COVID-19; THE INEQUALITIES IN OUR HEALTHCARE SYSTEM

At this point in human history, the inequalities in our healthcare system has never been more glaring. As there is a stark difference between night and day so is the lacuna in the distribution of wealth and health. The developing economies of the world have taken and continue to take loans from the developed economies. The conditions attached to most of these loans are such that the borrowing nation will be in perpetual debt. This cycle of borrowing coupled with incorrigible leadership has resulted in inequalities in health. While the seemingly unsurmountable gulf between the haves and have nots will continue to exist, the chasm can be bridged.

In less than six months, the ongoing pandemic has caused more than three hundred thousand deaths globally. Five million people have tested positive for the disease and more than 180 nations of the world have registered the presence of the disease. More than half of the global population is on lockdown because of an unseen enemy that strikes both the developed and developing nations; rich and poor. This enemy is not a respecter of persons, place or time. It can strike in temperate as well as in tropical regions. It can attack in the winter and in the summer months. It strikes both the rich and the poor. Those in the higher echelons of government and royalty are not immune to its assault. This invader of the human race strikes equally but the outcomes can vary depending on the inequalities in our healthcare system.

In developed nations, the disproportionate deaths of African Americans when they make up 13-30 percent of the population causes us to pause. In USA, seventy percent of those who have died from the pandemic are African Americans. A similar picture presents itself in the United Kingdom. Even amongst healthcare workers, African Americans or people from a less predominant race were among the first to die. Fundamentally, African Americans or people of color have been marginalized. They cannot afford to go to the hospital. They usually have to choose between paying their house rent or electricity bill leaving no room for healthcare. They lack good nutrition and are the ones likely to suffer from obesity, hypertension and diabetes. They lack good nutrition because the hidden cost of making healthy meals is not economically accessible to them. Recent studies have shown that patients with comorbidities have a poorer coronary disease outcome. They are more likely to die.

Further, when everyone is asked to stay at home during a pandemic, they are the ones that have the low-paying jobs that are considered essential services; the sanitation workers, trash collectors, hospital cleaners, store clerks, bus drivers, meat packers, nursing aides and care givers. Their jobs cannot be done remotely. They usually live in multi-generational households and cannot afford to self-isolate when they exhibit symptoms. Entire members of the household get infected. And when they fall sick, they are more likely to succumb to the disease because of the underlying comorbidities.

In Nigeria, the inequalities in health are usually between the ruling class and the bourgeoisie. We are all Nigerians but some seem to be more Nigerian than others. This lockdown should be a watershed moment for the ruling class. The same healthcare system that they neglected while they hopped to the developed nations for their perceived ill-health is now the succour of both the rich and the poor. While the African Americans whose forefathers were forcibly taken to the USA are marginalized in their own country, Nigerians who have remained in their Fatherland have been alienated from the riches of the land.

Business can no longer be as usual. However, our elite leaders still don’t get it. Even in these desperate times, the ruling class is seeking solace in private hospitals deliberately ignoring the death sentence they are imposing on the unsuspecting healthcare workers. Similarly, they are subjecting their house-helps, security gatemen, drivers and other retinue of helpers into worse fate because those ones lack the array of available treatment options.

Our leaders do not seem capable of understanding the dynamics of the lockdown on those who are living on the fringes of the economy. While they continue to ignore the elephant in the room; the inequalities in healthcare and the poor in our society, they forget that these are the ones in the supply chain of the agricultural produce they eat. They are the ones who become their security gatemen and drivers. They are the drivers of the motor tricycles and other forms of transport. The unseen enemy ravaging nations is not in a hurry to go any time soon. It does not even give immunity to those who have survived a first attack.

Our leaders must face the reality on ground. The unrepentant attitude of our leaders is hunting them with a ravaging, unrelenting enemy. While the lockdown, wearing of face masks and social distancing are good strategies, have they given a thought to daily wage earners? A few cups of rice would not keep them at home. They live four or more in a single room with shared kitchen and toilet with twenty or more families.

They cannot afford to self-isolate. Face masks and alcohol-based sanitizers are not economically accessible to them. They know how to wash their hands but they do not have access to pipe-borne water to even take a bath. Some cannot even afford to buy soap. While many states are trying to put their educational lessons online using the internet, radio and television, these people do not have smart phones or laptops to access the internet. If they are connected, they cannot afford to pay for internet data. And many more do not have a television to watch lessons from selected channels.

It is not too late for the inequalities in our healthcare system to be tackled and the marginalized in our society to be adequately provided for. Let’s reassess the lockdown.