The precarity of pre-existing conditions

Elora Halim Chowdhury | Published: 00:50, Oct 15,2020 | Updated: 22:06, Oct 26,2020


Exhausted, anxious, she is waiting in front of the IEDCR for a consult to see if she could get tested for COVID-19. She has breathing difficulty for the past 10 days. After much persuasion, she was able to see the doctor at IEDCR, who then referred her to Kurmitola Hospital, and told they will collect the sample as soon as possible for Covid-19 test. April 2, 2020. — Parvez Ahmed Rony/Drik

THE World Health Organisation officially declared COVID-19 a global pandemic on March 11, 2020, which, in the opinion of many health and policy professionals, was already late in the game. Reports that China lacked transparency in alerting the publics about the outbreak since its initial detection in Wuhan Province in December 2019 (voanews, April 19,2020) and a questionable ‘missing 6 weeks’ that experts consider could have been a crucial delay before the US initiated its own organised response to the virus’s ubiquitous spread (The Guardian, March 28, 2020) add to the accumulation of right facts and wrong turns that have only increased as the days and months press onward. One thing we can agree upon is that the spread of the virus has been shrouded in mystery, misinformation and confusion. The information gleaned has emerged only bit by bit — an unfolding catastrophe that resembles fable, an allegory, a fairy tale (its dark underbelly in full effect). In this moment, we might reflect on how we — humanity — arrived here: to be retrospective, we consider how the power of imagination has been unleashed; to be introspective, we contemplate our individual praxis and values; and then, there is this pending prospective — what kind of future might we strive for on the other side of COVID-19?

A new book by Maggie O’Farrell on the social life of disease charts the outbreak of the Bubonic Plague that spread across Europe in the fourteenth century killing a staggering 50 million people. O’Farrell reminds us how some of our favourite nursery rhymes, including ‘Ring a Ring o’ Roses’ are actually describing Plague conditions in Europe during the 1600s: ‘The ‘ring o’ roses’ refers to the distinctive red marks on the skin, caused by the disease; carrying a posy of flowers was thought to ward off miasmas. The final lines — ‘Atishoo, atishoo, we all fall down!’ — are grimly self-explanatory.’ The operative word ‘miasma’ referred to rotten matter or noxious night air that apparently caused the deadly and mysterious disease. In 2020, the novel coronavirus appears to have leapt from animal to human, fantastic yet eerily resonant to the plot of the 2011 film, Contagion. Transmitted through droplets, it appears to survive in the air for thirty minutes, potentially infecting anyone who inhabits or passes through and inhales it in the space occupied by a carrier. Deadly and invisible, it lives on surfaces like cardboard, plastic, and metal. It was found to still be potent on surfaces in a cruise ship 17 days after its passengers had disembarked. It ravages the elderly and the immuno-compromised, yet usually spares children. It has unleashed a world where we cannot touch, shake hands with, or hug one another. Going outdoors means putting on protective gear and maintaining safe physical distance. The only effective barrier is scrubbing our hands and faces with soap and isolating ourselves in small social — familial and kin — units.

The virus’s path and preventive measures illuminate far-reaching relations of social and political inequities. The rate in which it has travelled across borders — national, urban- suburban, industrial and agricultural, race, gender and class, citizen, migrant and refugee, professional and daily wage worker — brings into sharp relief its stunning spread and expanse as well as the tremendous asymmetries of our lives. Not the least of these differential border crossings have been the consequence of unfettered capitalist development and accumulation. Indeed, feminist scholars in particular have pointed out capitalism as the virus, humans as its agents, and the ensuing pandemic and its fault lines as being caused by the relentless greed, plunder, individualism and ‘progress’ of the age of the Anthropocene. When we choose to not heed the signs of devastation wreaked upon the earth by ever-increasing encroachment into the natural habitats of the non-human species; when we choose to dismantle national pandemic teams, or deem it unnecessary to stockpile emergency medical equipment because they are not ‘profitable’ in the here and now; when we choose to build and sustain national economies on exploitation and oppression of disadvantaged and minoritised populations here and elsewheres in the global South, the shocking but not surprising, slow but sure consequence is all of us — that is, humanity — are brought to our knees.

From the outset, I have been following the responses and coverage in my two contrasting ‘homes’ — US, with its long imperial history of spectacular military aggression, presumably the world’s most powerful nation and Bangladesh, because of its history of travail, and also its triumphs, one of the world’s most resilient. At present, a series of unfathomable blunders by the highest office in this country has resulted in the US having the highest number of COVID-19 cases as well as deaths in the world. Journalists have talked about the ‘missing 6 weeks’ that could have slowed down the virus’s progression and allowed for a more concerted strategy to fight the disease. New York City, the epicenter, has been ravaged with the highest number of deaths — as well as job losses — occurring most especially among African American and Latino communities. Similar patterns are emerging in Boston, Chicago, Detroit, New Orleans. These are unemployed, and underemployed, communities living in substandard housing, with lower life expectancies, not eating ‘healthy diets’ and suffering from ‘pre-existing’ socio-economic and health precarities. Many of them not surprisingly also make up the category of ‘essential workers’ — at once disposable and at the same time on the frontlines fighting COVID-19, without adequate protection.

Dr Anthony Fauci, the wise director of the National Institute of Allergy and Infectious Diseases since 1984, has advised six US presidents, and responded to the bleak racial inequity and higher numbers of death and disease among African Americans by saying, ‘There is nothing we can do about it right now except to give them the best possible care and to avoid complications.’ In a similar vein, during a webinar on the South Asian response to COVID-19, Dr Srinath Reddy, president of Public Health Foundation of India, when questioned about the sensibility of the stern lockdown and its murderous consequences on migrant labour, responded that the time for post-mortem of such policies was later; efforts in the now needed to prioritise healthcare. In response to the ‘not now, later’ glib response by authorities, American Studies scholar Lynnell Thomas poignantly asks, ‘That begs the question, when can we do something about it? When can we stop replaying the same press conferences, rewriting the same sobering reports, reissuing the same dire warnings?’ (Radical History Review, April 13, 2020).

Comparisons are being made between COVID-19 and war zones. Decades of feminist research have revealed that in conditions of conflict and emergency (and relatedly pandemic), women are vulnerable. Although, we must be careful to not uncritically liken the pandemic to war, the traumatic circumstances it has engendered in the lives of many, evoke lived experiences and memories of trauma among many. My octogenarian mother who lives with me, from the outset of the pandemic has likened the experience to the previous war she lived through in 1971 — the independence war of Bangladesh. Curfews, food insecurity, life-threatening conditions where she, along with my father and siblings, had to keep shifting their locations for fear of being killed by the Pakistani army. They sought shelter in remote villages in northern Bangladesh with perfect strangers — peasant families who took care of them with a deep sense of compassion. She says it was that unquestioned care labour — often feminised — that got them through. These families did not know ours, nor several other intellectuals who also went into hiding in the same area, yet they opened their homes and offered their meagre resources with heartfelt generosity as the nascent nation waged its resistance to military domination.

Entrenched and often class-crossing norms of gender suggest women take on the triple labour of paid work outside of home, unpaid domestic work at home, and the emotional labour of maintaining family, kin, and community stability. Added to this is a fourth and additional realm of caregiving under lockdown. From China to Europe to America, there are reports of a concurrent spike in the global epidemic of domestic violence. Neglect and abuse of women and children has increased simultaneous to decreased recourses and services to address these proliferating cases. While worldwide we are seeing higher numbers of deaths among men, closer analysis within socio-economic categories show high numbers of the sick are also among occupations with higher numbers of women as well as minorities — service workers, nurses and health workers.

Following the course of action in the more developed world, Bangladesh instituted a lockdown on March 26, initially calling it a ‘general holiday’, a clever euphemism that enabled a lockdown without specifications regarding legal responsibilities. That is, there was no attendant recognition whether the ‘holiday’ falls under the guidelines of ‘The Communicable Diseases (Prevention, Control and Eradication) Act, 2018’ or the Disaster Management Act 2012 covering restrictions around workers’ lay-off. Experts in South Asia have been questioning the sensibility behind this approach given the vastly different national contexts existing between Europe, America and South Asia. They point out the need for prioritising local approaches in thinking about our strategies to combat a pandemic about which so much remains unknown, even as it wreaks havoc on an unprecedented scale.

For starters, in a national context where 90 per cent of the working population are engaged in the informal sector, what would social isolation look like? Middle- to upper-classes are maintaining the strict curfew-like imperatives having planned for and purchased supplies to hunker down for the duration. Their service staff — drivers, cooks, cleaners — have been released from their duties with, one hopes, advance salary payments. Many of their populations live in close quarters in the urban slums, often crammed 10 to 12 in a room. They do not have running water, let alone secure and sanitised living conditions. There has been an exodus from the city to the villages. This exodus includes migrant populations of daily wage earners and factory workers. Eighty four percent of the country’s export income comes from Bangladesh’s garment industry, which employs 4 million workers, mostly women. In its lockdown directive, the government did not specify closing factories down, leaving the decision to be made ad hoc by individual owners. Neither did the Bangladesh Garment Manufacturers and Exporters Association, the nationwide trade organisation of garments manufacturers in Bangladesh located in the capital city of Dhaka, offer a clear directive at the start of the lockdown as to what the workers might expect. Many workers were sent home without wages for the month of March. One garment factory in particular, A-One (Bd) Ltd. has been called out by labour organisers for not having paid its workers for four months. On April 16, when the workers gathered in front of the factory located in the Export Processing Zone to demand their overdue wages, police showered them with hot water and charged at them with sticks. Workers have been summoned multiple times by their managers but no payment has been made. Buyers include Tesco, Tessival, Terra Nova, Benito, Malagrida, Cupack, Jo & Jo.

A two-tiered enactment of humanity is at play. Human Rights discourse emphasises universal values of humanity and dignity, yet what the pandemic fallout and policies have shown, time and again, is the use of a euphemism like ‘essential workers’ and even more particularly, the much celebrated ‘women garment workers’ in the case of a neoliberal market economy-driven Bangladesh, to obscure the very real daily dangers these workers are forced to face in order to keep considerable segments of the population safe and comfortable. In each instance, we see a hollow celebration of frontline-workers, one literally serving the nation to convalescence at a time of emergency, and the other in building its capital. They are celebrated as heroes yet are sent to these ‘frontlines’ without adequate social protections.

About 2000 garment factories were open during the ‘general holiday’ in Bangladesh. In many, workers stood shoulder to shoulder. Ten corona-related deaths, and at least 96 corona-positive cases had been reported by May, 2020. BGMEA representatives talk about how Bangladesh has already suffered the loss of $1.3 billion contracts from foreign retailers within the first few weeks of the global lockdown. Contributing further to the confusion around the selective lockdown directives in Bangladesh, some factories have called their workers to return, and in the absence of proper transportation, many have made the long trek back to the city on foot. Among the poor in Bangladesh, there are stories of people dying of hunger and illness en route; of suicide in the face of hunger and the stigma of unemployment (Somoy News, March 25, 2020); and of sick relatives being abandoned by the roadside for fear of infection (New Age, April 14, 2020). The same people who in ‘normal’ times perform the most intimate of chores for rich households and serve the national economy (so they can shelter in place for the duration) are now shunned from their workspaces (or called back at their own risk). There are reports that when some factories announced a reopening (some had not closed down at all) that led to the workers walking back to the city, many were turned away by landlords for fear of contagion. The stimulus package extended as a loan by the government would only pay one month’s worth of workers’ wages, and that too if it were to be proportionately administered at all.

Who has the privilege to maintain a six-feet distance in a factory or in slum quarters? Whose health, wellness and safety do these policies protect and at the cost of whose livelihoods? Is it a real choice for the vulnerable whose ‘normal’ is already a condition of precarity to return to work at the face of death by starvation? Can we talk about health and disease in pandemic conditions, divorced from the pre-existing lack of socio-economic infrastructure of protection? Who can be held accountable for the fragility of a $22b annual industry that after four decades of growth and prosperity for the nation and multinational corporations, the so-called ‘essential workers’ who are the ‘backbone of the industry’ are being threatened with layoffs and no compensation, additional to the extreme lack of emergency protection.

On a televised talk show, a DBC news anchor asked Taslima Akhter, coordinator of Bangladesh Garment Workers Solidarity, about the capacity of owners to ‘feed the workers as they sit idle’ (Malik ra koto din sromik der boshey khawate parbe?). This begs several questions: Who is feeding the owners and the retail companies in good times and in bad? Who has benefitted from the labour of factory workers that they can ride the lockdown without having to worry about the next meal, about feeding their children, about paying rent? This mis-recognition of profit and security as entitlement resonates within the debate around health insurance and protection in the United States that often excludes those most in need of protection. Under the US American capitalist system, insurance companies can refuse to provide coverage for those with health precarities, namely, those with pre-existing conditions; in some cases, socio-economic, racialised conditions are the pre-existing condition. Thus, workers’ vulnerabilities make them ineligible for social and corporate responsibility.

Labour activist Taslima Akhter captures this double-standard on a Facebook post-dated April 3 3, 2020:

‘Ten lakh workers are on the verge of losing their livelihoods. The professional classes are protected by the state but when it comes to ensuring the job security for workers the response from the factory owners has been an astounding, ‘how can we support them to sit idle?’ (In Bangla, the term literally means ‘support them to sit idle and eat’). Factory owners measure their estimated losses in anticipation of more cuts to contracts. Already, they are facing the potential loss of $3 billion from Northern retailers. Nowhere in this equation is a recognition of how the businesses have benefited from paying workers meagre wages — wages that did not enable nutritious meals and good health, that barely maintained the workers’ substandard and precarious lifestyles. At a time when our nation faces grave uncertainty, these business owners do not hesitate to turn their backs on the workers, talking about layoffs, and salary-cuts. Workers are being made to bear the burden of the lost contracts. What a cruel system this is that discards the very people who enabled this class to emerge as the leading manufacturers, and for our country to rise to middle-income status. If owners and buyers don’t take on the responsibility, who will? We must demand that the government will. The sweats of the workers are what grew the garment industry, yet these are the same people who are being made to bear the brunt of the pandemic. They face not just a health risk, but a risk to their livelihoods.

To those business owners: so you might be committing a little bit of money. It is the same for the foreign buyers too. This will not lessen your profit overmuch, nor hinder your capacity to buy new clothes. On the contrary, this investment in workers now will only help you and your business sustain in the future. If you don’t do this, the industry will be irrevocably damaged in the very near future. Workers do not ask for your charity — it is their human and humane right to get paid and to get health protection.’ (Translated by the author)’

As much as the incantation ‘we are all in it together’ alludes to the borderless transmission of the virus and appeals to an evocation of global community, it nevertheless obscures universal and deeply entrenched systems of social stratifications based on race, class, caste, and nation. Such incommensurate incantations also obfuscate what should essentially be a call for a just responsibility, a term feminist scholar Brooke Ackerly (2018) defines as awareness of location and privilege in our courses of political action and service towards humanity, encompassing an ethic of care and justice. The workers of A-One (Bd) Ltd. have not been paid in four months, leaving them to face starvation, eviction, illness and domestic violence. The owner of their factory has died of COVID-19 in Italy. Even if the factory is reopened, what of the goods produced? In conditions of global lockdown and mass-scale economic downfall, how feasible is the expectation that brands will come forward with payment for goods that are currently in the pipeline and in buyers’ houses and shipping docks, let alone revive an economy dependent on a supply chain apparatus?

A supply chain of profit must also integrate a chain of care and ethics. This surely includes the well-being of workers as much as the well-being of the business that is frequently highlighted over the plight of the workers. An over-emphasis on a single stake-holder’s interests — whether the national government, or the retail owners, or the factory owners in Bangladesh — are what we see reiterated by the BGMEA. These are the organisations with the most power — at least in the national context — to affect a care economy (Sourcing Journal, April 10, 2020). In a changing — reeling — global market context that is not just impacting Bangladesh, how should retailers and owners respond? The question posed to the president of BGMEA Rubana Huq in an interview with Sourcing Journal was, ‘Without the industry, is there a Bangladesh?’ Ought not the question be: ‘Without Bangladesh and its workers, is there an industry?’ What will the industry do to take care of its workers? Feminist researcher Dina Siddiqi (2020) raises the critical issue of Euro-American retailers unilaterally exiting the binding obligations of formal contracts through a contested invocation of the force majeure clause, a little-known feature of the international trade regime prioritising their position to withdraw contracts. What will the industry do to take care of its workers? Feminist scholar Nafisa Tanjeem explains that ‘[p]olicy-makers and corporate bodies in Bangladesh have consistently framed the narrative around the sufferings of Bangladeshi garment workers vs the survival of the businesses in the North. However, the question is not necessarily a binary one between business vs survival’ (New Age, April 14, 2020). That is, it is also essential to question what purpose the overly-determined survival narrative serves. Is it for protecting the business interests? What does it obscure for the well-being of those whom the businesses purport to protect, namely the workers? For as Akhter has repeatedly articulated, the question is not of charity — even as there is need for that all around — but of an investment and a responsibility toward the well-being of the world economy, the so-called supply chain, and an ethic of care for all who link the chain.

If we truly are in this together, what would a compassionate and just response look like? I started with an allusion to the pandemic’s likeness to allegory, so let us consider the musings, poems, and incantations that evoke the sentiment that what we are witnessing is the healing of Mother Earth. Certainly that imagery also conjures up a sense of inevitability (it is a cycle of renewal and plunder) if not paralysis (we can’t mobilise in public spaces), even compliance (it is time to hunker down now and organise later) and complicity (nothing can be done about the ravaging inequities now, the ‘post-mortem’ will come later) in the face of our calamitous global reality. Again, what do such incantations obscure and what do they illuminate? It delinks unbridled capital accumulation, rampant profiteering, and attendant decline from an awareness and investment in our mutual yet differential vulnerabilities and reciprocal dependences. In other words, a sense of collective good, deeper appreciation of an interdependence of humans with each other and the ecology, absent which we cannot confront the present pandemic. Yet, the pandemic’s — and relatedly capitalism’s — spread and consequences are far more lethal for those with ‘pre-existing conditions.’ Negligence and systemic structural oppression of race, gender, class, and nation has made it so. Arguably, we had already become isolated from a sense of collective interdependence (humans from each other, as well as from our ecology) and the pandemic has conjured war-like metaphors even as what will actually save us, ironically, is an ethical care for one another. We cannot be isolated from the idea of sociality — that our lives must be in touch, that our sense of responsibility must involve solidarity, reciprocity and mutuality.

Even as I am outraged by the ‘not now, later’ mantra, I am also bewildered by the constantly shifting situation. What we can say for sure is that the principles of capitalist growth must be stopped and an alternate way of living — emphasising a care ethic and economy — has to be imagined. I want to return to the idea of the power of imagination as an opportunity that we might unleash during this time of grave calamity. That we collectively strive to rid the world of the ‘miasma’ — the noxious air of uneven development, extractive economies, and appropriative human interactions. This notion recalls for me what my mother has always reiterated when she talks about how our family got to safety in the previous war they lived through: an appreciation of the mutual vulnerability and dependency of humanity with one another and our ecologies, and a cultivation of just responsibility in our collective actions. While our forward-thinking must be policy-driven, the policies that will truly disentangle us from the thorns of the virus have to be trans-disciplinary and transnational. This is reinforced by feminist scholars as well as a spiritual-humanistic scholar like Daisaku Ikeda who outlines three key principles to realise a mode of global citizenship rooted in a pluralistic, and diverse form of humanitarianism: first a realisation that all life and living beings are interconnected; second, the embracing of difference rather than denying or fearing encounters with the other; and finally, cultivating compassion and ‘imaginative empathy’ for others. Drawing from Buddhist worldview, Ikeda encourages an ‘all-encompassing interrelatedness’ by active dialogue and engagement with others in order to grow our own humanity (55). In the foreword to Ikeda’s essays, Hope Is A Decision (2017), feminist scholar Sarah Wider notes the centrality of the concept of Ubuntu in his work — the idea of ‘co-dependent origination’ and the belief, ‘I am because we are.’ She elucidates that even when Ikeda seems to focus primarily on individual and interpersonal interactions as the mode for personal transformation, he urges us to see the individual as inseparable from our relational worlds and the interconnectedness of all existences. The act of understanding and living this interconnectedness is what Ikeda terms a ‘committed persistence’ to the ‘profoundly relational world’ humans inhabit.

Scholar and educator Richa Nagar posits that one must seek a ‘metaphysics of interdependence’ (Alexander 2006), a planetary consciousness. She articulates this by evoking a powerful play written and performed by grassroots human rights organisers in Northern India, where activists repeatedly chant, ‘If I speak my truth you will feel a stabbing pain’ (177). In the same vein, Ikeda writes, ‘Harm done to anyone, anywhere, causes agony in the poet’s heart’ (61). These incantations align with a transnational feminist analytic of interconnectedness, interdependence, and what Ikeda calls the theory of dependent origination. In them, we find the acknowledgment of a mutual vulnerability of humanity across borders and a collective commitment to co-create, to strive for social justice and ethical responsibility.


Elora Halim Chowdhury is associate professor and chair of the department of women’s and gender studies at the University of Massachusetts Boston, and a co-founder of the South Asian Regional Media Scholars Network.

Want stories like this in your inbox?

Sign up to exclusive daily email