In my previous post I argued against the imposition of further “lockdown” measures to address the rising number of COVID-19 cases in areas of South Africa. This has seemed to be a dissenting view when compared to what is the reported policy direction of government to address the resurgence of COVID-19 in areas of South Africa.
I was, however, encouraged to read an article “Call to Action: A people-centred approach to disease prevention in the era of COVID-19” published in the Daily Maverick of 30th November 2020 penned by Yogan Pillay and Tracey Naledi. The article echoes many of the sentiments that I have expressed in articles over the preceding months. They refer to an article entitled “Reclaiming comprehensive public health” published in the British Medical Journal Global Health, which forms the basis of the “Call to Action” released by the “Reclaiming Comprehensive Public Health Group” motivating for an equitable and effective COVID-19 response. The authors of the BMJ Global Health article cite two approaches adopted by governments to COVID-19 one which “views the people as right holders who should actively be engage in proactive interventions” and the other where “people are seen as objects of relative technical, biomedical command and control interventions”.
While I may differ with of the certain views expressed in the BMJ Global Health article, I strongly support a more people-centred approach to the COVID-19 pandemic and its impact on South Africa. In the media it is reported that the National Coronavirus Command Council (NCCC) has or will determine the further government responses to the rising number of COVID-19 infections reported more especially from the Eastern and Western Cape. The NCCC consisting of politicians but ostensibly taking expert advice reinforces the militaristic “Command and Control” ethos that has characterised the manner in which the pandemic has been managed in South Africa. It also, in my opinion, is the reason why communities have become increasingly resistant to adhering to restrictions imposed in this manner. Notwithstanding the magnitude of corruption that has characterised aspects of the government response to the pandemic, the disastrous consequences of initially utilising the military and police to enforce a lockdown of citizens in a most draconian manner with arrests and even fatalities has eroded the necessary trust between government and the people to ensure adherence to the measures required to limit the spread of the COVID-19 virus. It is concerning when despite this some again promote the utilisation of a law and order response to the upsurge of COVID-19 infections.
While the “Call to Action” may still in my view focus too strongly on the public health aspects of the response to the pandemic, I have added my support to the “Call to Action” and would encourage others to do the same. In particular, I would echo the call for a people-centred and people-lead approach which would engage rather than enrage the people of this country. During my recent visits to hospitals in three provinces located in poorer communities, the lack of adherence to the wearing of masks and social distancing in the areas surrounding the hospitals clearly illustrated to me that people living in these communities have not bought into the messaging in this regard from Government. Messages contained in an address from the President, a Premier or MEC while important are inadequate without the strong support from community-based organisations to ensure that there is understanding and buy-in to the need to adhere to what is required to contain the spread of the virus. Communities must be engaged with clear messaging reinforced again and again at community level rather than enforced in a heavy handed manner by the imposition of fines and even arrests as occurred previously in some instances during phases of the previous lockdown.
The citizens of South Africa are not soldiers in a military “Command and Control” environment who can be given an order which they must obey, a fact that seems to have been ignored by the policy makers. In fact, the somewhat painful media briefings by senior politicians that characterised the early months of higher levels of lockdown, supported the impression that the policies were being implemented and enforced in a topdown manner. Concerns raised were peremptorily brushed aside by individuals who had the least to lose with their livelihoods and positions safely protected while the poor and the vulnerable were left to fend for themselves despite reassurances of financial support, outlined in impressive global figures by politicians, which failed in many instances to reach those most in need.
Given this reality, a concerted effort is needed to regain the trust of the people. Engaging civil society in the broadest manner will be an important first step. Listening to the people and ensuring that livelihoods are protected and indeed restored will go some way to achieving this goal. In a South African context, measures that further destroy livelihoods in whatever sector of the economy cannot be considered in a country with an unemployment rate that is in excess of 50% and where the economy, to put it politely, is in tatters. Communities should be persuaded through community-based organisations to adhere for the common good to the most basic measures to restrict the spread of the virus. As I have indicated earlier let government engage rather than enrage, persuade rather than command and in doing so return to a government sensitive in word and deed to the plight of the ordinary citizen.
“Call to Action: A people-centred approach to disease prevention in the era of COVID-19” Daily Maverick https://www.dailymaverick.co.za/article/2020-11-30-call-to-action-a-people-centred-approach-to-disease-prevention-in-the-era-of-covid-19/
“Reclaiming comprehensive public health” BMJ Global Health https://gh.bmj.com/content/5/9/e003886.full
““Reclaiming Comprehensive Public Health A Call to Action” https://www.healthysocieties2030.org/reclaiming-comprehensive-public-health
