BEHIND THE MASK
Whistleblowing During the Pandemic
Conference report By Lorin Decarli
The COVID-19 pandemic has exposed the world's contradictions and weaknesses. The conference, “Behind the Mask” (March 18-20, 2021), discussed the global health crisis through the stories of health workers and whistleblowers denouncing violations and wrongdoings in the healthcare systems. The pandemic will only be over when everyone has access to healthcare and vaccinations; issues of inequality and the universality of healthcare are now inescapable as we learn that only a just world is a safe world.
Thus, the fight against corruption in the health sector appears essential to tackling global health threats, and providing quality healthcare for everyone becomes a priority. Thanks to researchers, whistleblowers, activists, journalists and human rights advocates, this conference served as a platform for sharing experiences and strategies among people and communities reacting to the COVID-19 crisis by building new forms of collective care and social justice, fostering accountability and literacy on the discourse of the pandemic, and ultimately seeking to defend human rights on a global scale.
Coronation: Film Interview
The pandemic ushered a wave of censorship and human rights violations; concerns around the surveillance measures enforced by governments around the world quickly arose. Roberto Perez-Rocha, Director of the International Anti-Corruption Conference Series at Transparency International, introduced a conversation with dissident Chinese artist Ai Weiwei and Jess Search, Chief Executive of Doc Societyin UK, focused on Ai Weiwei’s new film, Coronation.
Ai Weiwei’s film, remotely directed and secretly produced from his home in Berlin, is an exceptional documentary shot by amateur Chinese citizens during the militarised lockdown in Wuhan. Coronation is a collection of tapes capturing the apocalyptic atmospheres of the first city hit by COVID-19. The documentary questions the role of individuals in a controlled society, portraying human behaviours both in the individual private sphere and in collective life under the surveillance and restrictions of the state. The film’s narrative juxtaposes the residents’ struggle to survive, the overwhelmed hospitals, the strained staff and the patients lined up in hallways.
Lack of transparency, authoritarianism and control do not help scientific clearance. We saw doctors dubbed criminals and whistleblowers after warning of the imminent outbreak. Some argue that the pandemic required a tougher concentration of power to be effective and maintain order. Ai Weiwei’s work is proof of why the world needs participation and transparency instead.
The Freedom of Speech Index released by Reporters without Borders (2020) confirms that the situation in China is abysmal. The country is ranked 177 in 184 positions, and Chinese authorities have been accused of tightening their grip on news and information even more since the COVID-19 pandemic began.
Defending the Truth in the Pandemic: Is Whistleblowing the Magic Wand?
58 journalists around the world have been killed for doing their job in 2019, reporting mostly on issues around corruption and human rights. 525 have been imprisoned, whilst 129 are still missing. 2020 was not any better, and members of the International Consortium of Investigative Journalists (ICIJ) are warning of rising restrictions, violence and intimidation against free speech. It is no wonder that whistleblowers and journalists do not feel safe enough to report human rights violations, crimes, corruption and wrongdoings.
Data indicates that in Mexico — one of the world’s most dangerous and deadliest countries for the media, according to Reporters Without Borders (2021) — people are choosing neither to report nor to provide evidence of abuse, fraud, and violations. Over previous decades, trust in conventional channels of reporting has been shaken as corruption and impunity continue to grow. Nevertheless, lawmakers are reluctant to regulate mechanisms able to encourage and reward the reporting of acts of corruption and crimes. Deficiency around the protection of whistleblowers is alarming. Despite recent efforts and new anti-corruption policies, experts warn of the lack of technical instruments and regulatory problems.
María de los Ángeles Estrada, Executive Director of the Transparency and Anti-corruption Initiative, explained that in Mexico, in 2019, 92.4 per cent of all crimes went unreported or were not investigated. Official investigations were opened in just 69 cases, and 44.5 per cent of these ended with no tangible results. People are afraid of hostile and unreliable authorities, and fear retaliation and extortion.
In 2019, Derechos Humanos y Litigio Estratégico Mexicano and Tech de Monterrey published the website denunciacorrupcion.com, which provides free and confidential support to witnesses and victims of corruption, promoting whistleblowing among Mexican citizens through a tool that guarantees their anonymity. Experts help filing reports and assist in the processing and follow-up of the cases, if necessary supporting individuals economically. Since 2020, data gathered with this tool has generated real-time statistics on the experience of corruption related to COVID-19 vaccines. In the period April to December 2020, 381 people filed an official report via the tool; an impressive result, especially when compared to similar platforms and services implemented by institutional actors.
Across the world, international agencies and independent organisations are warning of the corruption risks in public procurement in response to COVID-19. They stress the need for openness and transparency, particularly in the allocation of resources and in the selection of suppliers. It is therefore a question of being able to identify the instruments capable of minimising these risks and promptly unveiling misconduct.
Former Public Protector of South Africa Thuli Madonsela explained that auditing — the most common investigation activity — exposes only about 10 per cent of corruption and fraud cases, with whistleblowing the reason for the greatest exposure of wrongdoing, be it criminal or civil. However, the term whistleblower is too often wrongly perceived as a derogatory one, implying someone working in the darkness and pursuing personal glory and fame. Considering the important role that whistleblowers can play in the public interest, Madonsela argued, a cultural change in society is needed to better value the light they shed on facts. They would greatly benefit from better protection, increased support from their communities, and increased safeguards for the personal impact of their brave choices.
South Africa has one of the best legal frameworks on the continent, but better measures are still needed to concretely protect whistleblowers. The case of Mosilo Mothepu — South African CEO of Trillian Financial Advisory, who exposed the state capture under former President Jacob Zuma — shows how negative the physical and emotional effects of whistleblowing can be. The South African criminal justice system has a witness protection programme which is unfit for them. Furthermore, delays and the high risk of suffering retaliation still work as obstacles.
To increase impact while reducing personal exposure, victims of wrongdoing can organise and effectively react together. The Italian initiative Noi Denunceremo (We Will Denounce) proves that community engagement matters. The initiative – presented by co-founder Stefano Fusco – is a committee of citizens, and the result of a 70,000 member Facebook group of people who lost their relatives and loved ones during the first wave of the pandemic. 6,000 people alone died during the first wave of COVID-19 in the Italian province of Bergamo. In the same period in Lombardy, a region with 10 million inhabitants, over 28,500 lost their lives. This is the highest mortality rate recorded in Europe due to the SARS-CoV-2 infection to date.
The more people were sharing stories online, the more a red line connecting the victims was evident. Thousands were dying with no assistance, left to their faith. In those dramatic days, videos showed Italian army trucks moving over nine-hundred coffins from Italy's worst hit city to remote cremation sites, as local morgues could not cope with more corpses.
Today, people want to know more about the management of the pandemic, and what went so terribly wrong considering that the region was supposed to have one of the best healthcare systems in Europe. In Italy, healthcare is managed by both the State and Regions, which have full autonomy in organising and running healthcare services in their own territories. The grassroots committee Noi Denunceremo, representing over 500 families, denounced delays and mistakes, and took legal action against the Italian government and the president of the Lombardy region, Attillio Fontana, for alleged criminal negligence over their handling of the pandemic.
Although over the last 11 years the WHO called on the Member States to update their protocols on eight occasions, Italy’s pandemic plan was last updated in 2017. During the first wave, health workers had no adequate personal protective equipment (PPE), there was a shortage of masks and sanitisers, and they used trash bag as surgical shoes. More than 300 Italian family doctors died from COVID-19. The number of deaths in Bergamo was up 568% in March 2020 compared with the 2015-2019 average. Fusco warned that the number of victims of the first wave in Lombardy might be twice higher than the official one.
Whistleblowing & COVID-19: Telling the Truth at the Centre of Crisis
The Council of Europe indicated that the term whistleblower must be broadly defined so as to cover any individual or legal entity that reveals or reports, in good faith, a crime or lesser offence, a breach of the law or a threat or harm to the public interest of which they have become aware either directly or indirectly (2019).
In Wuhan at the beginning of 2020, Dr. Wenliang Li posted a message on the App WeChat about a cluster of cases of a flu-like disease that had been treated at his hospital, expressing worries about seven patients in quarantine with symptoms similar to a suspected SARS. Screenshots of his message went viral, and he was soon targeted by Chinese authorities for spreading rumours. He died at the beginning of February 2020 due to the infection of that same virus he wanted to warn everyone about. International observers explain that it is possible neither to quantify the impact of such a censorship in China, nor how many lives could have been saved during the first months of the pandemic with transparent communication.
China is not the only country that hid news about the virus and retaliated against whistleblowers for raising the alarm. In the US, news outlets wrote about a navy captain fired days after officially requesting for help, and an employee of the Department of Health in Florida allegedly lost her job after refusing to manipulate COVID-19 data. All over the world, health workers and whistleblowers exposing pandemic related misconducts, violations of safety and labour law and corruption faced consequences for stepping forward.
In 1999, Eileen Chubb – a former care assistant in the UK, who became a whistleblower – started a campaign to address the complacency regarding elderly abuse in the UK. With her organisation The Whistler, a fellowship alliance between Compassion in Care and the Centre for Investigative Journalism (CIJ), she is now offering help to other whistleblowers from all sectors, particularly health workers overwhelmed by the current emergency. The organisation denounces an alarming level of aversion against those who blow the whistle, which is even worse now that the pandemic has caused a general deterioration in previously unimaginable working conditions.
Data indicates that there is almost no investigation into facts reported by whistleblowers in the UK. 90 per cent of those who have contacted Chubb´s organisation first reported their concerns to statutory regulators (more than 16,000 people). During the pandemic, the healthcare regulator CQC recorded over 2,600 reports of violations from whistleblowers, which resulted in just 17 official inspections, with the rest of the cases dealt with a phonecall to the care home. Controls are ineffective and officers lack investigation skills.
The organisation filed a Freedom of Information (FOI) request into the official number of deaths in the nursing and residential care homes. During the first wave of the pandemic, 6,000 people died in UK residential care homes, without any medical intervention. Many died of thirst and pain, in agony, with no pain relief or oxygen. 70 per cent of people in care are affected by senile dementia. Reports show that these fragile individuals were subject to all kind of abuses throughout the pandemic, due to lack of staff and consequent carelessness, locked in their bedrooms and kept under antipsychotics.
Chubb explained that whistleblowers suffer detriment as direct result of raising concerns. Unfair dismissals for alleged breaches of confidentiality or excessive sick leave are very common. When they do not directly lose their job, they work in hostile conditions and are forced to leave, or put on zero-hour contracts. UK health workers endured the chaotic months of the pandemic in 2020; working 14-hour-shifts, witnessing violations, suffering, fear and avoidable deaths — a fatal consequence of the failing government policy on hospitals. They did everything in their power to highlight the unfolding events and help their patients.
From an overall total of 246 cases monitored by The Whistler, 175 workers reported harassment or adverse treatment, and have been isolated or mobbed. In the UK, whistleblowers making a “protected disclosure”, and who are subject to detriment and dismissal because of raising their concern, are protected under the Public Interest Disclosure Act 1998 (PIDA).
Chubb is now leading a campaign asking for more effective whistleblowing protection, forcing authorities to take immediate action in cases of denounces. PIDA, she claims, does not stop the reported wrongdoing and risks, often leading to concealment, and the public never hears of the issues reported. To change this, bad companies need to be held to account, and it shall constitute a criminal offence to fail to act on the genuine concerns of a whistleblower.
A modern legislation would expose abuses and those who cover them up whilst protecting whistleblowers from potential liability, such as breach of confidence, defamation, data protection or copyright law. That is why the campaign Edna's Law aims at replacing the PIDA, which according to the campaigners has failed to protect the public, the victims and the whistleblowers. Lawmakers are also asked to introduce new regulatory standards and apply protection to all workers, without differentiations.
Erika Cheung has proven that it is possible to hold a nine-billion-dollar company to account. She was just 22 years old when she decided to blow the whistle on the company she was working for. Thanks to the data she provided, the Wall Street Journal was able to publish a series of articles shedding light on the wrongdoing of a blood diagnostic company, Theranos Inc., unveiling the scandal of the blood-testing start-up that turned out to be a fraud.
According to the company, its compact and elegant box could run blood tests with just a few drops of blood, giving results very rapidly; all thanks to revolutionary technology that the start-up from Palo Alto had developed. Despite the fact that influential voices in the scientific community had strongly criticised the possibility of building such a machine on the basis of modern expertise, Theranos had quickly managed to gather support and funding, from prominent politicians, billionaires and philanthropists.
It was a revolutionary technology on paper, but Cheung was running quality controls on patients’ samples at the Theranos’ lab, which constantly showed wrong and unreliable results. She talked to her co-workers, to the charismatic CEO Elizabeth Holmes, and to other board members, but her superiors lessened and ignored the concerns she raised. The machine technical details had not been disclosed at the time; Cheung knew that Theranos´ technology was dangerous for patients and a fraud, so she decided to quit her job and reported everything to regulators, who inspected the labs, and informed the press. As a consequence, patient samples stopped being processed and the company fast dissolved.
Just 10 per cent of healthcare workers report misconduct and violations they encounter in the workplace. Those who cannot bear indifference and violations and respect patients' lives decide to speak out, take action and handle the pressure of their choices alone. The first hurdle is the misconception of the role of employees, accused within their companies of not being “team players” when they express doubts, whereas they are actually reporting issues or even criminal activities. Here comes the importance of helplines for whistleblowers; providing them with someone to listen and support them as they swim against a tide of hostility.
Cheung is also the co-founder of the organisation Ethics in Entrepreneurship, which supports ethical decision making within companies, enabling people to speak out and address issues internally. The Theranos case is the result of a precise corporate culture that poses no ethical questioning and pursues self-interest even when it comes to essential goods and human rights.
A new generation of workers can be part of a cultural shift, to allow scrutiny and build an effective culture of honesty. Youth use tech to find communities to support their causes, activating social movements for change to oppose a culture of ruthless management and soulless entrepreneurship. It is very clear to them, that whistleblowing is also a matter of fundamental rights.
Too often, people tend to look at the finger, which is pointing at the moon, rather than at the moon. Whistleblowers are depicted as egocentric troublemakers looking for advantages and fame, which is a symptom of the culture of hostility from those at the top. To build a community around them, a further important initiative is represented by the Gavin MacFadyen Award, assigned every year to celebrate the efforts and bravery of those who speak out in the public interest.
Digging Deeper into Healthcare: The Vaccine Rollout, Pandemic Journalism & Corruption
Corruption decreases countries' capacities to manage national and global health risks. The vulnerabilities of the health sector due to corruption are structural: supply chains are long, global, complex and interdependent, and there are many decision-making points and decision-makers. Such fragmentation is a fertile ground for misconduct. As researcher and global health expert Sarah Steingrüber pointed out, the pandemic has led to an increase in this opportunistic behaviour.
The world spends USD 7.5 trillion on health every year (WHO, 2020). Conservative estimates show that about 6 per cent of this money flows into corruption, and figures are much higher in developing countries. It equates to USD 500 billion every year, which would be enough to achieve universal health coverage and ensure access to healthcare to every person worldwide. The weak state of healthcare in many countries and the impact of cuts, austerity measures and privatisations are worsened by corruption and collusion.
Considering health funds deployed for public procurements, data shows that up to 30 per cent of the overall contract value is lost to corruption. Critical aspects to consider here are related also to the service delivery component, briberies, the overcharging for services that shall be free of charge, absenteeism, conflicts of interest of individuals that work for more entities or mix public with private, nepotism and favouritism.
In a world of private health services and expensive treatments, Transparency International calculated that approximately 17 per cent of people have paid a bribe at least once to get healthcare. Low-level corruption is very common; transparency and accountability measures in health systems are often ignored. This reduces the trust in public institutions and pushes people away from seeking medical assistance.
Estimates show that 1.6 per cent of annual deaths in children under 5 — more than 140,000 deaths — can be traced back to corruption.
When we look at the COVID-19 vaccines, data show that funding went primarily to private companies that developed the vaccines, and those who are part of their production supply chain. Enormous contributions came from the public sector (97.18%), so that nearly all investments were from public funding, with the US and Germany by far the largest investors in research and development (Global Health Centre of Geneva, 2021). The question is how to make sure that the public interest comes before profit.
Risks in the development of vaccines are linked to a lack of transparency in clinical trials, undue influence of private companies on the pipeline and to falsified medical products proliferating in supply chains. Here the manipulation or withholding of data and conflicts of interest of corporate entities endanger the obtainment of effective results in the public interest. The regulatory authorities responsible for proving innovations are in most cases funded by corporate fees.
Despite much investment through public funds, private profit and patent protection are evidently the priority of the pharmaceutical industrialists worldwide. Meanwhile, we see delays in provision to countries in the Global South, disparity of pricings, scarcity of vaccines and, therefore, an increase of substandard and falsified vaccines in supply chains, which increase preventable deaths and costs of follow-up care. Data shows that just 30 per cent of national regulatory authorities have the capacity to be able to guarantee products to patients that do not cause them harm.
A higher volume of vaccines at lower cost could be provided by supporting a waiver of intellectual property rules and insisting on the transfer of technologies through the World Health Organisation’s COVID-19 Technology Access Pool. Experts explain that this could be achieved fast, and still grant a return for investors and private companies, as it has been done with several drugs in the past. Of course, it is a political choice, but also an ethical one. The Polio vaccine was never patented, and the disease has been eradicated fast where vaccines are available.
That is why the international community shall invest strategically in manufacturing COVID-19 vaccines across the developing world, too, fighting to ensure vaccines are freely accessible to everyone, everywhere. Nowadays, the same idea that healthcare and profit are compatible is questionable. Many think that profiteering on human rights and essential goods is deplorable. At least nine people have become new billionaires since the COVID-19 pandemic began, due to the enormous profits made by pharmaceutical companies with monopolies on COVID-19 vaccines. Their total wealth is higher than the cost of vaccines in the world's poorest countries (Emergency, Oxfam, 2021).
Jonathan Cushing, Head of the Global Health Programme at Transparency International, stressed how the current pandemic presents both unprecedented challenges and opportunities to healthcare systems. Secrecy over vaccine trials and over the deals between governments and drug companies risk the success of the global pandemic response. Given the huge amount of public money invested in research and development around the world, people have a right to know everything about the vaccines their taxes helped to fund. Fear and misinformation can be tackled with greater transparency.
There is a dangerous dearth of evidence in health journalism and Serena Tinari, co-founder of the non-profit organisation Re-Check[t2] , discussed the importance of working at the intersection of evidence-based medicine and investigative journalism. Investigative journalists that specialise in health and medicine often lack training in research methods, which is a problem when considering that medical journalism influences human health as much as policy and official research.
Science journalists are supposed to base their work on systematic reviews, thinking critically about the quality of sources and always keeping in mind the rules of the scientific method. They are expected to engage with research communities and provide a better dissemination of research evidence. During the pandemic, we have seen instead that evidence-free science journalism has been the most common approach. Worldwide, social media appears to be in in charge of defining what true science is; experts, virologists and epidemiologists are TV show guests and authors of newspapers and magazine columns.
Among the many ways that research can be conducted, the best standard level of proof — where treatments and therapies are concerned — is the systematic review and the meta-analyses of the Randomized Controlled Trials (RCT); that is to say, the systematic review of medical facts that ensures the exclusion from the process of as many sources of bias as possible. RCT is on top of an ideal pyramid; the further you go down the pyramid, the less strong the evidence is. At its bottom we find observational studies. Outside the pyramid we have what is non-evidence: expert opinions, consensus conferences and clinical experience without proof of systematic evidence, which are prone to bias or confounding factors.
Mass media and social networks disseminating information regarding public health and COVID-19 too often do not consider this classification, causing confusion and disorientation. A recent example of this can be found in the polemic over the effectiveness of masks.
Scientists support face coverings, which are saving lives during the pandemic, as observational studies suggest that masks could cut down the chances of both transmitting and catching COVID-19. However, the WHO also acknowledged that we lack high quality or direct scientific evidence that wearing a mask protects healthy people from SARS-CoV-2 in terms of prevention, and that there are no studies evaluating the effectiveness of universal mask use by health workers in preventing transmission of the virus (Advice on the use of masks in the context of COVID-19: interim guidance. 5 June 2020).
The only RCT on this subject, after one year into the pandemic, has been run and concluded by a research group in Denmark, which enrolled 6,000 participants, asking half to use surgical facemasks when going to a workplace. Its results showed that the infection with SARS-CoV-2 occurred in 42 participants using masks (1.8%) and in 53 participants without (2.1%). The between-group difference was -0.3 percentage point, suggesting that the difference observed is not statistically significant (DANMASK-19 Study, 2020). However, face masks are confirmed to be a plausible means to reduce transmission of respiratory viruses by minimizing the risk that respiratory droplets reach a wearer’s nose or mouth, and are also effective in reducing face touching. A further RCT — with around 40,000 people — is currently ongoing in Guinea-Bissau.
Given this situation, as the results of the Danish RCT were published, we observed a media pillorying of those journalists and scientists who divulgated them, as they were accused of undermining one of the few established rules we all agreed upon: we must wear masks. Amidst a tide of conspiracy fantasies and technical unpreparedness, contradictory interpretations of this RCT led to confusion and uncertainties. Journalists are supposed to critically fact-check what health authorities say, but also need to be able to read and understand scientific information in order to report about it.
The risks of secrecy and censorship in health, and the importance of journalists with expertise in health and medicine, were illustrated by Alexander Nanau, Director of the Academy Award nominated documentary Collective - Corruption Kills (2020). The work portrays the complex system of corruption in Romanian health system, unveiled after the national tragedy of the Bucharest nightclub Colectiv. In 2015, during a concert, a fire caused the death of twenty-seven spectators. Thirty-seven others died in the burns units of the Romanian hospitals over the following days. Right after the tragedy, the government assured the public that the Romanian health system could treat all patients.
When the number of deaths started to rise, it was clear that something was not working. Medical journalists could have easily proved that the country did not have the medical capacity to treat so many patients with burn injuries, but most of the Romanian media acted as government´s sounding board, republishing their statements without investigating. Only after a doctor blew the whistle, reporting how patients that were supposed to have high survival probability were dying, the Romanian government was forced to let doctors from Israel, UK, Belgium, Germany and France intervene, flying survivors out to their own burn units.
The Romanian government gloated about being able to treat up to a hundred and eighty patients with burn injuries in its hospitals. However, doctors abroad received dying patients, who had been given the wrong and sometimes fatal treatments. Moreover, Romanian doctors did not share clinical data with their colleagues — perhaps to hide faults and responsibilities — and slowed down the possibility of effective assistance causing further suffering.
Nanau also talked about another case from the Romanian chronicles, which demonstrates how healthcare is a global issue and how the management of healthcare services can suffer from greed and corruption in a sometimes irreparable way.
For ten years, the company Hexi Pharma, which received the procurement to manage the cleaning services in Romanian hospitals, diluted the disinfectants deployed by its cleaners. The result was that the WHO started to detect unprecedented and very dangerous bacterial infections, concentrated on the Romanian territory and in the medical facilities. These are values worse than those in areas of material and hygienic abandonment in developing countries.
The scandal, which involved ministers and public officers, blew up thanks to reporter Cătălin Tolontan. Such reckless criminal conduct is also particularly alarming because of the issue of bacteria resistant to antibiotics, which represent one of the greatest medical threats in today’s world. Violations in healthcare is such a global issue, that what a company in Bucharest does with the disinfectants for use in hospitals can affect the lives of millions of people all over the planet.
Voices of Care: Exposing Dangers to Public Health
Too often whistleblowers and healthcare workers suffer consequences for reporting failings in the system and trying to improve the care provided for patients. Cassie Thornton, artist and author of Collective Health as a "Beautiful Artwork, described how, through the direct experience of experts and workers witnessing wrongdoings in the healthcare sector, it is possible to understand the effects of greed and privatisation on the healthcare.
Taking part in the conference panel was Delphine Halgand, Director of The Signal Network. Her organisation is operational in 11 countries in the US, and in 10 European countries, and so far has provided support for over 2,000 whistleblowers, from corruption to the Me Too movement and the COVID-19 pandemic. The organisation works in tandem with media outlets from all over the world to build a more responsible and transparent society.
The Plasma File investigation is an example of this. An international investigation on plasma collection devices manufactured by the US health company Haemonetics Corp., and a result of months of research on hundreds of documents provided by whistleblowers to the media partners of The Signals Network. These machines have been illegal in France since 2018 due to mysterious particles found in collected plasma, but they are still in use in the rest of the world.
Halgand explained that plasma is the liquid part of the blood, rich in protein and tissue glue, and used in a variety of ways, from healing wounds to the treatment of autoimmune disorders. Nowadays, speculators consider it to be the gold of the pharmaceutical industry. Haemonetics‘ machines, used for the centrifugation of blood to extract plasma, could malfunction so that smaller particles might bypass the filter and be fed back into the body of the donor, together with the blood cells, with unclear health consequences.
The Plasma Files is a collection of reports, provided by whistleblowers to their media partners, on over 36,000 irregularities involving machines — distributed in 40 countries— produced by the Haemonetics, which is one of the three global leaders in the blood processing industry, with revenues of more than 900 million USD. The Signals Network coordinated the logistics, and developed safety protocols for the journalists. It took months to go through thousands of documents from different countries, published on the same day and showing that the US company might negligently put people in danger. Working with the media to maximize the impact, the network could reach 165 million readers in six languages and it called on national authorities to investigate. The organisation also provided legal support to some of the whistleblowers.
Yvonne Dellmark, Chair of the Swedish Medical Association and workers representative at the Karolinska University Hospital in Stockholm, recalled how her hospital was able to cope with the COVID-19 health crisis thanks to the efforts of the many workers, nurses, doctors and technicians who never stopped doing their job. In March 2020, as in almost all medical facilities around the world, the staff had no reliable knowledge about the illness and suddenly experienced a shortage of PPE, medicaments, respirators and beds.
In Sweden too, misinformation on medical issues related to the pandemic had the profiles presented by Tinari. Scientists and researchers have felt the weight of an information system gone mad, too often unfit for its important role. Self-styled experts and unprepared journalists filled the headlines with disinformation, causing damage also to those who were relentlessly working under strain, to keep the life-saving operations, facing a highly infectious virus that was killing thousands of people. However, healthcare workers did their best and the hospitals of Stockholm managed to arrange healthcare to everyone. However, Dellmark stressed that this was an exceptional situation, and an exhausting overload of work, which no one can bear for long.
Helen O’Connor has been working as nurse of the UK National Health Service (NHS) for 28 years. She saw cutbacks and privatisation rolling out, and their adverse impact on healthcare, and decided to join the GMB NHS Union. The NHS provides free of charge treatments, and people do not need insurance to access healthcare, which is 99 per cent tax funded. Access to healthcare is not a privilege but a right, which has been gradually stripped away for decades since the 1980s, in a process that still undermines the health service today.
In a few years, UK private companies took over the management of the non-care services and some of the clinical services too. This significantly reduced the standard of cleaning and catering as the focus became costs containment rather than quality, and senior staff were replaced by more junior staff with insufficient skills level. Moreover, in 2019, before the pandemic, the vacancies were 40,000 just for nurses and the system registered a massive reduction in hospital bed capacity: from 299,000 in 1987 to 141,000. No wonder, then, that the stress levels of NHS staff members rose, and hospitals soon hit the limit of their capacity as the COVID-19 pandemic took its toll.
Several factors accelerated the spread of the virus. No protocols for infected patients, poor infection control advice and a lack of PPE for the medical personnel, cleaners and porters. Workers kept on doing their duty whilst feeling unsafe and unprotected, keeping the country running as beds and oxygen shortages left patients gasping.
Drivers and personnel on the ambulance services with COVID-19 type symptoms could not access a test — particularly if they were with private companies. The logistics system had been completely fragmented due to privatisation, and the government had to quickly set up a way to ensure that hospitals could get protective masks.
Many workers in health services that go sick lose their wages or end up with statutory sick pay, equivalent of 95 pounds a week. Thus, O’Connor stressed, many decided to work, and spread the infection to the vulnerable patients they met. That is why unions demand an increase to sick pay, equivalent to a week’s pay at the real living wage, for all health workers, including employees that are currently not eligible.
Julian Assange: Repression, Isolation and Lockdown
To break the silence around the persecution of Julian Assange — Australian publisher and co-founder of WikiLeaks currently detained in the UK — the Disruption Network Lab closed its conference with a panel that brought together technology researcher and journalist Suelette Dreyfus, human rights lawyer Jennifer Robinson, investigative journalist Stefania Maurizi, writer and researcher Felicity Ruby in a conversation moderated by Anna Myers, Executive Director at Whistleblowing International Network, and introduced by Disruption Network Lab’s director Tatiana Bazzichelli. The panellists are among the most important experts involved in the case of Assange, who have made a decisive contribution to his cause.
Julian Assange has been incarcerated at the Belmarsh high-security prison in the United Kingdom since April 2019, facing extradition to the United States and criminal prosecution under the Espionage Act. The co-founder of WikiLeaks risks up to 175 years’ imprisonment for his role in publishing the leaks of the Afghanistan and Iraq war diaries and the US embassy cables. For those same publications he has been nominated for the Nobel Peace Prize, and awarded the Australian Martha Gellhorn Prize for most outstanding contribution to journalism. His prosecution sets a legal precedent that puts journalists reporting on secret documents, international affairs, and national security at risk. He has been experiencing restrictions on his personal liberty for the past 9 years; a condition unanimously and universally condemned by free speech groups, independent media and human rights organisations all over the world.
Assange’s WikiLeaks unveiled how public interest is under attack, and how people need access to information in order to make informed decisions in the public interest. He started WikiLeaks animated by his interest in investigating hidden information, data sharing, transparency and accountability, having volunteered in the free software movement for years and building tools that human rights activists could use to hook up a device to Internet, encrypt data and communicate safely. A few years later, WikiLeaks was the first organisation to innovate and introduce the secure digital drop box so that sources could safely disclose information to a publisher. People could get to the original source, accessing the original data set.
The public debate was confronted with human right violations, surveillance, war and international lies. Assange opened the way to collaborative global journalism, triggering an international community of people, organisations and investigative journalists working together to extract and analyse data, and get the local stories out of international affairs.
Even today, more than 10 years later, these files are used by activists, journalists, and scholars around the world and remain relevant. WikiLeaks was indeed meant to make information available for large communities and empower people. From the very beginning, governments and private actors wanted to prevent the publication of the files, which described facts that newspapers did not dare to report or viciously misrepresented in their articles.
Assange is paying a high price for his work. In the seven years that he was confined inside the Ecuadorian Embassy in London — at which he sought sanctuary in 2012, after Sweden issued an arrest warrant in connection with sexual assault allegations — no one tried to get access to the documents of his case, and the media reported mostly on the Swedish authorities’ press releases. Assange was meanwhile living in isolation, unable to access documents and instruct his lawyers.
Italian journalist Maurizi filed, at her own costs, a multi-jurisdictional litigation in the UK to gain access to the full set of documents related to the Assange and WikiLeaks cases, which was a game changer. She made a freedom of information (FOI) request and asked to see all recorded information held by public authorities. Although Maurizi was supposed to get access to the whole set of documents, she found gaps coinciding with crucial moments. The authorities consequently admitted that some documents were never laid, and had been unlawfully destroyed, without keeping any record of their content. Concerns arise when considering that the prosecution working with the Swedish authorities is the same currently in charge of the extradition in the US.
Surveillance is pervasive, and people who are under control do not like to speak openly about their condition. Assange’s private life was plummeted into persecution, too; sharing inconvenient and unfiltered truths is a further way of using his case as an example to intimidate others. People are working both behind the scenes and publicly to bring pressure on governments; Assange's father travels around Australia ceaselessly, talking about his case and finding overwhelming support.
Assange broke the traditional collusion between press and power, extending the spaces of democracy, strengthening free media and inspiring many others. Many around Assange have been put under pressure and threatened by the US secret investigation. It is difficult to map how many have been approached and offered immunity in exchange for collaboration or told they could be charged under the Espionage Act, too, if they do not cooperate with authorities.
There is an international community demanding that Assange should be released immediately from prison, and that a politically motivated extradition is denied. As pointed out many times during the panel, he is already weak and fragile, under special administrative measures. If extradited, he would suffer a severe detention which would at this point be unbearable. The panellists made clear that the US government should drop the charges of espionage and end its political persecution. Assange is a publisher, who operated in the public interest, standing for transparency and accountability. The conversation pointed out that Assange’s case needs an urgent solution.
As described on the conference’s page introduction, COVID-19 pandemic highlighted power asymmetries and injustices that already existed in society, but which are now impossible to ignore. The work of whistleblowers and those who speak out in times of crisis becomes therefore incredibly important to produce global awareness. Doctor Li in Wuhan was trying to share medical data and was warned off by the police. Before dying, he made sure that everyone could know about the mortal infection he had discovered. Thus, in medicine and healthcare, we immediately perceive the urgency of sharing information in real time, going against censorship — whatever it takes.