Morality and Law
Preventing COVID-19 from Becoming a Disease of the Poor – a Vision from Central America

Looking at how differently countries have responded and continue responding to the pandemic and what kind of economic and social implications it has for their population, it is also important not to forget about humanitarian aspects. In particular, how the most vulnerable groups of people are affected by the pandemic and what needs to be done to prevent COVID-19 from becoming another disease of the poor. Mexico and Central America may be good illustrations of the current problems and challenges to come.

I would like to share our experience on the ground with the pandemic in Mexico and Central America, where the ICRC is present. As of early August, the official figures for COVID-19 in Mexico is around 400,000 cases and surpass 44,000 deaths. In terms of mortality rate, Mexico is on the 4-5th position in the world, depending on the source. 

At the early stages of the pandemic, countries of the region followed the example of Europe, which introduced strict restrictions of movement and severe quarantines. Mexico and Central America imposed the same kind of restrictions on movements, businesses and the population at the same time as Spain, Italy and France. The difference was that in Europe, at that time, there were thousands of cases of infection and hundreds of deaths, while in our part of the world there were less than a hundred of cases and zero deaths. On the one hand, it was a good start in the sense that it may have prevented thousands of deaths and decreased the number of infected people arriving to these countries. However, the impact is that while the lockdown in these European countries has lasted for 3-3.5 months, here we have not really reached the peak, and the lockdown for both businesses and the population will last for at least 6-7 months in total.

This has had many consequences, applicable to other countries as well. One is obviously economic, which is particularly dire in the region: first, because the lockdown will total so many months. Second, and most importantly, is that 60-70% of the population in Mexico and Central America make a living out of the informal economy. They need to go out every single day to sell their produce or to find a daily job to feed their families. When we speak about this percentage, we should not forget that Mexico is a big country with a large population. So, we are talking about approximately 80 million people who need to go out to make a living. Obviously, none of these people can sustain a 3, 4, 5 months of economic lockdown.

The economic crisis is deepening and, in turn, puts a lot of pressure on the governments of the region to reopen the economies. They are already doing it slowly, but in the middle of the peak or rather a high plateau. And it looks like we will be on this high plateau for a long time. This is different from Europe, which started reopening when the peak had been passed.

Another consequence is the precarious state of the healthcare system, which is under a very heavy pressure now. In Central American countries, in particular, health services are very limited, and there is a shortage of technology, equipment and human resources.

Another consequence is the increasing violence. Mexico has a very high rate of violence with 36,000 homicides per year or 100 every day, which turns it into one of the most violent countries in the world. We can feel the impact of the increased violence on communities. Here, violence has been perpetrated mostly by non-state armed groups, dealing with drugs, human trafficking and extortion. However, now people whom they have been exploiting and who often belong to isolated and poor communities, do not have the money to pay them. The illegal income based on extortion from migrants in exchange of help to cross borders has also decreased because of a much scarcer migration. So, these armed groups are fighting each other for the control over the territory and population. 

All these consequences combined – economic problems, violence, pressure on different social services – are a breeding ground for both economic and political crises, which result from the population’s growing discontent with the lockdown and the response to the pandemic.

There is a tendency to forget that the world has not stopped because of the pandemic: disasters continue happening, the region goes through the annual hurricanes season causing floods, and it has experienced severe earthquakes. Disasters have their own economic, social and humanitarian consequences, people continue suffering and dying because of that and other reasons, and these problems need to be continuously tackled.

The ICRC has adapted its response just as in other regions of the world, trying to minimize and contain the impact of the pandemic on vulnerable communities. We work with governments, state institutions and civil society to help them prevent the spread of the infection, handle cases and provide for proper isolation, as well as to manage the dead. And this is another issue rarely spoken about. Why do we help authorities with the management of the dead? Because many people die, and their remains are not claimed by their families (morgues have 26,000 unidentified mortal remains only in Mexico). And they become missing persons. There are an estimated 70,000 missing persons in Mexico, which is a huge problem. The ICRC works on helping how to handle these bodies to make sure they do not become disappeared and are properly traced. 

We also work on campaigns against the stigmatization of the people with the disease and health workers. In some communities and countries, if you have survived COVID, you become socially unacceptable, and in many places, health workers are seen as potentially dangerous. They are attacked if not rejected from by their own communities. 

Prisons is another area we work on a lot. There is a huge overcrowding in many Mexican and Central American prisons, making social distancing literally impossible, despite COVID. They lack proper social and health services, and the situation often becomes disastrous. We work also with migrants, in shelters for migrants, with displaced communities, and with families of the missing. 

We are all concerned about 2020, but let us also look at 2021, because from the humanitarian perspective, the ICRC is equally concerned about the upcoming consequences of the COVID-19. I do not what to sound pessimistic, but I would like to highlight what a humanitarian organization like the ICRC sees as the upcoming impact of the pandemic on vulnerable communities and populations.

One of the traits of the pandemic is that it has made the whole humanity vulnerable, where we all are concerned about our own families, children, job security, the future... However, those who were vulnerable before the pandemic have now become super-vulnerable. These are the ones the ICRC is focusing on.

Secondly, while we may be rather optimistic about 2020, expecting that there will be better treatment and a vaccine, the primary danger is that the vaccine can transform COVID-19 into another disease of the poor. It can be like with many other diseases today that you can be immunized against, or like many diseases for which we have cheap and easy treatment, and yet they continue causing hundreds of thousands of deaths every day amongst the poorest and most vulnerable populations of the world. Once we have a vaccine, there will be millions of persons who will get immunized because theу can afford it or because for one reason of the other, have access to the vaccine, but millions of vulnerable people or belonging to poor communities, or having no access to health services, will continue suffering and dying from COVID-19.

Along with increased poverty and inequality generated by the global economic crises, we see the disease gradually moving from urban to rural areas, where there are no hospitals and very basic, if any at all, health services. So, in 2021, we expect an increase in displacement of people moving from rural areas to cities because of the loss of income; and  an increase of migration at transcontinental and transregional level from Central America and other parts of the world, going through Mexico, trying to get to the United States. This increase in migration will come at a time when cross-border movements are being very restricted because most states, including Mexico and the United States, try to protect their borders and economies because they also have increasing numbers of jobless people. And we also expect violence generated by non-state armed groups to continue increasing, which will lead to an increase in detentions, thus adding more people to the already overcrowded prisons. 

Finally, while humanitarian organizations depend on international cooperation and the financial support of governments, associations and private citizens, let us look at the future of international cooperation from a humanitarian perspective. 

While currently we can see a certain degree of international cooperation because of the realization that the virus has no borders, we can see it this solidarity fading away in the coming years as countries will concentrate more on themselves, looking inwards at their internal social and economic problems. International cooperation plays an important role in cases, such as the eradication of smallpox, or the attempts to eradicate measles, but all of this requires close interaction and coordination plus a lot of money. And I am afraid this is not likely to come materialize in the future as it was in the past.

Thus, it is very important for all of us as humanity, as society, to be capable of looking forward. Sometimes, I have a feeling that we are dealing with this pandemic as if it were the first one in history and as if it were to be the last one. There were pandemics before and there will be COVID-20, COVID-21... What we should aim at as society today is to learn the COVID-19 lessons with humility, build a more caring world, and be better prepared when the next pandemic arrives.
Views expressed are of individual Members and Contributors, rather than the Club's, unless explicitly stated otherwise.