Nov 09, 2020

Is Sri Lanka on a blind track?

In this major health crisis that shattered the already crumbling horribly corrupt economy, a responsible Opposition that does not agree with how the government is handling the COVID-19 pandemic, would not be wasting time throwing jibes at government ministers and leaders. This new Opposition led by its ever-rhetorical leader Sajith Premadasa is nowhere near a politically intellectual leadership to critically challenge the government’s approach. While they allege the government had failed the People, the whole Southern Sinhala opposition including the JVP have failed too.

COVID-19 remains the main cause of the devastating economic fallout. COVID-19 has dismantled global and local supply and distribution chains and has shut down many economic activities. Thus, “control and prevention” of COVID-19 as a pandemic is also about reviving the shattered global and local economy. For Sri Lanka with no capacity to meet even interests on debts, it is also about geo-political conflicts we are caught in.

Bankrupt and incapable

We were almost bankrupt when COVID-19 was first reported in late January. President Gotabhaya Rajapaksa was compelled to decide on a two month long island wide curfew and lockdown from late March. The military high command was brought as head of the presidential Task Force Committee to control the spread of COVID-19.

Slipping from bad to worse in a nauseatingly corrupt free market economy where over the past decades health, education, transport and common utilities were commodified for private profit, these public services could not face up to the challenges of a hitherto unknown pandemic. Medical professionals and the pharma industry promoted curative healthcare with heavy investments and sophisticated equipment at the expense of community level preventive healthcare. State sector refrained from being a competitor was totally incapable of meeting COVID-19 demands; increase PCR testing in high risk areas, increase capacities for intensive care in hospitals and accommodate increasing numbers for individually confined quarantine. With no real time answers to the economic crisis, government was unable to bring in new resources and improvements to existing public health facilities.

Firm regimented military control with the island wide 02 month lock down from mid March during the first wave could only provide a short respite for the government to claim successful control of the COVID-19 spread. Relaxing curfew after almost 02 months created a social mindset the country was getting back to normal. From countrywide elections to numerous festivals, restaurants and cinema halls opening with “reality shows” on TV creating an easy-going popular mood, the whole society was relaxing and factories had also relaxed. All the while in a gradually relaxing society, “asymptomatic virus carriers” were also increasing.

No marching to safety

The second wave of the COVID-19 pandemic swept across the Western Province (WP) the major economic plateau of the country in just three weeks. In those 03 weeks “positive cases” were reported in almost 20 of the 24 districts in the country. That compelled the government to clamp down curfew in WP for the 03 day long weekend immediately after US Secretary of State Mike Pompeo’s departure on 28 October. This was extended by a week, annexing more areas from Ratnapura, Kurunegala and Kegalle districts.

This brings up the question, “can regimented control of people’s daily life through commands and directives issued from Colombo, control the COVID-19 spread? On 04 October addressing the introduction of the “Stay Safe” digital platform for tracking “contacts” and movements of COVID-19 infected people, President agreed “People cannot be controlled by merely imposing a curfew” and lockdowns are not the answer. He said people should go about their daily work, but act with responsibility respecting health guidelines as the country cannot afford to stay locked down.

No country can live locked down holding the economy at a standstill. Therefore, it raises two serious questions that need precise and pragmatic answers. First, with curfews and lockdowns removed, what should the approach be in controlling COVID-19? Second, how do we plan to revive the economy without lockdowns despite COVID-19?

What's "normalcy" anyway?

Beginning with revival of the economy, the global spread of COVID-19 took no time in dismantling the entire global market. The “Congressional Research Service” in its update over a week ago on 27 October 2020 on “Global Economic Effects of COVID-19” notes, “Estimates so far indicate the virus could reduce global economic growth to a rate of -4.5% to -6.0% in 2020, with a partial recovery of a rate of 2.5% to 5.2% in 2021.” It then goes on to say, “The economic fallout from the pandemic could also risk continued labor dislocations as a result of lingering high levels of unemployment not experienced since the Great Depression of the 1930s and high levels of debt among developing economies. The human costs in terms of lives lost will permanently affect global economic growth in addition to the cost of rising levels of poverty, lives upended, careers derailed, and increased social unrest. Some estimates indicate that 100 million to 110 million people globally could enter extreme poverty as a result of the contraction in the global economy. Global trade could fall by an annual amount of 9.2%, depending on the depth and extent of the global economic downturn, exacting an especially heavy economic toll on trade dependent developing and emerging economies.”

Despite those very authoritative estimates on global economic downturn there is yet efforts to revive the neo liberal economy. Efforts to get back to “normalcy” there was before COVID-19. This is being seriously questioned in new discussions on international economic forums. “Normalcy” should not be the world that was pre COVID-19 they say. “Normalcy” in pre COVID-19 world including Sri Lanka is about an intolerably corrupt neo liberal global market that led to (1) Environmental devastation (2) increasing of social and economic inequality (3) increasing ethno-religious polarisation (4) perverted democratic rule leading to authoritarianism whether by elected governments or not (5) marginalising of the poor and minority communities and for countries like Sri Lanka (6) piling up massive, unpayable foreign loans.

Writing to World Economic Forum “COVID Action Platform”, Klaus Schwab Founder and Executive Chairman of the World Economic Forum that meets annually in Davos, says among many other things, “But other shibboleths of our global economic system will need to be re-evaluated with an open mind. Chief among these is the neoliberal ideology. Free-market fundamentalism has eroded worker rights and economic security, triggered a deregulatory race to the bottom and ruinous tax competition, and enabled the emergence of massive new global monopolies.” And he accepts, for sustainable development of the planet, it's vital our recovery prioritizes “new, greener ways to do business.”

His “greener ways in doing business” sounds very much about (1) safeguarding environment and collectively respecting the Paris Agreement (2) eliminating socio economic inequality with economic inclusivity and (3) the State made a decisive factor in governance through “participatory democracy” as argued by those who disagree with “normalcy” in pre COVID-19 world.

We therefore have to now fix our economic crisis including debt servicing with a totally new economic model. We now have to programme to address perennial issues in rural economy; subsistence farming, underutilised land and labour, lack of modern post-harvest technology and value addition. That needs People’s participation in local planning and answers the second question on the economic future in the context of the COVID-19 pandemic.

Got to fix it differently

Now to the first question; if not commands, directives and centralised regimented approach, what other? It should not be forgotten that from 1930’s onwards all epidemics including Malaria, Cholera, Small-pox, Filaria, Polio etc., were totally eradicated from this country through 1950’s to early 60’s with Community Health given all due importance and responsibility. An achievement, the WHO still have mention. It was an era when public health system was the only health system for the People with no private sector health industry working for profits. Medical doctors and dictates from Colombo were not what played a critical role in winning the trust and confidence of the people in eradicating these epidemics. They were carried out by Public Health Inspectors, Mid wives (then) and Sanitary Board Inspectors at community level working with the Medical Officers of Health (MoH).

First and foremost, the solution is not about regimenting society and controlling people. It is all about winning people’s trust and confidence that commands, dictates and “Apps” from Colombo cannot garner. Many stories about lack of and refusal to provide information and the coercive treatment of people transported for quarantine and PCR tests, spell out reasons why people prefer to avoid the “command and order” preventive method.

Instead we need to adopt a programme that could win the trust and confidence of the People in controlling COVID-19 outbreak. That is possible by bringing in health staff at community level, the People are familiar with, creating space for People’s positive engagement.

We have therefore to equip and authorise the office of the MoH in the area as the main co-ordinating and COVID-19 preventive centre. In a society that has 50 percent plus females, on principle and in practical terms it should be made compulsory to include Family Health Midwives in all visits to homes and when testing a female. Led by the MoH who should be available in the field as the overall Supervisor, the programme should;

01. immediately provide a 03 day familiarising programme at provincial level on the medical aspects of COVID-19 and on public relations to all PHIs, Family Health Midwives and GSN officers.

02. In every GSN division, every household should be provided with necessary information on COVID-19 control and prevention with assurance their privacy and dignity will not be tampered with

03. High risk areas with large numbers of confirmed cases and “contacts” should have their borders closed, left isolated without lockdowns and limited activities allowed as decided by the MoH

04. PHIs should immediately start recording from all residents above 45 years details about High BP, Heart ailments, Diabetes, Cancer and similar sicknesses that are health wise useful

05. Once a week, PHIs should conduct PCR tests in a random sample in every GSN division

06. PHIs should provide a weekly status report on every GSN division as an update from the previous week

07. All data, information and status reports should be digitally stored in the office of MoH in a user-friendly format

08. Every MoH office should have a dedicated telephone number for people to contact when urgently necessary and to obtain any information necessary

09. Every province should have a Co-ordinating Committee for COVID-19 Prevention headed by the Provincial DGH including District and Divisional Secretaries, Medical Superintendents, DMOs and MoHs meeting fortnightly to assess the situation and should thereafter brief the media on latest developments.

D Democratising of the State is therefore necessary, as that would be the only way to effectively carry out COVID-19 prevention campaign with people’s support and engagement. Effective control of COVID-19 is necessary and cannot be avoided for an economic revival programme, if the government is determined to do away with curfew and lockdowns. In short, getting back to “normalcy” with an inclusive, growing national economy is not possible, unless People become active players in COVID-19 prevention. Thus, the two questions on COVID-19 prevention and economic revival have only one answer. It is “a stronger democracy with People’s participation”. And that perhaps is how geo-political uncertainty could be answered too.

Kusal Perera

08 November, 2020