AHA! A discussion with Dr. Novil Wijesekara
With: Novil Wijesekara Berkley Center Profile
February 11, 2022
Dr. Novil Wijesekara is a community health and resilience veteran from Sri Lanka who is currently a Hubert H. Humphrey fellow at the Rollins School of Public Health at Emory University. He and his team received a grant from a European Union (EU) funded project, Awareness with Human Actions (AHA!), for an initiative titled as “Community Resilience through Religious Engagement for Community Trust during Covid-19 (CORRECT-19)” in Sri Lanka. The initiative examined the best practices of religious leaders towards promoting community resilience against Covid-19, and reassessed lessons learnt on their negative contributions that served to aggravate social division. He spoke to Dr. Sudipta Roy, WFDD, (by Zoom) on February 11, 2022, about his recent work with the religious leaders in Sri Lanka in the wake of the COVID-19 pandemic.
"Mis/disinformation can be very harmful. Sri Lanka, however, has a great advantage. I would say that the health literacy of our people is quite high. For example, we did an online survey in Sri Lanka in early 2021. 86% of the respondents were willing to get a vaccine."
“Religious leaders have unmeasurable amount of compassion. They don't have TORs for the projects like we do. Their contract with the community is lifelong.”
Sudipta Roy: Dr. Wijesekara, with your impressive career, what brought you into community resilience and peacebuilding work?
Novil Wijesekara: I'm Novil Wijesekara. I'm from Sri Lanka, from from an area called Piliyandala, which is about 20 kilometers from the Colombo city. I am a medical doctor and graduated from the Colombo university Faculty of Medicine. I was a tsunami graduate, in the sense that I graduated in the year of the 2004 Indian ocean tsunami. Right after graduation, I found myself in the middle of an enormous disaster. I had not yet received my license to practice medicine, but I wanted to go out and help people in need. So, I started volunteering. From thereon, I grew an interest in disaster management. I got to work a lot at the community level particularly through the Community Tsunami Early Warning System that we established after the tsunami in the Village of Peraliya, a southern fishing village in Sri Lanka.
Working with the religious leaders and faith actors was always a peripheral issue to me but soon it became a central one, a bit coincidentally. We had trained religious leaders on disaster preparedness before but that was it. One day my friend Suchith Abeywickrama, an interfaith activist and later became in interfaith fellow himself, dragged me to a training of a group of Buddhist monks from Myanmar who were studying in Sri Lanka on disaster management. I found it very interesting. From there on, I got engaged with the religious leaders on community resilience. The 2019 Easter bombing in Sri Lanka was another moment of revelation for me. I deemed myself responsible for such an incident in my country. I kept telling myself, "Okay, I'm responsible for that. Why I am responsible? Because I have not been able to prevent that kind of a situation occurring in our country." Then I decided that I had to work more with the religious leaders. Then came the COVID-19 pandemic and so came the AHA! project. I applied for the AHA! Small Grant program and got selected.
Going back to the tsunami time, you graduated and started volunteering. Did you get to practice medicine at all? Did you want to?
The tsunami happened in December 2004. We were, as if, floating for one year. Because of the Tamil-Sinhalese conflict then, universities usually had long backlogs. One had to wait at least a year before s/he could start an internship. I was actually working at the Colombo Plan Drug Advisory Program. In the meantime, I volunteered. Then I started practicing in 2006-2007. I did my internship in 2006 and 2007, and then I went directly into public health because I knew by that time, that my call was for public health. I worked as a medical officer of health at a preventive medical office of health in the remote village of Yatiyanthotoa. Then I came back for my Master's. During the tsunami, people were teasing me, "If you're a doctor, go and work in the hospital. Why are you in disaster management?" Since I grew an interest in the field, I pursued a Master's in Disaster Management. I did another Master's in Community Medicine and a doctorate in Community Medicine. Somewhere in my mind I was curious about cross-border peace and conflict issues. I did one diploma in Diplomatic Studies and Foreign Relations, and another is Human Rights and Peace Education.
These are all cross-cutting themes for sure. I am curious to know what your experience has been to work as a doctor and a public health specialist during the pandemic in Sri Lanka.
So, I am a medical doctor attached to the Disaster Preparedness and Response Division of the Ministry of Health, Sri Lanka. We remain in the middle of crises even without the pandemic. When the pandemic began, it was very confusing because nobody knew what the situation was and what it was going to be. We thought it was like the SARS virus. SARS spread in the Southeast and eastern Asia. There was only a case or two of SARS in Sri Lanka. So, we were overconfident at the beginning as a country, I would say. And then later we found that things were not going really well. However, we used whatever resources we had. One thing we found was that religious leaders became very important in the risk communication part of the pandemic. In my opinion, the whole pandemic has a flavor of ethno-religious conflict in Sri Lanka. For example, we found some COVID-19 clusters among some Muslim pilgrims who went to Indonesia. When the news went public, people started spreading hate speech against Muslims. The majoritarian mindset was like, "Okay, in 2019, they did the suicide bombing. This year, corona bombing." From the Disaster Preparedness and Response Division, we had to make it very clear that the virus had nothing to do with Muslims or any particular group. Rather, everybody is vulnerable. The biggest advantage that I had as a doctor, personally, was I was able to go out and go to work, when everybody was confined to their houses. That’s because I'm in one of the critical units. My work style changed. I had to go to work at 12:00 noon and come back in the midnight every day. But I really loved the fact that I could still go to work.
What kind of work were you doing in addition to countering hate speech?
I was part of the national COVID-19 prevention task force established by His Excellency the President under the Army commander. I was coordinating between the Ministry of Health and Defense. Our health desk at the COVID-19 task force was always lobbying for equal treatment for all, disregarding any race, religion, ethnicity, and class. Treating everybody with respect was nothing new: that's something that you do in every ward, or in every hospital, and you don't ask ethnicity or religion from a patient, right? Being a doctor helped me to uphold a right-based approach to the COVID-19 pandemic. My involvement at the top level also gave me a unique vantage point: I got a close view of what was happening in the country from both the Ministry of Health point of view and from the National Emergency Operation Center’s point of view.
My next question is what, in your opinion, is the Sri Lankan experience of the pandemic? As an island nation, Sri Lanka was safe from the pandemic for some time, but suddenly, as i, the floodgate opened, a lot of people got infected. There was confusion and a blame game. What went wrong? As you feel comfortable, please comment on the policy responses.
I think this is all about health system resilience. I mean, any health system has six building blocks: health service delivery, health workforce, health information systems, access to essential medicines, health systems financing, and leadership and governance. These building blocks have the ability to adjust and cope with shocks or challenges. In the very beginning of the pandemic, we had capacity and the shock was quite low. We were responding, and in my opinion, we were overresponding a little bit at that particular time. But then came the tipping point where the system could no longer withstand. In the early days, we did not have community level transmission. The cases came from outside. Therefore, measures such as border control and quarantining worked. When the community level transmission started, the situation worsened fast. It’s difficult to bring behavioral changes in a short period of time. We were also working with tremendously limited resources.
You also have to consider that each health system is an ecosystem with historical backgrounds. For example, some of the benefits we are seeing today in our health system, like low maternal mortality, and low infant mortality, and high life expectancy, are probably results of what our ancestors have been doing for the past hundred years. These systems are very robust. So, during a massive public health crisis, when we respond to these systems in a reactive manner, things get messed up. What I can tell you from my experience is that innovation can be really bad in a crisis. You want to innovate before the crisis.
Overall, what worked well for Sri Lanka was that people got together very quickly—from health ministry to immigration office to academia—we could get everyone involved in a very short period of time. But then it also came with some degree of disorganization. We might have tried too many things too quickly, which weakened our systems.
How were the social responses to the COVID-19 in Sri Lanka? The AHA! Project focused on issues like hate speech, mis/disinformation in the context of the pandemic. What were some of the dimensions of hate speech and mis/disinformation that you can speak to?
Those are very important issues. Mis/disinformation can be very harmful. Sri Lanka, however, has a great advantage. I would say that the health literacy of our people is quite high. For example, we did an online survey in Sri Lanka in early 2021. 86% of the respondents were willing to get a vaccine. 86%! Our vaccination rate has gone up to about 80% (at least one dose) which exemplifies the positive attitude towards the vaccines. There are some hesitancies regarding the booster doses, but it’s nothing like the Western countries. People generally trust their doctors, nurses, and health workers. However, hate speech was definitely a larger problem because religion and ethnicity are tied together with it. The cremation issue was a really big one. I would say that we have learned a historical lesson there: scientific knowledge, however correct it may be, should be interpreted in the ethno-religious and social-cultural point of view. I was personally very unhappy about the handling of that issue. The country was divided on this issue. There were a lot of people who believed that cremation was the only way to dispose of dead bodies. Others were defending the rights of the minorities. As a government official, I could not take any side personally. What we did was to provide evidence, we conducted an online public opinion survey on cremation of COVID-19 dead bodies. We told people, "Look, this is what the people of Sri Lanka are thinking," which then evolved over time. I would again say that it was a completely unnecessary debate that our country found itself in. It was taken up internationally and was used against the image of the country. In my opinion, since the end of the ethnic conflict in 2009, this cremation issue brought the greatest amount of shame on the country. This is another reason why religious leaders should be given more careful attention.
You talked about people’s overwhelming amount of trust in the medical system in Sri Lanka. Do you think that is more of a majoritarian perspective? In other words, do you think the ethnoreligious minorities have the same level of trust on the medical system in Sri Lanka?
I think the trust on the health system is way above these social barriers that you are talking about. I am saying this because, for example, if you go to the north, which has a very large Tamil population, you will see that the health system is run by people who speak Tamil. When you go to the east, most of the health facilities are run by Muslims. Broadly people are accessing healthcare within their own systems. So, in my opinion, there is no overarching lack of trust. I think people try to bring an ethnoreligious spin to whatever happens to the country. But yes, there were some mistakes. For example, we termed the first COVID-19 cluster a pilgrim cluster. If I were to term it today, I would use a different word because pilgrim can be a misleading word and can bring unnecessary attention to some specific group of people. People should be treated as people, not by their identity markers. Cremation controversy, as I said before, unfortunately and completely unnecessarily, we had to deal with a shadow pandemic within the pandemic—it was as if we confronted an infection of mistrust. I don't justify it, but I think that is the response to the Easter Sunday attack specifically as a country, in people's minds. I don't say it's correct, but probably that is how the narrative came into being.
How did the mistrust spread? Social media?
Yes, definitely! There were a lot of mis/disinformation and hate speech in the social media. But the fortunate thing was that the Ministry of Health, especially the Health Promotion Bureau, had a very strong surveillance of social media. They were looking at all the things that were going on. A lot of young doctors and young health professionals were using very innovative ways to counteract the mis/disinformation narratives. But the science vs. religion debate came to the front. I mean, sometimes Ayurvedic medicine, for example, has different interpretation of that. There was this man who was a native healer. I have due respect for the native medicine, it's really good. But then how it was approached was really, really bad. Everybody went and they flocked at that person's house. Thousands of people gathered and increased the susceptibility of the getting infected. These kinds of issues were there. But social media definitely played a big role. On the other hand, social media was used to balance it to some extent.
So, your AHA! initiative was set in a complex context. What did you do and how?
Of course! To give you the premise of our work, religious leaders play a critical role in building community resilience, which is the ability to prepare for, face, and recover from challenges such as disasters, emergencies, and outbreaks. Conversely, they could contribute to disrupting the community resilience through creating or aggravating social divides, based on ethno-religious fault lines. Covid-19 is an outbreak which has affected all aspects of the society and has demanded whole of society approaches in its response. The public health measures that Covid-19 demanded such as social distancing and quarantine have contributed to the curtailing of the outbreak; however, they have also created a breeding ground for hate speech, stigmatization, and victimization based on new as well as existing divisions within the society. Positive and negative instances of religious leaders’ contribution in relation to community resilience have been observed during Covid-19 in Sri Lanka. It is essential to examine the best practices of religious leaders towards promoting community resilience against Covid-19, as well as to revisit the lessons learnt on their negative contributions towards aggravating social divisions. Covid-19 provided an example of how unexpected challenges could aggravate existing divisions in the community. Hence, we believed that there was a need to explore and document the role that could be played by religious leaders in relation to community resilience in Sri Lanka. Further, we also took the existing gaps as an opportunity to build core competencies of religious leaders in addressing Covid-19 related victimization and stigmatization as well as escalated ethnoreligious divisions which date back to pre-Covid-19 era. We named our initiative Community Resilience through Religious Engagement for Community Trust during Covid-19 (CORRECT-19) to address these critical gaps observed in Sri Lankan community through religious leader engagement and empowerment. We wanted to turn COVID-19 to CORRECT-19!
We designed our work around a framework called the Community Resilience Framework that was developed by the Disaster Management Centre Sri Lanka in 2015. Let me explain this. Community resilience is the ability of a system to prepare, face, and recover from shocks and stressors. Shocks are usually short-term challenges and stressors are like long-term ones. The Disaster Management Centre developed this framework for Sri Lanka after reviewing a lot of technical and conceptual frameworks. I think this is a really good framework, and I have been using this to address disaster management, and especially to train religious leaders.
The center of this framework is the community. Then you have risks knowledge—knowledge about any risk such as disaster risk, pandemic risk, or risk associated to a conflict. Then there are subsystems. The subsystems are environmental, social, physical, economic, and human subsystems. None of these will work if you don't have good governance. Governance is about leadership, representation, and participation. Some problems that we are facing right now in the country are actually our governance issues. Now, where does religion fit in this framework? In my opinion, religion is a big part of the social subsystem, as well as the human subsystem, especially in our countries. From birth to death, everything is connected to religion.
So first of all, we wanted to listen to the religious leaders. I think it's very important that we listen to them. Since they are accustomed to preaching, when people like us want to listen to them, they have a lot to say. We were amazed by how much the religious leaders had to say! We reached out to Buddhist monks, Christian fathers, Muslim Maulavis, Hindu priests, representatives from Christian and Hindu nonprofits—you name it. Some of the questions that we asked them were: what did you do during the pandemic? What kind of problems did you face? How did you overcome those? We also asked, what are your training needs? What do you want to know to make things better or contribute better? We reached out to over a hundred religious leaders on several occasions.
After collecting and analyzing their stories, we came up with a new conceptual framework with eight desired roles of religious leaders, that can go both directions—positive and negative--during the pandemic. The first one was faith setter. The religious leaders had to reset their followers’ faiths during the pandemic. They told us that a lot of people were asking, "Where's God and why are so many people dying? Why did this happen?" So, the religious leaders went back to their original role to reestablish faith during the pandemic.
Religious leaders then had a health promotion role because people listen to them. Every religion has a captive audience. These people listen to them because they trust them. Religious leaders were doing a lot of things with their local health authorities on their own. Sometimes reaching out to the health authorities, sometimes they created WhatsApp groups with their religious, say, Muslim community. They created a WhatsApp with the leaders, with doctors in the group so that they could verify their information, and then health authorities could go and give them information. They were providing moral and psychological support by befriending people, being with them in need.
The next role we found was the role of a social worker. This is a very prominent role and they're very good at it. Religious leaders have unmeasurable amount of compassion. They don't have TORs for the projects like we do. Their contract with the community is lifelong. They were giving people food, water, and whatever their communities needed. Religious leaders are community mobilizers. They could mobilize a lot of resources in a short period of time. The next role was as network builders. Religious leaders are not only connected to the faith community, but also with government officials, political leaders, businessmen, and health workers in the area. They were able to leverage these networks to help the communities during the pandemic.
Then the religious leaders were the peacebuilders. It was one of the most important roles they were performing at different levels. They fix small conflicts within the faith communities. They were also instrumental in larger issues such as the dead body management, countering stigmatization and hate, and bring calm. Last but not the least was the advocacy role. For example, the Islamic scholars played a very important advocacy role during the cremation debate. They were highly patient, disciplined, and professional about it. They took a very academic approach to it—reciting from the holy books and balanced that with peacebuilding and advocacy work. They did not let the provocation take over reason even when they were not getting what they were advocating for.
These are some excellent insights. Your eight-fold framework for the engagement of the religious leaders during the pandemic seems to be comprehensive. You mentioned earlier that the framework goes both ways? Could you please elaborate on that?
Yes, all these things could be turned the other way. For example, advocacy could be not to take vaccines, or there could be a role in creating more conflict. We have written about it along with the eight roles in more detail in our paper that we published last year.
It would be great to see how the framework evolves in other country contexts. What else did you do with all these stories and knowledge beyond publishing the paper?
We also identified knowledge gaps and designed a four-day training for religious leaders. The training session had two major components: COVID-19 pandemic-related technical knowledge and conflict resolution and peace building. We had technical experts from both health, and conflict resolution and peace building sectors. We prepared a booklet titled as “Community Resilience through Religious Engagement for Community Trust during Covid-19” and shared printed copies with religious leaders. We tried to create a community of practice out of our program and have been somewhat successful at it. We tried to be as gender inclusive as possible, but it was not gender balanced due the nature of the religious leader demography in the country. Eleven Christian Sisters participated in the training. We also did some case studies with Muslim female faith leaders. We had to commission a female Muslim facilitator to speak with these religious leaders. Most of these interviews took place around 10 PM because these female Muslim faith leaders could only speak after they were done with their daily household chores as mothers and wives.
We also collected case studies on what the religious leaders were doing on the ground with the communities. The goal was to document this amazing work that they were doing for the current and next generations. I do not think we will have another COVID-19 moment in our lifetime but when something bad happens next, people will be able to focus on these case stories and learn what their predecessors did and how they did it. We collected some heartwarming stories. To take one example, a Buddhist monk went and plucked all the coconuts from his temple. He put them in one-meter distance and asked people to take their coconuts and go. Usually, people offer things to the temple, so he set an example by returning them to the community. There were many other stories about charity work that involved interfaith and intra-faith initiatives as well.
Was the training in person or online?
It was online. It was a very novel experience because we had not met any of these people in person. I never had thought before that a program with a hundred religious leaders was possible virtually! But we did it and we learned a lot. We experienced digital divides: some people participated only because it was virtual, others could not participate because they did not have access to internet or means to maneuver the Zoom platform. In order to make the participation more equitable, we offered as a lump sum a telecommunication allowance of 3,000 rupees (approx. $14) to pay for the internet bills. For the focused group discussions, we provided 1,000 rupees each. Some religious leaders did not take the money, some suggested that we donate to a charity of their preference, while others accepted the allowances. During the preparation for the online training, we discovered a great feature of the Zoom platform called the translator option. We had parallel translation going during the training in Sinhala and Tamil.
Awesome! How did you select the religious leaders for your program?
The selection was difficult as we tried to be as inclusive as possible. At first, we tried to collect the case studies. We created a Google Form and shared it with the whole island and waited to see if and how people responded. It didn't work. It was not the right strategy to get responses from the religious communities. They were not going to fill up a Google form and give us information! I think we got only one case study from the Google form strategy! What worked was to go through networks, the networks we built during our previous disaster related work. We used a snowball method to get names from one group to another. We first conducted 20 case studies. We asked these 20 people who might be good fit for the type of work we were planning to do. Initially, religious leaders were very suspicious of outsiders. When they heard about the European Union, they were very suspicious about our motives. They don’t like the word “project” and get quite squirmy around the word “foreign country.” We had some trust built through our previous work and we leveraged it to build rapport. One important lesson we learned was that we had to go to their events to build trust and relationship. At times, it is, as if with a transactional method (not financial of course)—they will do things for us when we do things for them. Attending their programs either physically or virtually was then very important to build trust.
While you were describing your project, you used “we” a lot. Did you work as a team?
Oh, yes! I had a very good youth leader who accompanied me in this project--Dimantha Jayasinghe. He's a graduate of conflict and peace education. Our AHA! initiative was not only virtual, but it was also a cross-country one since I left for the U.S. in the middle of the project. Dimantha was really the person behind all the work. We had a panel of experts that I have credited in the book who helped us with producing the case studies and drafting the training module. Our team was comprised of people from all three major religious traditions: Sinhala, Tamil, and Muslim. We worked as a community of practice—learning from each other.
During your four-day training period with the religious leaders, what kind of discussions and questions were the most frequent?
There were a lot of questions about disinformation and misinformation. People wanted to clarify a lot of things that they were hearing about the virus, how it is transmitted, how it is contained, etc. The science part of the pandemic was the most confusing to them. We learned that some religions teach “science” from their religious point of views. They use religious perspectives to explain the world. That is fine but, in my opinion, getting some science education for religious leaders is very important even if it clashes with their worldviews.
What are some of the takeaways for you from this AHA! funded initiative?
One of the main lessons is that we must recognize religious leaders as legitimate stakeholders of our pandemic response. They have been kept in the periphery for too long. People trust their religious leaders very much, particularly in the rural areas. We cannot avoid their roles in social behavioral decision making. On the other hand, we have to build their capacity. They are very good public speakers. They know how to mobilize resources. They know how to be empathetic. We just have to give them the tools.
After working with the religious leaders, I have developed a personal inquiry around the idea of conflict transformation to violent religious extremism. Religious people are generally very nice people. But I still do not understand how such a good person can become a suicide bomber? If you look at people who committed suicide bombing in Sri Lanka’s Easter Sunday attacks, they were well-educated people, had several degrees, and traveled all over the world. So, where is that switch that makes somebody a terrorist? No theoretical model can explain that. Continuing the brainstorming with Dr. Scott J. Hauger and Ms. Elina Noor, my Seminar leads from the Asia Pacific Center for Security Studies, Hawaii, this is what I'm trying to explore now. I am reading up a lot of available literature. I came across Prochaska and Di Clemente’s transtheoretical model, which I think is very useful. I'm trying to adapt this into a conflict transformation model in relation to violent religious extremism. It is a good tool to engage religious leaders more meaningfully.
Are you working on these questions as part of the Hubert H. Humphrey Fellowship at Emory?
Yes. I have connected with and had consultations with experts who are engaging religious leaders in public health programs from the CDC. In addition, I am volunteering for two organizations that work with faith-leaders in Atlanta. One is the Global Health Crisis Coordination Center (GHCCC) and, it has a subgroup called the Worship Action Coalition (WAC). WAC is doing a lot of work in addressing vaccine hesitancy. It’s funny, I pass CDC every day when I go to Emory, and two out of five days there is a man holding a placard in front of the CDC saying, “Vaccination is genocide!” Vaccine hesitancy is really a big problem here compared to Sri Lanka. The second organization is Interfaith Atlanta which has a very nice concept called Interfaith Speakers Network. They arrange training for people who are interested in interfaith speaking. They train them on how you should be talking with religious people from different backgrounds. I'm going to take that training in February.
For the conflict transformation model, I was very fortunate to get in touch with Professors James O. Prochaska & Janice M. Prochaska They then connected me with Dr. Deborah Levesque who has worked with them for over 20 years and specializes in violence prevention in the areas of bullying, domestic violence, dating violence, and juvenile justice. I am proposing to use the transtheoretical model for transforming violent extremism, which has not yet been done. Right now, I am just working on a conceptual paper. I really have to find some funding to test it, pilot test it.
I would be very curious to know your findings from the pilot phase. Going back to the AHA project, as the AHA! project is ending now, do you have words of wisdom for the project consortium?
First, I want to thank AHA! Project for coming up with a very valid agenda to work with religious leaders, women, and youth and implementing it during the pandemic. When all the organizations were broke and they were looking for grants, we had funding to implement a meaningful project. We got a wonderful experience to work with the interfaith ecosystem of Sri Lankan by being part of this project. We got to publish about the roles of religious leaders during the pandemic in Sri Lanka, which was internationally acclaimed. We are also very thankful that we got an extension from the project which helped us to complete our work. However, I must also mention that the financial reporting was really hard. I mean really hard! Because it's such a complex process, smaller organizations like ours had serious trouble comprehending what was required from us. We understand that these mechanisms are put in pace to ensure accountability and transparency but for community-run projects like this, the requirements should be tailor-made to the contexts.
Thank you very much for making the time to speak with me and for these thoughtful observations. It was an insightful one hour. I truly enjoyed speaking with you and I learned a lot about your outstanding work.