It’s odd. Very odd. Sitting in South Africa, in the Global South, and watching how the Global North responds to the coronavirus. I am from the UK, born in England, and all my family are there. Everyone apart from my mum, a renegade, who is under lockdown in a youth hostel in New Zealand, having packed up her life and set off on a bicycle. But everyone else is in Europe, at the epicentre of the virus outbreak. Speaking to my family, reading the BBC, it’s like looking into a dystopian future. I watch as the run on the health system begins, as people queue outside of supermarkets. I chat to my friend who is on lockdown with a tiny baby and she wryly tells me about her efforts to “get back to work”. I am working remotely from South Africa. Part of my day involves speaking to French professionals. Since March, my calls have become therapeutic interventions. “How are you managing during the lockdown?” “Do you have a garden?” “How are the children?” Here in South Africa, we have been on total lockdown since the early hours of the morning of Friday 27th March. They are calling it a “ruthlessly efficient fight” against coronavirus[1]. We are not allowed to walk the dogs, there is no “hour for exercise.” The South African response was swift, and brutal. We shut down our public spaces with a rapidity that a dictatorship would boast of. Ramaphosa, the president, has been applauded. South Africa shut down when we had only registered 400 cases. Since then, we have trained 10,000 field workers to carry out the most testing in all of Africa. Compared to the rest of the continent, we are strides ahead in our fight against the virus. And it is a fight, Ramaphosa has told us in no uncertain terms that we are at war with an invisible enemy. I mean for goodness sakes, we stopped the sale of cigarettes and alcohol. I am not quite sure for the rationale behind that – maybe public health – drunk people break rules? Or perhaps a rare insight into a puritanical streak in the underlying social norms of the country. And yet, if this is a war, what is the price that we will pay? And who pays most? South Africa is one of the most unequal countries in the world. When you look at the 6.6 million people filing for unemployment in America, I have a real sense that this will pale into comparison to the economic impact of coronavirus in South Africa. The economy has already been downgraded to “junk” status. At home, I sit on my laptop and support my little South African family; my husband, his sister and her husband and our three year old niece, everyone now unemployed. I have worked in the HIV response for many years and my LinkedIn is a smorgasbord of responses from the HIV sector; UNAIDS has been circulating an image of lessons that we can learn from the HIV response. It talks about the importance of involving communities in the coronavirus response and of removing the barriers to action – barriers such as insecure housing status, healthcare costs or the fear of unemployment. It talks about how we should be kind to one another and address fear and stigma. (see image) Yet even with the HIV response, we haven’t really learned these lessons. HIV remains an extremely stigmatised disease, often affecting the already dispossessed. When we look at the impact of coronavirus in Africa, the stark wealth and power disparities will only exacerbate the issue for those least able to respond. A recent study by the London School of Hygiene and Tropical Medicine looking at the impact of coronavirus in low income countries[2] made for sobering reading: modelling predictions looking at high-income countries suggested there would be a substantial excess mortality rate with un-controlled or partly controlled coronavirus measures. Yet the virus’ impact on people living in low-income settings or affected by humanitarian crises would be even more severe. This is partly because of more social mixing, higher existing rates of co-morbidities, including a population living with unsuppressed HIV or TB, and intrinsic weaknesses in national healthcare systems. In South Africa, 7.7 million people live with HIV, and yet only 62% of those people are on treatment. 2.9 million people living with HIV are not on treatment and are therefore susceptible to coronavirus mortality. In South Africa, it is our most vulnerable – those in urban slums, those without access to water, our homeless populations, those with multi-drug resistant TB – that will suffer most. It is no surprise that the government acted rapidly. While these sobering facts resound around my computer screen, I try and carry on as normal. I look at my future, the European reality, and I try to carry on working. If I were in the UK, I could volunteer with the NHS. In South Africa, I am on a tourist visa, not recognised by the Health Professions Council of South Africa. I fire off emails to Medicins Sans Frontiers, maybe they need me? As the world seems to stop, I try to find meaning. Am I living right? Am I doing enough? Sometimes I spend the day in bed. My story is not that of an individual. It may be personal, but in reality it is a global story. How many other people are there like me, who are sat at home? How many of us are struggling to remain upbeat, and struggling to be resilient? How many of us, who work in the humanitarian and development sectors, feel impotent? Some days I worry about my own mortality. My phone flashes as I go to bed, “13 year old dead in London from coronavirus. No underlying conditions.” Other days I shrug it off. For goodness sakes, I work in infectious diseases. What on earth do I have to be scared about – death? Yes, well, we all die one day. I am twenty eight and a model of physical fitness. Well, OK, not a model, but I am trying out yoga once a day – that has to count right? The point is, I know I am not alone. I am you and you are me. We are together at this time, facing the same challenges, and we are struggling to find the same meaning. In West Africa they say “on est ensemble.” We are together. Today more than ever, that is a global truth. At FD Consultants, we use a trauma informed model based on the term RESPECT, coined by Fiona Dunkley in her book, “Psychosocial Support for Humanitarian Aid Workers: A Roadmap of Trauma and Critical Incident Care.” RESPECT is a resilience toolkit, it’s an individualised way of how to look after ourselves during this time. It’s a way of building positive coping mechanisms to manage the impact of trauma, so that we can continue to find meaning and make a difference during this time. As Ramaphosa told us, we are at war. We are at war with an invisible enemy, and war is by its very nature a traumatic event. RESPECT gives us tools to foster our individual resilience in face of this trauma:
I read to unlock my relaxation, and I learn about how this crises affects my personal growth. I am in touch with my family daily, sending silly memes or laughing through Zoom calls. I ground myself through yoga, I get my cardio through dancing to Disney film scores, dangling my butt-naked niece on my hip, “under the seeeeeea”. I feed my creativity, drawing in chalk on the fence outside. And I challenge myself to turn off my phone when the social media becomes too much to manage. I breathe RESPECT and I take control. I will find meaning. If you are interested in any of the services that FD Consultants can provide, including remote support services, please contact us today. By Yasmin Dunkley, Independent Business Development Strategist with FD Consultants HIV and Sexual Health service provision specialist [1] https://www.bbc.com/news/world-africa-52125713 [2] https://www.lshtm.ac.uk/research/centres/health-humanitarian-crises-centre/news/102976#.XoWV8UOHVhk.linkedin
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