by Helen Tindall and David Bell
Humanitarianism in Southeast Asia in the Age of COVID-19
Humanitarian: “a person involved in or connected with improving people’s lives and reducing suffering”.
~ Cambridge English Dictionary.
Health: “a state of complete physical, mental and social well-being and, not merely the absence of disease or infirmity”.
~ Constitution of the World Health Organisation, 1946
Over the past 18 months the largest humanitarian agencies on earth have replaced the delivery of crucial assistance with an obsession over a single virus. This is having increasingly devastating consequences for the world’s poorest, who rely on these powerful organisations to defend their right to health and, often, material access to health or social care. Abject poverty has escalated to lethal levels. Communities are disempowered and sabotaged by an obsessive focus on COVID-19, manifested in lockdown policies and now coerced vaccination.
Global humanitarian organisations are well aware that the main determinants of health and mortality include income, food security, educational opportunity and healthcare access. Yet the World Health Organization (WHO), national donor agencies and private philanthropies, such as the Bill and Melinda Gates Foundation, are enthusiastically supporting pandemic response measures that, by design, negatively impact these levers of health. Abrogating prior pandemic guidelines, lockdowns disproportionately impact the poorest in society. Mass vaccination, rather than targeted programs, exacerbates this harm, diverting further resources from diseases that impose higher health burdens.
These harms are playing out starkly in Asian and African countries with relatively low COVID-19 burdens and notoriously authoritarian governments. On the receiving end are individuals, families and communities that leading institutions once claimed to support. The impact is on millions – but best understood through stories of individuals who have been abandoned. Here are some from Southeast Asia:
Deaths of despair
In personal reports from contacts involved in local communities, those attributed as Covid-19 deaths are prohibited a funeral ceremony. Few crematoria are willing and permitted to receive bodies labelled as such. Families pay extortionate amounts of cash to have Covid-19 removed as cause of death in order to bid farewell to loved ones appropriately. This is open to exploitation by any medical doctor with a propensity for profiteering in difficult times, in systems already immersed in corrupt practices. It has been observed that up to six people in hazmat suits often accompany one body, with only two handling the body, but all six receiving payment for their undertaking services.
Communities have been disempowered by mandates which frequently remove their means of survival. It is a well-known phenomenon that in disempowered communities, young people kill themselves – as described by Sir Michael Marmot. Suicides, like many other harms, are poorly reported and frequently anecdotal. While reported rates are rising in some countries, in others data must be patched together from stories on the ground.
When a subsistence business is banned, there is no social net – all is lost. During an eight-year close association with one of the countries Helen has lived and worked in, including three years working with local governmental and non-governmental health agencies, and while volunteering in impoverished communities, she had never once known of a single suicide case. In one week in June 2021 three cases of young male suicide, two successful and one attempt, were reported by friends. A few weeks prior, the body of a young man found hanging from a tree could not be released to his family until the Covid team had arrived to swab his nose. Only after the negative rapid test result was known were his family permitted to access the body and make funeral arrangements.
Removing life-sustaining health access
In another community “Matt”, in his mid-twenties, HIV-positive with drug resistant tuberculosis, could no longer access his medications, a problem predicted by global organizations overseeing HIV and TB management. Over a number of months, Matt became emaciated and unwell. When his illness finally appeared urgent enough that he agreed to seek some sort of care, he and his sister were turned away from multiple health care facilities “because of Covid”.
Removing access to food
Malnutrition-related deaths occur in poor nations at the best of times due to deep-seated poverty. Catastrophic food insecurity is increasing across the globe according to the United Nations, with lockdowns and disruptions having pushed another 118 million people into severe food shortages. Malnutrition deaths hit the poorest communities who live on daily wages and informal markets. With lockdowns, they no longer have a means to ensure their survival.
Sam and Mary, in their sixties, lived in a bamboo-floored makeshift hut and relied on scavenging for vegetables to sell along the roadside. As lockdowns imposed strict stay-at-home orders, they lost their capacity to find enough nutrition for survival. Hunger slowly devoured them until one morning in June 2021, Mary did not wake up. Their children, who live nearby, took her body to the local dilapidated temple to arrange cremation. The incinerator was irreparably broken, so they were turned away and unable to find an alternative affordable solution. Upon arrival back home with Mary’s corpse, their children were confronted with Sam’s dead body. They were forced to take out a loan for a plot of land on which to bury their parents, and are now indebted for years to come.
Abandoning the elderly
Protecting the elderly is the mantra of the pandemic. But it did not protect Jack. In his eighties, Jack became bed-ridden with gout and back pain, slipping into unconsciousness. No hospital would allow his family to stay and attend to care, as is necessary in Jack’s country, and doctors would not conduct home visits “because of Covid”. Barbed wire was used to barricade people into neighbourhoods, preventing movement. His adult daughters had to abandon their own families in order to provide care in his home. Jack, now with pressure sores despite their efforts, remains abandoned by the state health system at the behest of the WHO.
Shifting the blame
Attributing societal harm to ‘Covid’ is a false premise. It is not ‘Covid’ that prevents access to care, not ‘Covid’ that closes markets, not ‘Covid’ that closes schools and not ‘Covid’ that starves people. The virus causing COVID-19 kills less than 3 people per thousand infections and rarely affects the young. In many low-income countries most people may now be immune. It is the response – lockdowns – that has prevented ordinary people at very low risk of COVID-19 from going about their normal activities. A response that runs completely contrary to previous pandemic guidelines and is full of inhumane mandates, but which ‘humanitarians’ have stridently pushed.
Who are these humanitarians?
Staff qualifications and experience varies widely, and are sometimes at odds with the service positions they hold in impoverished nations. Their Western education is held in high esteem, regardless of how inappropriate to context it might be.
Many expatriate staff of humanitarian organizations in impoverished countries lead lives of luxury, far beyond what they could afford in their home countries. Large houses in the best neighbourhoods, cheap domestic help and access to swanky social establishments are common-place. Others call picturesque Swiss neighborhoods home, on tax-payers’ aid budgets. They live subsidized lives, stay in chic hotels and travel Business Class. With these privileges should come responsibilities. At a bare minimum, their guiding principle should be “do no harm”.
People generally join these organizations with good intent. However, their ideals are blunted as they become cogs in a machine, ‘trapped’ by comforts such as education subsidies and accumulating pensions, burdens most would wish to share. But they travel, they see, and they know what causes suffering and death.
Our appeal to humanitarians
Enacting quality public health measures requires reading the evidence rather than merely complying with authority. When employers act in apparent ignorance of such basic principles as “first do no harm,” by instituting policies bound to promote mass malnutrition, inequality, increased risk of child marriage and human trafficking, silence from their staff is unacceptable. This silence signals collaboration and their compliance equals culpability.
Humanitarian principles of delivering life-saving assistance with compassion, impartiality, neutrality and independence have underpinned the work of these organisations for decades. Many claim advocacy and social justice as foundational principles. Evidence-based pandemic plans clearly laid out interventions that were worthwhile and humane, rejected those considered ineffective or harmful, and emphasized ethics. In 2020 these guiding principles and plans were abruptly abandoned in favour of a totalitarian approach, driven by the Western wealthy and ignoring local data. A neo-colonialist approach that is enriching the already rich. Jack’s family now face the state police coming door-to-door to demand at least one household member submit to the WHO’s ’COVAX’ vaccination – in what can only be described as the final abandonment of the WHO’s basic principles of community participation in healthcare.
Whom are these lockdown policies designed to help? Not the vulnerable elderly. Not their children or grandchildren. They all need to eat, to access care, to work to support their futures. Now-abandoned principles of freedom of choice and a holistic view of health underpinned the formation of the WHO and modern humanitarian organizations. In order to begin rebuilding credibility and trust, the individuals within these global organisations will need to regain a conscience and remember why they are there.
Photo by Fernando @cferdo on Unsplash