Fundasaun Mahein recently published an article warning that the Government’s approach to managing Covid-19 risked provoking human rights violations, social conflict and increased hardship for many of our people, especially vulnerable groups. Unfortunately, since the establishment of the serca sanitária around Dili on 8-9 March, many of our fears have been validated. Recent events illustrate the dangers of implementing emergency measures which interrupt the normal functioning of society without fully considering their impacts and planning ways to mitigate them. This is especially important in Timor-Leste’s context, where many people live in or close to poverty, and the security forces have limited capacity to safely implement emergency measures. This article discusses some of the issues which have arisen during the implementation of the serca sanitária, and offers some suggestions for improving the state’s Covid-19 response, as well as for reducing the likelihood that current problems will escalate into a larger crisis.
First of all, we are extremely concerned that the Government initially failed to issue clear guidance to police and the public regarding the transportation of food products and other essential goods between districts and the capital city. This disrupted the supply of agricultural produce to markets in Dili, as well as imported foods to districts. This has contributed to rising food prices, which has an immediate and disproportionate impact on poor people, especially those in the city with little money and no agricultural land. Restricting movement between Dili and the districts has also meant that those who rely on cash sent by family members can no longer access these funds. Many people are already being affected by this, especially poor rural populations and students living in Dili who depend on cash sent by their families in the districts. While solidarity networks have sprung into action to provide assistance to those in need, this assistance will be unable to reach everyone, and the number of people suffering is increasing daily.
After a week, the Government clarified the rules regarding the movement of food products, stating that goods do not require prior authorisation from the Integrated Crisis Management Centre (SIJK). However, the fact that the Government failed to communicate this essential information to the police, and that police themselves failed to clarify the rules, illustrates both the dangers of rushing through emergency measures which disrupt the basic functioning of society, and the lack of capacity on the part of the authorities to implement measures without harming the wellbeing of large numbers of people. While the Government began discussing how to address these impacts last week, Fundasaun Mahein wonders how long it will take before assistance reaches those in need, especially given last year’s experiences and the ongoing problems with the State Budget. We are also concerned that the Government only began discussing the economic impacts of the serca sanitária ten days after it was implemented, rather than anticipating these consequences and making adequate plans to address them.
The new measures come on top of long-term economic difficulties resulting from both years of underdevelopment and the Covid-19 crisis, adding to frustrations around ongoing political issues and the delays in state budget execution. Many have taken to social media to express their dissatisfaction with current policies, including Covid-19 measures, as illustrated by numerous posts and viral videos complaining about police treatment, reduced income and the lack of clarity and consistency regarding the rules and their implementation. Last week, protests were held outside Dili Convention Centre after people seeking permission to leave Dili found that SIJK was closed, despite advice from SIJK itself to seek advice in person at its offices in the Convention Centre.
Another worrying development is the fact that the capacity of the healthcare system is falling as medical staff go into quarantine after testing positive. Many people with serious diseases are being left untreated, including some dialysis patients, whose lives are now in danger as a result of the lack of staff available to perform essential treatments. While Fundasaun Mahein understands the need to prevent Covid-19 transmission in health facilities, it is also vital that this does not result in reduced overall healthcare capacity, and so the Government should urgently consider alternative strategies (see below for further suggestions).
Then, on the morning of Sunday 14 March, PNTL carried out a major operation in the capital city, which led to the arrest of over 200 people for alleged violations of serca sanitária rules. Those detained included people who were driving to buy food, people exercising, cyclists and people simply walking in the street. Some were arrested because they weren’t wearing masks while outdoors, while many others were wearing masks but were detained for being outside with other people. The mass arrests sparked a public debate, with opinions divided between those who viewed this action as necessary because there were too many people “not following the rules”, and those who argued that it was excessive, arbitrary and illustrative of the lack of clarity of the rules and the inability of police to implement them sensibly. Others pointed out that the arrests themselves violated social distancing rules by crowding people together for hours, or wondered whether the prisoners had access to food, water or sanitation. Later the same day, SIJK issued a press release clarifying the rules around exercise, stating that people may exercise outdoors individually, as long as they avoid gathering in groups. However, Minister Fidelis Magalhães added further to public confusion and controversy when he published a Facebook post contradicting the earlier clarification, stating that people must simply exercise at home during the serca sanitária.
In addition to illustrating a failure of coordination and communication between different state agencies, these actions reveal a worrying lack of planning and broad thinking at the policy level. This includes failing to consider both the consequences of directing police to prevent outdoor exercise, and scientific evidence and advice from the WHO itself related to exercise and health. Not only is outdoor exercise highly beneficial to people’s mental and physical health, most scientists agree that the risk of viral transmission outdoors is minimal, especially through momentary contact such as walking – or jogging – past someone on the street. Fundasaun Mahein also reminds policy makers that the living conditions of most Timorese do not easily permit indoor exercise, and going for a daily walk or bicycle ride is essential for maintaining both the physical and mental health of many of our people.
In addition, although the Government has required people to weak masks at all times outside, the WHO recommends against wearing a mask while exercising due to the impact on breathing capacity and build-up of moisture around the mouth, which increases the risk of various infections. Despite this risk, many people continue to wear masks while exercising, both due to their lack of knowledge and fears of police harassment. There have been numerous incidents of police brutality during the State of Emergency related to mask wearing, including one man who was assaulted last week by a PNTL officer for not wearing a mask outdoors. As the risk of transmission outdoors is low, and mask-wearing while exercising is known to be harmful, Fundasaun Mahein questions the usefulness of this policy, especially when it is provoking police violence and eroding public trust in the authorities.
The chaotic implementation of Covid-19 measures, increasing social impacts and contradictory public statements indicate a worrying disconnection between government policy and the realities of most people’s lives, as well as a failure to consider evidence from other countries and anticipate problems which inevitably arise from these unprecedented restrictions. Rising public anger with restrictions and the widespread belief that the Government and media are ‘manipulating’ the crisis for political or other purposes are warning signs that the state may be facing a crisis of legitimacy. The consequences of the Government’s heavy-handed response to the pandemic are thus not only harmful for our people’s wellbeing – they risk provoking a major social crisis which threatens the overall stability and security of Timor-Leste.
By stating this, Fundasaun Mahein does not wish to appear as overly alarmist or, worse, provoke the situation even further by spreading fear. We also believe that the Government is doing its best to contain the spread of Covid-19. However, given the history and ongoing social divisions in our country, current signs are extremely concerning, and we believe the authorities must act now to prevent further social discontent and conflict. In dozens of wealthy, developed countries, long-term Covid-19 measures are provoking mass discontent and protests, as populations have grown weary of restrictions and become more aware of their negative impacts. Many of these protests have been met with police brutality and harsh punishments. Meanwhile, disruption caused by Covid-19 restrictions in developing countries has exacerbated poverty, food insecurity, non-Covid-19 diseases, child and maternal deaths and gender inequality. Similar events would be disastrous for Timor-Leste, and we believe the Government must do everything in its power to avoid such a situation.
As Fundasaun Mahein remains concerned about the transmission of Covid-19 within Timor-Leste, we agree that some ongoing measures are needed. However, they must be balanced, proportionate, and not provoke economic hardship and social conflict which threaten people’s wellbeing as well as the legitimacy and stability of the state. To improve the management of the crisis and address other long-term issues which are compounding the state’s current efforts, Fundasaun Mahein offers the following suggestions:
- It is currently difficult for members of the public to apply for permission to move between Dili and districts, and permission may be refused even in cases where there is a genuine need. Banning people from carrying out necessary activities creates hardship and erodes the state’s legitimacy by generating a negative relationship between communities and the authorities, especially as many people view the rules as unjust or unnecessary. Also, evidence from around the world suggests that less restrictive measures – such as advice, guidelines and limits on large gatherings – can achieve similar results for epidemic control as strict measures like travel bans, stay-at-home orders and business closures. Rather than imposing mandatory controls on movement and activities, the Government could advise the Government not to travel unless for essential reasons, and security authorities can be authorised to allow movement as long as people provide reasonable explanations and evidence at checkpoints along the main roads. Empowering the police and military to exercise discretion would also help to improve relations between the state and communities, while reducing social tensions and alleviating suffering.
- People who depend on cash moving between Dili and rural areas are already suffering – these people require immediate assistance, so the Government should quickly organise emergency food deliveries to those in need. SIJK can create teams which can quickly survey communities to identify people who live alone or without adequate supports. Food deliveries can be implemented by the security forces, which can also help to strengthen community trust in the authorities.
- Many experts have questioned the usefulness of mass PCR testing of asymptomatic people, as it consumes vast amounts of public resources, finds many false positives, and leads to many people being unnecessarily quarantined. Instead of mass testing communities to chase down ‘every case’ (which includes people who have already recovered but still test positive), a better strategy could be to concentrate resources on testing high risk individuals, as well as finding people with symptoms and ensuring that they are provided with adequate care, including safe, cheap treatments which are currently in use around the world.
- Mandatory 14-day quarantine of all who test positive, regardless of cycle threshold, symptoms or likely infectiousness, is leading to harms, including reduced healthcare capacity, loss of productivity and increased personal stress and stigmatization. Not only does this directly threatens people’s lives and wellbeing, it may also be of little epidemiological benefit. The Government should consider strategies for reducing quarantine times, especially for asymptomatic people and healthcare workers, including by using rapid antigen tests.
- As the vast majority of positive Covid-19 cases so far have been asymptomatic, with the remaining exhibiting only mild symptoms, Fundasaun Mahein questions the proportionality of current measures, which are causing hardship for a majority of our people and will provoke further social conflict if these issues are not urgently addressed. We suggest that the Government carry out a cost-benefit-risk analysis of current policies, based on empirical evidence on the overall impacts of Covid-19 measures in other countries, as well as evidence regarding asymptomatic transmission, possible alternative strategies and comparison with evidence from countries with similar demographic and geographic conditions as Timor-Leste.
- The current crisis illustrates the urgent need to prioritise food security, especially in light of ongoing increases in rice prices. Timor-Leste’s Governments have so far neglected the agricultural sector; as a result, much productive land has fallen into disuse, and farmers in many areas have reduced production due to the inability to sell their produce. Malnutrition and over-dependence on imports are major challenges to public health, financial sustainability and human security in Timor-Leste. Prioritising the agriculture sector will thus increase our resilience to shocks such as Covid-19, while improving our people’s wellbeing and ensure our long-term stability and development.