The years 2019 to 2021 will be remembered as the most significant global pandemic since Spanish influenza.
As COVID 19 and its mutated variants encompass the globe, it leaves a trail of human destruction in its wake.
Worldwide there are hundreds of thousands of lives lost, millions of persons affected with the disease. Potentially with long-term health consequences, global travel and trade disruption, and dislocation of communities and individual lives. No country has been spared, including the Caribbean Island states.
Thousands of people everywhere have declined to take the COVID vaccine because they do not trust their leaders’ information. Where the majority trust their political leadership, they have taken more of the vaccine than places where the administration is in any way mistrusted.
For leaders, this significant uncertainty exacerbates the challenges associated with decision making and requires a rapidly adaptive response not usually associated with leadership in more ‘business-as-usual times. For example, politicians are known generally to tell lies to achieve results. Others are known to adopt the “do not do what I do, do as I say”.
So, you have leaders who are known liars, known cheats, in their private and political lives. In the US, you have politicians and even the President and his wife who arrive and leave restaurants unmasked, yet citizens are prosecuted for doing that.
Now the US is in trouble because no one wants to return to work. Hundreds of police officers, airline personnel, doctors, nurses, all kinds of service industry workers are resigning sooner than take the vaccine. Half the American people distrust the current leadership.
But this is really about Saint Vincent because similar problems exist here. We have a Prime Minister, a leader who it is said in some quarters does not trust anyone in his administration to make speeches unapproved by him about anything. He is the spokesman for just about everything. Many do not trust him because they may disapprove of behaviour in his private life.
The health system in SVG is among the worst in the Caribbean. A global pandemic is, therefore, a ‘litmus test of trust in its health system’. So, if you do not trust the leaders then you cannot trust the health system. You do not trust the doctors and experts to present their own words and opinions; there is, therefore, just about no trust at all in Saint Vincent.
Trust is an individual’s expectation or belief, often in circumstances of vulnerability, that the actions or motives of another person are honest, fair, and based on integrity. Trust can be at a system, organisational or individual level. It can be inspired by confidence from past behaviours, however, it is also dynamic, developed de novo from individual, corporate, or government relationships.
Trust allows a person with less knowledge, power, or ability to process complex information, to rely on another individual or institution to make decisions aligned with their well-being. Thus, trust has historically been a cornerstone of clinical care and clinician-patient relationships, and healthcare systems and providers have traditionally been highly trusted.
However, once the Vincentian public received their health information primarily from health professionals, the political rulers pushed their views before those who knew. They have taken over, now nobody trusts them, and nobody trusts any of what they conceive as recused medical puppets.
At times of significant uncertainty, the people want leaders who will advise and cajole, not cudgel, them into doing credible things proven by science. They want to oversee their bodies, they do not want to be forced to take vaccines, they are frightened to take the word of their leadership.
This includes health professionals, researchers, managers, industries, and related sectors from shared stories and experiences from international colleagues, networks, and collaborative partners. Although intuition plays a role, leaders need to act following credible expertise and advice ultimately.
In SVG, the COVID situation was poorly handled from the first day. Now people are dying in greater and greater numbers due to the leadership’s initial handling, control, and advice.
Clinicians and researchers have constantly updated and adapted their definitions and understanding of the clinical course and management of COVID-19 in the face of emerging international data.
The Vincentian people are in crisis; they do not know which way to turn, who to believe. This crisis requires all leaders to take linked responsibility and do this visibly. The one-person world boss syndrome must stop. All politicians must talk to each other sensibly and like grownups.
The spite and malice type political rule must stop, and a spokesperson who the people want to believe must be promoted to do just that by being visible and responsible, and showing accountability and sharing risks with their followers, a vital sign of solidarity with the many health workers and others who face personal risks during the pandemic.
By being responsible, they show and model emotional vulnerability. Taking responsibility also means that leaders exhibit constancy and resilience. They are in this for the long haul and can be relied on to continue to persevere on behalf of their followers.
For followers to trust their leaders, they need access to objective information and to be able to speak up and ask questions. Being open and transparent are two of the most critical behaviours leaders can demonstrate to maintain the trust of their constituents.
This includes being accessible, available, open, honest, and willing to answer questions and providing credible, up-to-date information without bullying for their followers to consider.
It has rightly been said that the middle of the pandemic is not the time to identify detailed failings by leaders. However, leaders also need to show honesty in admitting when they have made missteps and when there have been failures. Making laws of enforcement should be consensual and the last resort.