While few people would currently consider the South Asian region a good example of how to deal with the COVID-19 pandemic, research also shows that, at least in the earlier stages of the pandemic, there is reason to speak of a correlation between culture and success combating the pandemic. South Asian culture, often regarded as highly social, has presented the region with both significant challenges and promising opportunities in dealing with COVID-19. In this case, the concept of “social distancing” is of invaluable importance, and the way it has been adopted and embraced by South Asians demonstrates that culture, societal and institutional practices, and history all go hand in hand when assessing the region’s response to current and future pandemics.
While the severity of the second wave currently hitting India can be attributed to numerous causes - such as oxygen shortages and insufficient public health infrastructure - many experts agree that it is largely a result of poor preparation and a lack of proper management from the government’s side. In September last year the Indian Prime Minister, Narendra Modi, declared COVID-19 beaten and opened up all places for public gatherings. This decision quickly led to fewer and fewer people adhering to social distancing rules, despite Modi recently encouraging people to again abide by distancing rules and to wear face masks (BBC, 2021).
Although there is not necessarily any reasonable excuse to defend the Indian government’s poor preparation, as a person with a South Asian background I know first-hand the dependency that South Asians, especially those of my parent’s and grandparent’s generation, have on social interactions with friends, families, and community members. To stay socially distanced has not been anything short of one of the greatest challenges my parents and grandparents have had to face as first generation South Asian immigrants living in Europe. The transition from family gatherings at least once or twice a week to none for months has been especially difficult for the older generation, as they do not necessarily possess the same types of networks as their children and grandchildren, nor a very good understanding of technology or social media related alternatives. Furthermore, South Asia as a region houses a large population of poor people and informal workers with already deprived working conditions, meaning that social distancing is in many ways a privilege that many people cannot afford in the same manner as those living in more well-off countries with stronger public health and welfare institutions.
South Asian countries, and the Asian region more generally, have had - unlike many Western countries - more recent practice in dealing with infectious diseases. However, while such past experiences have led to a culture of awareness and the practice of mask wearing becoming more of a norm in East Asian countries (Penn, 2020), it has arguably generated a kind of “Tuberculophobia” in many South Asian countries. Tuberculosis (TB), like COVID-19, is an infectious disease that primarily attacks the lungs, and South Asia has experienced almost 40% of the global TB burden. While impressive steps and gains have been made to control TB, it has remained a problematic disease for hundreds of thousands of South Asians for years (Basnyat et al., 2018).
Importantly, this “Tuberculophobia” that has been generated in the wake of COVID-19, and as a result of a long-time experience with TB, has resulted in the marginalised classes within the population becoming perceived as the main threat. When attempting to understand the concept of social distancing in a South Asian regional context, the concept of touch then becomes central. In many ways it comes down to the way that touch is practiced as a social code to differentiate classes and castes from each other, and thus how it strengthens already established social hierarchies in the region. While health advisors and many government officials are attempting to enforce new norms that encourage social distancing among people, at the same time they are arguably preserving the hierarchies within society that lead to the exclusion and marginalisation of certain groups. Examples of this include the enforced cremation of Muslim COVID-19 victims in Sri Lanka, as well as the Rohingya refugees in Bangladesh who are seen as high-risk people due to the cramped conditions in their refugee camps. These examples show that social distancing measures coupled with the idea of touch in South Asia affect social behaviour and preserve social hierarchies in the region (Dey, 2021).
In a recent article published in World Medical & Health Policy researchers based a study on Inglehart and Wetzel’s World Values Survey cultural mapping to show the importance of culture in a state’s COVID-19 response (Mayer et al., 2020). More specifically they found evidence suggesting a positive link between Confucian and South Asian national cultures and more positive COVID-19 outcomes. According to their results, South Asian culture’s emphasis on obedience to authority could explain the success of public health measures at the time, yet it is also important to emphasise that the article was published in December 2020 - a time when the COVID-19 infection rates in many South Asian countries were at considerably lower level than those of today (Wallace, 2021).
Furthermore, while certain cultural traits may explain differences in infection rates, the governance type of a country itself does not necessarily do so. In their research, Mayer et al. (2020) found that there is no indication that more authoritarian or less free nations have the upper hand in the battle against COVID-19, thus emphasising the importance of culture again as an important determinant for the success of responses to public health issues. While culture may appear to be a vague concept, it includes social practices based on factors such as level of trust in a society, both towards institutions and among people. Usually, it is thought that lower institutional performance and governance often results in lower institutional trust among the citizens. South Asia, however, provides us with an interesting exception, since there is generally higher institutional trust among the population despite low institutional performance (Finnigan, 2019). Here the importance of people feeling a duty of serving with obedience towards authorities plays an important role. Francis Fukuyama stated after studying Asian culture that “people are born not with rights but with duties to a series of hierarchically-arranged authorities, beginning with the family and extending all the way up to the state” (Finnigan, 2019). Obedience to authorities is seen not only as a central cultural trait but also shows that such an obedience-based culture of trust reminds one more of a parent-child relationship rather than a more rational give-and-take relationship (Finnigan, 2019). While such trust-based hierarchies may potentially leave those at the bottom of the system to deal with their principally unequal position in society, hierarchal culture in the case of South Asia may also work to generate greater institutional trust – creating a basis of successful public health response, regardless of governance type.
Although there is good reason to believe that culture matters in instances of greater collective public challenges, what is perhaps more important for decision makers to pay attention to is the power they possess to regulate cultural behaviour in such situations. While culture is something that continuously evolves and changes, especially the South Asian culture due to the growing young population both in the region and as a diaspora, decision makers have some say in how these cultures are expressed and practiced in society. Everything from the way that cultural practices that impose unequal hierarchies can be improved or dismantled, to how people of socially interactive cultures can be of help to each other in alternative ways during one of the biggest challenges many of us have ever faced is relevant in this regard. Looking further into the relationship between culture and responses to public health issues can then provide us with valuable insight into the situation that societies find themselves in, as well as the future we would like to see them moving towards.
Basnyat, B., Caws, M. & Udwadia, Z. (2018). Tuberculosis in South Asia: a tide in the affairs of men. Multidisciplinary Respirator Medicine, 13(10), 1-8.
BBC Reality Check team (2021, May 10). India Covid-19: Infections on the rise across South Asia. BBC. From: https://www.bbc.com/news/world-asia-53420537.
Dey, I. (2021). ‘Trust’, Sociality and the Pandemic. Society and Culture in South Asia, 7(1), 11-15.
Finnigan, C. (2019, February 27). Poor governance, trusting citizens: What explains South Asia’s high levels of institutional trust? LSE South Asia blog. From: https://blogs.lse.ac.uk/southasia/2019/02/27/long-read-poor-governance-trusting-citizens-what-explains-south-asias-high-levels-of-institutional-trust/
Mayer, J. D., Schintler, L. A. & Bledsoe, S. (2020). Culture, Freedom, and the Spread of Covid-19: Do Some Societies and Political Systems Have National Anti-Bodies? World Medical and Health Policy, 12(4), 498-511.
Penn, M. (2020, August 12). How Some Asian Countries Beat Back COVID-19. Duke – Global Health Institute. From: https://globalhealth.duke.edu/news/how-some-asian-countries-beat-back-covid-19.
Wallace, R. (2021, January 11). Confucian, South Asian cultures fare better in combating COVID-19: study. The Academic Times. From: https://academictimes.com/confucian-south-asian-cultures-fare-better-in-combating-covid-19-study/.