Invisibility and futures during the pandemic and beyond
28 July, 2021 | Developers f1000 |
This blog has been shaped by a recent high-level engagement on the role of social sciences and policy research towards COVID-19 response across Africa.
Since the wake of the COVID-19 pandemic, African communities have experienced diverse challenges. The pandemic has challenged health arrangement effectiveness in different countries and tested the responsiveness of existing multisectoral systems designed to mitigate its effects.
The pandemic has hit hardest those who are most vulnerable. People with disabilities, poor and single-headed households, women, and children, have received a disproportionate share of shocks resulting from measures designed to curb the spread of infection; these measures create specific vulnerabilities among those whose social and economic activities are brought to standstill. Informal traders, taxi operators, day labourers, women and youths involved in road-side businesses, have seen their businesses halt. In effect, both the pandemic and the measures designed to control it have created new vulnerabilities while escalating pre-existing ones.
Although most efforts are tailored to biomedical and public health responses of disease containment, inability and/or unwillingness to attend to vulnerabilities generated and magnified by the pandemic reduce the overall effectiveness of the interventions, and vitiated principles of equality upheld in theory by governments. Social interventions such as locking down people en masse, closing, or limited numbers in social spaces like schools, religious gatherings, and weddings and funerals, weaken social protection and support mechanisms. Fear of the unknown reinforce individual inward-looking responses, as COVID-19 patients and their families are stigmatised [i] [ii]. Experiences of past pandemics – HIV/AIDS, Ebola, and SARs — in most African countries highlight the ways in which pandemics escalate existing vulnerabilities and create new ones, while the COVID-19 pandemic has tested societal readiness to mitigate the effects on structurally vulnerable populations. Although interventions effectively mitigated these effects in some settings, such as in Rwanda [iii], this is not the norm. While many countries, including Uganda, Nigeria and Kenya, drew lessons from past interventions and adopted multi-sectoral interventions, they also fell short due to lack of attention to age, gender, disability and other underlying structural concerns.
Pandemics and their management render certain populations invisible and normalise institutional and structural violence. Responses to the COVID-19 pandemic using both existing and new interventions reveal that women and young people, people with disabilities, those in the informal sector, and those whose services are locked down, remain invisible to national and regional structures designed to plan and implement response guidelines. Pandemics invoke dehumanising responses: herding people into zones and forcing them to remain at home; criminalising people’s movements and associations [iv]. In most cases, this happens without any responses to mitigate the effects or mitigations come late, in insufficient amounts, irregular in supply and ineffective in distribution. Such populations are often side-lined from priority setting and implementation processes, thus forcing them to retreat into positions of resistance and subterfuge. What then remains of the future of these invisible populations after pandemics?
The policy choices a country makes during a pandemic reflects the way in which society values people who are marginalised, and the direction of the nation’s core interests and values. Policy options in pandemics often highlight which sections of the population are left to suffer, whose lives are most valued, and which sections are privileged and so cared for. In Judith Butler’s terms, invisible populations are rendered ‘ungrievable’ because they were never recognised as existing [v]. Neutrality is an illusion, a tool that conceals and silences that on which society places lesser value, seeks to control and subjugate. Yet policies normalise institutional and structural injustices against the populations it renders invisible.
Tools of population power are blind to pandemics. Even in death, resources procured in the name of the poor are appropriated by those privileged to be in positions of authority. Often times, African scholars blame ‘weak institutional arrangements’ for corruption, and suggest strengthening systems as the panacea [vi][vii]. Yet, resources spent in the name of institutional strengthening are also betrayed by appropriative practices. This perspective negates the reality that sometimes, corruptive tendencies are cultivated into an institution’s work. In countries like Rwanda, where strong systems served the vulnerable, the values cherished by the leader seem to be reflected in the way institutions work.
As
new viral strains escalate the pandemic and lockdowns, and fear and anxiety are
normalised with each phase, the dignity and life futures of invisible populations
rest first on the ability of policy makers to reimagine, in time, the
worst-case scenarios across all population groups to prevent this from
happening. Second, restoring their dignity requires rediscovering a sense of common
humanity when planning and implementing responses, and third, invoking
leadership in designing and implementing strategic interventions in the binding
spirit of collective welfare. Above all, reducing vulnerability requires constantly
reflecting on and learning from pandemics responses with an ear on the voices
of plight, an eye on the sights of the sufferers. Empathising with those who
are underprivileged builds a robust system in which all lives matter in equal
measure.
[i] Divya Bhanot, D., Singh, T., Verma, K. S., and Sharad, S. (2021). Stigma and discrimination during COVID-19 pandemic. Frontiers in Public Health 8:577018. doi:10.3389/fpubh.2020.577018.
[ii] Turner-Musa, J., Ajayi, O., and Kemp, L. (2020). Examining social determinants of health, stigma, and COVID-19 disparities. Healthcare 8, 2: 168. doi:10.3390/healthcare8020168
[iii] Phillips, D.E., Bhutta, Z.A., Binagwaho, A., Boerma, T., Freeman, C. M., Hirschhorn, R.L., Panjabi, R. (2020). Learning from exemplars in global health: a road map for mitigating indirect effects of COVID-19 on maternal and child health. BMJ Global Health 5: e003430. doi:10.1136/bmjgh-2020-003430
[iv] Levine, S. and Manderson, L. (2020). The militarisation of the COVID-19 response in South Africa (#WitnessingCorona). Medical Anthropology/Medizinethnologie, Curare: Journal of Medical Anthropology, the Global South Studies Center Cologne, and boasblogs. https://www.medizinethnologie.net/the-militarisation-of-the-covid-19-response-in-south-africa. [Accessed 8 July 2021].
[v] Butler, J. (2015). Precariousness and grievability—When is life grievable? https://www.versobooks.com/blogs/2339-judith-butler-precariousness-and-grievability-when-is-life-grievable. [Accessed 8 July 2021].
[vi] Bratton, M. and Gyimah-Boadi, E. (2016). Do trustworthy institutions matter for development? Corruption, trust, and government performance in Africa. Afrobarometer Dispatch No. 112, 23 August. https://afrobarometer.org/publications/ad112-do-trustworthy-institutions-matter-development-corruption-trust-and-government. [Accessed 8 July 2021].
[vii] Gossel, J.S. (2018). FDI, democracy and corruption in sub-Saharan Africa. Journal of Policy Modelling, 40 (2018) 647–662. https://doi.org/10.1016/j.jpolmod.2018.04.001. [Accessed 8 July 2021].