Immigrant communities pay a heavy price for Sweden's handling of the coronavirus

Charlie, my aunt Ziyanet, who is like a grandmother to me. There are of course also sunshine stories. Two of my cousins and one uncle have been discharged.

I worry about all my relatives, friends and acquaintances working in elderly care and in hospitals.

The same day, management from five churches in five European countries have sent me information on how many of their members have died of covid-19.

In France there are 22, in Germany there are five, in the Netherlands two, in Spain one, in Belgium two and in Switzerland and Austria no one has died of the disease. A total of 30 people. I have asked for the numbers because Assyrians/Syriacs in many cities in Europe live as close to each other as in Sweden and Södertälje (a city south of Stockholm with a sizeable community inhabitants of Assyrian/Syriac descent). They are not as concentrated, but often live in clusters around churches and associations, and their homes are close to one another.

I also have relatives and acquaintances in all the above-mentioned countries. It is not uncommon for minorities in the diaspora. We are scattered, but we keep in touch. I have therefore talked to 32 people in recent weeks to ask how they are feeling, but also to investigate how their social life works.

Here in Sweden at least 92 Christians immigrants from the Middle East have died of covid-19 to date. The figure has been confirmed by churches, associations and relatives of the deceased.

Then there are people who have died in their homes with symptoms suggesting that they may have been infected, but those have not been confirmed as covid-19 deaths after the fact. I know of three such cases.

Lack of protective gear 

On March 3, I was at my mother’s home in Södertälje.  Home care staff were there, as they were expected to be, four times per day. They had neither gloves, masks nor hand sanitizer. My mom is battling many illnesses. She suffers from severe asthma, goiter, cardiovascular disease and is wheelchair-bound. 

In mid-February, I watched many videos from Iran, pictures of people who suffered tremendously after getting infected by the coronavirus.

I had previously been interested in the virus, after a doctor in Lebanon warned us about it. He was afraid it could mean a disaster for the refugees that my voluntary organization A Demand for Action (ADFA) is helping in the slums of Beirut, as well as other places. The doctor asserted that many of them have so-called pre-existing conditions such as diabetes, pulmonary disease, asthma and cardiovascular disease and that an infection can mean death for them.

On February 21, the first coronavirus infection in Lebanon was confirmed.  Eight days later schools, restaurants and other venues where people gather were closed. On March 15, the government declared that everything else would also be closed. On April 22, The Washington Post reported that in two months, after the first case of coronavirus, 22 people had died in Lebanon, a country, as large as Skåne, Sweden, with six million inhabitants and at least two million refugees.

One of the medical assistants later became infected, and is now in a hospital with confirmed covid-19.

Back to Sweden. On March 4, I again contacted my mother’s home care company. Now they had given the staff new directives, all according to the municipality’s recommendations, which in turn followed the guidelines of the Public Health Authority (FHM). In an email to me, one manager wrote: “If you have traveled to any of these areas, you should hold off on visiting our operations until the recommended two-week period has expired. This is to ensure that any infection is not passed on.”

So staff were asked to stay home if they had been in countries where the outbreak was extensive. Personnel who worked with my mother and, for example, if they sneezed, were told at the same time that they could neither call in sick nor receive any kind of compensation if they stayed home. Therefore, they were still at work. Many of them are paid hourly.

On March 11, my mother was isolated. My siblings and I came to the conclusion that the best solution was for me to move in with her. I couldn’t travel anyway. Lectures and conferences were canceled. I was able to do some of the coordinating work on the computer and cellphone. We paused mom’s home and transportation services. The days before, I had, among other things, accompanied her to the physiotherapist. I asked the medical assistants why they weren’t wearing masks. Why they weren’t protecting their mouths, noses and eyes? They replied that they had not received any such directives. In the waiting room, patients sat close to one another. Two of them sneezed and one coughed a little. One of the medical assistants later became infected, and is now in a hospital with confirmed covid-19.

At the end of February, while we were working to help prevent any spread of infection in the slums in Beirut, I also began to take an interest in the situation in areas with low socio-economic status here in Stockholm. What did those living in those areas know about how the coronavirus spreads? I was horrified by their ignorance. At the same time, people I know in the Järva area (area in western Stockholm with a high proportion of immigrants) and Södertälje began to fall ill in covid-19. Many younger people, at least 15 of whom I knew, had had symptoms. My aunt and several others I know became infected even though they were isolated and only home care staff visited them.

On February 29, my aunt in Södertälje asked me to stop her husband from going to a memorial service in Hallonbergen. We Assyrians/Syriacs tend to gather in crowds between 100 and 800 people when we pay our respects to someone who has passed away. For a week, I had talked to churches and associations urging them to close their services, at least in part. But there were no such directives from the authorities, and so they didn’t listen to my pleas. My uncle went to the memorial service and was later admitted to Södertälje hospital with confirmed covid-19 for a month. He has been discharged, but cannot even stand on his legs.

On March 11 the ban on holding public gatherings and public events with more than 500 participants came. On March 29, the number was reduced to 50 people. Between those dates, there were still many people at associations, churches, mosques and cafés where a large number of people gathered.

Infection control came too late 

By March 11, churches and mosques had already taken measures that exceeded the government’s recommendations. But it was too late. One ambulance after another was heard picking up sick people in the Järva area. After a few weeks, in Södertälje and Botkyrka.

In early March, people contacted me on social media saying that their relatives or they themselves had become infected at health centers or when visiting a hospital.

At the same time, I started contacting authorities, media and nonprofit organizations. I shared my concerns about the lack of knowledge that existed among residents of poor neighborhoods and other immigrant-dense areas. They live in tight spaces, many of them multi-generational. For example, on an ordinary weeknight up to ten people could gather with my mother and watch a television series. On the weekends we could have more than 30 people over for lunch and coffee.

In Middle Eastern cultures, there is hardly any age segregation. On the contrary, it is natural to spend time across generational boundaries. The elderly are also in a particularly vulnerable position. That was another contributing reason for isolating my mother and me so that no one would come to her house.

In early March, I asked on social media if a PR agency could help me build a 12-language video site about how to protect yourself against corona. Bright Mind Agency in Jönköping contacted us right away. On March 18, Svenska Dagbladet’s editorial page published my article on the situation in Stockholm’s suburbs. Neither the public service media nor the authorities had been interested in my proposal on how we would best reach out to immigrant-dense areas. Bright Mind Agency and I set up  tellcorona.com and #tellcorona, a website with video messages on how to stop the spread of the virus, delivered in languages other than Swedish, by well known personalities within migrant communities. The videos are now available in 15 languages, and have been mentioned in five of the world’s largest media outlets.

the language spoken by most immigrants and their children has been excluded from the brochures

On March 23, the Swedish Agency for Social Protection and Preparedness (MSB) was commissioned by the government to coordinate all information from Swedish authorities and ensure that it reaches everyone in Sweden. I contacted the authority the same day. Cecilia Nilsson, communications strategist at the authority, and I had a good conversation. But by April 23, the agency declined the video clips.

There is some kind of strange confusion at MSB. In Södertälje, Assyrian/Syriac— the language spoken by most immigrants and their children— has been excluded from the brochures in which 22 other languages are featured. In the material, Somali was also wrongly translated, so some sentences have a completely different meaning.

MSB does not want to share tellcorona.com since, according to the authority, it has other partners and doesn’t need more information to distribute. Even though they get the video clips for free (we are volunteers). These clips have now been viewed over 700,000 times on Facebook alone.

So foreign-born people were not reached by information on how to protect themselves against the corona virus until the end of March. Three doctors in Södertälje with whom I spoke say that the efforts of the authorities have been inadequate.

On April 9, Svenska Dagbladet published my article entitled ”Another knife in our hearts.” In it I report new figures, that 43 of the 225 who had died on April 4 were Assyrians/Syriacs. A clear over-representation.

On Tuesday, April 14, Swedish chief state epidemiologist Anders Tegnell admitted at the daily conference that immigrants are over-represented among the infected.

He also said that information should now be directed to these groups.

Baffled by the ignorance

Emad Issa is a specialist in general medicine and operations manager at Kringlan Health Center in Södertälje. He is also a popular TV doctor in the Assyrian/Syriac television channel Suryoyo TV. He himself has been infected by covid-19 but has recovered. He says the lack of information has not been or is the only problem. He tells me that the doctors at the health center on March 23 were called in to Per Follin, chief at Infection Control Stockholm, to discuss the dissemination of information in other languages.  And that he was surprised at the lack of knowledge that he thought the Chief of Infectious Disease displayed when he wanted the meeting to be solely about information. Emad Issa and his colleagues believe that disseminating information is not enough, but that socio-economic and cultural conditions must also be taken into account in the calculation.

Emad Issa and his colleagus responded that it is not enough to disseminate information, but that socio-economic and cultural conditions must also be taken into account.

Then, while trying to suppress his tears, Emad tells me how he and his wife, when they open Facebook each morning, are met by pictures of people they know, or whose relatives they know, who have died from covid-19. In some cases, they are relatives, in others, friends. Some are patients he has had.

He exhales, and is silent for a few seconds. Then he changes his tone and sounds very determined. He points out that both in primary care in Södertälje and in the Assyrian/Syriac group have generally adapted to the recommendations of the authorities.

Measures were also taken in addition to them. But the spread of the coronavirus continues. A contributing reason is that home care staff have not been protected and are still unprotected unless they work with people with confirmed or suspected Covid-19. Many of them also take public transportation to get to work and provide for themselves.

Emad’s aunt is one of those who has been infected by home care staff. She was completely isolated for over a month and had only visits from them. Now she is fighting for her life.

Two of his colleagues were also infected, one of them in a respirator. They were infected by the patients. Emad is upset and says that authorities and the government didn’t alert the public in time, and did not take sufficient action to stop the spread of infection.

It is still not too late, and much can be done to save lives, says Emad. But he feels defeated when he hears that his relatives who work in home care are being denied protective clothing.

Blaming each other

Posting in public environments and distribution of information leaflets started according to Stockholm city commissioner Anna König Jerlmyr around March 19. In a message to me, she wrote:

“Stockholm City’s billboards have been used for materials in Swedish as well as several other languages. An extension of this poster campaign is planned, also in several languages.”

She also wrote that it was not until March 16 that medical advice hotline 1177 on the phone temporarily began to give information even in Persian. Earlier, advice was available in Arabic, Somali and Finnish.

Jerlmyr claims that she posed questions to Infection Control Stockholm to get a picture of the spread of infection and find out if there were any particularly vulnerable areas. But she never got an answer.

“Since the general infection tracing ended on March 10 after a decision by the FHM, we did not have the information we have now. We have really tried to follow both Infection Control Stockholm and FHM’s recommendations. But we did not get confirmation until later that there was a greater spread of infection in Järva. This despite the fact that we asked questions.”

While Swedish authorities are starting to blame each other for acting late and wrong, one would think that I am writing this text from a battlefield.

On April 25, according to FHM and Södertälje municipality, only staff working with people who have been found to have covid-19 should be protected. The others do not need a visor, mask or gloves, it is said. It is enough that they just follow the hygiene instructions.

”They tell us that we don’t need protection at the same time as both my colleagues and several of our elderly have been infected,” assistant nurse ”Linda”  said when I called her, adding that it feels like Russian roulette.

During the years 2012–2014 I ran the home care company Omtanke in Södertälje and therefore know many of those working in elderly care in the city. This weekend, April 18-19, I did a survey in the form of a text message that I sent to 14 people working in home service. Only three of them had enough protection. Two had bought visors themselves. The vast majority of people working in elderly care in Södertälje and other places with many immigrants are themselves either immigrants or second-generation immigrants. It becomes like a vicious circle of virus-spreading that no government seems to want to understand.

I have asked FHM for new statistics. I want to know how many of those who have died in the whole country were immigrants and how many of those who died in Stockholm were. I intend to continue to investigate the causes. I know that coincidence may have played a part when many people became infected at two memorial services in the Järva field.

Of course, I am aware of the cultural differences and I know the socio-economic aspects well. Questions remain that I, and probably many others will seek answers to:

Would it have been possible to save lives if the authorities acted more quickly?

Do authorities lack knowledge about cultures other than the ethnic Swedish?

How come you didn’t reach people speaking languages other than Swedish with information quickly enough?

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 Nuri Kino lost two more relatives after writing this text: his aunt Ziyanet and his cousin’s husband Jack.

 

Nuri Kino is an investigative journalist and promoter of tellcorona.com.

Translated into English by journalist Daniela Babylonia Barhanna in Los Angeles

Proof read by journalist Susan Korah in Ottawa, Canada