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Abstract
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... We are beginning to take stock of the social, economic, and political fallout that will follow as the virus surely spreads, with colder weather, to the global and geographic south. We are witness to: mediatization of the pandemic; closing of schools and universities, libraries and museums; cancellation of conferences and smaller meetings; and loss of income for people who run stalls and street-side services and work in the informal economy. Political leaders and managers are under enormous pressure as they must decide what to keep open, what to close, what workers to keep, and who and when to retrench. The fear and panic come less from the risk of infection and more from the growing reality of its fall out.
Medical anthropologists have contributed substantially to understanding the impact of epidemics and pandemics, their effects on social and economic life, and their toll on health services and health workers. In recent decades, in monographs and articles, we have attended to HIV, including on how people drew on historical imagery of the plague, and how fear of infection fed social exclusion and discrimination (for reviews, see Briggs 2005; Parker 2001; Schoepf 2001). More recently, we have analyzed the spread, global efforts, and impact of SARS (Mason 2012), H1N1 influenza (swine flu) (Atlani-Duault and Kendall 2009; Leach and Tadros 2014), H5N1 (avian flu) (Høg et al. 2019), Ebola (Benton 2017; Moran 2017) and zika (Gray and Mishtal 2019; Stellmach et al. 2018); and attended to local outbreaks of diseases, many assumed to have been historic – cholera, measles, mumps, hepatitis, and more. What is unprecedented with this current pandemic of COVID-19 is not its scale, but the reaction of nation-states to contain viral spread.
In their article on anthropologists’ engagement in policy settings with Ebola, Martineau et al. (2017) describe the attraction of anthropological expertise on funerary practices, and the perception of the significance of “culture” in this regard, but the dismissal of anthropological insight on home care. While anthropologists were considered to contribute uniquely to understanding the care of dead bodies, the care for sick people was not seen as subject to “cultural” norms and sensitivities.
“Culture” was always included in popular discourse and media accounts of Ebola. This is not so for coronavirus disease 2019, named COVID-19 to disassociate the disease from Wuhan, China, where viral infection was first identified. COVID-19 appears to be outside of culture. Yet the institution of quarantine practices, lockdowns, and border controls, and the insistence on adherence to hygiene practices (handwashing) highlight how human practices and behaviors are implicated, and foreshadow a global humanitarian crisis as community transmission takes hold in global south communities. Here, manifold risks are tied to the poverty of infrastructures and resources (Satterthwaite et al. 2019). Consider the potential rapid spread of the virus with co-sleeping in cramped living quarters, poor ventilation, poor or absent hygiene and sanitation, water shortages and broken taps, and the lack of capacity for householders but also institutions (including local health centers) to provide soap and hand sanitizers. Consider the impact on community health workers, and the challenges that they face, in trying to manage pneumonia in older villagers when transport and district level services are miles away. Or consider the wildfire spread if (when) COVID-19 takes hold in informal settlements and slums in South Africa, Kenya, and Nigeria, cities like Rio de Janeiro and Mexico City, and cramped refugee camps in east Africa, Turkey, Jordan, Bangladesh, and Pakistan. In such settings, COVID-19 will capitalize on structural violence (Farmer 2006) and vulnerability (Quesada et al. 2011), in which context people are at high risk of infection, vilification, and social exclusion.
It is tempting to ask what the world would feel like had governments responded to other global health disasters – gender-based violence, climate change, war, poverty, HIV/AIDS, or hunger – with such vigor. The burden on public health care systems globally would arguably have been ameliorated, to some extent, had world leaders and celebrities tweeted their infections like many have done with COVID-19. But in South Africa, the first cases of the virus were diagnosed in urban townships, the possible result of residents having been exposed to the virus in more affluent households where they are employed as domestic workers, gardeners, and nannies. The likely transmission from privileged to underprivileged bodies is the nightmare scenario we must all attend to. The extent to which this mode of transmission has not tarnished the affluent with stigma is striking.
China has led the way in demonstrating the value of dictatorship in containing viral spread. The first wave of viral infections that spread from China to Europe and North America fueled the news making industry without leaning into the logic of stigma, discrimination, or blame. The closing of ports of entry in South Africa cannot, for instance, be conflated with the rise of xenophobic violence in the country. The same cannot be said for the US where the closing of borders and emerging policies of developing a vaccine only for US citizens plays into Trump’s eugenicist tendencies. Had the virus first been detected in a context of what James Quesada calls “structural vulnerability” (2011), our hunch is that renewed metaphorical punishments and iatrogenic discourse might have held sway. Thus, global efforts to identify a vaccine, promote “social” distancing, shut down ports, and stem wide assemblages of economic activities and public life are happening in a new context of a new restraint away from blame (cf. Farmer 2006) ...
Language: en |