每日英語跟讀 Ep.984: MSF: What the coronavirus pandemic can teach us about universal healthcare 無國界醫生:新冠肺炎大流行暴露了我們集體的脆弱

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本集由財團法人無國界醫生基金會公益贊助

This episode is sponsored by Médecins Sans Frontières/ Doctors Without Borders Taiwan Foundation

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How are you supposed to wash your hands regularly if you have no running water or soap?

How can you implement ‘social distancing’ if you live in a slum or a refugee camp?

How are you supposed to stop crossing borders if you are fleeing from war?

How are those with pre-existing health conditions going to take extra precautions if they already can’t afford or access the treatment they need?

Everyone is affected by the COVID-19 pandemic but the impact may be felt by some more than others.

試想以下問題：如果您沒有自來水或肥皂，該如何勤洗手？ 如果您住在貧民窟或難民營中，如何與人保持社交距離？ 如果您要逃離戰火，能不越過國界嗎？如果那些健康有問題的人早已無法負擔或獲得所需的治療，該如何採取額外的預防措施？ 每個人都受到了2019冠狀病毒病（COVID-19，或新冠肺炎）大流行的影響，但某些人可能比其他人更首當其衝。

As COVID-19 spreads further, it will continue to expose the inequalities that exist in our health systems. It will expose the exclusion of certain groups from accessing care, either because of their legal status or because of other factors that make them a target of the state.

It will expose the under-investment in free public healthcare for all, which means that access to quality care will for some be based on purchasing power and not medical need.

It will expose the failure of governments – not just health services – to plan for and deliver services that meet the needs of everyone. It will expose the life-threatening vulnerabilities caused by displacement, violence, poverty and war.

隨著新冠肺炎的進一步擴散，它將持續暴露全球衛生系統存在的不平等現象：某些群體因法律地位或其他因素，使他們成為當地政府的目標，被排拒於醫療體系外，無法獲得醫療服務；它將暴露政府在免費公共醫療方面的投資不足，也就是說，有些人要獲得有品質的醫療服務，是取決於購買能力，而非醫療需求；它也會暴露出各地政府在規劃和提供服務以滿足需求上的失敗，而這不僅限於醫療服務；它將暴露面對流離失所、暴力、貧窮和戰爭威脅者生命的脆弱。

The people who will especially suffer will be those already neglected – due to austerity measures, who have fled because of war, who don’t have access to treatment for existing conditions because of privatised healthcare.

And it will also be those who can’t stock up on food because they already can’t afford a meal every night of the week, who are underpaid, overworked and deprived of sick leave, unable to work from home – and those trapped in conflict zones under bombing and siege.

社會中被忽視的群體遭受更多的苦難，包括受緊縮措施影響的人、逃避戰火的人、因醫療私有化無法就現有疾病接受治療的人、無法存夠糧食，甚至連每日一餐也負擔不起的人；還有低薪階層、過勞、被剝奪病假、無法在家工作的人，以及在武裝衝突地區飽受轟炸和圍困的人。

And how are you supposed to treat patients without all the material that you need?

Many health systems bracing for the impact of COVID-19 have already been hammered to breaking point by war, political mismanagement, under-resourcing, corruption, austerity and sanctions.

They are already barely able to cope with normal patient loads.

還有，在醫療物資短缺的情況下，又該如何治療病患？ 由於戰爭、政治管理不善、資源不足、腐敗、緊縮政策和制裁等原因，許多準備應對新冠肺炎衝擊的衛生系統已經瀕臨崩潰，這些國家幾乎無法應對一般會出現的病患人數。

COVID-19 is demonstrating how policy decisions of social exclusion, reduced access to free healthcare and increased inequality will now be felt by all of us.

These policies are the enemy of our collective health.

新冠肺炎讓我們所有人都感受到，社會排斥、免費醫療服務減少、以及不平等加劇帶來的後果，而這些政策是我們維持整體社會健康的共同敵人。

As MSF scales up its response to the COVID-19 pandemic, we will focus on the most vulnerable and neglected.

We started working in Hong Kong earlier this year in response to the first cases of COVID-19 and we now have medical teams deployed to respond in the heart of the pandemic in Italy.

We will continue to scale up as much as it is feasible as this crisis spreads.

無國界醫生會擴大新冠肺炎大流行的應對行動，重點關注最弱勢和被忽視的人群。我們從今年初在香港，即新冠肺炎病例初期出現的地方展開工作，現在我們已經派出醫療團隊在義大利疫情爆發的中心參與救援。隨著這場危機的蔓延，我們將盡可能擴大工作規模。

However, there are decisions that can be taken now that will already ease the impending disaster that many communities may soon face.

The congested camps on the Greek islands need to be evacuated. That doesn’t mean sending people back toSyria where war still rages.

It means finding a way to integrate people into communities where they will be able to practice safety measures such as social distancing and self-isolation.

然而，我們現在可以採取某些決策，以緩解許多社群迫在眉睫的災難。待在希臘群島擁擠難民營內的難民需被撤離，這並不代表要將他們遣返回戰爭仍在持續的敘利亞，而是尋找一種方法協助他們融入社會，讓他們能自行採取防疫措施，例如保持社交距離及自我隔離。

In addition to this, supplies need to be shared across borders according to where the needs are the greatest. This needs to start with countries in Europe sharing their supplies with Italy.

It will soon need to extend to other regions that will be hit by this pandemic and whose ability to cope is already compromised.

除此之外，各國應跨越國界共享醫療物資，運送到有最大需求的地方，此舉可由歐洲各國與義大利共享醫療物資開始做起。相信不久的將來，有更多地區會受到這場疫情的影響，它們的應對能力已被削弱，這種共享醫療物資的援助，必須擴展至這些地區。

As MSF, we will also need to manage the gaps we will face in staffing our other ongoing emergency projects.

Our medical response to measles in DRCneeds to continue. So too does our response to the emergency needs of the war-affected communities of Cameroon or the Central African Republic.

These are just some of the communities we cannot afford to let down. For them, COVID-19 is yet another assault on their survival.

作為無國界醫生，我們還需處理人員短缺，以派出救援人員到其他緊急專案。我們還要繼續應對在剛果民主共和國爆發的麻疹疫情，協助喀麥隆或中非共和國當地的人因戰爭影響產生的緊急需求，這些都是我們無法置之不顧的社群。對於他們來說，新冠肺炎對他們的生存是另一種衝擊。

This pandemic is exposing our collective vulnerability. The powerlessness felt by many of us today, the cracks in our feeling of safety, the doubts about the future.

These are all the fears and concerns felt by so many in society who have been excluded, neglected or even targeted by those in positions of power.

I hope COVID-19 not only teaches us to wash our hands but makes governments understand that healthcare must be for all.

這次新冠肺炎大流行暴露了我們集體的脆弱。今時此刻，我們當中有許多人感到無力、不安全，甚至對未來產生懷疑。這些都是社會中許多被當權者所排拒、忽視，甚或被針對者所感到的恐懼和憂慮。我希望新冠肺炎不僅教會我們要勤洗手，同時也可使各國政府明白，醫療服務必須要顧及到所有人。

MSF授權中文文章: https://www.msf.org.tw/news/202006/502 ; MSF授權英文文章: https://blogs.msf.org/bloggers/jonathan/covid-19-what-coronavirus-pandemic-can-teach-us-about-universal-healthcare