How did Victoria get here? Examine the lack of diversity in decision-making

It was hard to watch Premier Daniel Andrews’ speech yesterday in which he said, and I quote (very loosely): “All you Victorians are terribly naughty for misbehaving and now I, as a benevolent leader, must once again lock you down.”

Despite the fact that, overall, the Victorian government’s response has been acceptable, and arguably better than the response from the opposition (which was to call for more golf and fewer bats in the leafy suburbs along the Yarra), this was rather unkind.

The premier could have explained, instead, that despite an extremely high level of compliance with the hardest and longest restrictions, a series of both foreseeable and unforeseeable events (in the middle of a pandemic that is only worsening in other parts of the world) had resulted in a rising case load and the need to increase restrictions again.

How did this happen?

The hotel quarantine program seems to have been a source of reintroducing infection back into the community. With as much as five minutes’ training, guards from a variety of firms were given the job of overseeing the quarantined returned-travellers, making them feel safe, avoiding any demonisation of their condition since they hadn’t done the slightest thing wrong in travelling overseas, and making sure they were appropriately supported in their two weeks of isolation while maintaining strict infection control.

But of course, that’s not what they were tasked with doing. Rather they were given the job of making sure that these awful people who had committed the terrible crime of not loving Australia enough to just stay within its borders were kept in their place so they couldn’t contaminate the rest of us.

Should we be surprised if it is really true that some of the travellers commenced illicit relationships with the guards, or that the guards took insufficient precautions with the sharing of cigarette lighters?

Arguably, the use of police or the Australian Defence Force would not necessarily have led to either people feeling safer, or to better infection control, because treating people like criminals has, over the last 3000 years of recorded history, repeatedly been shown to result in some of those people behaving like criminals. And giving people power to detain other people has, over the last 3000 years of recorded history, repeatedly been shown to result in some of those people wielding that power in inappropriate ways.

From the very start, some people have escaped hotel quarantine, others have attempted to escape, and yet others, more compliant, have simply complained bitterly about feeling unsafe, detailing sexually suggestive and other threats from the guards, regardless of the type of badge worn by those guarding them or the State in which they were held.

Throughout, the response of the government has been the same to this as it has been to everything else: “We appreciate that we are asking you to endure something unpleasant, but stopping the pandemic is the most important of all competing policy priorities right now and that includes the physical and mental wellbeing of whichever minority or disadvantaged group that is disproportionately affected.”

Instead of listening to the “consumers” of hotel quarantine, their now clearly valid criticisms were written off as middle-class whinging. Even this week, we heard NSW Police insist that a two-week stay in a five-star hotel was not so onerous after a woman was so distressed that she tried to escape, without a moment’s consideration that perhaps there might be something wrong if thousands of people complain and some try to flee.

In Victoria there has been no consideration more important than infection control. We are not, after all, like those Americans who don’t practise any infection control at all.

But here is the problem: infection control is not primarily about viruses, it is about the people in whom the virus resides, and those people have concerns and fears that are not secondary to the virus. Amazingly, most people think of themselves as people first, and vectors of viral transmission somewhere between twelfth and sixteenth.

So it was that the strictest government, with only our best interests at heart, relaxed restrictions on social gatherings proximate to the celebration of Eid, because there were no representatives of relevant groups on any of the relevant committees, and it simply did not occur to the well-meaning thoughtful people in the corridors of power that such a festival existed, or that if permission to gather in homes in groups of twenty and presumably share food was given, then people would, in fact, gather in groups of 20, and share food.

It also did not occur to them that many of those people were also those who had worked outside the home throughout the entirety of the previous lockdown — slaughtering animals and packing and serving groceries, driving taxis, manning petrol stations, caring for the elderly or young children, and undertaking cleaning — constantly exposed in an environment where the public health officials had always warned there was a low level of community transmission.

And when all these families congregated together, abiding by the published rules of the day, they were not misbehaving in any way. These were not visits to the proverbial third-best friend from primary school; they were the culturally important celebrations conducted completely and entirely within the prescribed limits.

And if, after months of such exposure undertaking front line work, parts of our society felt ill, there were significant barriers to presenting for testing, or agreeing to a test due to additional systemic issues. People who didn’t have a Medicare card didn’t know they could be tested; people on temporary, refugee or other visas, trying to fly under the radar, worried about the sharing of contact details and location information with local and federal bureaucracies; casual workers worried about the requirement to isolate while awaiting results and the consequent loss of critical income; and the lack of understanding as to when they needed to get tested or where to go. Unfortunately, the political bubble is not just a problem with Canberra.

Most recently we have seen the locking down of 3000 people in public housing towers. From the very beginning the residents of these towers have been paternalistically cast as so vulnerable and disadvantaged that they can’t be expected to comply with public health orders or to appreciate the importance of infection control. In other words, people from the countries that continue to deal with infectious diseases every day and have for centuries (and in some cases, whose countries of origin have had an even better public health response than most Western nations), cannot be expected to understand what the very important white men are asking them to do. Instead of congratulating them for avoiding the spread of contagion for three months in among the most challenging conditions for hygiene and physical distancing any group in this country has faced, they are being demonised and subjected to conditions of strict detention.

Now there is a field hospital outside the public housing towers for general medical issues, set up so the residents of the housing towers will not spread viruses in our public hospitals, a mother who cannot provide breast milk to her premature infant who is in hospital because no one thought to offer her priority testing and safe haven in a separate hotel, and sustenance in the form of a series of mal-selected foodstuffs.

I’ve learnt this week that apparently, once detained, people lose all their agency and the ability to cook; that it was seemingly impossible for any government agency to ask a single detainee for a list of basic groceries that would feed a family for a week (which would have been written out in five minutes, and could have been turned into 1000 boxes of food by any major supermarket in the space of a single morning); and that the adjective “culturally appropriate”, when applied to food delivered to these detainees, often means “generic food” that few people want to eat.

Ultimately, the cause of these issues, and the ongoing problems with the response stem from the same commonality — in the corridors of power, not enough people look around and ask: “Who is not in this room, but should be?” Our society is diverse, in many ways, and yet, whole swathes of it are written off as uninterested in participation, or unable to engage. The reality is that most people have important insights, and hold a key to the overall puzzle. Whole communities cannot be said to be disengaged; rather they are excluded. Their exclusion from the political processes that drive our society is a form of violence at the best of times; but in a pandemic, this oppression will bleed out and cause impacts on everyone’s lives.

This is not the first pandemic. Nor are we the first country to bear the brunt of this current pandemic. In other countries, it is the abattoirs, the meatworks, and the high-density housing that has caused the most significant outbreaks. To this extent, the current issues in Victoria were entirely foreseeable. It is bad luck that the infection seeded these locations in Victoria, but the conditions for their growth and spread exist everywhere. To every laughing Queenslander or New South Welshperson, I would say that your city has these issues too, and as in Victoria, it will take only a tiny spark to light the inferno.

It can be easy to kid oneself that as a generally benevolent leader, or a benevolent government, that all of these inequities are being addressed to the best of the government’s abilities. But the reality is that unless the most marginalised people have a seat at the table, no policy maker can truly understand the issues. Consultation is a laborious process and often skipped; but having diversity at the table means that there will always be a set of eyes and ears on all critical decisions, to make sure that holes in any response are not being missed.

Public health has, for its long existence, run close to moralism. It is a field of delineating the clean and healthy from the dirty and infected. The sanitation campaigns of the 19th Century were as much aimed at the moral degeneracy of an overpopulated working class as they were at the foul smells of industrialising Europe. We are quick to forget that the author of the first Public Health Act in England was also the architect of the workhouse.

The best public health resists this tendency and puts people first. Only then can it be effective. If people do not believe they are safe, they will not present for testing. If they are afraid the police will harass them, they will not seek assistance. If they expect their fears will be ignored, they will not speak up. And most importantly, if they do not believe the government is acting proportionately and treating them with respect, they will not comply.

Neela Janakiramanan is a reconstructive plastic surgeon and author.

This article was originally published at Women’s Agenda and is republished here with permission.