Lessons learnt from the pandemic: what the health and economy experts say

  • Family
  • Friday, 19 Nov 2021

Community leaders and volunteers distribute food aid to families in need living at PPR Lembah Subang, Selangor. Photo: Yayasan Hasanah

During the lockdown in June, Uma Devi, 39, and her family contracted Covid-19. All nine of them were quarantined in their home in Semenyih, Selangor, because the hospitals were full at the time.

They didn’t have any money to buy food or other necessities because Uma Devi’s husband Ganesh, 39, was a day worker and was unable to go out to work. They had five children aged 14, 10, seven, five and two to feed, and Ganesh’s aged parents were also living with them.

“We weren’t able to go out to get food, but not only that, we had no money for food in the first place,” says Uma Devi, a former factory worker.

“Everyone was also afraid to help us. They didn’t dare to come near our house because they knew that we had Covid,” she reveals, adding that they were living in the Red Zone so nobody from outside could go in to send them aid.

Also badly impacted by the pandemic was former sales manager Choo, 38, who had to go to the food bank regularly to get groceries.

Although he felt embarrassed to do so because he wasn’t from the lower-income group, it was the only way he and his family could survive when he lost his job during the first MCO.

“It was something that I never thought I would have to do, but my wife had just given birth to our third child at that time and we couldn’t even afford to buy milk for our baby,” he reveals.

Subsequently, Choo and his family have relied on withdrawals from his EPF savings to survive.

“Of course, we’re worried about the future and whether we’ll have enough EPF savings for retirement, especially since we’ve so many expenses and we also need to think of our children too. But what can we do, we’re just focusing on our day-to-day survival during the pandemic,” he says.

Uma Devi and Choo’s households are just two of the many low and middle-income families that have been impacted during the pandemic.

There is a need to look at what went wrong in the system because people were not able to feed themselves, let alone survive during the pandemic, says Datuk Shahira. Photo: Yayasan HasanahThere is a need to look at what went wrong in the system because people were not able to feed themselves, let alone survive during the pandemic, says Datuk Shahira. Photo: Yayasan Hasanah“The number of people who have been struggling (during the pandemic) is extremely worrying,” says Yayasan Hasanah managing director Datuk Shahira Ahmed.

“One of the things that Yayasan Hasanah, through its NGO partners, has been involved in since the pandemic began, is distributing food aid. We need to look at what went wrong in the whole system that with just over one big (pandemic) shock, people aren’t able to feed themselves, let alone survive. It shows that so much more needs to be done in terms of our society’s basic social protection,” she says.

Yayasan Hasanah, an independent grant-making foundation that focuses on the country’s community and social issues, recently organised the inaugural Hasanah Forum, themed ‘From Charity to Justice: Vision for an Equal and Just Malaysia’, which was focused on “driving socio-economic change and social justice”.

The forum featured global and local experts and leaders from across civil society, academia, government as well as concerned citizens who, over two days, shared, deliberated and charted progressive actions to address challenges that the nation is facing.

Areas of concern

Professor of Medicine and Infectious Diseases at Universiti Malaya’s Medical Faculty Datuk Prof Dr Adeeba Kamarulzaman, says that there are three especially vulnerable and impacted groups during the pandemic: prisoners, migrant workers (documented and undocumented) and refugees, and the urban poor.

According to Dr Adeeba, there initially wasn’t much focus on the impact of crowded indoor environments which these three vulnerable groups face as they live in extremely packed, housing areas, dormitories, detention centres, or multi-generational housing situations.

“Firstly, for the urban poor, they lacked access to food (they were located in enhanced MCO/red zones during the first and second MCO). Secondly, their work/livelihood is unstable (many of them are day workers so they have no work and no income during the MCO), and thirdly, they live in cramped situations and multi-generational households, and all this puts them at higher risk,” says Adeeba, adding that most of the clusters at the time came from factories, construction sites, as well as 50,000 prisoners and their families.

There are many lessons to be learnt from the pandemic, says Dr Adeeba. Photo: Yayasan HasanahThere are many lessons to be learnt from the pandemic, says Dr Adeeba. Photo: Yayasan HasanahAnother big area of concern, she says, is the numbers of those who were brought in dead (BID) at the height of the pandemic.

“For an upper middle income country, despite all it’s flaws, we’ve got a really good health system. So, to have so many BID during the height of the pandemic was extremely distressing. At the Universiti Malaya Medical Centre itself, 43% of the deaths that were registered were BID,” reveals Dr Adeeba who is also a WHO Science Council Member and part of the National Recovery Council and Selangor Covid Task-Force.

“During the pandemic, we had a forum which involved NGOs working with prisons and highlighted these issues, and as a result, the All-Party Parliamentary Group Malaysia for the Reform of Prisons and All Places of Detention (APPGM) spearheaded by Special Advisor to the Prime Minister on Law and Human Rights Datuk Sri Azalina Othman Said and other MPs, came about,” she says.

According to Dr Adeeba, issues discussed included not placing in already overcrowded prisons those who had committed minor offences such as stealing because they were hungry (no job, no income), and releasing prisoners who may have only two to three months of sentencing or were in prison for only minor offences.

“It was obvious that for some prisons, 60% of the prisoners were in for minor drug offenses when they should actually be channeled to evidence-based treatment and rehabilitation rather than being imprisoned,” she says.

“Not only are they subjected to TB, Covid-19 and other communicable diseases in prison, about 80% of them relapse because they don’t have a proper support system when they’re released,” she says. “So, not only is imprisoning them ineffective in curbing the drug problem, it also costs the government miliions of ringgit.”

Dr Adeeba also highlights the issue of the migrant workers who have helped build the country’s economy as the “cheap labour” for work that locals aren’t willing to do.

“Most people realise this, but we’ve not really addressed the root of the problem which is their housing situation and their access to healthcare,” she says.

One of the reasons foreign workers were featured disproportionately among those BID, she said, was because they feared being arrested (if they were undocumented), sent home if they were unable to work (loss of income), and had concerns about hospitalisation costs.

“Furthermore, even though they were among the most impacted groups – and added to the number of Covid-19 cases – vaccine roll-out to them was later,” she adds.

Dr Adeeba says that from the urban poor group, there were entire families being infected from low-cost housing areas (PPR flats).

“This was largely due to the high-density multi-generational living and lack of awareness among the lower-income groups, most of whom were daily wage earners,” she says.

According to Asia School of Business assistant professor of economics and MIT Sloan School of Management research affiliate Dr Melati Nungsari, the pandemic highlighted two main issues.

Dr Melati says that social justice is when we move away from a world where some are doing excessively well, while others can’t even feed their children. Photo: Yayasan HasanahDr Melati says that social justice is when we move away from a world where some are doing excessively well, while others can’t even feed their children. Photo: Yayasan Hasanah“Firstly, the pandemic magnified existing structural issues that were already present in the system even before the pandemic – such as poverty. And secondly, there were issues related to Covid-19 such as the lockdowns, access to vaccines and testing,” she says.

“These aren’t separate issues – in fact, the structural issues fuel the Covid issues, for example, poor working or living conditions such as overcrowding or high density situations had an impact on many lower-income families, including those of migrant workers, during the pandemic,” she adds.

“Even though the economy is built on the back of these individuals, we as a society honestly don’t treat them very well. And that has only gotten worse since Covid,” she says.

“When the first MCO happened, we studied the impact of the first stimulus package on households and discovered that almost 40% of the people would run out of funds to pay their bills within three months.” adds Dr Melati who, along with Dr Adeeba, were among the panelists at the recent Hasanah forum.

In Indonesia, one year’s loss of schooling for children can cause 7% loss of lifetime earnings. Although such figures aren’t available in Malaysia, we can gauge that the long-term effects of school closures are going to be tremendous, says Dr Melati.

“Malaysia has closed schools for a long time and it’s a good and necessary move during the pandemic, but this will disproportionately affect children from lower income families in very real ways, it’s going to translate to lifetime earnings or other negative impacts,” she says.

While closing schools during the pandemic was a necessary move, it will disproportionately affect children from lower income families in very real ways, says Dr Melati. Photo: Yayasan HasanahWhile closing schools during the pandemic was a necessary move, it will disproportionately affect children from lower income families in very real ways, says Dr Melati. Photo: Yayasan Hasanah

“There are many issues that are worrying from an economist’s point of view, but one that I would like to highlight is that many Malaysians don’t have sufficient savings to rely on when they retire,” says Dr Melati.

“The recent EPF release – while needed for their survival during the pandemic – saw 6.1mil EPF contributors depleting their lifetime savings to below RM10,000 each and 3.6mil of them now have less than RM1,000 in savings.

“These are mainly people in the private sector. You would think most people have their EPF to rely on when they retire, but many actually don’t,” she says.

Lessons from the pandemic

There are many lessons to be learnt from the pandemic, says Dr Adeeba.

“Firstly, there needs to be more investment in public health – in terms of surveillance and response to infections such as Covid-19, as well as in the curative hospital side of things,” she says.

“Secondly, an all of society response is needed – whether it involves NGOs, and whether it’s locals or foreigners living in Malaysia - to overcome a pandemic or other devastating disaster of this magnitude. We can no longer afford to work in silos, because unless we all work together, the next time a pandemic or any other disaster comes along, we’ll face the same issues and challenges again,” she adds.

“Thirdly, we’ve to think big and realise that we live in a completely different world now. We’ve got to invest in digitisation, especially in healthcare,” says Dr Adeeba.

“At the core of it, each one of us matters – the whole of society – so we need to build resilience and empower certain communities so that they can weather such storms in the future,” says Dr Melati.

“While having more handouts and cash aid was severely needed during the pandemic, moving forward and looking at the big picture, we need to think about what went wrong, why they needed so much of this aid, and then try to fix those root causes,” she says.

While Dr Melati acknowledges that not everyone struggled during the pandemic, she says that social justice is “when we as a society move away from a world where some (usually a minority) are doing extremely, even excessively well, while others can’t even feed their children”.

“It’s not really about a ‘zero sum’ or taking away from the rich and giving to the poor like a ‘Robin Hood mentality’, it’s more of a collective goal or ‘win-win’ situation,” she says.

“This is because if we don’t fix these issues as a society, if the lowest rung of society – the urban poor, prisoners, migrant workers or refugees – are infected with Covid-19 during the Delta wave, it affects everyone else – the cases increase, lockdowns are imposed, and jobs and businesses are impacted, even those of the middle income group,” she explains.

“As a middle class or above individual, we may think it doesn’t concern us, but in reality, it does. Indirectly, what happens to lower-income families impacts society as a whole and we should care about such issues. And something needs to be done about it because we’re all part of a link in the chain and when one individual or one part of society is affected, we all are or will be, eventually,” she says.

“Because of the prison clusters, the cases increased, and the hospitals were overcrowded, which is possibly what led to the MCO being prolonged. So everything is all interlinked and it’s all closer to home than we think,” adds Dr Adeeba.

Both Dr Adeeba and Dr Melati concur that we can only move forward if we fix the most vulnerable or lowest layer of our society.

These are some things that we’ve learnt from the pandemic from a social justice perspective. Just as a team is only strongest as its weakest member, a society is only as strong as its most vulnerable or lowest member, they conclude.

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