The spread of coronavirus COVID-19 across the world has been accompanied by an explosion of activity on social media as people have tried to make sense of the implications of the virus and the speed of change. But the story that is emerging amid the chaos has failed to draw attention to the effect of the virus on low-income groups, making visible a radio silence on the plight of those in the Global South in particular. We need to break the silence to ensure the implementation of inclusive responses and a widening of the narrative beyond that of the privileged, write Lize Swartz and Josephine Valeske.
Following the progression of the coronavirus on news and social media from within the Netherlands, we have witnessed a worrying parallel development: a focus on the immediate economic effects of the crisis, including financial losses; reports of panic buying that have fueled further panic and anxiety; and the effects of quarantining on personal life. In the higher income households of Europe, social distancing and isolation are no more than an inconvenience for many, and one of the biggest concerns among young adults seems to be the boredom that will hit when being forced to stay at home for two weeks. For others it will be the lack of freedom of movement, the inability to travel for leisure and business or do things for pleasure.
Thus, two sides of the virus have become highlighted: either inconvenience through social distancing leading to eventual recovery, or death of the vulnerable as an impact of the virus itself. The ‘middle’—the physical suffering the virus will bring, rooted in pervasive structural socio-economic inequalities, has not sufficiently been discussed. The pandemic uncovers the effects of decades of neoliberalism undermining the welfare and healthcare systems all across the world. But in the Global South as well as in intentionally forgotten places in the Global North like the refugee camp Moria on Lesbos, the suffering will assume another dimension altogether.
There is still hope that low-income countries can avoid the pandemic, with Africa having put travel bans on Europe, China, and the US in a powerful twist of the discriminatory global visa regime. But if the coronavirus hits impoverished countries with high levels of social inequality and inadequate public health systems that still suffer the effects of (neo-)colonialism, that inequality will increase. For the vulnerable, the coronavirus will not be just an inconvenience, leading to loneliness or a temporary loss of income—it will likely cause untold suffering. The virus may result in the death of the physically vulnerable, including undernourished children and adults, or those with tuberculosis or Aids.
While it is true that the elderly across all income groups are experiencing the highest mortality rates, it is likely that young people in low-income groups will experience higher mortality than those that are wealthy, as is the case with influenza. A study by the University of Edinburgh found that the level of access to healthcare is associated with <65 year-olds’ influenza mortality rates. Deaths are not just numbers, but real experiences resulting in trauma and emotional distress.
Furthermore, often it is the suffering before possible death that strikes us hardest. Wealthier residents in the Global South, as many people in the Global North, will be able to self-isolate by withdrawing into their own lives, surrounded by high walls—properties where they can live in relative comfort for a few weeks, waiting for the storm to pass. Their place of safety is others’ place of danger. In informal settlements, isolation is not possible, where toilets and taps, where and if they are available, are shared. It is here where several people are crowded into a single room, sharing beds, utensils, space. It is here where diseases including tuberculosis spread more quickly. The suffering of those who cannot distance themselves socially, whose houses are not necessarily homes, or who do not have a house with a door and four walls, needs to be emphasized. The suffering of those who usually wander the streets during the day and now have to be confined into what might become a death trap.
When the time for isolation comes, not only will it be impossible in densely populated areas, it will become devastating. Many workers survive from their daily wage, living hand to mouth. Those without a choice will have to go to work, and the virus will spread. The dependence on public transport, particularly buses and trains, in developing countries should not be negated. Wearing a mask won’t help if you’re crowded into a small space. And as horrible as working with a fever and breathing troubles sounds, it might still be better than what will happen if the governments declare shutdown and sentence the extremely poor to go hungry for days or even weeks.
In addition, school feeding programmes for many children provide the only nutritious meal that they get each day—or the only meal they may get. Staying away from school can be devastating for families who cannot afford to feed their children, both in the Global South as also in places like New York City, which hosts 114,000 homeless children. And impoverished people who cannot afford private healthcare will have to wait in queues in clinics and at hospitals for free medicine—to the extent that they are accessible or proximate—increasing their risk of exposure to sickness.
Perhaps the worst of it all, however, is that for many low-income groups in the Global South, the physical effects of the pandemic and the sudden confrontation with death by illness are not at all as novel as they are for us in the rich countries. Death and suffering from communicable diseases is much more common in the Global South than in the North (see figure below). The daily death count of “poor people’s diseases” such as tuberculosis and malaria are at present much higher than those of the coronavirus, but these illnesses, often easier to fight than the novel virus, are usually forgotten―as are their victims.
The coronavirus is threatening to sharpen divides both intra- and internationally, not only revealing differences in adaptive capacity based primarily on socio-economic circumstances that affect individual responses to the virus, but also highlighting ignorance regarding the constant high level of exposure of vulnerable groups to communicable diseases. The very silence about these inequalities perpetuates them. Strong responses are sorely needed, including ongoing pressure to ensure that interventions are inclusive and target vulnerable groups first instead of focusing on the business sector.
Moreover, individuals need to break the silence by directing their gaze outward, away from their own societies, to reshape the narrative of the crisis by driving the focus away from the privileged who continue to dominate sense-making processes and who are dampening or silencing the voices of others in the process. And finally, it should not be forgotten that what wealthy societies are facing now has been the daily reality for many around the world, and that our imperial gaze often prevents us from recognizing this.
This article is part of a series about the coronavirus crisis. Find more articles of this series here.
About the authors:
Lize Swartz is a PhD researcher at the ISS focusing on water user interactions with sustainability-climate crises in the water sector, in particular the role of water scarcity politics on crisis responses and adaptation processes. She is also the editor of the ISS Blog Bliss.
Josephine Valeske holds a MA degree in development studies from the ISS. She is currently an intern at the Transnational Institute in Amsterdam and the blog manager of the ISS Blog Bliss. Her reseach interests lie in the areas of aid, corporate accountability, and social and economic justice.