By Grace A. Jibril
What can we learn from the challenges that the COVID-19 pandemic is forcing us to face about ourselves both culturally and socioeconomically across either side of the Atlantic? A comparative look at disparities in local healthcare provision America offers a revealing perspective.
On April 17, 2020, at the height of the COVID-19 Epidemic, the governor of the state of Georgia, USA announced the opening of all barber shops, nail salons and restaurants effective April 24, 2020. Many questions arose about why he chose to open businesses that are not life preserving or considered to be essential services to the public, especially in a city like Georgia’s capital Atlanta where the threat of an increase in infections is very real because the city is quite densely populated and serves over six million people within a vast metropolitan area. Noting that African Americans make up 51% of the residents of Atlanta compared to 38% whites, and given the close cultural correlation businesses like barber shops, hair salons, and liquor stores have with the socioeconomic status of many of Atlanta’s black residents, critics consider Governor Kemp’s decision to open these specific businesses in poor taste and prone to endanger a relatively vulnerable population.
Many black communities in the United States have been ravaged by the current pandemic, and the growing infection rates within these communities provides a grim picture of what more is to come. Besides neighborhoods surrounding Chicago, New Orleans and Atlanta, there has emerged a massive uptick in infections in areas like Prince George’s County in the state of Maryland which also happens to be one of the five wealthiest African American communities in the United States where the average annual income ranges between $83,000 to $172,000. Despite the economic affluence of areas like Prince George’s and other well-to-do black communities, there continues to be a lack of funding for hospitals, for affordable housing, and for educational institutions. The healthcare infrastructure, especially, is woefully underfunded for such wealthy communities.
To get a snapshot of Healthcare disparity in the US, it is important to step back and analyze the socioeconomic profile of regional healthcare service provision and consider how communities allocate their public resources. Prince George’s county has a population of 909,327 as of 2019 , a number relatively comparable to the 1,050,688 residents in the neighboring Montgomery County. Proportionally, however, there are only 53 primary care physicians in Prince George’s county per 100,000 residents, while in Montgomery County there are 95 primary care physicians per 100,000 residents. The majority-black Prince George’s county is served by only six hospitals in comparison to Montgomery County which has a majority white population and boasts fourteen hospital facilities. The Prince George’s county hospital bed capacity is insufficient, especially since this region has the highest levels of the COVID-19 related fatalities in Maryland. To date, there have been 1,156 COVID-19 related deaths in Prince George’s county compared to 268 deaths in neighboring Montgomery County; and the numbers are increasing by the day. Prince George’s county also leads the state in the highest number of cases of diabetes, heart disease and hypertension. Based on the current fatality statistics, residents of Prince George’s county with the above-noted conditions are less likely to survive a COVID-19 infection. While neighboring and larger jurisdictions like Washington, DC, and Alexandria, VA, have invested heavily on healthcare infrastructure, Prince George’s County lags behind in funding such critical infrastructure projects and as a result, lacks the capacity to manage a surge in the ongoing pandemic. This means that with the expectation that infection rates and fatality rates will increase over time, the interconnectedness of people in the Prince George’s County area further complicates efforts to contain and arrest the high infection rates. Many residents in the DC-Maryland-Virginia metro area travel in and out of the region to go to work or to socially interact with one another. This, in turn, has contributed to relatively high infection rates in the DMV region.
Unfortunately, we are seeing the same kind of rise in infection rates in the Atlanta region. As of Saturday May 4, 2020, COVID-19 cases spiked between April 17 and April 29, 2020, with a majority of new cases occurring in Atlanta, Georgia. This is an indication that the Governor’s announcement and subsequent re-opening of some areas of the state did more to increase infections than to restart the economy. It is particularly disturbing that the high infection rates occur in areas with high concentrations of the barber shops, hair salons, and eateries that the Governor declared open. The city of Atlanta is situated in Fulton County where the 498,044 majority black residents of Atlanta make up 54% of the population in the city and must now contend with the losses associated with COVID-19. The socioeconomic health disparities are just as great as they are in Maryland, Illinois and other urban areas outside of Fulton County which currently has the highest COVID-19 infection rates and fatalities in the State of Georgia. If the COVID-19 pandemic is to be arrested and stopped, legislators must address the issue of lack of funding for adequate health care services, facilities, and infrastructure to support the health and education of those living within the above noted areas. It is important to note that much of the blame for the lack of proper infrastructure is as a result of poor leadership.
These are the same challenges we face in Africa within our respective countries, where “mismanaged” public funds earmarked for critical infrastructure projects are squandered on vain pursuits or end up in a Swiss bank account of an unnamed official. The COVID-19 pandemic is opening the eyes of many in the African Diaspora and within Africa on the importance of good stewardship of public resources. The culture of corruption — which encourages greed and celebrates private gain in wealth and status and disregards the wellbeing of the people — be it in the United States where it is thought to be non-existent, or be it in any African country, simply must stop.
We are witnessing the degradation of our family structures as a result of the high fatality rates concentrated within the black communities across the globe — from the United States to the United Kingdom.
In Africa, countries like Tanzania, Ghana, Cameroon, Ivory Coast, Senegal and Nigeria each have significantly rising infection rates. Many of these countries lack the medical infrastructure to respond to a pandemic like COVID-19 where large scale fatalities are inevitable. So essentially, a number of African governments are depriving their citizens of adequate medical facilities, supplies, and other infrastructure, all of which are a basic human rights. The disparities we see in these African regions very often have more to do with corruption, or blatant misuse of public funds, than they have to do with either socioeconomic challenges, or even the kind of racial injustices that plague the African Americans in areas like Atlanta, or the DMV area.
The one macabre gift COVID-19 has given all of us in Africa and in the Diaspora is an opportunity to self-reflect and open our eyes to the understanding that we must work together to enhance our core standards of living and the quality of life for those around us. If we are to thrive as a people, we must look after the wellbeing of our brothers and sisters and become their keepers.
The fact that we live in lavish homes and drive expensive cars, be that in Africa or overseas, does not mean that our quality of life is necessarily better than that of the poor who live among us. It only takes a pandemic like COVID-19 to force us to re-assess what we find important in life and to understand that the difference between life or death may actually be in the hands of the local medical facility you conveniently neglected to support. Working as a global community using the mechanisms that exist to enhance the capacity of our local or nearby health centers, clinics or hospitals must be as important as the building a fence around our lavish compound in Kenya, or the purchase of the latest and greatest security alarm system in the United States.
Even when planning for our retirements at home after spending years in the diaspora working and accumulating wealth, we very often focus on building “my house in the suburbs/village” in Africa’ rather than ensuring and supporting the existence of a viable medical facility in the area. But we never consider that the realities of aging require that an adequate healthcare facility be available to care for our needs when it will become necessary.
This essentially means that we Africans across the globe must slowly and deliberately support ethically conscientious, bold thinkers who can lead the way through this critical period of transition locally, regionally, and nationally throughout Africa and across the world.
Grace A. Jibril is the Director of HR and Organization Development for the U.S. State of Maryland Health Department, Anne Arundel County