What happens when people open their hearts? They get better. Haruki Murakami
I think that little by little I’ll be able to solve my problems and survive. Frida Kahlo
The question is not how to get cured, but how to live. Joseph Conrad
As soon as healing takes place, go out and heal somebody else. Maya Angelou
I think I have served people perfectly with parts of myself I used to be ashamed of. Rachel Naomi Remen
And here you are living despite it all. Rupi Kaur
Poetry heals the wounds inflicted by reason. Novalis
Inside and outside the UN, health-related matters continue to occupy center stage in our collective consciousness. Some good medical news related to infection levels in the US and remarkable progress reported from Oxford (UK) on a potential malaria vaccine was more than offset by news of devastating health emergencies in countries from Brazil to India – overwhelming existing health infrastructure and sending front-line health care workers in these and other countries to their emotional breaking point. It was unnerving to read of doctors in India describing the “mental torture” they now experience from treating what even they depict as India’s “hopeless” COVID crisis.
This “torture” is reminiscent of what medical personnel have experienced over this past year in community after community, country after country, places where political leaders have routinely bungled pandemic responses both within and across borders. Their not-infrequent politicizing of a public health menace has left medical workers with little option but to pick up the pieces from infected persons who, in many instances, refused to adhere to public health warnings and protocols. Such workers have been left to cope with waves of variants that are sure to multiply as cases explode in areas of the world largely (and sometimes willfully) excluded from adequate vaccine coverage, areas which in some instances are also coping with water shortages, limited sanitation and health access limitations which compromised local health outcomes long before the onset of COVID-19.
This pandemic isn’t over. Through our science-suspicion, our short-sighted policy choices, and our lack of solidarity across borders and regions, we have seen to that. And this is clearly not the only health-related threat to which we should now be paying attention.
The UN system has done some robust and cross-cutting policy work on matters of disease control, health access and the protection of health infrastructure. This past week alone, the outlines of a comprehensive response to the current health crisis facing our planet once again came into focus. For instance, in the Permanent Forum on Indigenous Issues, the outcome document referenced the grave health disparities which indigenous communities face worldwide, noting both the diminishing health infrastructure in more remote rural areas and the important work done by rural caretakers to protect the forests and other natural resources that remain under severe threat, protection which is indispensable to biodiversity preservation and might even help us avoid future pandemics.
And in the General Assembly, the GA president hosted a high-level dialogue on Antimicrobial Resistance, a challenge to what the PGA called “our over-dependence and over-use” of antibiotics which have in many instances compromised our ability to stem infections and prevent the evolution and spread of antibiotic-resistant bacteria. As speakers noted from across the UN system, the combination of threats including substandard sanitation systems, lack of access to potable water, and high levels of antibiotics in the meat some of us routinely ingest are enabling preventable outcomes, including making people with under-treatable bacterial infections more susceptible to COVID-19 threats.
What was particularly hopeful about this GA discussion is the degree to which it enabled an assessment of other health-related concerns to which states and the rest of us should be more mindful. The GA president, for instance, used the opportunity to call once again for states to commit to “universal health access.” The Deputy Secretary-General Amina Mohammed used her speaking time to call for “alternatives to antibiotics” and increased investment in health infrastructure as one means of “getting our commitments to sustainable development back on track.” Dr. Tedros of WHO reminded delegations of the primary health-related responsibility of states to ensure fresh water and sanitation access, while the director of FAO noted the importance of ensuring food security and related measures we can and must take to improve public health instead of simply “waiting around for new medicines” to be developed.
And in the Security Council, a session on the “protection of indispensable civilian objects” hosted by Vietnam’s president highlighted the extent to which, as Ireland’s Foreign Minister noted, “war is the enemy,” the enemy of trust and confidence, the enemy of person-centered funding priorities, the enemy of stable and effective health infrastructure, the enemy of brave doctors and nurses forced to “work from caves” in a herculean (and often futile) effort to heal wounds of war in settings far less conducive to caregiving than the now hollowed-out hospitals where they used to work. The makeshift mash units to which some transitioned have too often become targets of armed violence as well, causing many medical personnel to once again and quite literally flee for their lives.
And it isn’t just hospitals. As noted by the Foreign Minister of St. Vincent and the Grenadines – a country now coping with health consequences from a major volcanic eruption — attacks on civilian objects by parties to conflict now directly target water and other infrastructure with growing frequency, leading inexorably to the spread of otherwise preventable diseases, including cholera. Such infrastructure looting and outright destruction endangers both short and longer-term health care access, gravely imperils the growth and development of children, skews our funding priorities towards more military hardware and away from health facilities, and exacerbates displacement-related miseries that most of the rest of us can scarcely imagine. War, indeed, is the enemy of healthy societies in multiple ways.
The question now for UN stakeholders is whether or not we have the collective will to hear and heed the advice from this week of policy discussions, to internalize and respond in kind to the mental burdens of front line workers and the misery and insecurity of those suffering under what one health aide this week referred to as a “genocide” of pandemic and other disease-related casualties. Such a “genocide” affects all sectors of society, but especially those persons with disabilities, the economically marginalized, the aged and those in relative rural isolation. It is obviously that much harder to appreciate sunsets and spring flowers or the wonders of poetry and art while carrying around wounds that won’t heal or dealing with sickness that drains away energy while children cry out for a proper meal.
The remedial blueprint is clear but it will require much from us. Tangible commitments of persons, priorities and treasures are required if we are fix currently-grave health disparities given, as this pandemic has reminded us, that an out-of-control virus in one part of the world affects health outcomes in every corner of the world. We must make forest protection (and its protectors) a priority. We must demonstrate levels of solidarity required to distribute vaccines and health resources fairly and evenly across all areas of need. We must do more to counter health disinformation and, while doing so, help to restore public confidence in both science and governance. If we insist on eating meat, we must also insist on options for more humanely-treated and less antibiotic-infested animals. We must invest more in community health with a focus on prevention, nutrition and alternatives to the medicines which once reliably saved lives (including twice my own) but which our overuses have made increasingly unreliable. We must cease our relentless dismantling of health infrastructure, especially in rural areas, due in part to our skewed funding priorities and tax policies which have put money into dubious outcomes such as nuclear weapons modernization while also lining the pockets of those whose investment accounts are already filled to overflow.
And we must protect the infrastructure we already have, ensuring that “indispensable civilian objects” and those brave souls determined to provide the essential services within them are spared the horrific impacts of armed conflict, impacts from indiscriminate air raids and explosive weapons which must be removed in practice as their legitimacy has long been “removed” under international law. War, indeed, “has rules” as many noted this week in various UN digital “conference rooms,” but those rules are increasingly disregarded. The Security Council must do more to enforce them. And war as an alleged enabler of anything remotely constructive for civilians in either the short or long term must be thoroughly debunked.
We are now facing a health crisis with multiple dimensions and causes highlighted and exacerbated by the current pandemic. As someone who is serially blessed by vaccinations and adequate health care access, I fear for those increasingly desperate for the portion of health care that should rightly be theirs, persons perpetually shouting (or praying) away the wolves of disease and violence baying outside their dwellings on a daily basis.
Unless we take the recommendations from this week seriously, unless we step up regarding practical manifestations of genuine solidarity, my fear is that their desperation will eventually become our common franchise, their misery will spread as quickly and defiantly as our own self-interestedness. Then, the stench from so many burning bodies will fill our nasal cavities as thoroughly as those who manage the fires of India’s now-overloaded funeral pyres. I was stunned this week by a 1961 photo of a Russian doctor preforming a self-appendectomy while stranded on a base in Antarctica. How many in this world are forced into similarly desperate measures to treat personal and family health emergencies without access to any of the technical skills and training possessed by that doctor?
For their sake, for our own as well, we simply cannot allow this desperation to persist any longer. Our hearts need to open wider, our blessings shared more liberally. We know what needs to be done to enable healthier outcomes for all. We are collectively, undoubtedly, urgently on the clock.
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