It is 58 days since the first Covid-19 infection was recorded in Bangladesh. February now feels like a distant memory, even early March. Almost like another era. Now, nothing appears certain. The daily drip of official statistics on the infection adds to the uncertainty. Not the figures in themselves, but what they may not be telling. Where is Bangladesh on the infection curve? Where may it go? Are we even serious in trying to find an answer? Is low rate of testing a conscious policy decision or simply lack of one?
Compounding the uncertainties is the tendency towards “rosy” reporting by courtiers and armchair bureaucrats that belie ground realities. A spiralling chaos is nearer to the truth if you care to listen to the testimonies seeping out from the frontline, such as the Mugda General Hospital on quality of PPE or the long queue for testing and the longer wait for test results. And what of patient experiences? Desperately seeking and failing to find a health facility that will take them, or once admitted, an equally desperate quest for “treatment” within the facility. And now the chaos is about to get murkier.
Policymakers, seemingly overwhelmed by a dilemma of life-or-livelihood, appear to be giving way to the “livelihood” agenda without the benefit of any clarity on where we stand on the “life” agenda. And this too not in any coordinated way, but in fits and starts, driven by economic lobbies with “voice muscle”. First, a hide-and-seek policy game on RMG factory reopening. Then a police authorisation of Iftar restaurants—both with toothless pronouncements of “shasthayabidhi”. This week may see the end of the “chuti” altogether. How and when to ease and exit from the “lockdown” is certainly a critical issue, but the disjointed policy pronouncements on the matter gives the impression more of a gamble rather than a well-considered policy decision.
It is very true that no one has been sitting idle—neither the government nor society at large—in the face of the twin crisis of pandemic and economic standstill. Known and unknown actors have swung into action to the best of their abilities. The boro crop has largely been harvested. After initial hibernation, there has been a flurry of policy pronouncements, at least on paper. However, notwithstanding the many initiatives, the sense of uncertainty and escalating crisis appears to be deepening, if not worsening. Why is the sum failing to become greater than the parts?
Looking back, an uneasy conclusion is unavoidable. There has been a critical communication failure in Bangladesh. Official and social messaging on Covid-19 narrowly focused on hygiene and social distancing protocols only, but failed to prevent an overall panic syndrome taking hold that has led to an entrenched social perception of the corona patient as a “villain”. And not just in perception but in practice, being treated so whether in the neighbourhood or in the hospital, or even in the graveyard. This is forcing patients to hide symptoms, on one hand further exacerbating infection spread, and proliferating inhumane treatment of patients and their families on the other.
From the start, the authorities opted to delegate the Covid-19 messaging to departmental mandarins. The urgency really was of creating an informed national mood and an overall atmosphere of trust. The outcome has been anything but. The health mandarins signally failed to rise above their narrow bureaucratic world-views, obsessing with control and red-tapes and brushing ground realities under the carpet. Little wonder that distrust and panic syndrome has become the norm. An unfortunate side-effect has been to put non-corona healthcare virtually out of focus. A combination of the panic syndrome and collapse in frontline health workforce morale—both public and private sectors—has dramatically shrunk easy access to non-corona healthcare needs. This is particularly impacting chronic patients, children and vulnerable segments of the population.
Can we get a grip on the chaos staring at us, without fundamentally taking out the panic syndrome that is clouding the efforts to stem the infection spread and return safely to economic resumption? A rebooting of the communication strategy must certainly be on the cards, but the challenge is as much of establishing the credibility of the messenger as the efficacy of the message. Ultimately, the issue really is about the policy mindset, which to a large extent continues to read the unprecedented nature of the crisis as another “disaster” to be narrowly dealt with by departmental bureaucrats, rather than given purpose and drive through an empowered strategic centre. Not surprisingly, weak implementation has again emerged as a key concern, to a large extent due to the preponderance of “ex-officio” committees plugged into the implementation process. These tend to be over-attentive to status and hierarchy concerns, and usually lack strategic cohesion and the capacity to drive coordination and synergies. Unfortunately, the Covid-19 policy response so far appear to be underpinned by this familiar and ineffective mode of policy implementation.
April has passed. What does May have in store? Power and Participation Research Centre (PPRC) and Brac Institute for Governance and Development (BIGD), through a joint nationwide survey in April, brought home some new realities that demand policy rethinking. Our entire development discourse has been predicated on a certain understanding of poverty dynamics, with the focus only on those below the poverty line. Thus the Bangladesh Bureau of Statistics, projecting from 2016 Household Income and Expenditure Survey data, puts the poverty rate at 20.5 percent in 2019. However, the PPRC-BIGD survey has brought to attention the plight of a segment of those who were above the poverty line in February but fell into poverty due to the economic standstill. These vulnerable non-poor, subsisting on average about 40 percent above the poverty line income, suffered a 66 percent drop in income between February and early April and are suddenly a new group of what we have characterised as the “new poor”, with particular concentration in urban centres. They will add an additional layer of as much as 22 to 25 percent to the 20.5 percent of poor. But the challenge is not merely quantitative. Existing social protection schemes have not covered these groups. There are no prior lists of such groups. How can one target them effectively and with what support? The government appears to have taken cognisance of the “new poor” but fallen back on the usual bureaucratic channels for targeting. This is a major innovation area, not just in targeting but also with regard to the types of programmatic support—now and in the future—that make most sense for the vulnerable non-poor. The government will do well to partner on these strategic tasks with research organisations, NGOs and social platforms with credible track records on the ground.
May should also lead to an expansion of the Covid-19 discussion beyond health and economics, to the social too. Lockdown has not only brought an economic standstill. It has also put youth and students in limbo. Notwithstanding sporadic initiatives here and there, their plight is yet to engage the concerted attention of policymakers and social actors.
Hossain Zillur Rahman is Executive Chairman of Power and Participation Research Centre (PPRC) and a former Advisor of Caretaker Government.