase our old concepts and begin to draw closer and closer to the people and to be increasingly aware. We must approach them not as before. You are all going to say, 'No. I like the people. I love talking to workers and peasants, and I go here or there on Sundays to see such and such.' Everybody has done it. But we have done it practising charity, and what we have to practice today is solidarity. We should not go to the people and say, 'Here we are. We come to give you the charity of our presence, to teach you our science, to show you your errors, your lack of culture, your ignorance of elementary things.' We should go instead with an inquiring mind and a humble spirit to learn at that great source of wisdom that is the people.

Later we will realize many times how mistaken we were in concepts that were so familiar they became part of us and were an automatic part of our thinking. Often we need to change our concepts, not only the general concepts, the social or philosophical ones, but also sometimes, our medical concepts.

We shall see that diseases need not always be treated as they are in big-city hospitals. We shall see that the doctor has to be a farmer also and plant new foods and sow, by example, the desire to consume new foods, to diversify the Cuban nutritional structure, which is so limited, so poor, in one of the richest countries in the world, agriculturally and potentially. We shall see, then, how we shall have to be, in these circumstances, a bit pedagogical- at times very pedagogical. It will be necessary to be politicians, too, and the first thing we will have to do is not to go to the people to offer them our wisdom. We must go, rather, to demonstrate that we are going to learn with the people, that together we are going to carry out that great and beautiful common experiment: the construction of a new Cuba.

Many steps have already been taken. There is a distance that cannot be measured by conventional means between that first day of January in 1959 and today. The majority of the people understood a long time ago that not only a dictator had fallen here, but also a system. Now comes the part the people must learn, that upon the ruins of a decayed system we must build the new system which will bring about the absolute happiness of the people.

I remember that some time in the early months of last year comrade Guillên arrived from Argentina. He was the same great poet he is today, although perhaps his books had been translated into a language or two less, for he is gaining new readers every day in all languages of the world. But he was the same man he is today. However, it was difficult for Guillên to read his poems here, which were popular poetry, poetry of the people, because that was during the first epoch, the epoch of prejudices. And nobody ever stopped to think that for years and years, with unswerving dedication, the poet Guillên had placed all his extraordinary poetic gift at the service of the people and at the service of the cause in which he believed. People saw him, not as the glory of Cuba, but as the representative of a political party which was taboo.

Now all that has been forgotten. We have learned that there can be no divisions due to the different points of view of certain internal structures of our country if we have a common enemy and a common goal. What we have to agree upon is whether or not we have a common enemy and whether or not we are attempting to reach a common goal.

By now we have become convinced that there definitely is a common enemy. No one looks over his shoulder to see if there is anyone who might overhear- perhaps some agent from the embassy who would transmit the information- before giving an opinion against monopolies, before saying clearly, 'Our enemy, and the enemy of all America, is the monopolistic government of the United States of America.' If now everyone knows that is the enemy, and it is coming to be known also that anyone who fights against that enemy has something in common with us, then we come to the second part. Where and now, for Cuba, what are our goals? What do went want? Do we or do we not want the happiness of the people? Are we, or are we not fighting for the total economic liberation of Cuba?

Are we or are we not struggling to be a free nation among free nations, without belonging to any military bloc, without having to consult the embassy of any great power on earth about any internal or external measure that is going to be taken here? If we plan to redistribute wealth of those who have too much in order to give it to those who have nothing; if we intend to make creative work a daily, dynamic source of all our happiness, then we have goals toward which to work. And anyone who has the same goals is our friend. If he has other concepts besides, if he belongs to some organization or other, those are minor matters.

In moments of great danger, in moments of great tensions and great creations, what count are great enemies and great goals. If we are already agreed, if we all know now where we are going - and let him grieve to whom it will cause grief- then we have to begin our work.

I was telling you that to be a revolutionary you have first to have a revolution. We already have it. Next, you have to know the people with whom you are going to work. I think that we are not yet well acquainted, that we still have to travel a while on that road. You ask me what are the vehicles for getting to know the people beside the vehicle of living in the cooperatives and working in them. Not everyone can do this, and there are many places where the presence of a medical worker is very important. I would say that the revolutionary militias are one of the great manifestations of the solidarity of the Cuban people. Militias now give a new function to the doctor and prepare him for what was, until a short time ago, a sad and almost fatal reality for Cuba, namely, that we are going to be the victim of an armed attack of great breadth.

I ought to warn you that the doctor, in the function of soldier and revolutionary, should always be a doctor. You should not commit the same error which we committed in the Sierra. Or maybe it was not an error, but all the medical comrades of that period know about it. It seemed dishonorable to us to remain at the side of a wounded man or a sick one, and we looked for any way possible of grabbing a rifle and going to prove on the battlefront what we could do.

Now the conditions are different, and the new armies which are being formed to defend the country must be armies with different tactics. The doctor will have an enormous importance within the plan of the new army. He must continue being a doctor, which is one of the most beautiful tasks there is and one of the most important in a war. And not only the doctor, but also the nurses, laboratory technicians, all those who dedicate themselves to this very human profession, are of he utmost importance.

Although we know of latent danger and are preparing ourselves to repel the aggression which still exists in the atmosphere, we must stop thinking about it. If we make war preparations the centre of our concern, we will not be able to devote ourselves to creative work. All the work and all the capital invested in preparing for a military action is wasted work and wasted money. Unfortunately, we have to do it, because there are others who are preparing themselves. But it is- and I say this in all honesty, on my honour as a soldier- the truth is that the outgoing money which most saddens me as I watch it leave the vault of the National Bank is the money that is going to pay for some weapon.

Nevertheless, the militias have a function in peacetime; the militias should be, in populous centres, the tool which unifies the people. An extreme solidarity should be practiced, as I have been told it is practised in the militias of the doctors. In time of danger they should go immediately to solve the problems of the poor people of Cuba. But the militias offer also an opportunity to live together, joined and made equal by a uniform, with men of all social classes of Cuba.

If we medical workers- and permit me to use once again a title which I had forgotten some time ago- are successful, if we use this new weapon of solidarity, if we know the goals, know the enemy, and know the direction we have to take, then all that is left for us to know is the part of the way to be covered each day. And that part no one can show us; that part is the private journey of each individual. It is what he will do every day, what he will gather from his individual experience, and what he will give of himself in the exercise of his profession, dedicated to the well-being of the people.

Now that we have all the elements for our march toward the future, let us remember the advice of Martí. Although at this moment I am ignoring it, one should follow it constantly, "The best way of telling is doing." Let us march, then, toward Cuba's future.

Surviving the COVID 19 and Reviving the Sri Lankan Economy

It is no secret that our country is facing a very difficult situation. BOI Industries that were in place are at a standstill. Construction activities have died down. Trade is limited to fuel and essential food items. 

by Professor N.T. Sohan Wijesekera

Part 1: Survival

Controlling the Rebellion

The deadly COVID 19 is continuing its devastation of our life styles. Many say that this is natures retaliation for the harm that we have caused because of our greed. The COVID 19 is making us prisoners in our own homes. In this trying period everyone must be told about the “rule of three for survival” and request cooperation.

The nature is exercising its force against a rebellion. The tamed ones will be pardoned, some will be disciplined and pardoned, the rest will be condemned, but not until all rebels are rounded and locked down. During this lock down its important to survive and perfect our mind through the practice of positive thinking.

Food Security

We all are aware that a healthy mind is in a healthy body. I am elated to note the commencement of a cultivation drive by the government of Sri Lanka which has looked at the distribution of seeds, how to plant and use fertilizer etc. This has to be considered from the point of view of an urban dweller, who would have to opt to potted planting which requires pots, soil and fertilizer. Making the condominium dwellers to grow during lockdown situations will also ease their boredom. Ensuring success is in the hands of the agriculturists and other subject specialists. Vegetable cultivation is a vital matter for survival during the lockdown. Growing green leaves must be the first choice because the harvest can be reaped in weeks. The importance of growing from home was sufficiently covered in my previous articles. The key point is for the government to increase television programs etc., to show how to grow vegetables in pots and in the back yard.

However, attention must now focus on the distribution of dry rations, vegetables and fish. This has two aspects. One is the service to the community and the other is the assured income to those who are making a living by supplying rice, vegetables and fish. A poor delivery system and corrupt middle men would not only break the backbone of farmers and the fishermen, but also deteriorate the confidence of consumers. This is the time for the government to establish a lasting food delivery system by winning the faith of consumers, middlemen and producers.

Water Security

Another point that I had highlighted in my previous articles was the water supply. Notice of the National Water Supply and Drainage Board in yesterday’s (4th April 2020) news clearly shows an impending water crisis. The caution by NWSDB indicates that there is a resource crisis. It is likely that this is not about the water in the rivers. State must evaluate the critical items associated with water treatment and immediately issue notices to control the use. Do we know whether we would receive adequate supplies for a reliable delivery of freshwater? If our ship which is stranded in the middle of the ocean has only a limited supply of water, then our options would be to control what we have and commence rainwater harvesting. The public can bury empty plastic bottles with tiny holes to store rain water for farming. Garden soils can be kept moist for plants to flourish. The government must immediately appeal to those with private wells to share their water with neighbours. This would support the supply of water for those who have no access to safe groundwater.

Health Security

The Government along with its armed forces is demonstrating a committed service by supporting the doctors and the health service personnel combating COVID 19. Media reports indicate that the testing, identification and quarantine operations are gathering momentum. Present concern is the support available to regular patients who require hospital services and regular medicine supplies during and after curfew. The government is making a committed trial and error approach with regards to the supply and delivery. It may fervent hope that the delivery services may ensure an equitable distribution before the community starts to panic.

Sinhala and Tamil New Year

Scheduled dates for the celebration of this important event is around the corner. Though most of us have not been told, we are aware of the necessity to let go the celebrations. Video celebration is an option to cheer up during self-isolation. However, most people in the back of their heads must be hoping that they would get the opportunity to do a quick run or they could take leave from essential services to visit their loved ones. By looking at the behavior of Sri Lankans during curfew, this is a very likely event. It would be insane for us to allow such movements during this time. Instead of allowing people to pin hopes, the state must act explicitly. The authorities must take quick action to issue a ruling to postpone any such intended visits to greet their loved ones. This is a time to make sacrifices and the government must decide and declare what is best for the country. Early action is necessary because It is fair to provide sufficient time to accept the solution.

Part 2: Revival

State of Economy

It is no secret that our country is facing a very difficult situation. BOI Industries that were in place are at a standstill. Construction activities have died down. Trade is limited to fuel and essential food items. We do not hear about our exports. Most of the work force is without wages. Rupee is getting devalued. Banks are piling interest on loans. Public is getting worried about a regular income. This is the current situation that needs no calculations to understand the gravity. It is time for the government to impose limits on the bank charges and margins during currency transactions. However, it must be emphasized that this is the time for the economists to move forward from the commonly made “motherly statements” and provide hard numbers by adequately considering the tangible and intangible costs and benefits. They should leave financial analysis to the accountants and carryout economic analysis as eye openers for the president and the cabinet of ministers. This is the time for the economists to show their true colour.

Working from Home

Working from home which commenced in mid-March has now consumed nearly three weeks. It is a time for a postmortem. Concept of working from home originated overseas was imported and applied to our country. It is prudent for us to evaluate the acceptability of this method to our country which is a fresh middle income state. We cannot expect a 100% success. A percentage close to 50% would be a great achievement. Efforts of the state can be seen from the numerous work from home circulars originating from the office of the president. Let us take a moment to perform a situation analysis. This is a data scarce situation. Hence let us discuss the most likely reality.

Working from home to be successful, there should be infrastructure, internet facility, software, data and bandwidth. What percentage of our work force has access to minimum infrastructure? Even a smart phone with sufficient memory is a rarity. Internet and data are still luxuries. We have not attempted methods such as, flexible working hours, working from many offices etc., as precursors to “Working from home”. Therefore, we have to set aside the intention of getting meaningful work from a good portion of our workforce. This is a good time for the government to at least collect data from each and every public and private sector agency in order to make an assessment and then get ready for the future.

For the time being, let us assume that the logistics are in place. Then the next is about “Work”. “Work” must identify the objectives, tasks, intended outputs and time allocations. “Work” needs to recognise tasks that have to be executed by each team member and the temporal sequence of delivery.  This means quantification of efforts. Quantification of efforts will automatically point to the need to evaluation of output quality. According to my knowledge and experience, most Sri Lankan organisations and especially the government and semi-government organisations do not have online task management systems. In many developed countries, each employee should account for their time and deliver quality assured outputs within the agreed time period enabling an organisations to measure performance and improve productivity. In case time targets cannot be met, the teams and organization can carry out performance review and hence improve the delivery

In our country, at least the top management who are conversant and equipped can be asked to list the tasks in hand, prepare time sheets and assign work to each employee. Though this will be a trying exercise, the time is opportune for us to put the place in order. The government must urgently send a directive to all senior managers of Ministries, Departments and Corporations to identify their tasks, human resource requirements and time targets. Tasks and time limits must be assigned at least down to the middle manager level. In a setting where this had not been practiced before, these attempts will act as an eye opener. On the other hand, recognition of work schedules will assure enhanced productivity at places where such systems were already in place. The government can evaluate the agencies that already had such systems and then display those as examples to others.

The Revival

The situation created by COVID 19 will last several months but not several years. During this period the Sri Lankan government must start the recovery. As at present, the reactions indicate that most of us are at a near zero level. In order to reach full recovery, each sector must identify its revised objectives, recognize the tasks, assign resources and commence working. During this “work from home” period if the Sri Lankan government can ensure that the ship is on course then we will definitely win the race to full recovery. The work from home directives discussed above will be the litmus to capture the state of the nation. We would at least know who does the work, how many are there to monitor the progress and whether we have the right Key Performance Indicators in place. We need to carry out a holistic planning exercise or else we will face the Hambantota Harbor syndrome where we had the harbor without ships.

Our revival must be well planned, well directed and carefully monitored. We must carry out adequate brainstorming within all sectors to ensure that they are functioning at critical level and our resources are optimally utilized. At this situation we may not be able to utilize resources optimally. If we attempt to use them reasonably well, then we can easily optimize them under normal condition. We must listen to the pulse of the outside world and act with commitment. We will not be the same world after the COVID 19. Everyone will have to rethink about the meaning of life. We will be assigning much more value to human life and the environment. We will ensure self-reliant systems. In very simple terms, the world will re-look at happiness and will re-define “Happiness”. Containment will be the motto. Under such circumstances we need to find out our options for full economic revival.

A recent report by the Asian Development Bank identifies innovation as the core to development and growth in the Asia Pacific region. It goes on the state that sustained innovation requires an educated and skilled work force. Basic education systems need to provide a mix of hard and soft skills that combine the likes of science, technology, engineering, and mathematics with learning to promote critical thinking, problem solving, and creativity. In this, the importance of on-the-job training cannot be sidelined. Institutions must train their employees to enhance innovative capabilities. The government must evaluate ministerial and departmental plans to ensure such characteristics are adequately embedded. The time is ripe for us to make most of our “work from home”.

Professor N.T.Sohan Wijesekera is a Senior Professor, University of Moratuwa and the Chairman, Construction Industry Development Authority

After The Coronavirus Passes – Will Normalcy Return?

The irony is that now many people look to China in wonder, impressed by the way it overcame the epidemic. American newspapers such as USA Today completely changed their tone, now publishing stories such as “what can we learn from China?”

by Zulkifli Nazim

We are at a pivotal moment in history.

Societies throughout history have faced many epidemics that have shaken the illusion of human control over the planet. Epidemics affect individuals who have experienced the crisis directly, changing large aspects of their personalities. The impact of epidemics extends across generations. The cross-generational impact confirms epidemics not only affect us physically, but they have a huge impact on our personalities psychologically. Since any society is a gathering of a number of individuals, any change incurred on a person leads to the change in the community as a whole since epidemics are similar to wars, leading to transformations of people’s daily habits and wiping out others.

Ordinary diseases, regardless of their seriousness or fatality to patients, may be worse than an epidemic. However, epidemics scare individuals more. This is because we are affected by the feeling of uncertainty associated with the possibility of developing an organic disease to feeling that what awaits us is unknown and mysterious. Fear of the indefinite affects the entire community, and this increases with rising numbers of victims. The scenario of panic aggravates whenever no vaccine is suitable to eradicate an epidemic.

The unknown in the case of epidemics becomes gloomier and even murkier as the epidemic approaches the individual’s circle. In the case of organic diseases, a person feels fear for himself only, but in the case of epidemics, the person does not know whether he is the next victim of the epidemic, or any member of his close circle, such as children and family members.

At the time of an epidemic, human behaviour consists of two extremes: rationality and irrationality. In times of tranquility and serenity, man can hide his irrationality and restrain it as much as possible, as this helps him with his daily routine. Yet, in the case of epidemics the routine fades, logic and lucidity sits in the back seat and irrationality holds the steering wheel. By then, the individual wears glasses of fear and anxiety, and proceeds to do what he previously denied. Getting rid of modern lifestyle and resorting to traditional methods in which he thinks only of himself, and of securing his basic needs for the longest possible period, even at the expense of others.

Besides, communities always get into a state of fear of the unknown with every pandemic, regardless of technological development. For example, the scientific and technological potentials of mankind today cannot be compared to what was available to human beings at the time of the outbreak of the plague or cholera. In the case of COVID-19, people are terrified by the novelty of the epidemic and the lack of information about it.

The corona pandemic may be the first global epidemic that has caused this big death toll, but it is not the first epidemiological pandemic.

During this wild time, we’re all in need of some good news. But what we’re in need of more than good news, is real good news. The first claim is that China was able to close down its last emergency temporary coronavirus hospital as the number of new cases has diminished. This claim is legit. China has in fact closed down all of their temporary hospitals, including the ones in Wuhan.

It appears that China has managed to take control of the epidemic, or at least to dramatically reduce infection rates. The attitude towards the spread of the virus in China, which as it was expressed only a month ago in endless belligerent and arrogant statements by Western politicians and public officials. These statements ranged from condescension to pleasure at someone else’s misfortune were inundated with expressions of unconcealed hostility towards China, and each misstep was touted as proof of its government’s incompetence. All this was accompanied by a wish to see the downfall of the Asian superpower.

The irony is that now many people look to China in wonder, impressed by the way it overcame the epidemic. American newspapers such as USA Today completely changed their tone, now publishing stories such as “what can we learn from China?”

All 42 official Apple retail stores opened on Friday, 27th April, although some stores had special business hours. It shut the stores in mid-February, as China put several cities on effective lockdown in a bid to contain the virus.” Going back to the original keyword search, multiple articles from “the Business Insider”, “The Verge” and “CNBC” all confirm this.

The Wall Street Journal also admitted that the tough measures employed by China in response to the virus cast doubt over conventional wisdom regarding the way infectious diseases should be dealt with.

In retrospect, the steps taken by China were indeed draconian, but steps taken now around the world, especially in Israel, are also quite brutal. Like for example : monitoring of cellphones and every form of communication, where these methods will require an invasion of citizens’ privacy. For many, this seems a necessary step given the gravity of the crisis. But when this is added to a policy encouraging reporting of quarantine violators and to serious restrictions on leaving homes, there is concern that we are sliding towards an unbridled technological monitoring of citizens, which could set a precedent for future crises.

The Post-Corona World

The current situation in China reminds us of what life will look like after the epidemic is defeated, or after its peak is behind us.

The Post-Corona world will be very different from what we have previously known. After the Corona crisis, the world will change, governments will suffer, strong economies will falter and international alliances may disintegrate while other coalitions will emerge. Perhaps the phrase “the world beyond corona” is now frequently used.

Many people also suffer doubts about their surroundings; people doubt their abilities to survive due to the mass media coverage and warnings that this epidemic is uncontrollable, especially as this disease has no medical treatment so far and the soonest vaccine would be available within 6 months to a year as western experts believe. Thus, the state of suspicion and fear of the unknown is similar to going to war without seeing an enemy. Such war is not governed by logic or reason. The only way to finish this ordeal is to find a medication and people stick to precautionary and preventive measures.

Moreover, many are trying to find solace, comfort and consolation in religion, in search of treatment or tranquility. However, this does not necessarily mean that the curve of religiosity in society rises at the time of the outbreak of epidemics, but people resort to faith and religiousness to help them resolve their issues and get away from the reality. Somehow people are convinced that they need religion, and that they are in urgent need of the tranquility that religion gives them, as people do not know what tomorrow holds for them. So they must draw a line somewhere between beliefs and reality. Disruption is happening; but that doesn’t have to mean it’s bad. It is at times like these, we start to see a bit of truth.

To sum up, many people may return to religion to alleviate the tragedy caused by the epidemic, believing that God sent the affliction as punishment, and that when they turn to Him, He will wipe out the plight. This is similar to the AIDS cases which spread around the world in the early 1990s, when major transformations in the beliefs of people had taken place, with many of them resorting to religion in a bid to treat what is impossible to be treated by modern technologies and medicine. This direct link between obedience to God and the epidemic confuses people when the epidemic is prolonged, lasting longer than expected, forcing many to enter into an internal struggle.

We need to go back in time and refer to our thousands of years of history, literature, virtues and knowledge to decide what we want the next version of our society to look like.

Superstition and Science in Midst of Covid 19

In the age of reason and knowledge, the significant concomitant is not superstition but religion-the religion of love and compassion in action.

by Ananya S Guha

And we are back to it again. Superstition. We are asked to light lamps and candles for nine minutes at 9 pm. What is so propitious about the number nine? Earlier on we were asked to beat drums and sound conch shells to drive the virus away. The danger with superstition is that it plays to the gallery and draws masses thereby generating ignorance. The last time in response to the Prime Minister’s call people came out in numbers which is potentially inimical given the contagious nature of the corona virus. So the lockdown on that Sunday could have turned virulent among groups. Wasn’t that taken note of?

The question is how will lighting lamps help to tackle the fight against the disease? Keeping our homes dark how will that combat the virus? This is baffling embattled as the whole world is in the crisis. This is also obfuscating science with superstition, when doctors and health care workers are battling it out, when scientists are striving to cohere scientifically methods to contain the virus in India and the world over, when the WHO is articulating preventive measures, when again the media is relentlessly propagating such measures for the benefit of the public.

In times of such crises in the world don’t we also have to think of the economy, the poorest of the poor, the daily wage workers who are starving? Shouldn’t our thoughts rivet to such people and money or provisions should go to them immediately? But superstition goes down well with both the literate and the illiterate. Should we not mingle politics with caution? What I am saying is that this is a humanitarian crisis, the poor need cash and food and not the sound of gongs. If this is a symbolism then I am sorry to say, in the given crisis it is misplaced. The need of the hour is to contain the spread of the virus, which we are doing in the country with a oneness; marvellously, and then monitor it minute by minute. And the economic fall out should be measured, antidotes worked out pragmatically. The poor and the suffering should be uppermost in our minds.

In the age of reason and knowledge, the significant concomitant is not superstition but religion-the religion of love and compassion-in action.

This is not the time to propagate the formal religion of the majority. Some say that the number nine echoes Hinduism, Nav Ratri. Could be correct. Commingling formal religion with scientific attempts to fight the virus only leads to irrationality because superstition comes in , others belonging to different religious groups may not accept this. Also people who believe in a scientific approach to combat diseases or sickness of such proportions. What might be worse is that people might again come together to light lamps. We saw last time how they transgressed rules. India is a vast country there will always be some over enthusiastic misguided people. Superstition can play havoc and have deleterious effects in a time when the whole world is trying to fight with ferocity the community outbreak of this dreaded virus.

It is unfathomable why this has been urged upon the citizens of the country, instead health workers must be constantly lauded and pepped for risking their lives for us.Staying twenty one days locked up is a torture but we all realised that this must be done for the common good, in the midst of a veritable war. Rather what the people need is mental succour and encouragement. While the intention of our Prime Minister is good the constant allusion to do something which is superstition does not gel with the science which needs to be invoked to prevent the virus to spread to community proportions. What should be done at this stage is to remind the people of such hazards. We have seen what has happened as a result of the Islamic meet in Delhi. At a time when we were controlling the virus this was discovered and in one day statistics catapulted. The Nizamuddin episode was grossly negligent and uncalled for. It put the clock back at a time when our health and social workers were fighting valiantly.That too was superstition in the guise of formal region when the world and India was wracked by the corona virus.

To sum up we need knowledge, a scientific temper with love to fight this malaise. The latter is demonstrated by individuals and NGOs who have come out in numbers to help the needy, the poor and the starving, the street people, the rickshaw pullers and the daily wage earners. Our doctors are constantly reminding us of what we should do and what we shouldn’t. The media is facilitating this admirably. But superstition and irrationality may only ignite that dreaded community backlash, the fear of the virus afflicting at the community level and by implication- killing.However in all fairness this has come on a Sunday, a day observed as a holiday by all in our country. This perhaps works as a balancing factor but the play off between science and superstition still remains.

Can newspapers survive Covid-19 pandemic?

As the pandemic infected over 3000 Indians with over 100 casualties, its immediate impact was observed over the circulation of newspapers in Mumbai where the vendors ceased to work because of Covid-19 menace.

by Nava Thakuria

As an unprecedented lockdown continues in India, the newspaper groups face an uphill task to maintain its devoted readership. The complete shutdown, to continue till 14 April 2020 next
because of Covid-19 pandemic, instantly prevented the vendors to deliver morning newspapers at reader’s doorsteps as rumour spread that the paper itself could carry the novel corona virus even forced many publishers to drastically reduce their circulation figure.

As the China originated deadly virus started smashing almost all the countries on the planet resulting in affecting over a hundred thousand people and casualties up to few thousands, Prime Minister Narendra Modi came to front to lead the fight against the deadly virus. Modi in a televised address to the billion-plus nation on 24 March announced the lockdown break the chain of infection so that the spreading of Covid-19 can be prevented in the large country.

As the pandemic infected over 3000 Indians with over 100 casualties, its immediate impact was observed over the circulation of newspapers in Mumbai where the vendors ceased to work because of Covid-19 menace. Managements of all print media houses after a meeting with Brihanmumbai Vruttapatra Vikreta Sangh resolved to suspend publications for some time. The decision finally resulted in no newspaper day for the residents of Mumbai as well as Thane, Pune, Nagpur etc.

However, managements of The Times of India, The Indian Express, The Hindu, Hindustan Times, Mid-Day etc made it clear that even though no physical editions would hit the stands on account of the new-found restrictions their newspapers would be thoroughly available in the internet. Many media houses started sharing the PDF version of complete newspaper free of cost. Journalists have also been extensively used for the purpose.

Acclaimed news magazine Outlook, RSS mouthpiece Organiser, sports magazine Sportstar, Manipal’s weekly Taranga, Hindi daily Mahanagar with few others have already suspended print editions. Most them vowed to continue their digital versions for the readers. The voice of ethnic Indians in USA, Gopal Raju’s 50 years old weekly India Abroad also faced the same fate on 29 March.

Soon after Mumbai the wave reached Bangalore, Hyderabad, Bhopal along with Guwahati, Imphal, Agartala, Aizawl in northeast India, where readers missed their favourite morning newspapers as the local distributors decided temporarily to shut their works scaring the deadly virus. Guwahati newspaper-hawkers’ association, Manipur hawkers’ association, Tripura and Mizoram based newspaper vendors separately came out with the resolution that they would not distribute the newspapers for some days.

The region with a population of over 60 million supports over 50 morning dailies in different languages including English, Hindi, Assamese, Bengali, Boro, Meitei, Karbi, Khasi, Mizo, Nagamese, Nepali, etc. Few viral posts on the social media identifying newspapers as a potential career of corona virus created panic to hundreds of newspaper agents and hawkers along with other media employees. Many families collectively prevented the vendors from delivering newspapers in the localities.

World Health Organization (WHO) has however asserted that newspapers remain safe to touch by anybody even though the corona virus can live on a surface for several days. The papers used in print media outlets are produced in highly automated mills and the process hardly needs human hands. Moreover, the likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes Covid-19 from a package that has been moved, travelled, and exposed to different conditions and temperature is also low, it added.

From Sylhet (Bangladesh) to Colombo (Sri Lanka), Rabat (Morocco) to Rome (Italy), Vatican City to Jordan, Oman, Yemen capitals along with American cities like Pittsburgh, Seattle, Missouri, West Virginia, Lewisburg etc witness the temporary suspension of newspaper productions. Those media outlets have already committed for entering into the digital platforms completely.

The largest democracy in the world today supports over 82,000 registered newspapers with a cumulative daily circulation of 11 crore estimated to be a Rs 32,000 crore (5 billion USD) industry. As India has been improving its literacy rate up to 75 percent, more citizens now develop the capacity and resources to access newspapers and digital forums. More middle class Indian families now start using the internet for various activities for the first time in their lives. So advertisement revenues, earlier meant for traditional media, have slowly shifted to digital platforms.

Prior to declaring the 21-day nationwide lockdown to fight against Covid-19, Modi who did not bother to interact with news media groups prior to the sudden announcement of demonetisation (2016), abrogation of Article 370 from Jammu & Kashmir (2019), paving ways for the citizenship amendment act 2019, had managed to talk to some selected media barons in the country. The participants proudly offered suggestions to Modi over the issue.

Even Union information & broadcasting minister Prakash Javadekar issued a statement asking everybody nobody not to believe in rumours. ‘You will not get infected by reading newspapers. There is just one rule to follow- wash your hands after doing any work’ stated Javadekar, who used to work as a professional journalist, adding that newspapers have tremendous credibility and those can play a constructive role in the time of crisis.

Understanding the heat of changing social engineering, various print media houses opted for boosting their presences in the digital media. As millions of Indians now start using smart phones with internet connectivity, the media owners come to the realization that they would now prefer to get all necessary and almost free news contents from the digital platforms rather than paying for newspapers or even news channels. So the advertisers have also substantially shifted their focus to the digital media space.

It needs not to be reminded that a newspaper in India is sold in the market at a lower price than its actual cost. The deficit (also profit) is managed by the commercial advertisers. They want a newspaper to reach more people (with a price or even without it) so that their products get necessary visibilities. Minus circulation, the advertisers would not support the newspapers anymore. So the inability to distribute newspapers (even it is duly published) simply means the shrinkage of advertisements for print media outlets.

Moreover, traditional advertisers of newspapers from the sectors like automobile industry, construction, home appliances, private education, travel, hospitality, etc have faced the shutdown equally and once the people lose the affording capacity for such items at least for the next few months, the advertisers would restrict their resources. Finally the newspapers may have to significantly depend on government advertisements only in the post-corona period.

The situation can emerge alarming for regional newspapers like those published from Guwahati, Imphal, Agartala, Aizawl etc, as the owners may not be able to sustain their publications for a longer period. It would directly impact the employees including thousands of scribes in the region. A number of media bodies came out with statements against the rumour that newspapers can carry the corona virus and also requested the concerned governments to support the media houses to deal with the situation.

Earlier a host of Guwahati based media houses including Asomiya Pratidin, The Assam Tribune, Dainik Janambhumi, Niyomiya Barta, Dainik Asom, Amar Asom, Purbanchal Prahari, Sadin, The North East Times, The Meghalaya Guardian, etc made a collective statement that there is no scientific proof for newspapers carrying the corona virus to the readers. The managements claimed that a section of electronic and social media outlets spread the incorrect news.

But strongly countering it, many social media users put a challenging question to those media houses if they could assure their valued readers of authenticated, credible and balanced news here after ! The world would return to normalcy fighting against Covid-19 after some months, but would the traditional media houses in the region ever get its dedicated readers back in the post-corona era, a difficult question to be pondered at this hour!!

The author is a Guwahati, India based media activist

Redefining vulnerability in the era of COVID-19

Vulnerable groups and health inequalities are also evident in developed countries.

What does it mean to be vulnerable? Vulnerable groups of people are those that are disproportionally exposed to risk, but who is included in these groups can change dynamically. A person not considered vulnerable at the outset of a pandemic can become vulnerable depending on the policy response. The risks of sudden loss of income or access to social support have consequences that are difficult to estimate and constitute a challenge in identifying all those who might become vulnerable. Certainly, amid the COVID-19 pandemic, vulnerable groups are not only elderly people, those with ill health and comorbidities, or homeless or underhoused people, but also people from a gradient of socioeconomic groups that might struggle to cope financially, mentally, or physically with the crisis.

The strategies most recommended to control the spread of COVID-19—social distancing and frequent handwashing—are not easy for the millions of people who live in highly dense communities with precarious or insecure housing, and poor sanitation and access to clean water. Often people living in these settings also have malnutrition, non-communicable diseases, and infectious diseases such as HIV/AIDS and tuberculosis. In South Africa, 15 million people live in townships where the incidence of HIV is around 25%. These immunocompromised populations are at greater risk to Covid-19. Another concern in African countries is that the response to COVID-19 will come at the expense of treating other diseases. For example, in the Democratic Republic of the Congo, the response to Ebola resulted in the resurgence of measles.

The effect of the policy response on children in the fight against COVID-19 is also a concern. On March 23, UNICEF reported that in Latin America and the Caribbean over 154 million children are temporarily out of school because of COVID-19. The impact of this policy is more far-reaching than just the loss of education—in this region, school food programmes benefit 85 million children, and the UN Food and Agriculture Organization assessed that these programmes constitute one of the most reliable daily sources of food for around 10 million children. Questioning whether appropriate evidence exists to support the reduction of transmission through school closures, Richard Armitage and Laura Nellums considered the long-term risks of deepening social, economic, and health inequities for children in a letter published in The Lancet Global Health. A 2015 UN report analysing the socioeconomic effects of Ebola in Africa also highlighted the increased risks of pregnancy in young girls, school dropout, and child abuse.

The most vulnerable children are part of families in which parents have informal jobs and are not able to work from home. This predicament is particularly concerning in countries like India, where over 80% of its workforce is employed in the informal sector and a third of people work as casual labourers. In socioeconomically fragile settings, a lockdown policy can exacerbate health inequalities and the consequences need careful consideration to avoid reinforcing the vicious cycle between poverty and ill health. Human Rights Watch has reported that the lockdown in India has disproportionately affected marginalised communities because of the loss of livelihood and lack of food, shelter, health, and other basic necessities. Under this unprecedented challenge, governments must be mindful that strategies to address the pandemic should not further marginalise or stigmatise affected communities.

Vulnerable groups and health inequalities are also evident in developed countries. The USA is a stark reminder of the divide that exists in countries without a universal health-care system. For people who do not have private medical insurance, this pandemic might see them face the choice of devastating financial hardship or poor health outcomes, or both. During the 2009 H1N1 influenza pandemic in the USA, individuals with poorer health outcomes were those in the lowest socioeconomic groups. This same group of vulnerable people have now been caught in the middle of a major health emergency as a result of long-standing differences in affluence.
While responding to COVID-19, policymakers should consider the risk of deepening health inequalities. If vulnerable groups are not properly identified, the consequences of this pandemic will be even more devastating. Although WHO guidance should be followed, a one-size-fits-all model will not be appropriate. Each country must continually assess which members of society are vulnerable to fairly support those at the highest risk.

Courtesy: The Lancet - Editorial