Prabir Purkayastha With the U.S. deciding to walk out of the Open Skies agreement, the U.S. is signaling to the world that it intends to return to days of Pax Americana that existed post-World War II, when it was the sole possessor of nuclear weapons. It has already walked out of the Anti-Ballistic Missile (ABM) Treaty in 2002 under George W. Bush, and the Intermediate-Range Nuclear Forces (INF) Treaty under Trump. The only nuclear arms control treaty that still remains in place is the New Strategic Arms Reduction Treaty (START), which provides a rough limit and parity on the U.S. and Russia’s nuclear arsenals. Its days also seem to be numbered, as it expires on February 5, 2021, leaving very little time for any serious discussion.
The Trump administration is now considering a resumption of nuclear tests, which would be in violation of the Comprehensive Nuclear Test Ban Treaty, or CTBT. Is this yet another treaty destined for the waste paper basket? This is apart from other nuclear restraint treaties that the U.S. signed with other states such as North Korea and Iran, and subsequently tore up unilaterally, prompting the view that the U.S. is no longer capable of upholding treaties.
Marshall Billingslea, who is the U.S. official arms control negotiator, has talked about how the U.S. intends to spend Russia and China “into oblivion,” as it had done with the Soviet Union earlier. Obviously, as an arms control negotiator, he is a fitting successor to John Bolton, whose chief claim to fame is wielding a hammer to smash all arms control agreements.
The U.S. continues to pour its money into military technology and its political energy into defense strategies against what it perceives as threats to its global hegemony from China and Russia—even during a pandemic. The U.S. has modeled for the rest of the world that the politics of security lie in terms of arms, no matter that funds are desperately needed for public health.
So what is the Open Skies agreement? The treaty permits all its 35 signatories—the U.S., Russia and other NATO allies—to fly over each other’s territories. Effectively, it allows official military reconnaissance flights.
So why does the U.S. want to exit a treaty that makes it possible to launch surveillance flights over Russia? This is a question that even military experts are hard put to answer. One reason given is that the U.S. has complete imaging capabilities over Russia using its satellites, and does not need old-fashioned aircraft-based methods. Therefore, the U.S. is denying Russia overflights over its territory in the belief that Russia will not be able to match the U.S. space-based surveillance capabilities. And if it tries to match the U.S., it is back to the Billingslea-Trump game; the U.S. will win the new weapons war, or else move to an economic war. But war it is either way.
The U.S. also has a second target motivating it to walk out of the Open Skies agreement. European countries are very much a part of this agreement, just not the U.S. The U.S. did not even talk to its NATO allies before making the decision to abandon this agreement. The U.S. wants to deny any strategic independence to its NATO allies. If the Open Skies agreement now fails, as Russia has no incentive to offer other NATO countries overflights when it has none over the U.S., other NATO allies will be even more dependent on the U.S. for information. This is a strike as much against its own NATO allies as against Russia.
During the initial negotiations on the New START, Trump and Billingslea are talking about bringing in China in order to limit its nuclear arsenal as well. This was also one of the arguments given when the U.S. abandoned the INF Treaty.
Consider the respective nuclear arsenals of countries. Currently, the United States and Russia have more than 6,000 total nuclear warheads each, while China has about 300, according to the Arms Control Association’s factsheet. So any agreement that brings in China can only increase its voluntary limit and not reduce it! Just for the record, France also has 300, with the UK at 200, and India and Pakistan around 150 each. Israel has about 100, and the Democratic People’s Republic of Korea (North Korea) has about 30.
In summary, the U.S. believes that since the ’90s, it has been and continues to be the sole global hegemon. Any arms control treaty hinders the exercise of its military might. It recognizes that it can no longer control the global economy, where China is already in the process of overtaking the U.S., give or take a decade or two. A trade agreement that follows the rules, even if the rules were put in place in the ’90s by the U.S. and its allies in the World Trade Organization (WTO), no longer helps the U.S. Faced with competition not only from China, but a range of other countries, the U.S. has fallen back on its military power as its key “bargaining” strategy: Agree to what it says or else. And if any country tries to match the U.S. militarily, the U.S. will bankrupt them as it did with the Soviet Union.
Historians Richard Lebow and Janice Stein have pointed out that the collapse of the Soviet Union was not due to its military competition with the U.S. Its defense budget did not increase in Reagan’s Star Wars years. Neither is Russia willing to surrender to the United States. Russia’s President Vladimir Putin has made it clear that Russia will not accept that the U.S. can become the global overlord as it did during the Yeltsin years, and dictate to it and other countries.
The U.S. change in tack with respect to China is part of what is now being called a hybrid war—military threats coupled with economic actions—to inflict enough damage that China is forced to sue for peace, accepting its subordinate status.
That is why China and Russia have come together. China’s economic strength and Russia’s military capabilities provide formidable opposition to U.S. dominance. Russia’s technological strength in missiles, submarines, and radar has always been cutting-edge. The S-400 defense shields with radar arrays and defensive missiles are still the best in the world, and that is the reason why even U.S. allies such as Turkey and Saudi Arabia are procuring them. China is likely already the world leader in quantum communications and is set to overtake the U.S. in artificial intelligence within the next five years. So when it comes to competition, China and Russia are not as far behind as the U.S. seems to believe. And the U.S. policies in the last 30 years have cemented Russia-China ties at a much deeper level than in the past.
What options, then, do Russia and China have? Russia and China do not plan to copy the U.S. strategy of global dominance, or engage in the game of one-upmanship the U.S. is playing. For Russia and China, the ability to inflict sufficient damage on the U.S. is deterrence enough. So they are not going to make the mistake of matching the U.S. military spending dollar for dollar. Putin’s strategy is to develop weapons that can inflict maximum damage at a minimum cost—in other words, develop a strategy for asymmetric war. This is the reason behind the six new Russian weapons that Putin unveiled last year: from hypersonic weapons to a new generation of ballistic missiles.
The difference between the two approaches is their strategic visions. For the U.S., it is spelled out in its various strategic documents: it needs to militarily dominate every region in the world. Any country that challenges the U.S., even in controlling its coastal waters, is a revisionist power. This requires not strategic parity but overwhelming superiority, or force projection in any global theater. In today’s day and age, this is well beyond any country’s military reach.
The world is entering perhaps the most dangerous period it ever has, not just because of climate change and the COVID-19 pandemic. The nuclear arms race is taking place with the U.S. belief that it is winnable. Abandoning all arms control agreements with one excuse or the other is not simply the aberration of a Trump or a Bush, but very much a part of U.S. exceptionalism.
The future of all nations is either surrender to the rule of the hegemon, or allow a global nuclear arms race. This is Trump’s vision, enunciated by his arms control negotiator. It has consequences for all of us. Why then, are all other countries silent? This is why there is an urgent need for the global peace movement to revive. People everywhere have to fight for peace. It is not just Russia or China or the United States at risk, but the whole of humanity.
The response of socialist Cuba to the global SARS-CoV2 pandemic has been outstanding both domestically and for its international contribution. That a small island nation, subjected to hundreds of years of colonialism and imperialism and, since the Revolution of 1959, six decades of the criminal United States blockade, can play such an exemplary role is due to Cuba’s socialist system. The central plan directs national resources according to a development strategy which prioritises human welfare and community participation, not private profit.
Cuban authorities reacted quickly to Chinese information about SARS-CoV2 at the start of the year. In January, authorities established a National Intersectoral Commission for COVID-19, updated their National Action Plan for Epidemics, initiated surveillance at ports, airports and marines, gave COVID-19 response training for border and immigration officials and drafted a ‘prevention and control’ plan. Cuban specialists travelled to China to learn about the new coronavirus’ behaviour and commissions of the government’s Scientific Council began to work on combating the coronavirus. Throughout February, medical facilities were reorganised, and staff trained to control the spread of the virus domestically. In early March a science and biotechnology group was created to develop COVID-19 treatments, tests, vaccines, diagnostics and other innovations. From 10 March inbound travellers were tested for COVID-19. All of this was before the virus was detected on the island.
On 11 March, three Italian tourists were confirmed as the first cases of COVID-19 in Cuba. Cuban healthcare authorities stepped into action, organising neighbourhood meetings, conducting door-to-door health checks, testing, contact tracing and quarantining. This has been accompanied by education programmes and daily information updates. The population went under ‘lockdown’ on 20 March, required to abide by social distancing rules and wear facemasks when leaving homes on essential business. Business taxes and domestic debts were suspended, those hospitalised had 50% of their salaries guaranteed and low-income households qualified for social assistance and family assistance schemes, with food, medicine and other goods delivered to their homes. Workshops nationwide began to produce masks, bolstered by a grassroots movement of home production, and community mutual aids groups organised to assist the vulnerable and elderly with shopping for food as long queues became the norm. On 24 March, Cuba closed its borders to all non-residents, a tough decision given the importance of tourism revenue to the state. Anyone entering the country was required to spend a fortnight in supervised quarantine, under a testing regime. Defence Councils in the Provinces and Municipalities were activated.
Video: Cuba’s Isolation Centers
In April payment of utility bills was suspended, likewise local and regional transport, while transport was guaranteed for medical staff and other essential workers. Havana and other cities were disinfected. 20 communities in six provinces were placed under total or partial quarantine. A Cuban-designed mobile phone app, ‘Virtual Screening’, went live with an opt-in application allowing users to submit an epidemiological survey for statistical analysis by the Ministry of Public Health (MINSAP). Measures were taken to keep the virus out of prisons, with active screening twice daily and no reported cases by 23 April.
By 24 May, a Cuban population of 11.2 million had reported 82 deaths and fewer than 2,000 confirmed cases; 173 confirmed cases per million people, compared to 3,907 per million in Britain. Not one healthcare worker had died, although 92 had been infected by mid-April.
Cuba’s exemplary response is based on five features of its socialist development. First, its single, universal, free public healthcare system which seeks prevention over cure, with a network of family doctors responsible for community health who live among their patients. Second, Cuba’s biopharma industry which is driven by public health needs, produces nearly 70% of the medicines consumed domestically and exports to 50 countries. Third, the island’s experience in civil defence and disaster risk reduction, usually in response to climate-related and natural disasters. Its internationally applauded capacity to mobilise national resources to protect human life is achieved by a network of grassroots organisations which facilitate communication and community action. Fourth, the island’s experience in operating infectious disease (border) controls. For decades, Cuba has sent healthcare professionals to countries which have infectious diseases long-since eradicated on the island and has invited tens of thousands of foreigners from those countries to study in Cuba. It has well-developed procedures for quarantining people (re)entering the island. Fifth, Cuban medical internationalism, which has seen 400,000 healthcare professionals providing free healthcare for underserved populations in 164 countries; some 28,000 medical personnel were serving in 59 countries when the pandemic began. By late May, an additional 2,300 healthcare specialists from Cuba’s Henry Reeve medical brigades, specialists in epidemiological and disaster response, had gone to 24 countries to treat patients with COVID-19.
A commitment to high-standard public healthcare
In 1959, Cuba had some 6,000 doctors but half of them soon left; only 12 of the 250 Cuban teachers at the University of Havana’s Medical School stayed. There was only one rural hospital. The revolutionary government faced the challenge of providing a high-standard public healthcare system almost from scratch. To that end, in 1960, the Rural Medical Service (RMS) was established and over the next decade hundreds of newly graduated doctors were posted in remote areas. RMS physicians served as health educators as well as clinicians. National programmes were established for infectious disease control and prevention. From 1962 a national immunisation programme provided all Cubans with eight vaccinations free of charge. Infectious diseases were rapidly reduced, then eliminated. By 1970, the number of rural hospitals had reached 53. Not until 1976 was the pre-revolutionary ratio of doctors to citizens restored. By then, health services were available nationwide and indicators had improved significantly. A new model of community-based polyclinics was established in 1974 giving Cuban communities local access to primary care specialists. Training and policy emphasised the impact of biological, social, cultural, economic and environmental factors on patients. National programmes focused on maternal and child health, infectious diseases, chronic non-communicable diseases, and older adult health.
In 1983, the Family Doctor and Nurse Plan was introduced nationwide. Under this system, family doctor practices were set up in neighbourhoods, with either the doctor or the nurse living with their family above the practice, so medical attention is available 24 hours a day. Family doctors coordinate medical care and lead health promotion efforts, emphasising prevention and epidemiological analysis. They rely on history-taking and clinical skills, reserving costly high-tech procedures for patients requiring them, holding patient appointments in the mornings and making house calls in the afternoons. The teams carry out neighbourhood health diagnosis, melding clinical medicine with public health, and individualised ‘Continuous Assessment and Risk Evaluation’ (CARE) for their patients. Family doctors and nurses are also employed in large workplaces and schools, child day-care centres, homes for senior citizens and so on.
By 2005, Cubans had one doctor for every 167 people, the highest ratio in the world. Cuba now has 449 policlinics, each attending to 20,000 to 40,000 people and serving as a hub for 15 to 40 family doctors. There are more than 10,000 family doctors spread evenly throughout the island.
Primary Health Care as the backbone of Cuba’s response
An article in April 2020 Medicc Review describes Cuba’s primary health care system as a ‘powerful weapon’ against COVID-19. ‘Without early access to rapid tests, massive testing was clearly not in the cards as a first strategic option. However, primary health care was.’ Cuban authorities ensured that everyone in the healthcare system, including support staff, received COVID-19 training before the virus was detected. Senior medics from each province were trained at Cuba’s world-famous hospital for tropical diseases, Instituto Pedro KourÃ. On returning to their provinces they then trained colleagues in the second tier – hospital and polyclinics directors. ‘Then they went on to the third tier: training for family doctors and nurses themselves, lab and radiology technicians, administrative personnel, and also housekeeping staff, ambulance drivers and orderlies. Anyone who might come into contact with a patient’, explained a polyclinic director, Dr Mayra Garcia, who is cited in the Medicc article.
Each polyclinic also trained non-health sector people in their geographical area, in workplaces, small business owners, people renting homes, especially to foreigners, or managing childcare facilities, telling them how to recognise symptoms and take protective measures. Senior medical professionals in the polyclinics were sent to family doctors’ offices as reinforcement. Medical staff were posted in local hotels to provide 24-hour detection and health care to foreigners residing there. Walk-in emergency services were re-organised to separate anyone with respiratory symptoms and to provide 24-hour assessment. Non-COVID-19 related appointments were postponed where possible or shifted to home visits for priority groups.
The Medicc article underscores the importance of the CARE model for combating COVID-19. All Cubans are already categorised into four groups: apparently healthy, with risk factors for disease, ill, and in recovery or rehabilitation. Doctors know the health characteristics and needs of the community they serve. ‘The CARE model also automatically alerts us to people who are more susceptible to respiratory infections, the people whose chronic diseases are the risk factors most commonly associated with complications in COVID-19 patients’ explained Dr Alejandro Fadragas.
Throughout Cuba, CDRs, or street committees, organised public health information meetings for family doctors and nurses to advise neighbourhoods about the pandemic. Once the first cases were confirmed, the family doctors daily house visits were extended and became the ‘single most important tool’ for active case detection, to get ahead of the virus. Some 28,000 medical students joined them going door to door to detect symptoms. This procedure means the whole population can be surveyed.
Video: Cuba’s Door-to-Door Doctors
People with symptoms are remitted to their local polyclinic for rapid evaluation. Those suspected of having COVID-19 are sent on to one of the new municipal isolation centres established throughout the island. They must remain for a minimum of 14 days, receiving testing and medical attention. If the case appears to be another respiratory illness, they return home but must stay indoors for at least 14 days, followed up in primary care. Hospitals are reserved for patients who really need them.
Primary healthcare professionals are also responsible for rapid contact tracing for all suspected cases; those contacts are tested and must isolate at home. In addition, the homes and communal entrances of patients sent to isolation centres are disinfected by ‘rapid response’ teams consisting of polyclinic directors and vice directors, alongside family members. Family doctors’ offices are also disinfected daily. Meanwhile, workers in hotels where foreigners are lodged are checked daily by medical staff. The polyclinic provides them with PPE and disinfectants. Polyclinics and family doctors are also responsible for 14 days follow-up for COVID-19 patients discharged from hospitals.
Home-grown medicine
The Cuban treatment protocol for COVID-19 patients includes 22 drugs, most produced domestically. The focus has been placed on prevention, with measures to improve innate immunity. Early on the potential of Cuba’s anti-viral drug Heberon, an interferon Alfa 2b human recombinant (IFNrec), was identified. The biotech product has proven effective for viral diseases including hepatitis types B and C, shingles, HIV-AIDS, and dengue. Produced in Cuba since 1986 and in China since 2003 through a Cuban-Chinese joint venture, ChangHeber, in January 2020 it was selected by the Chinese National Health Commission among 30 treatments for COVID-19 patients. It soon topped their list of anti-viral drugs, having demonstrated good results.
The drug has most efficacy when used preventatively and at early stages of infection. In Wuhan, China, nearly 3,000 medical personnel received Heberon as a preventative measure to boast their immune response; none of them contracted the virus. Meanwhile, 50% of another 3,300 medics who were not given the drug did get COVID-19. Cuba’s IFNrec is recommended in the medical protocols of several countries, by the World Health Organisation (WHO), Johns Hopkins Medical Centre and the World Journal of Paediatrics among others. The product was already registered in Algeria, Argentina, Chile, Ecuador, Jamaica, Thailand, Venezuela, Vietnam, Yemen and Uruguay. By mid-April requests for its use had been received from some 80 countries and it was being administered by Cuba’s Henry Reeve medical brigades treating COVID-19 patients overseas. On 14 April it was reported that 93.4% of COVID-19 patients in Cuba had been treated with Heberon and only 5.5% of those had reached a serious state. The mortality rate reported by that date was 2.7% but for patients treated with Heberon it was just 0.9%.
Other Cuban medicines reporting promising results include:
+ Biomodulina T, a immunomodulator which stimulates the immune systems of vulnerable individuals and has been used in Cuba for 12 years, principally to treat recurrent respiratory infections in the elderly.
+ The monoclonal antibody Itolizumab (Anti-CD6), used to treat lymphomas and leukemia, administered to COVID-19 patients in a severe or critical condition to reduce the secretion of inflammatory cytokines, which cause the massive flow of substances and liquid in the lungs.
+ CIGB-258, a new immunomodulatory peptide designed to reduce inflammatory processes. By 22 May, 52 COVID-19 patients had been treated with CIGB-258; among those in a severe stage, the survival rate was 92%, against a global average of 20%. For those in a critical condition the survival rate was 78%.
+ Blood plasma from recovered patients.
Cuban medical scientists are producing their own version of Kaletra, an antiretroviral combination of Lopinavir and Ritonavir, used to treat HIV/AIDS. Domestic production will eliminate costly imports from capitalist big pharma and subject to the US blockade. Meanwhile, the homeopathic medicine, Prevengho-Vir, which is believed to strengthen the immune system has been distributed for free to everyone on the island. Medical scientists are evaluating two vaccines to stimulate the immune system and four candidates for specific preventative vaccine for COVID-19 are under design.
By early May, Cuban scientists had adapted SUMA, a Cuban computerised diagnostic system, to detect antibodies for COVID-19 rapidly, allowing for mass testing at low cost. ‘The objective is to find new cases and then intervene, isolate, seek contacts, and take all possible measures to ensure that Cuba continues as it is now’, said Cuba’s top epidemiologist, Francisco Durán during his daily televised update on 11 May. This means the island no longer relies on donated tests or expensive ones purchased internationally. Cuba’s comparatively high rate of testing is set to soar.
BioCubaFarma is mass producing facemasks, personal protective equipment (PPE) and medical and sanitary products, as well as coordinating state enterprises and self-employed workers to repair vital equipment, such as breathing ventilators. Cuban efforts to purchase new ventilators have been obstructed by the US blockade which, for almost 60 years, has included food and medicines among its prohibitions.
Leading the global fight
On 18 March, Cuba allowed the cruise ship MS Braemar, with 684 mostly British passengers and 5 confirmed COVID-19 cases, to dock in Havana after a week stranded at sea, having been refused entry by Curacao, Barbados, Bahamas, Dominican Republic and the United States. Cuban authorities facilitated their safe transfer to charter flights for repatriation. Three days later, a 53-strong Cuban medical brigade arrived in Lombardy, Italy, at that time the epicentre of the pandemic, to assist local healthcare authorities. The medics were members of Cuba’s Henry Reeve Contingent, which received a World Health Organisation (WHO) Public Health Prize in 2017 in recognition for providing free emergency medical aid. It was the first Cuban medical mission to Europe. By 21 May, over 2,300 Cuban healthcare professionals had gone to 24 countries to treat COVID-19 patients, including a second brigade in northern Italy and another to the European principality Andorra.
The threat of a good example
Cuban medical internationalism began in 1960, but the export of healthcare professionals was not a source of state revenue until the mid-2000s with the famous ‘oil for doctors’ programme under which 30,000 Cuban healthcare workers served in Venezuela. US President Bush’s administration responded by attempting sabotage Cuba’s medical export earnings with the Cuban Medical Parole Programme. This induced Cuban professionals, who had paid no tuition costs, graduated debt free and voluntarily signed contracts to work abroad assisting underserved populations, to abandon missions in return for US citizenship. President Obama kept the Programme, even while praising Cuban medics combating Ebola in West Africa. It was ended in his last days in office in January 2017.
Video: Doctors speak (Cuban medical internationalists)
The Trump administration has renewed attacks on Cuban medical missions, fueling their expulsion from Brazil, Ecuador and Bolivia, and leaving millions of people in those countries without healthcare. The motivation was the same; to block revenues to a nation which has survived 60 years of US hostility. In the context of the pandemic, when the US government’s willful failures have resulted in tens of thousands of unnecessary deaths, socialist Cuba’s global leadership has represented the threat of a good example. Lashing out, the US State Department has labelled Cuban medics as ‘slaves’, claiming that the Cuban government seeks revenues and political influence. It has pressured beneficiary countries to reject Cuban assistance in their time of urgent need. These attacks are particularly vile; it is likely that Cuba is receiving no payment, beyond costs, for this assistance.
Meanwhile, the criminal US blockade, which has been punitively tightened under Trump, is preventing the purchase of urgently needed ventilators for Cuba’s own COVID-19 patients. A Chinese donation to Cuba of medical equipment was blocked because the airline carrying the goods would not travel to Cuba for fear of US fines. There is now a growing international demand for an end to all sanctions, not least against Cuba which has shown global leadership in combating the SARS-CoV2 pandemic. We must all add our voices to this demand. There are also calls from organisations and individuals worldwide to nominate Cuba’s Henry Reeve Contingents for a Nobel Peace Prize. What is clear from its history of principled medical internationalism is that, with recognition or without, revolutionary Cuba will continue to fight for global healthcare wherever its citizens, and its example, can reach.
The unprecedented migrant-labor crisis in times of corona pandemic was in fact a ticking time-bomb that policy makers and development experts chose to overlook as India’s urban population grew to around 31% according to last held 2011 Census. World Bank’s estimates pitch these numbers to 34% in 2017, and predict that with this upward slope, above 50% of India will live in cities by 2050. These predictions however were made for an affluent India with an average 7-8% targeted growth rate per annum something that we witnessed before 2008 crisis and even after it until the 2014-15 drought.
These spiking urbanization estimates were based on the population explosion and growing rural-unemployment, as more and more youth were moving away from agriculture based activities in villages. Another push factor from villages to cities were the rates at which we were generating jobs before 2012, which were in tandem with the number of internal-migration taking place between and within states. To put it straight, before unemployment pegged to an all time high lately, with rural India being the worst hit, India was fairly able to generate jobs for non-agricultural laborers who flooded cities.
With the rising urban population due to internal-migration, labor-migration being one of them, India was able to absorb most of these workers in various industrial, manufacturing and service sectors and in other non-farm employment apart from the informal sector. But this is just one side of the growth story, as while we were happy utilizing our demographic dividend along with prosperous growth, the social and human impact of urban-growth was unfolding itself in forms of congested urban slums with poor healthcare and sanitation, low standards of living and an overbearing psychological stress with very poor quality of life. Where we failed, was in reading our economic growth along with social and civic aspects of life.
Had we asked our experts to handle economic growth with social development, the picture that we have of the urban India, unfolding in front of us today, with millions of migrants deserting cities just to themselves keep alive, would have been different. We simply refused to accommodate our social-scientists across disciplines in our policies as abundantly as we should have, and instead focused on one-way growth without acknowledging the obvious fall outs all along.
Most of our experts went on handling India with numbers and statistics, when our most brilliant universities were a repository of social scientists who had read India socially and knew what she needed for a holistic social progress and social security besides economic growth. As we see this crisis unfolding today, we again have been dealing with numbers, understanding labor-migration as over 100 million work-force in peril walking day and night back to places that they left in search of growth. According to 2017 Economic Survey’s estimate, India’s internal labor migration is around 20% and India’s urban population is around 34%. In nutshell, over 100 million workers were in service of around 277 million urban-dwellers, that is one worker for every third urbanite.
As all of them have been leaving our urban centres today, we need to question the rationale and humane cost of such a social structure? In short, when we are distressing over such a reverse-migration that can potentially take India years back on its growth trajectory, can we now care to ask, why did over a 100 million people leave their villages in the first place? The answer will be because we made our villages unsustainable for their livelihoods.
A simple answer, that all of them were looking for non-farm/non-agricultural jobs won’t suffice. Had we developed sustainable models for our villages, a large number of labor workforce could have been absorbed in and around their villages or district centres. The fashion in which we modeled our manufacturing/services and industries compulsorily required non-farm labor to migrate to such great distances. Majority of these manufacturing hubs were permitted to be established according to respective interests of the capitalists and other industrial giants with cheap labor, availability of resources etc.
In the name of developing our villages, we permitted industries in mining, roadways, that not only benefited the affluent few but also weakened our villages, further pushing them into never ending cycles of fair compensation pursuits and Jan-aandolans because of forcible land-grabs. We uprooted our villages and minimally compensated them. As far as regular push and pull rural-urban factors are concerned, we again defend it through numbers by saying that with each expanding family the pressure on the size of the land-holding grows and hence moving to cities is their only option.
If we go by the data, by 2050 when more than 50% of India will live in cities, the rate at which India is urbanizing is still slow as compared to the world average, and it is estimated that along with her growing urban population, India will add another 400 million to its rural-population by 2050 as well. The need to refocus on villages hence arises here when we are seeing the migration disaster unfolding at a time when the world is fighting corona.
The current tragedy calls for a paradigm shift where along with our cities we focus on holistically developing our villages in a fashion that generates employment and growth in a sustainable way within villages. Our policies need to create opportunities within the villages for the sake of 400 million that will be added to the existing village population gradually. If we do not take any steps in that direction, then the rate at which people migrate to cities will rise uncontrollably, making life in our urban centres more challenging than it already is. Sustainable growth and development of our villages can start from some of the already existing models such as Cluster-Model-Villages, MP’s individually adopting villages, infused with employment generating policies exclusive for villages such as MNREGA. However, these are some of the pioneer initiatives that can lead the way for new sustainable models.
The idea of India Residing in Villages is here to stay for long. The terminologies for locating such an India will keep shifting from rural-rurban-urban. Because of the ongoing reverse-migration, we are already adding millions of unemployed workers back to our villages that shall further lead to a sharp spike in the rural-unemployment rate. We need to tackle this disaster within our village centres, and the first step we need to take is to cease considering Cities as our only engines of growth. Prosperity and growth in villages shall not only take the excessive pressure off our already suffocating cities, but will create a balance that will take our villages out of poverty and backwardness in the long run. Now is the time, when we innovate and develop new models for a sustainable village life, and immediately chip in our experts, academicians and bureaucrats to think and lead in this direction.
APJ Abdul Kalam in his Target 3-billion floated a similar idea under PURA-Providing Urban Amenities to Rural India in which he discussed how expanding economic opportunities to rural-India shall be beneficial for an overall sustainable growth. The tragedy of this on-going reverse migration has sent shockwaves within the labor-force who are surviving one day at a time in hope of finding their homes. The misplaced policies in this disaster has further added to their misery and what we witness every day is writing of a history that will not be kind to many of us who saw them fall into this pit and couldn’t do anything. It will hence take a long time for them to migrate again to cities. We cannot keep building our policies where we push them to urban-slums and then push them back to hunger and poverty awaiting them in their villages. Our governance needs to show them that their lives matter, and working towards their sustainable future in villages is first step in that direction.
“Education is the most powerful weapon which you can use to change the world.” Nelson Mandela.
Derived from a Latin word “ Educatum” it means the act of teaching or training. The training to nourish the good qualities in human beings and to bring out the best in every individual. Education seeks to develop the innate capacities of man. To educate individual is to give him some desirable knowledge, understanding skills, interests, attitudes and critical thinking. It is education which enables individual to differentiate between good and evil.
The modern age is the age of “Digital Technology and Digital Masters”. From small retail stores to big government offices, almost every task is being carried out by using digital technology. During the present crises the system of education has heavily come under the purview of digital technology.
Although, education is one of the basic and fundamental prerequisite for the development of a person and personality, an individual can develop himself into a potential being only by pursuing education. In fact, education and digital technology are adjacent to each other but once the digital technology becomes the only agent of communication, it unfolds a different perspective where the class distinction comes into the limelight.
While the government of India had launched the “Digital India Campaign” to make the government services available to each and every citizen electronically by providing them online infrastructural improvement and connectivity. It also aims to empower the country digitally in the domain of technology, education and to provide high speed internet networks to rural areas.” India is home to the largest population of children in the world, with an estimated 430 million children in the age group of 0-18 years ( Censusindia.gov.in) which absolutely is a great asset to have. The campaign also claims to bring in the policy of inclusiveness, where everyone is supposed to be engulfed under it. But when introspected, it looks upside down. As the requirements to bring in the digital development can not be met out by each and every individual of the society, they can not afford it on their own. So the first query that strikes the mind is, what are the parameters of making a pure digital country? Who is having the access to digital technology, what it requires to be the part of “Technologically Enhanced Learning” or e-Learning.
Obviously, it requires the proper investment in digital infrastructure, to make each and every citizen connected to the digital world, for that matter one must have access to smart phone, internet, electricity, personal laptops, digital skill etc. Going by the present circumstances, it seems that, to have access to these things is a remote possibility as half of the population in India is struggling for their livelihood, be it food, shelter, health etc.
On the one hand, the draft on “New Education Policy 2019” says that “the new vision of India’s new education system has been crafted in such a way as to ensure that it touches the life of each and every citizen, consistent with their ability to contribute to many growing developmental imperatives and would also ensure to create a just and equitable society.”
Though the pandemic forced the government to project the e-learning or online classes as a sole medium to impart education. But on the other hand, it becomes imperative to understand that, is government providing adequate opportunities for all to get access to the digital world, Does everyone receive the same kind of education, opportunities, benefits, attention and does equality prevail in receiving the education.
Although the Indian constitution under article 21A makes the right to education a fundamental right for children between the age of 6 to 14 years and makes it free and compulsory for the same, but the current situation demands that the investments in educational system in India should be made in such a way that everyone gets equal opportunity for the full development of his personality and then only he/she can play a positive and active role in the development of society.
The current scenario also unfolds a sorry story for the poor and deprived students, they can not avail the opportunity of online classes or e-learning as they do not possess the electronic devices. Socrates one of the great philosopher had said that “Education means the bringing out of the ideas of universal validity which are latent in the mind of every man”. But the authorities are restricting the universal asset i.e., education to the privileged few and deny others the opportunity to bring those ideas into concrete reality. So the proletariat are not only being alienated socio-economic and politically but educationally as well.
Talking about Kashmir the digitalization of education is a dysphoria as we often see internet blockade on one pretext or other. The electricity or the power cuts are no less than a play of hide and seek. During the present crises, when the whole world is trying to stabilize their education system by turning to digital technology. The poor Kashmiri students are still demanding the restoration of 4g speed internet which we have been deprived of following the abrogation of article 370. Being a student we are really finding it difficult to keep our pace as authorities have failed to provide the basic requirements of digital technology.
In my opinion “Digital Education” in India in general and Kashmir in particular is not a bad move but the “Digital Transformation” should be carried out in such a way that it does not differentiate between the haves and have not’s. It must take into consideration each and every student irrespective of class, caste, gender, region etc. It should provide equal opportunities for all where everyone’s education, interests, existence is being taken care of. Therefore, it should not be projected in a way that you can not study because you do not have access to electronic devices and digital technology.
The current pandemic situation across the globe has accentuated the pre-existing trend of mental health issues to the global forefront. What is more alarming is most of the world is under complete or partial lockdown and people living or developing mental health issues are unable to access the basic treatment. The emergence of mental health issues which is visible now in the low and middle income countries and its address has been thwarted by the pandemic on the run.
The COVID-19 as it unfolds is going to have lasting and profound effects on the mental health. Under the sub-text of ‘Changing the Conversation’ we would be writing series of articles on how to put forward a public health response on mental health challenges from different vantage points. The deniability of mental health treatments to individuals and vulnerable groups is due to lack of awareness and stigma attached to it. This stigma multiplies over a period of time having an enduring effect on mental health. Moreover, absence of coherent data, form, extent, duration and distribution has led to difficulties in mitigating the mental health issues now. Here, we look at the onset of mental health problems which is looming before us and how we must start a conversation.
Distress, Disorders and Disabilities
There is no health without mental health. A healthy person should have a healthy mind. A healthy person should be able to think clearly. A healthy person should be able to find solutions to her problem. A healthy person should be able to have good relations and be satisfied. It is in these essential aspects of our health which is known as mental health. Prof. Vikram Patel (one of the leading psychiatrist of the world) says mental health problem is ‘a problem experienced by a person which affects their emotions, thoughts or behaviour, which is out of keeping with their cultural beliefs and personality, and which is producing a negative effect on their lives or the lives of their families.’ The way a physical body can be ill, the mind too can be ill.
However, it is important to understand there is severity in which mental health problems can be categorized as it affects the impact of the individual.
Distress is the most common type of mental health problem. Distress is characterised by a mixture of different complaints (such asfeeling sad, worried, tense or angry), often of short duration, and in response to difficulties in one’s life (such as the loss of a loved one).
Disorder is a more severe, but less common,type of mental health problem. Disorders are characterised by more clearly defined groups of complaints which can be classified using a medical diagnosis, typically of a longer duration than distress, and not necessarily associated with, or explained by, difficulties in one’s life.
Disability is the most severe, and least common, type of mental health problem. Disabilities are characterised by enduring impairments in a person’s daily functioning (e.g. the ability to communicate with others) and may be present from birth or very early childhood, or appear later in life as a consequence of a mental disorder.
The categories lay emphasis as Prof. Patel highlights on mental health problems which can be suspected and thrive on an individual even in the absence of physical disease.
Identification and Assessment of mental health problems
According to the survey conducted by The Indian Psychiatry Society after 21 days of the lockdown in India revealed a rise of 20 percent rise in mental health cases. This survey has raised pertinent questions on the need for early recognition of mental health issues during a health crisis and the consequences for the person affected by it. Can we say that the rapid propagation of online surveys which claim some representation and media attention captured atleast the broader mental health problem during the pandemic? How can the value of the data collected through the samples be measured against the use of the data? Does larger sample sizes in identifying the mental health issues solve the biases attached?
There is inter-dependency on how we identify the mental health problems and which lead to timely assessment and treatment. The causes of identification problems includes lack of knowledge of health and social care staff, about the symptoms ( be it emotional, cognitive, behavioral or perceptual), not addressing the learning and physical disabilities, lack of information being shared among peers and difficulties for an individual to communicate her distress. Since the identification of the mental health problems is impaired; assessment and resource allocation becomes ineffective. We need now comprehensive evidence through surveys with detail sample strategy which is currently unavailable to mitigate the mental health challenges before us today.
Starting the Conversation
Mental health problems, depression, anxiety and so on are conversation which the society till now is not willing to engage with and take note of. The individuals going through the traumatic experience are categorized as weak, attention seeking and they need to toughen up. This belief which lingers on in a community is one of the central reasons why stigma is attached to mental health education.
In this health crisis another crisis of mental health has emerged. How do you a start a conversation in this pervasive atmosphere. The community needs to be receptive and take the initiative. If someone you know, or even don’t know needs assistance and to have a conversation ask them “Are you OK?”, “I’ve got time to talk” “So tell me about..? “Lots of people go through this sort of thing. Getting help will make it easier” “There are people that can help. Have you thought of visiting your doctor?”.
Moreover, the role of family members and caregivers becomes paramount to identify for instance the behavior, signs of distress, loss of skills or onset of cognitive systems. Since family is the first point of contact to an individual, when families raise concern the treatment by paid career or psychologist could be carried out. The lockdown due to pandemic have forced the persistence of mental health problems and denied access to diagnostic interventions. But community and family can be integrated to promote mental health at all levels of care.
The plight of migrant workers during the lockdown period has necessitated to examine the law prevailing relating to the migrant workmen. We have witnessed reverse migration and the pathetic conditions faced by the migrant workmen in the process. Thousands of migrant workmen started trekking hundreds of kilometres to their villages in spite of the tightened surveillance by the authorities to prevent people from crossing states amid fears that they could carry the virus.
The sudden clampdown throughout the country generated insecurity in the minds of the migrant workmen mostly who are working in un-organised employment such as shop assistants, security guards, cooks and other casual jobs. There is no record maintained with regard to the particulars of such migrant workmen by any of the employers. The only law that is governing the field of migrant labour is The Inter-state Migrant Workmen (Regulation of Employment & Conditions of Service) Act, 1979. Now the question is as to whether the said Act takes into its fold the grievances of all the migrant workmen mostly those who are working in un-organised employment.
Most of the people migrate from rural areas to urban areas wherein there are green pastures of labour employment in various sectors such as industries, farms, labour markets, hotels, tea stalls and such other allied businesses. The lack of uniform development throughout the country, deficit rainfall in certain areas adversely effecting agricultural activities, stimulated the migration of labour to the urban areas. The largest employer of the migrant workers is the construction sector, domestic work, textile industries, brick kill work, transportation, mines and quarries and agriculture. Most of them are managed by private labour contractors. The migrant workmen can be classified into two categories (1) those who are working in any establishment wherein five or more migrant workmen are engaged and (2) those who are working in petty businesses and jobs. These migrant workers are the most vulnerable group and subjected to opportunistic in difference. The private contractors or any other like source of agencies are not duly identified in case of those migrant workmen falling in the later category. In such crisis as we are facing today, it would be necessary to maintain a record of the migrant labour working in various cities so as to prevent such a huge calamity of reverse migration. If proper record is maintained encompassing various types of migrant labour, it would be easier to protect their interest by the State in such a situation as we are facing now.
The Central government though had directed the local authorities to provide food, sanitation and accommodation to migrate workmen, most of them could not be benefitted for the reason of lack of their identity as migrant workmen. Obviously most of the migrant workmen working in small businesses and works are outside the ambit of The Inter-state Migrant Workmen (Regulation of Employment & Conditions of Service) Act, 1979 and therefore it has become very difficult to identify them.
The Inter-state Migrant Workmen (Regulation of Employment & Conditions of Service) Act, 1979 is only the major Act governing the field. The said Act was enacted with a main objective to eliminate the abuses prevalent in the system. In the background of the inter-state migrant workmen who are generally illiterate, unorganised and have normally to work under extremely adverse conditions, it necessitated for passing the said legislation to prevent exploitation.
A reading of the provisions of the said Act shows that the said Act is made applicable only to the establishments wherein five or more inter-state migrant workmen are employed on any day of the preceding twelvemonths. The Act is not applicable to those migrants who are engaged in petty businesses and in fact they are larger in number. The provisions of the Act mandate that the establishments have to get registered with the department if engaging migrant workmen. License is granted under the said Act to the contractors through whom the migrant workmen are inducted by the establishments. The Act specifies duties and obligations on the contractors and also various aspects relating to wage rates, welfare and other facilities to be provided to the inter-state migrant workers. Most of the obligations are cast upon the contractors only. Therefore the identity of those migrant workmen who are working in any establishment as defined within the ambit of said Act can easily be established.
Since the Act is limited in its application, it does not take into account the spread of migrant labour in the major cities engaged in small businesses. There is no record pertaining to the migrant labour engaged in petty businesses and works. The Act as stated above speaks only with regard to the duties and obligations of a labour contractor and to some extent establishment in which the migrant workmen are engaged.
The definition of migrant labour of the said Act is a very confined definition. It defines inter-state migrant workmen as a person who is recruited by or through a contractor in one State under an agreement or other arrangement for employment in any establishment in any other State whether with or without the knowledge of the principal employer in such establishments. This definition shows that it does not take into its ambit the various migrant labour spread in various mega cities working in small businesses and doing petty works. Most of them are migrated to the cities in such of employment directly without approaching any contractor. The Act does not take into its fold such migrant labour and therefore there would not be any record available in relation to such type of most spread and un-organised migrant labour and their identity cannot be easily established.
In the type of calamities which we are facing today, the migrant workers try to go back to their village where they have homes, food and support systems from close-knit communities. Since their identity is already established in their villages, the feel secured if they return back to their villages.
In order to pass on the benefits provided by the State to minimise the plight of the migrant workmen, a proper record fully containing the particulars of the various types of migrant workmen who are working in petty businesses and works irrespective as to whether they are engaged through a contractor or not has to be maintained and the same would resolve the problem of identity of such migrant workmen. There has to be a comprehensive legislation contemplating maintenance of records and creating obligations upon the employers who are engaging migrant workmen in small businesses and works in big cities. This would benefit such class migrant workmen who are outside the ambit of The Inter-state Migrant Workmen (Regulation of Employment & Conditions of Service) Act, 1979 and to some extent may eliminate the fear of lack of identity generated in their minds.
On June 8, the Irish Taoiseach (prime minister) Leo Varadkar, leader of the current Fine Gael government, will instigate Phase Two of a five phase plan to exit from the coronavirus lockdown.
Under Phase One, 1,500 retail shops reopened on May 18 along with outdoor workers, including construction workers, returning to sites. Varadkar’s government is planning to reopen further shops and businesses, with a full opening up of the economy in Phase Five of the plan by August 10. Schools and colleges will reopen in September.
Varadkar told the Dáil [parliament] last week that the government’s mission was to get “business open again” and “get the economy humming.” But he is not moving quickly enough for business. The Irish Business and Employers Confederation (IBEC) has insisted that the government bring forward the phases of reopening of the economy and scrap the two-week quarantine restrictions for people entering the country.
There have been over 25,000 confirmed cases of the coronavirus in Ireland, almost half in Dublin. Almost 8,000 have been among healthcare workers. Of the 1,650 deaths from the pandemic, one of the highest death-to-infection ratios globally, the old and infirm have suffered greatly with 62 percent of deaths occurring in nursing and residential homes. Northern Ireland has seen approaching 5,000 cases and over 500 deaths. Around half have been in care homes.
The scandalous treatment of the old and infirm in nursing homes led Dr. Marcus De Brun to resign from the Irish Medical Council in late April. On May 30, it was widely reported that Dr. De Brun had released a memo from the Health Service Executive (HSE) showing that doctors in care homes were instructed that if one resident tested positive for the virus, others should not be tested as it was assumed they already had it.
The decision not to test cost the deaths of 52 residents in the North Dublin nursing home to which he was attached. Dr. De Brun stated last week, “Residents I had put on the list to be tested were being booted off the list without me being informed. To be denied the possibility of testing, to figure out if this COVID or not COVID, that created huge difficulties for the sector and certainly for the nursing staff and any hopes of isolation.”
Just two weeks ago, more than 600 coronavirus infections were reported in 12 meat processing plants across the country. Frigid temperatures, cramped conditions, and long hours put meat processing workers internationally in danger as the super-rich seek to rake in profits at any cost.
The collaboration of Varadkar’s caretaker government with the bosses who own and control the meat plants came sharply into focus last week. Irish Chief Medical Officer Tony Holohan revealed that the Health Service Executive (HSE) was running a practice whereby COVID-19 test results of workers were being given to the companies instead of to the workers concerned. In many cases the first time that workers heard of their positive diagnosis was from the company and not from the HSE.
Even though this was condemned by the Data Protection Commission as “not legitimate”, Minister for Health Simon Harris condoned the arrangement stating baldly, “It has been necessary in the interests of public health to give the results of confirmed cases of Covid-19 to the management of meat plants.”
There is widespread anger among working people at the callous indifference shown to workers and young people by the ruling elite. It is four months since the Irish general election on February 8 which resulted in Varadkar’s governing Fine Gael party coming third in the poll, both in seats and in first preference votes. Even before the pandemic, the vote reflected working people’s anger at a growing housing and homeless crisis, coupled with a deterioration of the health services and all aspects of social care.
In response, the two main bourgeois nationalist parties, Fianna Fáil and Fine Gael, are posed to abandon their already nominal differences—resting on a historical division over the Irish border and Civil War—and concentrate on jointly implementing the dictates of the ruling elite. The Green Party are holding talks with both Fianna Fáil and Fine Gael and are seeking to enter government with them. Sinn Fein, who have no fundamental differences with the talks’ participants, won the election with some left posturing but have thus far been excluded.
The talks between the three parties are to be concluded in two weeks. Varadkar and Simon Harris have set the agenda of future policies by scrapping the state takeover of private hospitals implemented at the start of the pandemic with the aim of returning the sector to private interests.
A right-wing ideological barrage against workers opened last week when Varadkar outlined to the Dáil an extension to the €350 COVID-19 pandemic unemployment payment beyond June 8. The temporary payment, introduced in March, is paid weekly to laid off and self-employed workers. As of mid-May, around 585,000 were in receipt of it. In total, 1.26 million workers are relying on state support for all or part of their income through various similar schemes, including a wage subsidy scheme for which 54,000 employers registered.
Varadkar insisted the €350 payment would be cut by the next incoming government because some workers were better off on the payment than when working. Varadkar sniped, “I have heard stories of people who have asked their employers to lay them off, because they would be better off on the €350 payment. I would say to anyone who is thinking that, we are all in this together, and nobody in any walk of life should seek to be better off, or seek to make a profit out of this crisis.”
Varadkar was supported last Saturday by the Irish Independent newspaper which gave a two-page spread to Pat McDonagh, owner of Irish burger chain Supermac’s. McDonagh, who spoke in opposition to the continued payment and whose estimated wealth is €117 million, compared the emergency pandemic payment of €350 for low paid workers during the pandemic to being like “winning the lotto.”
The social policy of the Varadkar government, which is willing to dispose of the elderly, the sick, and the immune-compromised, while attacking workers’ conditions on behalf of the financial elite, will continue with the aid of the rest of the political establishment—likely with the forming of the three party coalition government. An indication of any new government’s agenda can be drawn out from the fact that talks with the Greens are reported to be dragging on over finance, levels of social protection, the state deficit, the pension age and carbon emissions. Last time the Greens were in power, they assisted Fianna Fáil in launching billions of euros of austerity measures in the aftermath of the 2008 financial crisis.
Workers in Ireland, North and South, find themselves irreconcilably opposed to the economic interests of the Irish capitalist class and the capitalist system. Fighting the pandemic and the assault on jobs, wages and benefits requires that Irish workers mobilize independently, form rank-and-file action committees in every workplace and seek to unite as a class in Ireland and internationally.
