COVID-19

Healthcare frontliners struggle with stigma in Bangladesh

A representational image.
A representational image.Reuters file photo
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Novel coronavirus has spread like a wildfire among health workers including physicians, nurses, hospital’s lab technicians and cleaners in Bangladesh. In many districts, almost half of the infected people are health officials. Bangladesh’s healthcare system is already fragile. And now, the suffering of the frontline fighters from COVID-19 crisis has dangerous repercussions.

Lack of protective gear and the questionable standard of the existing personal protective equipments, lack of training, and the overall mismanagement in the healthcare system were identified as major causes behind COVID-19’s swift spread among the frontliners. However, one of the most apparent, but less discussed and deep rooted causes is ‘stigma’, which is responsible for this state of the healthcare community. And this situation has already jeopardised the healthcare system in Bangladesh.

Lack of protective gear and the questionable standard of the existing personal protective equipments, lack of training, and the overall mismanagement in the healthcare system were identified as major causes behind COVID-19’s swift spread among the frontliners.

We are well-known for a very special characteristic. If we fail to defeat someone by logic, we instantly move to smirch the person’s character. And we resort to certain words to tarnish our opponent’s character. Most common terms of these are ‘atheist’, ‘infidel’, ‘characterless’, ‘adulterous’, ‘dissolute’, etc. Again, in a so-called progressive society, being religious is also a ‘crime’ of similar magnitude. The point is, tainting someone with any of these identities which bear negative social connotations. The specific identity to be attributed depends on the nature of that society we live in.

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People have a lot of identities depending on their ethnicity, nation, religion, ideology and so on. The propensity to defeat someone by imposing a specific identity under specific circumstance is not a new phenomenon. Social stigma begins with this propensity. Prominent sociologists like Emily Durkheim and Ervin Goffman provided the theoretical basis of social stigma. When politics is mixed with social stigma, things get more complex. This leads to the politics of stigmatisation.

There is a relationship between this politics of stigmatisation and COVID-19. In turn, it has a connection with the spread of COVID-19 among the health workers. It requires understanding the identity politics in an endeavor to understand how this process actually works. Celebrated economist Amartya Sen in his book ‘Identity and Violence: The Illusion of Destiny’, stated that people have numerous identities. Identity is not a fluid concept. It varies depending on time, space and context. To put it with simple terms, when we live in Europe or America, our Asian identity becomes well-suited. Similarly, if we are living somewhere in Asia, our identity as Bangladeshi becomes stronger.

Again, if we are in Bangladesh, the regional identity gets priority, be in Mymensingh, Chattogram, Sylhet or Rangpur. In this vein, the identity of particular upazila, union, village, clan, and family gets priority. Besides, we have myriads of personal identities like gender, class, religion, ideology and so many things.

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In the same fashion, when someone fall ill with any disease that also becomes the person’s identity. People with similar ailments feel solidarity with each other. It would not be surprising if we see them get together under a banner of an organisation. Bangladesh Diabetic Society can be a case in point. This happens following exactly the same formula as of identity politics.

Therefore, people’s identity is boundless. But the problem arises when a certain identity is imposed upon someone with a bad intention, for say, stigmatisation. And when this happens, it can lead to the creation of violence towards that particular identity holder. Violence is not only about beating and bloodshed. Depriving someone from his or her human rights is also violence. Rather, this structural violence of depriving people from their natural rights and human rights is much dangerous and deeper than the physical violence.

Therefore, people’s identity is boundless. But the problem arises when a certain identity is imposed upon someone with a bad intention, for say, stigmatisation. And when this happens, it can lead to the creation of violence towards that particular identity holder. Violence is not only about beating and bloodshed. Depriving someone from his or her human rights is also violence. Rather, this structural violence of depriving people from their natural rights and human rights is much dangerous and deeper than the physical violence.

To make structural violence understandable, we can resort to the example of NRC and CAA of India. This arrangement was orchestrated to make people of certain religion fall into the prey of structural violence by nullifying their legal rights of citizenship, which will pave the way for physical violence as well.

This is also applicable to the plight of the Rohingya people in Myanmar who took shelter in Bangladesh after being ousted from their homeland. First they were denied their citizenship rights (structural violence), and then the physical violence followed suit.

The same thing happened with the COVID-19 patients. Whenever we found out that someone is affected with COVID-19, we have tainted them with stigma and eventually turned them into ‘untouchables’. The structural violence of depriving their natural rights started with that process. We see the symptoms of structural violence when house owners threatens to oust suspected COVID-19 patients from their flats, children were thrown to the streets, nobody comes to the aid of ailing people to take them to hospital. Even if they are taken into hospitals, the rights of medical treatment is denied. More shockingly, they do not even receive a proper funeral after their deaths.

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The fear psychosis that was derived from these situations leads to the tendency of concealing COVID-19 symptoms. With this concealment, COVID-19 affected people helped spread this virus among others. Although everyone is exposed to this deadly respiratory disease, the health workers are directly affected as they are the primary contacts for the patients. It brings out a usual consequence: increased isolations and quarantines of the health officials and the dramatic rise in the numbers of hospital lockdown.

COVID-19 is no longer a biological issue. It has rather become a bio-political one. The role of ideology is an addition to this crisis that has complicated the issue further. Chinese people were the victims of this situation around the world. In our country, we first stigmatised those who came from China, then it turns around to the people returned from Europe and the US. Now, we are using this bio-politics to the people of our own country, especially people from the places where the number of COVID-19 patients is quite high such as Dhaka, Narayanganj, Gazipur, Munshiganj, Narsingdi, etc.

Our trait is that we don’t accept our faults and try to impose these on someone else. There is no surprise to see the psychology of dependence among the populace like us who were repressed by the foreign rulers for a very long time. To the population of this kind, the only thing they own is the tendency of depending on others and the mentality of imposing blame on others to get relief from own guilt. And the rest of them just copy.

And so the inevitable has happened in a society like this. It is much easier to impose blame on the COVID-19 affected people by stigmatising them and making them untouchable rather than sharing the burden of being aware and abiding by the rules of maintaining social distance in this time of coronavirus crisis. If the blame can be imposed successfully on COVID-19 affected people, then our gathering in the tea stalls, roaming in the streets and all other normal acts can go on without interruption.

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When society rejects an individual, that individual also rejects that society, at least subconsciously. That is why people with COVID-19 symptoms hide it from the doctors while visiting hospitals. Lots of people are not even willing to go through COVID-19 tests despite having the symptoms, because this society where they belong to, will not show any sympathy towards them once they have been diagnosed. It will rather arrange everything to expel them from society.

This cycle of rejection, society’s rejection of the individual and individual’s rejection of the society, hampers that very society in the end; because when the health workers are affected with COVID-19, it is a matter of fact that the rest of the people will also be affected gradually. It ensures that whatever possibility of getting health services we had in our fragile healthcare system, will also be difficult to avail any longer with the decrease of number of health workers and the rising the number of hospital lockdown. This situation denies the health services not only to the COVID-19 affected people, but also to the patients suffering from other diseases.

Now the decision is ours as how long we will continue stigmatizing COVID-19 affected people and bring further calamity down upon us. This is not a revolt against human tyranny that we can be motivated by rebel poet Kazi Nazrul Islam with his line like this: “Mrittu ke daak jibon paane” (invite deaths towards life); rather this situation requires following something like Jibon ke daak jibon paane (invite life towards life).

*Khalilullah is an assistant editor at Protichinta. He can be reached at khalil.ullah@prothomalo.com.

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