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Message from Dr. Masamine Jimba, Regional Vice President, on the COVID-19 Pandemic

COVID-19 is still threatening us even after more than six months from its beginning. By the end of June 2020, confirmed cases are reported to reach 10 million in the world. The Western Pacific Region of WHO, where I reside, has performed comparatively well, and the total confirmed cases in the region is reported to be just above 20, 000 in June.

One Japanese virologist mentioned that might be due to the Eastern lifestyle’s uniqueness. For example, in the Japanese culture, bowing is common when greeting instead of shaking hands or hugging, and taking off shoes before entering a room is the norm. It may be, to some extent, true, but we have no evidence.

In the era of evidence-based public health, we should appreciate the increasing scientific evidence to cope with the new virus. However, we also need to narrow the gap between “what to do” and “how to do.” The former usually is presented as scientific articles, and the latter comes from fieldwork in real-world settings.

Take physical distancing, for example. The current evidence from The Lancet shows physical distancing of 1 to 2 meters or more significantly reduces the risk of infection. It shows “what to do,” and it may be true in science, but regarding “how to do it,” it is almost impossible in many settings, such as slums of Asia and Africa, and favelas of South America. Even in Tokyo, where three million people commute every weekday, they have to squeeze themselves in jam-packed commuter trains, where taking 1 to 2 meters distance is nothing but a dream. However, there was a month-long exceptional period from April 7. On that day, the government of Japan declared a nationwide state of emergency, and during this period, the trains were far less crowded. Currently, in June, the emergency declaration has been lifted, and the streets are almost as crowded as before, even if about 50 new cases are detected daily in Tokyo.

Then “what to do?” to do “how to do?” In Japan, windows are open in the trains for ventilation, and nearly 100 % of the passengers wear masks. In many parts of the world, such ideas are born like growing mushrooms. More ideas have been invented for hand washing, wearing masks and other personal protective measures. When we face a crisis, innovative ideas naturally appear everywhere in the world.
It reminds me of an article written by Prof. Ilona Kickbusch: “Health promotion: Not a tree but a rhizome” (Health Promotion in Canada: Second ed., 2007). She mentioned that “health promotion …is a rhizome.” Learning from a “A Thousand Plateau,” written by Gilles Deleuze and Felix Guattari (1976), she explained that “rhizome is a system that has many roots, that is connected and heterogenic; it does not respect territory but expands continuously, thus creating its own plateau.”

Thirteen years have passed since its publication and now we live in the era of social media. Not only the specialists, but general citizens can share their voices easily. Since the beginning of COVID-19, health professionals have been shouting their voices from the hospitals. Older people have been mourning from their nursing homes; and business persons, groaning with pain from losing their offices. At the same time, however, we have heard positive actions. A 9-year old Kenyan boy invented a low-cost, hand washing machine using available water and soap. Using her own pocket money, a young junior high school girl made more than 600 masks for the older people living in nursing homes. These examples are all about “how to do” to help other suffering people beyond themselves. More and more innovative ideas and actions are now flooding in the world.

We have a skyrocketing root of ideas, and connections are becoming more complex. Heterogeneity is significantly increasing. The rhizome is growing a giant. If health promotion is still the rhizome, we have to rethink and react how we can live in it to be with COVID-19. Even before the COVID-19 era, we have always lived in a world full of diseases, including NCDs, infectious diseases, and others. Despite living in such a world, our body and mind were not fully damaged. Ottawa Charter mentioned, “Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.” This statement is an asset for us who are willing to live in “health promotion.”

 

 

We invite you to read all COVID-19 messages from the IUHPE President and Regional Vice Presidents.