RAM SEEGOBIN, with contribution of Lindsey Collen, for LALIT
The fight against the novel coronavirus is exposing some contradictions in the way people see health and illness.
The first contradiction is the difference between preventive and curative health outlooks. Since there is no cure for Covid-19, then obviously the only method to fight it is through preventive means.
Some countries have completely neglected this very important preventive aspect of medicine, and have instead concentrated for decades on curative health, often as a business, e.g. the USA. That country, for all its “development”, is having trouble fighting against the spread of the coronavirus. In countries like Mauritius, where there is still some degree of collective memory of preventive health eradicating an epidemic, we may in the long run have a clear advantage in this fight against coronavirus. It is proving quite a tough nut to crack.
Clearly, the fight against the coronavirus depends mainly on the whole population being informed in a very intelligent way. It also depends on a constant battle against rumours – innocent or malignant – and against the temptation towards sensationalism in some of the media – written or spoken.
Informing people properly is part of developing a “will”, a “collective will”, in the people, so that all the necessary preventive measures are embraced voluntarily and adopted actively. And to do this fast because the disease spreads fast. People should want to adopt the strict personal hygiene measures, want to maintain social distancing and strict confinement. And to do this out of their own free will.
We certainly must not depend on repression as the recent regimes in Mauritius have done for everything. For measures to be significant, they have to be adopted actively by the population, not through fear of police repression.
In Mauritius we have one advantage, an historical advantage, that many other countries do not have.
There is still the historic memory of the fight against malaria and its almost total eradication in the late 1940s and early 50s during colonial times.
Mauritius was selected by the WHO for this first-ever eradication campaign world-wide, partly because the mortality rate from malaria was so high here, and also because Mauritius is one or two islands. This meant complete eradication was theoretically possible. And then a malaria-free country could be maintained by “trace-and test” methods.
This historic memory has translated into physical infrastructures that, even up to now, 70 years after the successful eradication of malaria, are still here for all of us to see all the time. We see them as we come through the airport and are visited the next day by someone from the Biro Saniter, who takes a blood sample if we have been anywhere near malaria. We watch as teams of “malaria men”, the government labourers who clear stagnant water on the banks of streams and drains where mosquitoes might breed, work.
Apart from this physical infrastructure, there is also an almost subconscious culture around the concept of public health that persists until today. Let me explain.
Many, like the elites in most countries, have been conditioned by liberal capitalist ideology not even to see “public health”. Public health has come to mean just that small, unnoticeable bit of the health system that is neither private nor commercial.
In fact, the concept of “public health” is a very clear idea of health measures that aim at the “public good” and “health for all”. It is about health. The emphasis is very far from the drive over the past decades towards expensive, high tech medicine and treatments designed to combat an individual’s illnesses – if he or she can pay – which is about illness and about profit – for insurance and drug company owners, as well as owners of clinics. It is to do with sickness, not health.
Now, I’d like to share some distant personal memories involving this public health fight against malaria which, at the time, was a real epidemic in Mauritius. The rich, like the poor, suffered terrible illness. It was the main cause of death. There was no good treatment.
So, how did the public health fight work? At that time in the 1940s and 50s, there was no TV. There was just the Mauritius Broadcasting Service. People used to share radios: children and whole families would gather around the one magical box in the neighbourhood. There were many more people then who could not read.
So, how was the “collective will” to eradicate the mosquitoes that transmit malaria developed? Especially with an unpopular colonial regime in power?
The “will” was, to a large extent, created through the school system. Primary teachers gave daily talks to the children in their class. The children were encouraged to ask questions and to understand how the spread of malaria could be stopped by preventing malaria parasites from reproducing themselves, to be able to move from mosquitoes to us, humans, and back again. (This is the same kind of predicament we are in today: how to stop the coronavirus from reproducing itself, by moving from one person to another, and using our cells?)
So, children developed the “will” to fight the malaria. At my Brown Sequard Government School in Curepipe, all of us spent one afternoon every week going along streets and into vacant lots, gathering empty cans, broken bottles and anything that might store water, and putting them in jute bags for disposal. We understood that stagnant water was the thing to be cleared to stop the cycle of reproduction of the malaria parasite. Parents learnt from, inter alia, the children. This was how, for example, in areas full of bamboo hedges, adults became conscious, often through their children, of the fact that cutting the bamboo haphazardly between the nodes, though easier, was, in rainy regions like Curepipe, creating ideal breeding ground for mosquitoes in the water collected inside the cut bamboo. People then cut bamboo at the node.
Rich people, in the days of malaria, did seek individual solutions. They moved, for example, to cooler areas in the high plateau where there were less malaria infested. They put up mosquito nets. This individual approach worked for no-one, and is not a way to fight an epidemic. Malaria continued to kill rich and poor alike.
It was the mobilization of the whole of the people that worked.
This was reinforced by “Inspekter Saniter” in the Health Department going door-to-door regularly to enquire whether any household member had a fever. These public health officials are, in Kreol, wittily called “marsan lafyev”.
The mobilization against malaria that was finally achieved by the eradication of the mosquitoes that transmit the disease, had been further reinforced by the development of the “political will” that was growing in the drive towards Independence, led by the Labour Party, IFB and others. So, although Public Health measures were set up by the British Colonial Administration that was repressive and unpopular as a regime, it was the Independence movement that embraced the campaign and gave it the necessary steam to win. The people took the campaign over.
In that way, the population began to develop this necessary “will” to eradicate malaria. The discipline was not imposed by the colonial state, let alone the police.
But there is another level of understanding necessary, an international level.
The World Health Organization was founded in 1948, as part of the United Nations system set up in 1945 with a Charter that was against colonialism. And one of the WHO’s first campaigns was this campaign to eradicate malaria in Mauritius. So, the “political will” was further nurtured by these new institutions that codified the international movement to end colonization. This was how the adults could co-operate to eradicate malaria, as part of their working class and national liberation struggles against the colonial regime.
Obviously Covid-19 demands a different set of actions from people – mainly isolating ourselves although we are all social beings – but it also involves us developing the intellectual capacity to distinguish between the political regime of Pravind Jugnauth’s MSM-ML organizing the campaign and the more social aspects of the State like the Public Health doctors and other workers. It also means that, though two-thirds of people did not vote for this regime in November, the fact that this regime is demanding the confinement measures does not mean it is the wrong measure.
We need to respect the confinement “modord” because it is in the interests of the whole people, because it is in the interests of our shared public health. Just as the mosquito-fighting measures were applied, not because the colonial regime organized them, but because it was in the interests of the whole people.
And we start with an advantage: we have 70 years’ experience of the one thing the WHO says works against the spread of Covid-19, and that has worked in China, South Korea and one village in Italy that tried it: “trace-and-test”. Our “marsan lafyev” system is already up and running and doing a good job.
Now, it depends on us getting the “political will” built up to maintain strict social distance, hand washing, and not touching our faces. This is why LALIT has signed up, for example, to the common platform with the unions, so that this public health struggle joins up with the struggle for a better society as we come out of the crisis.