The Birth of the Humanitarian Crisis: Unpacking the Relationship between Crisis Adaptation Measures and Medicalization of Socio-Cultural Fault Lines
By-Kalpita Bhar Paul and Soumyajit Bhar
Our life amidst the COVID crisis has transformed on various fronts. While it is transforming our everyday living practices, it is also changing the societal perception of death. Death is not an unusual phenomenon in any society. The world used to witness 150000 deaths every day due to disease and old age prior to the COVID 19 outbreak. Across the globe, COVID has already caused thousands of deaths. The social protocols around death have witnessed a sea change post COVID due to the very nature of the disease. The distancing of the dead body, the bureaucratic restrictions imposed on conducting the last rites, and the shrinking space for collective grief and sharing of loss over time — all this has turned death into a game of mere numbers. The highly personal space of grieving has been taken over by the medicalization of death and its socio-cultural experience. In medicalizing the process of dying, death becomes a biological process, and the medical system can only explain how one died. With COVID, the medicalization of death has become the predominant face of death. Not only our lived-experience of death, but our everyday social experience is also witnessing a certain degree of medicalization; here, we reflect upon the broader socio-cultural implications of the same.
COVID crisis is one of the greatest humanitarian crises that has globally threatened us after the Second World War. Since 1945, we have come a long way, owing to the spread of neoliberal economic policies and economic liberalization aided through technological breakthroughs and consumerism. It is often thought that when faced with an imminent crisis, humans strive to be more social than usual to better cope with difficult circumstances. During the present crisis, however, we observe individuals with economic capital striving to remain in a safe cocoon and easily shifting their social collaboration on the internet — social media fulfills their social needs. It follows that for a certain section of society, it is easier to practice social distancing, which is recognized as a crucial step to hinder the spread of COVID-19. Collectively, in all public places, we are enforcing social distancing norms, and that definitely medicalizes our lived-experience as social beings. We are creating an imaginary bubble and acknowledging that space as a private one in the public realm. We sanitize a collectively used object before using it, be it an ambulance stretcher, a supermarket shopping trolley, or a seat in public transport.
COVID-safety norms provide a scope to medicalize the notion of purification. Social distancing norm is the need of the hour, but the question is whether the practice will continue even after the need ends? History records once a medical practice is rolled out and gets appropriated as a hygiene protocol, even if it is not globally practiced, a society can easily continue practicing that without much objection. A few examples include the mask-wearing practice in Japan or the flossing practice in the USA. Similarly, if social distancing practice continues in the name of precaution, can it be challenged on humanitarian grounds to protect social harmony in the context of India? We need to ponder over whether an apparently a-political measure of social distancing, being prescribed by medical science, can help reinstate the hegemonic power of castes or classes over the marginalized sections.
India, as a country and as a culture, carries a long history of purity. The hegemony of the caste system is grounded in the idea of purity. Social distancing is not a new phenomenon in India. Culturally, we have practiced caste-based social distancing as well as discrimination for centuries together. In the public domain, creating an imaginary private space was an accepted practice to grant purity to the upper castes. Instead of present-day’s alcohol-based sanitizer, we used Gangajal (water from the river Ganga) to purify a commonly used entity. Post-independence, the Indian Constitution and the four pillars of democracy worked to overcome this caste-based discrimination by formulating inclusive policies as well as by providing reservations to marginalized castes. However, our societal circumstances demonstrate that one’s lived-reality is far removed from being what is claimed or desired. With increasing caste-based violations in India, COVID-induced social distancing norms can very well serve as scientific rationale, and in turn, can medicalize the process of maintaining purity. The progress made to eradicate caste-based discrimination in the last seven decades, however inadequate it may seem, can very well be reversed through the public health safety measures of social distancing. It allows individuals to maintain their purity in the public domain as and when required.
In the private realm, practicing social distancing norms relies on one’s economic capital. People living in overcrowded areas or congested towns hardly have the luxury of a private space for each family member. On many occasions, the public and private spaces overlap in such areas. If we keep aside the distancing between members of a family and focus on the outsider’s access to one’s home, it is easy to notice the fallouts of social distancing and COVID safety norms. It rationalizes caste and class-based distancing at home and enforces the maintenance of purity. Some of the most common practices of caste-based discrimination observed in Indian households are the use of separate utensils and discriminatory seating arrangements for individuals from lower castes. These gestures act as signifiers. Up until now, these issues were limited to uncomfortable conversations between comparatively progressive and traditional members of the same family, as without resorting to caste discrimination, it was hard to normalize this age-old differential treatment. With COVID safety norms, it now becomes convenient to bring both progressive and traditional family members under the same umbrella of medical science. Medicalizing social experiences magnifies the casteist purification that was slowly fading away through systematic policy- and governance-based efforts. Medicalization allows individuals to access their freedom of choice-based moderation of social distancing norms and normalization of existing societal fault lines.
Social distancing is an emergency protocol for COVID safety; it is also recommended to be continued to contain future waves of the disease. However, in India, it puts a huge toll on the social experience of different communities and their interactions. The socio-economically marginalized communities are going to bear the cost of it as their lived-experience would be filled with emotions like disgust, threat, anger, or hatred. It is easy to blame these marginalized communities for spreading the virus as they are the most vulnerable to it due to their lack of infrastructure and economic capacity. We have already witnessed the same blame game towards Muslims or Dalits. The discrimination against migrant workers evidently possesses an undertone of caste-based discrimination. Or the same discrimination can also be said to have led to the biased distribution of relief packages during the lockdowns. An EPW article reports how the attitudes towards sanitation work, a profession in India that still carries the burden of caste-based discrimination, deteriorated drastically during COVID. In a moment of crisis, the dark shades of society come alive and reinforce individuals’ conditioning and biases, which a progressive society tries to transcend but fails.
If the measures to tackle a crisis can potentially deepen socio-cultural biases or normalize them, then it is a matter of deep concern. COVID measures are one such example. As each of us wears a mask to safeguard ourselves from the virus, social distancing can be the mask offered by medical science to protect our socio-cultural prejudices. While we acknowledge the importance of maintaining social distancing as a critical way to tackle COVID-like health emergencies, we highlight the need for vigilance and social scrutiny so that such distancing does not deepen the existing socio-cultural fault lines. Along with COVID, the other crisis which is most talked about in the current time is Climate Change. On many occasions, experts have highlighted that our capability to manage COVID demonstrates our future capability to manage Climate Change.
The pressure of the rising population is designated as a significant contributing factor to the climate crisis. If the energy and resource-intensive lifestyles prevalent in the global north are considered to be the standard, Earth can sustain only a fraction of the present world population’s consumptive demand. Be it the half-earth project, neo-Malthusianism, eugenics, or UN agenda 21, such lines of thought showcase the need to contain or possibly reduce the rapidly growing population of the global south nations. It is, however, ethically unjustifiable to juxtapose the pressure of the luxurious lifestyles of the citizens of developed countries on the environment and the resource base with the pressure exerted (even if it is higher in absolute terms) by billions of people living a barely subsistent life in the developing countries. The disproportionate contribution of the former to the climate crisis is overwhelmingly higher than the latter. In spite of that, when the climate crisis becomes even more immediate, not only would some form of fascist population control measure be implemented and systematically targeted towards the socio-economically marginalized sections of the developing world, it would also normalize and rationalize the draconian measures resulting in a reinforced abyss of marginalization. For example, COVID crisis is already denoted as a manifestation of nature fighting back and how we, rather than COVID, are the virus. Clearly, this framing has an eco-fascistic undertone, and this ‘we’ in ‘we are the virus’ can be targeted towards those marginalized sections who have higher population growth rates; higher population rates can conveniently be equated with the growth rate of various microorganisms like viruses and bacteria. There are already examples of eco-fascistic policies being implemented in India, evidently targeting the marginalized and minority sections.
The outbreak of COVID-19 virus in the human population is rightfully denoted as a prime example of how environmental imbalances can affect human health. Now, as many are considering COVID to be the tip of the iceberg and climate crisis the iceberg itself, several such health emergencies are predicted in the next few decades. Many experts have recently proposed that climate change should be announced as a health emergency. Instead of dealing with climate change as a socio-environmental threat after the outbreak of this pandemic, one must consider climate change as a public health emergency. In addition to medical emergencies, by far, the most despicable humanitarian crisis that is going to be induced by these climate disasters is that of climate migration. The cascading nature of climatic disasters can possibly be an invisible factor — capable of inducing fear and panic of the highest order. When a large portion of the world will witness more frequent and intensified climate disasters, a climatic disaster phobia induced by eco-anxiety is likely to creep in and make the society fragmented, borders restricted, and spatial division more stringent. So, on the one hand, a direct link between environmental imbalances and health emergencies is likely to give rise to the medicalization of ecological harmony, which in turn, can strengthen eco-fascistic sentiments and measures. On the other hand, eco-anxiety and climatic disaster phobia can bring to the fore deep-rooted xenophobic sentiments and rationalize eco-fascistic measures to control the population of certain sections.
Crisis, by its very nature, invariably attacks our sense of security and the idea of certainty in our ways of life, which are afforded by this modern world running on fossil fuels. Medicalization of the climate crisis eventually ties in this sense of security of individual life with the impending crisis situations we are likely to witness. Undoubtedly, this is one of the most effective ways to capture individual attention toward the severity of the climate crisis and help drive international cooperation to combat it. However, if we continue to replicate the patterns of marginalization observed during the COVID crisis and the medicalization of purification, both of which worsened the situation, we must explicitly create checks and balances to block the medicalization of the existing socio-cultural biases in our fight with the climate crisis. Otherwise, this can further fragment our society along existing fault lines and adversely impact humanitarian values, turning the climate crisis into a deplorable humanitarian crisis.
A short version of this article appeared on Down to Earth
