Monthly Archives: June 2020

Brazil currently has the worlds second highest number of deaths from covid-19. The lack of action from the Brazilian President, Jair Bolsonaro, and his open denial of the pandemic is widely seen as being one of the reasons for this crisis. However, while that is undoubtedly one of the causes of the high rate of infection and deaths from covid-19, we argue that the countrys underlying conditionsits deeply rooted socio-economic inequalities, the fragmentation and chronic underfunding of its public health systemare equally important factors. In the midst of a rapidly evolving public health and economic crisis, there are early signs of some form of resilience in the system, and possible lessons to be learned for the countrys future.

Although the pandemic has not yet reached its peak in Brazil, the country is at risk of being shattered by the coronavirus. The bed occupancy rate in Intensive Care Unit (ICU) is over 90% in three Brazilian statesAmazonas, Cear, and Rio de Janeiro. How did Brazil reach this point? It is the combination of the health systems flaws and entrenched inequalities, as well as President Bolsonaros denialism and lack of action that have cost the lives of so many Brazilians.

Since Brazils first case of covid-19 at the end of February 2020, Bolsonaro has denied the gravity of the pandemic and acted against public health measures such asphysical distancing. He has used words such as hysteria, neurosis and fantasy to criticize the reaction of people and the media to what he classified as a little gripe. [1] Within one month, two of his ministers of health left their position, refusing to implement Bolsonaros plans to end quarantine, and prescribe hydroxychloroquine to all covid-19 patients regardless of their health condition. But despite his antics and blunders, it is too simplistic to only blame Bolsonaro for the rapid escalation of the epidemic.

It is really the underlying conditions of Brazils health system that have allowed the pandemic to take hold and get out of control. Brazils health system is highly fragmented. Although everyone uses the public unified health system (Sistema nico de Sade SUS), 25% of the population hold private health insurance, mostly through their employment. This has created an ethical, equity, and social justice problem within the pandemic, as those who can afford it, use private health services. The large majority of those who cannot pay for an insurance, use the SUS. Long before this pandemic, Brazils SUS struggled with chronic underfunding, aggravated by the austerity measures introduced in the aftermath of the 2014-2016 economic recession. [2] Despite the universal public system, 56% of Brazils health expenditures are private. [3] In the last few years, there has been an increase in out-of-pocket expenditures, especially for medicines.

In Brazil, the pandemic started in affluent urban areas more exposed to contagion from international travel. It is now quickly spreading to the suburbs and favelas (slums). Brazils deeply entrenched social inequalities and the vulnerability of specific populations, have provided a hotbed for the pandemic. In Brazil, the wealthiest 1% of the population concentrates 28.3% of the countrys total income. About 150 million Brazilians live on an average monthly salary of 420 Reais (around $70). Roughly 13 million Brazilians live in favelas, where hygiene and sanitation is poor. [4]. The virus has also spread among more than 600,000 prisoners in the country, and there is the likely risk of rapid dissemination among the population of Indigenous people, which is approximately 800,000 people.

With such underlying conditions, it is surprising the system did not collapse sooner. Thankfully, a few mitigating factors have been able to boost resilience in the face of Bolsonaros lack of action and denialism. There are currently 478,000 active doctors (2.3 per 1,000 population) and 2.3 million nursing professionals. Despite its numerous failings, Brazils SUS still guarantees free access to all levels of health services, from primary care to specialists. Its extensive primary health care network in particular stands out: there are 43,000 Family Health teams and 260,000 community health agents in Brazil, embedded in the community. The primary care network functions as a gateway for early case identification, referral of severe cases to specialized services, monitoring of vulnerable groups such as older people, people who are immunosuppressed, chronically ill, and pregnant women. The primary healthcare system also provides surveillance of mental health disorders, rates of domestic violence, and alcoholism during lockdown.

The joint performance of professionals working in the SUS system, universities and public scientific institutions, have historically helped overcome crises and produced sound public health responses, such as dealing with the Zika outbreak, or the national responses to the HIV and AIDS epidemic [5,6] Most importantly, responsibility for the health system in Brazil is decentralized and regionalized. [5] Decentralised funds for healthcare are larger than the funds transferred by the central state. States and municipalities manage hospitals and services, buy supplies, hire human resources, and carry out health surveillance. As the spread of coronavirus occurs at different time intervals and geographical regions, such decentralisation has allowed the implementation of locally-tailored measures. This localised approach has allowed to keep the epidemic in check to a degree, stopping its spread to the rural areas.

Despite all the challenges posed by the pandemic, it would appear that the checks and balances of Brazils democracy, together with its decentralized health system, still seem to be working, and are tapping into the countrys vast, if depleted, capacity to respond to the pandemic. It would appear that strengthening its national healthcare system and preserving the existing democratic institutions are Brazils only guarantees in dealing with covid-19.

Raquel Nogueira Avelar e Silva, Department of Clinical Epidemiology, Aarhus University Hospital, Denmark

Giuliano Russo, Centre for Global Public Health, Queen Mary University of London, The UK

Alicia Matijasevich, Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Brazil

Mrio Scheffer, Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Brazil.

Competing interests: None declared

References:

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Covid-19 in Brazil has exposed socio-economic inequalities and underfunding of its public health system - The BMJ - The BMJ

Theatre, ultimately, is not about buildings or props or sets its about people. The people who make it, the people who engage with it, and the crossover between.

The greatest threat to the vitality of plays, musicals and live performance once the lockdown ends is a drain of people leaving the arts. Audiences who can no longer afford ticket prices against a backdrop of economic strain, reinforcing the idea that culture is not for them. Skilled artists particularly those from lower socioeconomic and working-class backgrounds (yes, we do exist in the arts) who cant afford to remain in the industry.

In normal times, theatre is a hugely profitable industry, and one of the UKs most successful cultural exports. But the industry has always been staffed by precariats. Despite the glamour of the trade, almost three-quarters of its employees, no matter what our backgrounds, are freelancers living from job to job. And a significant proportion of this workforce fell through the cracks of the governments job retention schemes.

Right now, nothing frightens theatre creatives more than a slowdown or reversal of even modest gains made in recent years in terms of the inclusivity and diversity of the theatre, on stage and off. These included Natasha Gordon becoming the first (and sinfully late) black British woman to have a play in the West End, with the extraordinary Nine Night, and the National Theatres commitment to 50:50 gender representation. But theres still so much left to do.

The postwar settlement in 1945 was built on the passionate belief that art for everyone was vital to peoples wellbeing and social cohesion. Our aspirations for the future of the industry should be just as hopeful and as high. Assuming the industry survives, its incumbent upon us to hardwire radical, imaginative, hopeful strategies into its recovery, ensuring greater access across society.

For this reason, class barriers require our full attention. Theatre has a class problem. Few would deny it, but there is often a squeamishness in talking about this particular area of representation and a lack of confidence in how to define it. I myself have wrestled with the existential angst that once you reach a certain level in the industry, you must abandon any claim to this identity.

There are also justifiable suspicions, particularly from black, Asian and minority ethnic artists, that the term class is deployed as a proxy to mean exclusively white, working-class men. So it is vital that any discussions of class must wholeheartedly intersect with every community, identity and culture in Britain, and for white working-class writers to amplify and champion their even more neglected peers.

The socio-economic group you were born into and the levels of social deprivation youve experienced are the most decisive factors in whether or not you go to the theatre, let alone carve out a career within it. It seems that half the country goes, half the country doesnt. And the half who dont are unlikely to want to if they cant hear their voices or see their own stories represented on stage.

There are glimmers of opportunity in this crisis. Zoom networks offering peer-to-peer support in quarantine have sprung up, including the digital coffee mornings for working-class artists led by Common, an arts and social justice organisation Im a patron of, alongside the director Matthew Xia and writer Nessah Muthy. Such engagement should continue as leaders listen to the lived experiences of their freelancers when deciding how to rebuild.

Theatre outreach and education departments have been some of the most dynamic during the pandemic. In Leeds, the theatre company Slung Low, based at The Holbeck, an old social club, has been active in distributing food and care packages in the community.

But other mountains feel steeper to climb. The cultural disparity between the south-east, where much of the arts and theatre industry is concentrated, and the rest of the country could grow wider as smaller local organisations and touring groups collapse. The unforgivable demise of arts education in state schools over recent years may further narrow the already limited pool of artists and audiences.

Most importantly of all, of course, are cheaper tickets. Cheaper, cheaper, cheaper, cheaper tickets. We know this will be even more challenging for theatre companies barely able to make ends meet. Whatever new, inventive, convention-defying methods that artists, fundraisers, producers and sponsors can collectively devise, our new theatre culture can only claim to represent contemporary Britain if everyone who lives here is allowed to come and see it.

James Graham is a British playwright and screenwriter

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British theatre has a class problem, and coronavirus could make it worse - The Guardian

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A group calling itself Coalition of Aggrieved Customers of collapsed banks in the country has given the government a 14-day ultimatum to pay their cash deposits totaling millions of Ghana cedis or face their anger amidst the Corona Virus Disease (COVID-19).

The 2,221 aggrieved customers, spread across the Bono Region therefore threatened to embark on a protest march to besiege the Jubilee House, the seat of government if President Nana Addo Dankwa Akufo-Addo failed to address their grievances.

According to the group, comprising customers of the defunct GN Bank and UT Bank, as well as the DKM and God is Love Micro-finance, whose cash deposits were locked-up following the collapse of the financial institutions, President Akufo-Addo had failed to refund their cash deposits.

Last year, the Bank of Ghana (BoG) revoked the licenses of some savings and loans companies in the country.

The revocation of the licenses of the financial institutions, according to the central bank were necessary because they were insolvent even after a reasonable period within which the BOG had engaged with them in the hope that they would be recapitalized by their shareholders to return them to solvency.

But, at a news conference held at Abesim, near Sunyani, some members of the coalition who wore red armbands and headgears to portray their anger, explained that the life time savings of many of them were locked up at the defunct banks, thereby collapsing their businesses and worsening their socio-economic livelihoods.

Many of us who entrusted our money and lifetime savings in these banks and financial institutions held on to Governments promise that our monies would be safe, Mr. Nicholas Saddari, the convener of the group, said.

We never anticipated that the Governments so-called clean-up of the banking and financial sector would take-down so many banks and financial institutions especially on the basis that Government itself indicated that it required between GH9 billion to GH13 billion to solve the crises in the banking and financial sector.

Today government is saying they cant pay us, so they have issued a five-year bond for our locked-up deposits, that is zero or no interest paid on our deposits and investments after we have to wait for the 5 years to receive our money.

Then after many of us depositors agitated by saying we cannot wait for five years then government tells us to take the five bonds to Consolidated Bank of Ghana which will discount the bonds by 50 percent of the face value amount of the bond and pay that to us whilst we forfeit or forgo the remaining 50 percent the bond value which CBG will keep.

Source: GNA

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Aggrieved customers of collapsed banks threaten to besiege Jubilee House - Ghana Business News