SOCIAL MURDER
When COVID 19 first hit the world, it revealed that
many societies had successfully obscured widespread social inequities. Towards
the end of 2020 data confronted us from the US and UK that unveiled these
outrageous inequities as COVID 19 struck had. COVID 19 made visible a form of embarrassing
social inequities. But these were known as deliberate outcomes of public policies
that had developed over centuries in capitalist countries.
The morbidity and mortality from COVID-19 among the
disadvantaged population demonstrated a need to review the dominant policies
that seek the production of health. The poor and less powerless section of the
population, mostly people of color, immigrants, the elderly single mothers, and
the elderly were the most exposed, contracted, and died from Covid-19.
Such morally objectionable differences between people
that we can correct through a democratic and equity-oriented public policy became
the defining moment for the developed industrial countries. Even superpowers
were helpless in halting and reversing the onslaught of coronavirus.
Social inequities anywhere call for immediate action
to address the structural and systemic facets that make them thrive.
Specifically, the situation with COVID 19 called attention to the
redistribution of social, cultural, economic, and political resources - all of
which are determinants of health. It called for less commodification and stratification
of society but more of decommodification and destratification. The pandemic
response should have been driven by a unified global sense of urgency to save
humanity from its indignation, suffering, encountering unnatural deaths, and not
to entirely commercialize or profit from it!
The causes of social inequities in every society have their
historical, structural, material, and power relations. Power and governance are
key determinants of social inequities, especially under the neoliberalism
capture. How power is distributed
determines which group gains or loses societal privileges to better services and/or
social and economic resources to live a healthier life.
Those without power are deprived of the material
conditions to live a fulfilling life in the same society, thereby creating a
two-tiered nation – of the poor majority and a rich few. In Uganda, we saw how
some people reaped big from the streams of COVID-19 prevention monies lavished
to Uganda.
When Rudolf Virchow introduced the concept of social
medicine in 1848 in his report entitled: "The report on the typhus
epidemic in Upper Silesia", he had studied the developments in Upper
Silesia that led to a frequent typhus epidemic and concluded that the people
there were suffering because they lacked education, liberty, and democracy.
Those people lacked civic engagement and decision-making power and were quite
impoverished. Virchow recommended that the treatment of the typhus epidemic was
not pharmaco-medicine, rather a "full and unlimited democracy".
It follows since then that there is a causal link
between oppression on people with the overall standards of health of the
oppressed. People who lack political or civil rights tend to be at a high risk of
getting sick and dying young. This observation, which is beyond the scope of
this article, has been an obsession of many social epidemiologists for decades.
In Uganda, the history and patterns of oppression are easily
traced to how power is appropriated and maintained violently within a tribal
cabal. Every post-colonial regime that ascended to power - except for Idi Amin
- enacted its constitution as a procedural tool or standards by which to cling to
power. Where the constitution is tested and fails, these regimes reverted to the
strong arms of colonial laws to perpetuate oppression. The constitution has not
served Ugandans beyond a regime. As such, there is no guarantee that subsequent
grabbers of power will not oppress and exploit Ugandans.
The current regime's oppression is characteristically corrupted
and violent. It is driving the young Ugandan population into various vulnerabilities
leading to an early and unnatural death. Most are resigning too soon to fate
while the desire to flee Uganda has peaked. Sizeable others are disinterested
in matters of governance or accountability owing to the politicization of
everyday social spaces complemented by crude violence – torture, deforming, humiliation,
and death.
The monopoly of power has transformed this Museveni
regime into the most reliable source of morbidity and mortality outside
tropical diseases, epidemics, and pandemics. The regime kills Ugandans even
more than the natural calamities such as landslides and El Nino rains.
Someone may ask, how so?
I believe Friederich Engel referred to such unconscionable
conduct of the regime in which the masses are led to die maliciously through
deliberate policy decisions, as social murder.
Covid-19 has demonstrated that Uganda's health care
system is far from its potential to contain a pandemic. Understandably, the
colonialist and subsequent post-colonial governments did not design the
healthcare system to handle pandemics. Rather, healthcare was part of the
colonial social policy package designed to incentivize participants in the colonial
rule and economy.
Subsequent post-colonial regimes maintained a
healthcare system that would respond to the health needs of all Ugandans in
line with the WHO 1946 constitution. The current regime has for decades,
embarked on undermining and dismantling it. It prefers the proliferation of a
predatory private health sector most accessible by regime loyalists in the same
fashion as the colonialists’.
The violent repression, occasioned by a state-inspired
corruption deprives Ugandans of the opportunity to seek accountability just as
the people of Upper Silesia. Inevitably, the state’s neglect of the public healthcare
system in Uganda is nothing short of social murder.
End.
CUT - Unedited
Access to a good healthcare system is not only a
common good but a basic human right. This is proscribed in the WHO’s 1946
constitution of which Uganda is a signatory, demands "…the highest attainable
standard of health as a fundamental right of every human being." According
to the WHO, health as a human right creates a legal obligation on states to
ensure access to timely, acceptable, and affordable health care of appropriate
quality and allows addressing underlying determinants of health. At the moment
majority of Ugandans cannot afford good quality healthcare.
The out-of-pocket costs in the private hospitals have
come to bear on household expenditures and it has reached beyond what experts
consider calamitous spending levels. Hospital bills averaging Shs 60m from a
short stay in a private clinic or hospital, especially when the patient dies,
leaves families highly indebted and immediately slides them into abject poverty,
misery and early death.
Recently, I read Hon. Betty Nambooze's (Mukono
Municipality MP) plea in a situation where a doctor who treated COVID 19
patients himself contracted the virus. Unfortunately, the doctor was rushed to
a private hospital where he died after a short stay. The hospital held the corpse
hostage pending payments of exorbitant hospital costs that the family, friends,
and the clan combined, could not raise among them. The private hospital
administrators suggested that the family sell off the deceased man's family house
to recover the service costs from which he died. The doctor is only one such
example as many people prefer to die from home for a decent burial than indebt
their families.
Engel wrote in 1845 that
“…when society places
hundreds of proletarians in such a position that they inevitably meet a too
early and unnatural death, one which is quite as much a death by violence as
that by sword or bullet…or forces them, through the strong arms of the law, to
remain in such conditions until that death ensues…it is murder!
Covid-19 has demonstrated a need for the government to
rethink its policies on strengthening the public healthcare sector. A two-tier well-balanced healthcare system would still work to complement each other. The economic
sense of this argument is that a healthy population is a prerequisite for a
robust economy.
End.
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