Blog 4 | HEaL Institute & IJME – Covid-19 Insights | April 15, 2020
On April 14, 2020, the three-week lockdown was extended till May 03. Following the announcement, Bandra Railway station and few other places saw thousands of migrant workers coming out in protest and demanding to be allowed to return to their homes. We all witnessed the hardships of migrant workers following the initial announcement of the lockdown on March 25, 2020. One wonders if the governments—both at the center and state—considered inclusive approaches in planning out their strategies, while also considering how they affect citizens, particularly the marginalized and vulnerable groups. In this piece, I emphasize that the two intertwined ethical issues, transparent effective communication and inclusive decisions, based on justice are non-negotiable ethical obligations by the state during pandemics, such as Covid-19.
Transparent communication, democracies, and human rights
In democratic societies, open communication plays a significant role, and its importance in the response efforts during a pandemic is even greater as it demands community engagement and participation, making individuals active participants. However, for this to happen, all citizens need to be treated with respect and seen as respect-worthy. History shows us that disease outbreaks within different legal and constitutional traditions have evoked vastly different responses. While democratic societies give importance to the protection of human rights, authoritarian governments have been less concerned or have disregarded fundamental human rights, such as civil liberties, and have either participated in promoting or have done little to prevent stigma and discrimination.
The recent and earlier public addresses by the prime minister were mainly various appeals made to the general public with specifically the middle classes in mind. He asked us to care for the elderly, to follow the AYUSH ministry’s advisory on boosting immunity, and to use the Aarogya Setu App; he also demanded solidarity and compassion towards household service providers and asked us to respect workers in the essential service sectors, especially doctors, police, nurses, and sanitation workers. While these are important, it is also important that the government consider wide ranging issues that need attention, while using inclusive approaches to interventions and strategies in response efforts across all social and class groups. Here, I briefly illustrate the instances of poor transparency in public communication and non-inclusive planning in the Covid-19 response. First, there was lack of engagement with stakeholders on the imposition of a single day lockdown—as a symbolic gesture—while using the word “curfew” in a public speech (‘janata curfew’). Second, strategies to address the crisis with regard to personal protective equipment (PPEs) and other medical equipments, relief and safety nets for the poor, and food supply have not been discussed in detail. Third, a 21-day lockdown was announced without consideration of the hardships that the vulnerable groups may face, with no transparent communication of what the lockdown would entail, and how it would be managed by the government. Following the lockdown announcement, many faced with the prospect of no food, shelter and immediate medical attention, began arduous journeys by foot to return to the comfort of their villages and their families. The public assurances regarding shelter and food for the migrant workers came few days after the lockdown had begun, by which time, many had already begun their journeys back home, as all public and private transport had been taken off the road. Fourth, the “curfew” led to inhumane actions, such as beating and shaming, on the part of the police (curfew is considered a law and order issue); this was a glaring example of the gap in planning and communication. Fifth, instances of officials referring to a surge in Covid-19 cases and a specific congregation, while BJP party officials made references to Muslims as ‘human bombs’ and created false narratives, have fuelled further hatred and physical acts of violence towards the Muslims. This was taken into consideration later and the ministry released a statement against prejudices and social stigma and provided a list of Do’s and Don’ts of responsible citizens.
An inclusive approach to public communication during the pandemic response requires public officials to be sensitive to the language and messaging. The public intervention and decisions during the crisis should consider the values of accountability, transparency, inclusiveness, reasonableness and responsiveness as fundamental principles. The blanket assumption that public discussion on the pandemic and its scientific uncertainty would cause anxiety or fear in is not a valid justification for withholding information from the public.
Way forward: Inclusive decisions based on justice
The lack of inclusive planning, poor logistics, and poor implementation strategies have led to a cruel and inhuman situation for thousands of migrant workers during the ongoing lockdown in India. The lockdown is necessary and is based on a good public health ethical principle of precaution; it ensures the protection of the population at the cost of curtailing the freedom, liberty, and privacy of individuals. However, democratic societies should consider least intrusive alternatives, remain transparent, and should adopt values of fairness and justice in their approaches to public health interventions and communications. In order to be least intrusive during the pandemic, the state needs to carefully consider the extent to which the individual’s human rights are suspended. Justice in public health interventions and communication needs careful assessment of how the intervention strategies will affect the socially vulnerable and marginalized. Thus, careful assessment and inclusive planning is required.
Fair and transparent interventions and strategies require public health officials, government officials, and the state to make decisions in a transparent and accountable manner. It is the moral responsibility and obligation of the state to provide scientific facts and evidence, reasons, and justifications for the decisions on public health interventions and strategies. While the precautionary principle is being invoked to limit the freedom of individuals, public health ethics and justice demands that the vulnerable groups are also provided a social safety net. Being inclusive in pandemic response strategies and basing it on principles of justice and fairness helps in building public trust in healthcare systems and the government, and in turn helps in response efforts.
Blog editor: Sunita VS Bandewar Download pdf