One single enemy
The world is under the spell of the corona virus. As Damiaan Denys, a Dutch psychiatrist and philosopher, wrote in a Dutch daily newspaper: instead of humans fighting each other, this time “the world is threatened by one single enemy.” Still, although fighting the same enemy, we see that people react very differently all over the world. One reason for those differences is the moment in time in relation to the virus, i.e. when does the virus impact the people. Depending on whether the pandemic is still a far-away threat, has just arrived in the vicinity or has started to take its toll (making people realize its deadly force), determines a part of the reactions.
While the virus was only still in China, many countries throughout the world were hardly taking action: ‘it’s just another virus and we’re not going to disrupt our lives and economies because of it’, was a generally widespread opinion. Slowly but steadily this attitude changed dramatically. Many Europeans woke up when the alarming reports started coming in from Northern Italy. Likewise, the US president Trump had to stop in his tracks and change his opinion after COVID-19 hit New York severely. Even President Bolsonaro of Brazil is toning down his messages nowadays. Apart from these leaders, the fact that people have reacted slowly, depending on the momentum in the spreading process, seems to be part of human nature: we won’t upturn our societies based on a far-away threat. With the virus spreading, these differences have largely disappeared.
There are other differences in the types of reactions, which cannot be explained by the time lapse. Some of these are based on cultural differences and we can compare some of these reactions to the cultural dimensions of Hofstede. In countries with high scores on Uncertainty Avoidance for instance, there is a tendency to control more tightly. Most countries in ‘Latin’ Europe are experiencing a complete lock-down, with strict rules and high fines. When I (virtually) spoke to my colleague in Luxembourg I saw the shock on her face when I told her that my son is seeing a friend who’s had COVID-19 already. The difference is also felt at the Dutch-Belgian border, where the Belgians consider the Dutch rules as too loose, somewhat reckless and dangerous. In a village at the border, customers from the Dutch side are not allowed to go to their regular supermarket, located in the Belgian section. The country that is, in South European eyes, even far more ‘reckless’ than the Netherlands, is Sweden. Based on the Hofstede dimensions, Sweden is the most feminine country on earth and with a much lower uncertainty avoidance score as well. In Sweden both restaurants and pre- and elementary schools are still open, while the whole world holds their breath watching it (and in the last few days, it seems this policy has started to take its toll).
One other big difference is related to the collectivist-individualist divide. While enjoying my newspaper to the full, I find another interesting article. This one speaks about the scary scenario that, at a particular stage, we need to address challenging ethical questions in the hospitals in the Netherlands. In case there’s not enough Intensive Care (IC) beds, one would have to choose between patients, not only on medical criteria (chances for survival) but also on other criteria. Does a younger person have more rights to the last bed than an older person? Do parents need to be saved over non-parents? Can we give priority to healthcare workers? Such are tough questions for everybody, but they are almost impossible to the individualist mind, where the best care is being provided to every individual based on their personal health condition. In the Netherlands people are scared to death for this so-called ‘black scenario’ in which “we can’t give the care up to the standards that we’re used to.” We do not know how to think in terms of taking care of the collective. Doctors say: this is beyond our profession and beyond our oath, it should be decided by government. Indeed an ethical committee has been trying to prepare a protocol for such circumstances. The committee advised the government on this, as far back as 2012. However, until today, there has been no reaction – little wonder.
Indeed I notice the emotion and the anger of the people around me if I start to talk about this and I can foresee the protests of people who would probably find themselves at the bottom of the criteria lists. Denys writes: “Modern man has lost the ability to transcend his instant being. Our view on the world has narrowed to the individual and the pragmatic. We can only think from the personal and emotional experience. (…) We have reduced the world to the experience of the individual.”
Thinking in terms of the collective
Such are the issues we’re facing in a wealthy, individualistic and feminine country. (Please click here for a glossary of these terms and a succinct explanation of Hofstede’s Culture Dimensions). Yet, these are not the main discussion points in other countries across the world. In China, the privacy of individuals is being sacrificed for the collective, and many people do not have an issue with it: such measures are for the common good. ‘We’re all being told to give our information to the collective (i.e. the state), therefore we’ll be able to track the virus and flatten the curve (or keep it low).’ After all, in a collectivist society, people do feel far more part of one common body and the rights of the individual are simply not as relevant. In Europe technical/digital solutions are also discussed, but with the condition of privacy and temporality.
In other collectivist countries, like the countries in Africa, the discussion is very different as well. As everybody can see, the virus is possibly gravely hazardous for this continent, since we find the combination of a weak health care system with the difficulty of social distancing (due to crowded neighborhoods as well as the necessity for many to go out and make a small living). At the same time, Africa is used to pandemics, so for the average African the question becomes: what is more dangerous, hunger, malaria, TBC, aids or corona? In comparison, the death toll of corona varies per country but it is generally believed not to exceed 2,5%, while ebola, which has recently been mastered on the continent, has a death rate of 40% (although ebola isn’t spread via the air like corona, making it much easier to contain). It sounds bizarre for all those people whose life has come to a standstill, but at this stage for many Africans this virus is just another illness on the block and let’s hope it stays that way. Hunger is a huge threat and we’ve witnessed footage from Kenya of desperate crowds and fights at a food distribution center.
Having experience with pandemics, Africa also has an advantage: many African countries, like Ghana or Uganda, started to take measures as early as beginning of January. Travelers were being checked for fever at the airports, questions were asked and if considered necessary, people were quarantined in specialized ‘quarantine centers’. Africa also seems less connected to the world, and this may well be a second reason why the spread has been low on the African continent so far. Thirdly, the continent has a relatively young population, which might prove to be an advantage as well. Finally there’s hope (but no scientific evidence) that the corona virus might survive less well in tropical heat and that it may have a relationship with malaria, which might make the population less susceptible.
At this moment, most cities in Angola are experiencing a two week lockdown. Expats have fled back home and the ones remaining in the country, are scared that their personal freedom will be taken away and that they will be brought to the quarantine centers. They’re sending each other horror pictures of the bars in front of the windows, the adverse circumstances and the bad food. Most Africans don’t trust these centers either, and they will try not to end up there. At the same time, they do agree that these centers are necessary. These are rough generalizations, but it’s safe to say that the average Chinese accepts giving up his privacy and the average African accepts the possibility of being locked up for the common good, for the collective.
In various African countries, a large part of the public discussion is focusing on the power play by military, police and government. As is often the case in collectivist and more hierarchical societies, there’s more acceptance of differences in power on the one hand. Still, it goes hand in hand with a lack of trust in the institutions exerting these powers. In Nigeria, there are fears of the abuse of the ‘free hand’ given to law enforcement agencies. In Kenya the military uses teargas to disperse desperate and furious market women trying to ensure their meal for the day. And in Ghana there’s suspicion about a new law, which has given more powers to the president above the existing emergency law. Many Ghanaians agree that the current emergency laws could have been used just as well.
In one of the most advanced countries in Sub Sahara Africa, South Africa, Keymanthri Moodley, the Director of the Centre of Medical Ethics and Law of Stellenbosch University, simply states that there are and will be resource constraints in the healthcare system. Tough choices and “soul wrenching decisions” will have to be made and apart from the medical criteria (in which aids also plays a big role). She mentions age (saving years of life after treatment) as well as giving possible priority to health staff. She even considers the possibility of removing people from a ventilator in case there’s no improvement taking place. She ends by saying: “Everyone needs to accept that not all people with COVID-19 will be able to access ventilators should the outbreak worsen substantially.”
And in doing so, Moodley captures the African mind in one sentence. While no-one is willing to die and many people are hoping, praying and working hard to prevent the pandemic from spreading and taking its toll on the African continent, there’s a level of acceptance of fate and the knowledge that the collective is remarkably resilient.
See the original article on LinkedIn. https://www.linkedin.com/pulse/culture-corona-africa-ao-alette-vonk/
With thanks to my colleagues Okey Okere and Val Rodriguez Brondo for their contribution to this article.
Damiaan Denys. Je kunt Corona ook omarmen. NRC, 04-04-2020
Pim van den Dool en Frederiek Weeda. Welke patient gaat vóór: de moeder of de single? NRC, 04-04-2020
Geert Hofstede, Gert Jan Hofstede & Michael Minkov. Allemaal andersdenkenden. Business Contact, 2010.
Mayke Kaag. A virus’ journey: what does corona teach us about Africa’s global connections? Africa Studies Center Leiden, 23-3-2020.
Keymanthri Moodley. Tough choices about who gets ICU access: the ethical principles guiding South Africa. The Conversation, 07-04-2020