INSIDE LABOUR: What the coronavirus can teach us about basic healthcare
It has been widely speculated that the world will never be the same again after the Covid-19 pandemic. Perhaps so, but, then again, perhaps not.
After all, the political, economic and social system that has matured globally in various forms over the past few centuries, has shown a remarkable ability — like viruses — to adapt, mutate and survive.
Perhaps the future will see the spread of the authoritarian, statist model of China, meaning more of the same, only more rigid. Or it could herald the early dawn of a more democratic and caring social order. What will be lies in the realm of speculation.
But such speculation has arisen because the pandemic has brought to the surface a number of reasons why the present system requires change if we are not to repeat the same cycles all over again.
In the first place, it has been more clearly highlighted than ever before, how integrated the world is; how, within hours, let alone days, travellers can reach the farthest corners of the globe, carrying with them more than they bargained for.
And Covid-19 has shown itself to be no respecter of class, caste or social position, being carried, for the most part, from its apparent source in China, by members of the jet set and cruising class. Government ministers, diplomats, sports idols and domestic workers have all fallen prey to the disease.
However, it has also been officially estimated that probably 98% of those who contract it will survive; most at risk being the elderly and those with compromised immune systems. But, in the absence of a vaccine, all that can be done is to try to limit the spread of the virus.
Buffoonery and denialism
At national and international levels, with the exception of the buffoonery in the United States and the attempts at denialism in countries such as Turkey, there has been generally sound advice given, centred on hand washing, the use of sanitisers, avoidance of close contact and self isolation. But such advice only makes sense for those individuals with a decent roof over their heads and who are fit, healthy and well nourished. And they are likely to survive even if they fall prey to the disease.
Unfortunately, this is not the lot of the working class in much of the world, including South Africa. Sanitisers and self isolation would simply be beyond the capacity of families living cheek by jowl in even scrupulously clean one-room shacks where there is often no regular — or even any — access to clean water and grossly inadequate ablution facilities are shared.
Similar conditions apply in many rural areas where the crippling burdens of poverty and neglect are clearly evident. In many instances, these areas also share the ongoing experience of epidemics, with the classic example in South Africa being tuberculosis (TB).
Every year, TB alone kills more than 20 000, mainly poor, South Africans and the disease has been rampant for decades. If the number of deaths of people with both TB and HIV (they are recorded as HIV deaths) are added, the mortality figure is probably close to 60 000.
Yet this bacterial and airborne infection is both treatable and curable. But there are inadequate facilities and the conditions in which the poorest of the working class poor live, ensures that the epidemic continues, with some 350 000 new cases reported in the past year.
Among the new cases recorded are a number of reinfections, mainly people who, because of their circumstances, were unable to complete treatment regimes. This is one of the causes for the evolution and prevalence of multi-drug resistant (MDR) TB and the extreme (XDR) form of this disease.
Ideally, individuals infected with XDR TB should be isolated to limit the spread of this most dangerous form of TB. But there are not enough facilities; not enough beds, so XDR patients, while being treated, continue to live in their communities and to use — even drive — taxis.
Unlike Covid-19 where no vaccine yet exists, TB could have been all but eradicated given a more just society that valued equally all human life. Perhaps the one good thing to come out of present pandemic — apart from the development of a vaccine — will be a willingness to eradicate the conditions that needlessly kill millions of working people the world over.