By Bhavna Mohan
The stigmatization of persons diagnosed with, recovering from, or exposed to COVID-19 is detrimental to efforts in curbing the pandemic and is undeniably putting the citizenry and life as we know it in the new normal at risk, further compounding the new coronavirus clusters in the island.
After several months of no reports of COVID-19 among the community, to say an explosive number of cases is being reported on a daily basis is not an overstatement. As the virus is highly transmittable – a latest Australian study even claimed it can survive on smooth surfaces for up to 28 days (in a dark laboratory environment) – we need to ensure that we are doing our best in curbing its spread.
Essentially, whilst protecting ourselves by wearing masks, maintaining one-meter distance, washing and sanitizing hands often, and avoiding touching our nose and mouth have rightly become almost second nature to us, we need to pay attention to another aspect that is detrimental to curtailing the spread of the virus – stigmatizing persons associated with COVID-19.
An August study on “Stigma at the time of the COVID-19 pandemic” published in the Clinical Microbiology and Infection journal elaborates how epidemic outbreaks have historically been accompanied by stigma and discrimination; people with tuberculosis, HIV, leprosy, and Ebola were also stigmatized.
With the emergence of COVID-19 earlier this year, certain countries – even Sri Lanka – experienced xenophobia, which was a result of the virus being dubbed the “China virus” or “Wuhan virus” in media and even by political leaders, thereby making a false association between the race/country and the virus. Although the coronavirus originated in China, medical experts reiterate that it could have happened in any country, and no race is immune to contracting it.
What perpetuates COVID-19 stigma in Sri Lanka?
Reports in local media following the discovery of the first COVID-19 cluster this month referred to it as the “Brandix” cluster, which resulted in slander against the company. Allegations were leveled that employees of the company who had returned from India (allegedly including an Indian national) had not undergone the mandatory 14-day quarantine, leading to the company being blamed for “bringing the virus into the country”. Subsequently, however, Army Commander Lt. Gen. Shavendra Silva, speaking to the media, put those allegations to rest.
Added to that, in referring to the the initial COVID-19-positive persons in the same cluster, some local media outlets stated they were “spreading their COVID-19” virus, which implied ownership of the virus whilst suggesting they intentionally spread it to other people.
The use of such language and terminology is a result of irresponsible and insensitive reporting by the media, and was seen mainly online and on TV.
“The language we use when we talk about COVID-19 matters a great deal in perpetuating stigma. For example, ‘that COVID case’ and other similar statements can be stigmatizing, whereas ‘someone diagnosed with COVID-19’ or ‘someone recovering from COVID-19’ are more appropriate statements to use,” shared counselling psychologist Nivendra Uduman, speaking to the Colombo Gazette.
“I also believe a key contributory factor is inaccurate information,” added Uduman. “Inaccurate information often breeds fear, and that further aggravates the stigma.”
Social media has been more of a bane during this time; it allows the spread of fake news, misinformation, and disinformation, which has detrimental effects. For instance, the family of the first individual who tested positive for the coronavirus in the second wave faced mudslinging on social media, and claimed that they were now “ruined”.
Whilst there are laws in place against the spread of misinformation in the Penal Code and Code of Criminal Procedure to prosecute individual perpetrators, this aspect is rather grey for the media.
Whilst the media is governed by the Code of Ethics (1981), it is set out in the Sri Lanka Press Council (SLPC) Law of 1973 which only covers print media, it is learnt.
Sharing his expertise with the Colombo Gazette, SLPC Press Commissioner Niroshana Thambawita said: “As the (SLPC) law was implemented in 1973, it does not govern social media.”
Asked about holding the media accountable for their actions, he said: “If something that has caused reputational damage or that has caused disrespect to someone is published in a newspaper, they can complain to us and launch an inquiry. However, if it is published online or on social media, we cannot take any action.”
In this Age of Information where media has been successively shifting to the online platform over the past years, Sri Lanka seems to be far behind in taking steps to regulate it.
Asked Thambawita about this, he said: “As far as I am aware, there is a court order in place at the moment where newscasting websites have been asked to register themselves. Apart from that, unfortunately, TV, radio, social media, and web media do not have an administrative body.”
The effects of this lack of accountability have been seen time and again. In fact, most heartbreaking was a recent news item aired by a local TV broadcaster where the interviewer took it upon themselves to inform a child who had just completed the Year Five Scholarship Exam, about his mother’s death due to COVID-19. The news outlet then aired footage of the son wailing over his mother’s casket.
Asked Thambawita if the laws would be amended or new laws introduced in order to curb unethical journalism on platforms other than print. “We were in discussions to amend the act to include all these (TV, radio, social media, online) aspects, and now we are in the process of amending it. Once we do that, no matter where it is published/broadcast, we will be able to take action,” he said, speaking to the Colombo Gazette.
In efforts to promote ethical journalism, the Sri Lanka Press Institute (SLPI) released its recommended guidelines on “COVID-19 and Reporting”. Whilst touching on how the journalist can ensure their own safety, it also emphasized on media responsibility in the face of a pandemic, and instructed journalists to: report accurately, communicate guidelines issued by state health officials and authorized institutions such as the World Health Organization (WHO) and help in building trust amongst the people, verify facts from a credible source before sharing with the public, and pay attention to sensitivity and discretion that may arise when reporting.
Creating environments where the virus is more likely to spread
Whilst certain media needs to change its modus operandi, the actions of other stakeholders, namely the local authorities and tri-forces involved in efforts towards curbing COVID-19, also came under the spotlight recently.
The authorities and military have come under fire for being insensitive to persons being sent for quarantine or treatment. Numerous instances were reported in Sri Lanka of those diagnosed with COVID-19 running away while being treated at hospitals; meanwhile, a video which captured people fleeing a bus that was transporting people to quarantine centers after it had broken down, was also aired recently.
The Liberation Movement, a collective of leftist women fighting against all forms of oppression, recently published a statement online about the actions of the authorities.
It said: “The manner in which the Government and the military has handled this recent crisis, considering the way they have dealt with women workers in particular, has been very problematic. The lack of clear information/awareness, unsafe transportation, unsanitary quarantine facilities, and failing to conduct PCR tests prior to loading workers onto buses and upon admission to the (quarantine) center, are in clear violation of the basic COVID-19 guidelines said to be adhered to by the Government.”
The statement went on to relate an account by an individual who stated they were treated like prisoners, being told that they “should not try to run away because the place was surrounded”. They were also not informed of where they were being taken.
Speaking to Colombo Gazette on the tactics used, Uduman stated: “Fear tactics being used to encourage people to follow health regulations, etc. may also contribute to the stigma and exaggerated fear.”
Speaking on the topic at a Sri Lanka Medical Council (SLMC) webinar on ‘Breaking the chain of transmission through rational and scientific approach’ held earlier this month, Prof. Athula Sumathipala, a professor in psychiatry and the Chairman of the National Institute of Fundamental Studies, reiterated this sentiment: “Using fear as a health promotional tool is totally incorrect and unacceptable as it affects negatively by aggravating stigmatization.
“Especially in the process of quarantining, it should never be highlighted as a punishment but as a preventive healthcare measure.”
Meanwhile, reports of the deplorable conditions at the quarantine centers also made headlines recently. Images of the conditions showing unclean toilets and insipid, and sometimes undercooked, food, were leaked to the media. Added to that, it was reported that the conditions were not conducive to a quarantine facility having implemented the safety protocols to prevent COVID-19 spread; no doctors or public health inspectors (PHIs) were on location either, it was claimed.
The effects of this can be disastrous. Being aware of the above conditions, coupled with the stigma surrounding the virus, drives people to hide the illness, prevents people from seeking healthcare immediately, and discourages them from adopting healthy behaviors.
In fact, speaking to the media recently, Sri Lanka Police Spokesperson Deputy Inspector General of Police (DIG) Ajith Rohana stated that the main issue faced in the operational process of controlling the spread of the virus was tracing the close contacts of COVID-19-positive persons, as some did not divulge accurate information; he cited the stigma associated with the virus as the underlying cause for this.
This reactive behavior facilitates the spreading of infectious pathogens, especially among those with mild symptoms who avoid seeking medical attention and act as usual so as to not raise suspicion on their condition, explained the aforementioned August study.
The WHO states that stigma can undermine social cohesion and prompt possible social isolation of groups, which might contribute to a situation where the virus is more, not less, likely to spread. This can result in more severe health problems and difficulties controlling a disease outbreak.
Better late than never?
The WHO explains that the stigma associated with COVID-19 is a result of three main factors: 1) it is a disease that’s new and for which there are many unknowns; 2) we are often afraid of the unknown; 3) it is easy to associate the fear with ‘others’.
Whilst it is understandable that there is confusion, anxiety, and fear among the public, unfortunately, these factors are also fueling harmful stereotypes.
Notably, the pattern of stigma also changes; in certain countries, for instance in Italy, it was rapidly redirected towards ethnic Italians in the North of Italy where the first few cases of the virus was reported; healthcare workers in the frontline were also discriminated in numerous countries, including Sri Lanka.
In a backdrop where Sri Lanka is scrambling to implement appropriate risk mitigation measures, with the Government adding locations to its list of “quarantine curfew” areas on a daily basis and struggling to increase testing facilities, stigma and discrimination favor the spread of the virus.
Some actions the WHO recommends to counter stigmatizing attitudes is by spreading the facts, engaging social influencers on promoting reflection on people who are stigmatized and how to support them, amplifying the voices, stories, and images of local people who have experienced COVID-19, making sure you portray different ethnic groups, promoting ethical journalism, and linking up activities addressing stigma and stereotyping.
As more awareness is being raised with regard to the stigmatization and its effects in the local space, the Health Promotion Bureau (HPB) has launched a mass campaign to help fight it. The campaign features an individual who contracted COVID-19 sharing details about the places he visited on social media, and portrays him as a hero for doing so. It went on to state that while some people may choose to blame him for “bringing corona”, he was fulfilling his social responsibility.
In raising the following important points, the campaign aims to aid in abating the stigma surrounding COVID-19.
“Last time, Sri Lanka defeated COVID-19 not by blaming each other, not by discriminating each other, but with everyone’s utmost sacrifice. Because we all fulfilled our social responsibility last time, the whole country was saved.
“Everyone likes to be healthy; no one likes to get corona on purpose. Corona spreads the same way as the common cold or flu.
“Do not point fingers at people with corona, because tomorrow, that finger may point at you.” (Colombo Gazette)