Somdeep Sen
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| A rite is held for a person who died from COVID-19 at a crematorium in Guwahati, Assam, on June 5, 2021. (Str/Xinhua via Getty Images) |
Em 19 de maio, a Índia estabeleceu um recorde mundial nada invejável, tendo relatado 4.500 mortes de COVID-19 nas últimas vinte e quatro horas. O número de mortos no país está agora avançando para 350.000. O Instituto de Métricas e Avaliação de Saúde prevê que esse número chegue a um milhão em agosto.
Uma iminente crise de saúde pública já parecia provável nos primeiros meses de 2020, quando especialistas listaram a Índia como um país de alto risco para a disseminação da COVID-19 para além da China. Muitas pessoas esperavam que o decadente sistema público de saúde não fosse capaz de lidar com um surto grave do vírus.
Parecia que a Índia havia evitado o pior cenário possível. Em março deste ano, o ministro da Saúde da União declarou que o país estava no limite da epidemia. Ele se gabou de que a Índia estava bem preparada para uma campanha de vacinação em todo o país e também forneceu vacinas para dezessete países de baixa e média renda.
Um mês depois, o país enfrentava escassez de vacinas, oxigênio medicinal e leitos hospitalares. O Lancet criticou o primeiro-ministro Narendra Modi por ignorar os sinais de alerta de uma segunda onda e por sua gestão catastrófica de uma crise nacional de saúde pública.
Uma pandemia raramente é apenas um problema de saúde pública: é também uma questão de política. As ações de Modi pioraram muito a trajetória da pandemia na Índia. O líder da Índia tratou isso como uma oportunidade de fortalecer seu culto à personalidade após falhas políticas significativas. Os resultados foram desastrosos.
Uma crise inevitável
O acesso aos cuidados de saúde - ou a falta deles - depende de até que ponto os serviços de saúde são acessíveis, de qualidade aceitável e fisicamente acessíveis. A constituição indiana garante o acesso a cuidados de saúde para todos os cidadãos. No entanto, um sistema de saúde pública institucionalmente fraco e carente de recursos significa que o setor de saúde privado da Índia é responsável pela maioria dos cuidados de internamento e ambulatório.
O setor privado, em grande parte não regulamentado, não é confiável em termos de qualidade de serviços. Além disso, os dispendiosos pagamentos diretos levam setores vulneráveis da população que, em sua maioria, carecem de seguro, ainda mais para a pobreza. Assim como os 10% mais ricos da população da Índia detêm 77% da riqueza nacional, níveis semelhantes de desigualdade governam o acesso a um padrão aceitável de saúde durante a pandemia.
Previsivelmente, os hospitais públicos e privados ficaram sem leitos muito rapidamente durante a segunda onda da pandemia nos congestionados centros urbanos da Índia, onde o distanciamento social e o saneamento são privilégios de poucos privilegiados. Sem um sistema de coordenação centralizado, os produtores de oxigênio no leste do país têm se esforçado para atender às necessidades médicas de oxigênio das regiões mais afetadas no norte e no oeste da Índia. Isso levou a cenas de partir o coração de pacientes morrendo, muitas vezes na porta de hospitais que não estavam equipados para lidar com o aumento repentino.
Claro, os habitantes mais pobres das cidades da Índia são os mais afetados. Eles são os mais expostos ao risco de contrair o vírus e menos capazes de pagar os cuidados médicos necessários. Na Índia rural, a maioria da população também não tem acesso a serviços de saúde adequados e a propagação da pandemia não foi controlada e não foi relatada.
Falhas de política
Quando a pandemia começou, as credenciais de Modi como primeiro-ministro que poderia presidir o crescimento econômico e o desenvolvimento livre de corrupção e benéfico para o cidadão comum pareciam estar em questão. A Índia estava passando pela pior desaceleração econômica em três décadas.
A principal iniciativa econômica de Modi produziu resultados desiguais. A desmonetização de notas de quinhentas e mil rúpias deveria conter a circulação de notas falsas, dinheiro sujo e financiamento do terrorismo. Mas a implementação da política pelo governo foi aleatória. No curto prazo, isso resultou em uma grave escassez de dinheiro, um aumento no desemprego e uma queda significativa na renda e na atividade econômica.
Com o desdobramento da pandemia, as políticas econômicas do governo de Modi foram examinadas novamente quando ele aprovou novas leis agrícolas em setembro de 2020. As leis abrem o setor agrícola para grandes empresas corporativas e deixam os pequenos agricultores expostos às forças do mercado. Seis governos estaduais votaram contra os novos projetos federais. Houve uma greve nacional e agricultores de estados vizinhos marcharam regularmente para Nova Delhi desde novembro do ano passado para protestar contra as novas leis.
O mandato de Modi também foi marcado por conflitos religiosos enquanto ele busca reforçar suas credenciais nacionalistas hindus. Vimos um aumento na violência anti-muçulmana, políticas governamentais que restringem o abate de gado, a Lei de Emenda da Cidadania de 2019 que limita o acesso dos muçulmanos à cidadania, bem como a revogação do status especial da Caxemira na constituição. O governo restringiu severamente a oposição a essas medidas, especialmente no Vale da Caxemira, onde desligou a internet, telefones celulares, telefones fixos e TV a cabo por dias.
Modi's PR Campaign
With few policy successes to speak of, Modi mounted a sustained effort to build up his public image during the pandemic. He declared March 22, 2020, to be a people’s curfew, encouraging citizens to bang pots and pans at 5 PM that day in support of frontline health care workers. On April 9 last year, he asked citizens to light candles and lamps at 9 PM for nine minutes in solidarity against the pandemic. These campaigns had little effect on the outbreak, but they received widespread support from prominent public figures on social media, with many hailing Modi’s leadership in a time of crisis.
When Modi ordered a national lockdown with four hours’ notice, it had a devastating impact on the vulnerable population of urban and rural areas. The BJP boasted that the lockdown received a score of 100 on the Stringency Index, citing this as evidence of Modi’s effective crisis management. However, this measure of “stringency” had very little to do with the efficacy of policies against the spread of the virus.
Modi and his allies have depicted the fight against the pandemic as a personal struggle for the Indian leader. When his government set up the Prime Minister’s Citizen Assistance and Relief in Emergency Situations Fund in March 2020, many people questioned the rationale behind it. After all, there was still unused money left over in the long-established Prime Minister’s National Relief Fund. But one clear advantage of the new fund was that its title could be abbreviated to “PM CARES,” symbolizing Modi’s direct involvement. It was also a way for pro-Modi corporate donors to channel funds they had already allocated to corporate social responsibility, or CSR.
The BJP has framed the ongoing vaccination drive as a personal victory for Modi. In contrast with other countries, where vaccination certificates bear the logo of the national health and disease control authorities, India’s certificates have an image of the prime minister with the message “Together, India will defeat COVID-19.”
Many observers have blamed the recent spike on the Kumbh Mela, a religious gathering held in Haridwar in the state of Uttar Pradesh, which saw millions of people gathering on the banks of the River Ganges. Conducted without any precautionary measures, it may have well been the world’s single largest super-spreader event. Allowing the festival to take place was a political decision in a BJP-led state: it was meant to show that India was now in the endgame of the pandemic.
Against the advice of public-health officials, assembly elections also went ahead in several states during March and April. The large campaign rallies and long polling lines resulted in an immediate surge of infections. In West Bengal, where the BJP was anxious to overthrow the ruling Trinamool Congress (TMC) government, Modi flooded the state with the ruling party’s resources. While the BJP eventually lost the West Bengal contest, the party’s rallies contributed to the highest-ever infection numbers in the state.
Modi and his Hindu nationalist government have also faced criticism globally. Many consider his handling of the second wave to be a severe failure of leadership and foresight. But the BJP was still more concerned with censoring criticism on social media platforms than addressing the ongoing public-health crisis.
The vast human cost of the pandemic was painfully evident when hundreds of bodies washed up on the banks of the Ganges. While this tragedy was unfolding, the Central Bureau of Investigation (CBI) arrested four leaders of the TMC on May 17 in Kolkata in connection with a highly publicized corruption case.
The timing of the arrests led many to suspect that Modi is deploying federal institutions against the BJP’s rivals. TMC cadres protested in violation of the lockdown and attacked the local offices of the CBI.
At present, Modi is also pushing on with the Central Vista Project, a $2.8 billion redevelopment plan that is meant to revamp the central administrative area of the national capital. His government has respond to criticism by claiming that the project will “ensure readiness of the country in terms of progressive infrastructure and public facilities.”
While Modi’s administration has invoked the Essential Services Act to allow laborers to work on the project in New Delhi, it previously neglected to do so in order to secure supplies of medical oxygen during a shortage. It is once again evident that the pandemic in India is a public-health crisis that is also inseparable from the country’s political struggles.
Sobre o autor
Somdeep Sen teaches development studies at Roskilde University and is the author of Decolonizing Palestine: Hamas Between the Anticolonial and the Postcolonial.
With few policy successes to speak of, Modi mounted a sustained effort to build up his public image during the pandemic. He declared March 22, 2020, to be a people’s curfew, encouraging citizens to bang pots and pans at 5 PM that day in support of frontline health care workers. On April 9 last year, he asked citizens to light candles and lamps at 9 PM for nine minutes in solidarity against the pandemic. These campaigns had little effect on the outbreak, but they received widespread support from prominent public figures on social media, with many hailing Modi’s leadership in a time of crisis.
When Modi ordered a national lockdown with four hours’ notice, it had a devastating impact on the vulnerable population of urban and rural areas. The BJP boasted that the lockdown received a score of 100 on the Stringency Index, citing this as evidence of Modi’s effective crisis management. However, this measure of “stringency” had very little to do with the efficacy of policies against the spread of the virus.
Modi and his allies have depicted the fight against the pandemic as a personal struggle for the Indian leader. When his government set up the Prime Minister’s Citizen Assistance and Relief in Emergency Situations Fund in March 2020, many people questioned the rationale behind it. After all, there was still unused money left over in the long-established Prime Minister’s National Relief Fund. But one clear advantage of the new fund was that its title could be abbreviated to “PM CARES,” symbolizing Modi’s direct involvement. It was also a way for pro-Modi corporate donors to channel funds they had already allocated to corporate social responsibility, or CSR.
The BJP has framed the ongoing vaccination drive as a personal victory for Modi. In contrast with other countries, where vaccination certificates bear the logo of the national health and disease control authorities, India’s certificates have an image of the prime minister with the message “Together, India will defeat COVID-19.”
Many observers have blamed the recent spike on the Kumbh Mela, a religious gathering held in Haridwar in the state of Uttar Pradesh, which saw millions of people gathering on the banks of the River Ganges. Conducted without any precautionary measures, it may have well been the world’s single largest super-spreader event. Allowing the festival to take place was a political decision in a BJP-led state: it was meant to show that India was now in the endgame of the pandemic.
Against the advice of public-health officials, assembly elections also went ahead in several states during March and April. The large campaign rallies and long polling lines resulted in an immediate surge of infections. In West Bengal, where the BJP was anxious to overthrow the ruling Trinamool Congress (TMC) government, Modi flooded the state with the ruling party’s resources. While the BJP eventually lost the West Bengal contest, the party’s rallies contributed to the highest-ever infection numbers in the state.
Modi and his Hindu nationalist government have also faced criticism globally. Many consider his handling of the second wave to be a severe failure of leadership and foresight. But the BJP was still more concerned with censoring criticism on social media platforms than addressing the ongoing public-health crisis.
The vast human cost of the pandemic was painfully evident when hundreds of bodies washed up on the banks of the Ganges. While this tragedy was unfolding, the Central Bureau of Investigation (CBI) arrested four leaders of the TMC on May 17 in Kolkata in connection with a highly publicized corruption case.
The timing of the arrests led many to suspect that Modi is deploying federal institutions against the BJP’s rivals. TMC cadres protested in violation of the lockdown and attacked the local offices of the CBI.
At present, Modi is also pushing on with the Central Vista Project, a $2.8 billion redevelopment plan that is meant to revamp the central administrative area of the national capital. His government has respond to criticism by claiming that the project will “ensure readiness of the country in terms of progressive infrastructure and public facilities.”
While Modi’s administration has invoked the Essential Services Act to allow laborers to work on the project in New Delhi, it previously neglected to do so in order to secure supplies of medical oxygen during a shortage. It is once again evident that the pandemic in India is a public-health crisis that is also inseparable from the country’s political struggles.
Sobre o autor
Somdeep Sen teaches development studies at Roskilde University and is the author of Decolonizing Palestine: Hamas Between the Anticolonial and the Postcolonial.
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