全球汇 | 疫情下的国际专家声音：健康城市源于健康社区

导 读

新冠疫情(COVID-19)的爆发和发展时刻牵动着全国人民的心,作为世界卫生组织认定的突发公共卫生事件，也引发了国际社会的广泛关注。除了与病毒争分夺秒地斗争，积极在危机中总结经验、吸取教训并前瞻性地思考更好的未来也尤为重要。很多议题值得去探讨，比如危机后人们的身心健康问题，人居环境和生活品质的改善；以及如何快速恢复生产、消费与经济活力，同时平衡环境和生态；在考验和转折中寻找创新动力，通过规划、政策、治理方面的改革使城市具备更高的危机应对能力和更高质量的发展。

西浦城市与环境校级研究中心致力于关注城市化带来的经济、社会、人口、健康变化等议题。依托西交利物浦大学国际化平台，本专栏旨在邀请一系列国际相关领域专家参与讨论，建立对话，就我们关注的这些问题分享他们的观点。从多元的角度，拓展的视野，碰撞新的思维，聚焦和助力健康城市的发展。

    主题 | 社区福祉（community wellbeing）

嘉宾 | Dr Janaka Jayawickrama

英国约克大学健康科学系副教授

研究领域：社区福祉

Associate Professor in Community WellbeingDepartment of Health Sciences, University of York, UK.

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Janaka博士是一位社会人类学家，他的工作主要围绕灾害、冲突和不平衡发展影响下社区福祉提升的学术研究、政策咨询和实践展开。他在各种人道主义反应中发挥了关键作用：包括斯里兰卡海啸(2004年)、苏丹达尔富尔西部失所人民援助(2005—2006年)、巴基斯坦境内阿富汗难民问题(2006年)、马拉维难民问题(2006年)、约旦境内伊拉克难民问题(2007—2008年)和伊拉克北部的叙利亚难民问题(2017年至今)。Janaka持续为联合国和国际机构提供人道主义事务方面的建议。其在“关爱”和“福祉”概念上的开创性工作影响了全球人道主义政策和实践以及发展干预方面的话语。

Dr Janaka is a social anthropologist, he has worked within and between academia, policy and practice in disasters, conflicts and uneven development. He has played key roles in various humanitarian responses including tsunami responses in Sri Lanka (2004), internally displaced people in Western Darfur, Sudan (2005-2006), Afghan refugees in Pakistan (2006), refugees in Malawi (2006), Iraqi refugees in Jordan (2007-2008) and Syrian refugees in Northern Iraq (2017, ongoing). Dr Janaka continues to advise the UN and International Agencies on humanitarian affairs. His pioneering work on concepts of care and wellbeing has influenced the policy and practice of the global humanitarian and development intervention discourse. 

* 访谈文字整理如下

1

您认为“福祉”指的是什么，它为何对社区来说具有重要意义？

基于我过去25年深入亚洲、非洲和中东受灾害和危机影响社区的工作经验，我愿意将“福祉”定义为生命个体有效应对生活中的不确定性和挑战的能力。

环顾四周，生活充满危险和不确定性。我指的不仅是灾难或重大危机事件，它甚至存在于我们的日常生活中。不断上涨的房价、交通事故、破裂的关系、突发的疾病和失业都时刻提醒着我们——生活充满了变数。基于此，许多社会已经形成了一套复杂而务实的方法来应对这些不确定和危险。如我们的宗教信仰、人际关系、家庭、传统和精神都是其中的一部分。自人类文明伊始，我们就一直在应对这些挑战，所以其中一些提升人们福祉的方法是经过时间检验和证明的。

因此在我看来，社区福祉是一个通过我们对外部生活的内在理解和发现自身的能力来应对外部世界的过程。

What do you mean by wellbeing and why is it important to communities?

Through my experiences of working with disaster and crisis affected communities in Asia, Africa and the Middle East over the last 25 years, I am defining wellbeing as the individual’s ability to effectively engage with uncertainty and challenges of life.

When we look around, we realise that life is dangerous and uncertain. I am not just talking about disasters or big crises, but even in general and day-to-day life. Rising house bills, road accidents, broken relationships, sudden illnesses and job losses are reminding us how tentative our lives are. In this, communities in many societies have developed very sophisticated yet pragmatic approaches to deal with these uncertainties and dangers. Our religions, relationships, families, traditions and spiritualities are all part of this. Since the beginning of human civilisation, we have been dealing with all these challenges, so some of these approaches to wellbeing are time-tested and proven. 

So, in my perspective, community wellbeing is a process that we deal with external life through our internal understandings of them and finding our abilities within.

2

在城市环境中，尤其是现代都市变得更大且更密集的背景下，人们提升其福祉的主要挑战是什么？

城市，尤其是大都市都具有发展迅速、资源丰富、个人主义盛行和拥有极端繁忙的生活方式等特点。让我觉得有意思的是，在像伦敦这样的大城市里，人们总是看起来忧心忡忡。他们忙于追赶时间，甚至没有时间对彼此报以微笑。我们可以将这样的生活归纳出以下三个特征：

•  住在大城市里，你如果不是非常富有，上下班的通勤路程一般都会很长。

• 你的工作主要保证你有资格留在城市里，你不可能在失业的时候仍然维持一个体面的城市生活。所以，你的生活终究只能围绕着你的工作。 

• 忙碌的生活方式不会给你的人际关系、爱好留任何空间，甚至会剥夺你“什么也不做”的权利。你没有时间去关心他人，也没有人有时间去关心你。

基于以上几点，一个人在城市里的生活是有可能变得非常孤独的，这对人们提升个人生活福祉有很大的影响。

What are the main challenges to wellbeing in urban settings, especially when cities become larger and clustered?

The urban, especially big cities can be defined by fast-phase, resource heavy, individualistic and extremely busy lifestyles. I always find interesting to see that in big cities like London, people look very unhappy. They are too busy running, do not have time to even smile with each other. What we can generalise here are three things:

i. To live in a big city, you either have to be very wealthy or you are commuting a huge distance to work in the big city.

ii. Your work mainly keeps you in the city. You cannot be unemployed and maintain a city life. So, your life revolves around your work and nothing else.

iii. Due to your busy lifestyle, there is no space for your relationships, hobbies or even just not doing anything. While you do not have time to care for others, no one has time to care for you.

In this, one can live a very lonely and isolated life in the city, which has a major impact on their wellbeing.

3

像COVID-19这样的重大灾难发生后，对处在一线的医生和社区工作者，以及普通公众有什么主要的心理影响?

当你是医疗专业人员或社区工作者时，你的目标是帮助和照顾受影响的个人和社区。不仅在COVID-19疫情中，而是在面对任何危机时，专业护理人员也是相当无助于无力去拯救每个人的。当你意识到这一点时，你可能会大吃一惊。但即使有这个觉悟，当你看到你的人类同胞遭受了很多痛苦，并目睹他们死亡时，也会是一个巨大的精神挑战。这些记忆甚至会长期困扰你，这也就是为什么对从事护理职业的人来说认真考虑自身的健康福祉也是很重要的。

对于普通大众来说，挑战在于不知道该做什么。在互联网和社交媒体普及的今天，很多人习惯于在对形势没有正确理解的情况下妄加评论，互联网上的这些反应很可能诱导矛盾的发生。然而，与此同时，社交媒体又可以把受危机影响的人们聚集在一起，使他们团结一心。正如我之前提到的，意识到我们的生活是多么的不确定和危险是非常令人沮丧的。这也就是为什么在遇到重大危机后，鼓励人们重新拿回掌控自己日常生活的主动权将变得大有裨益。

What are the main psychological impacts of major disasters such as COVID-19 for both frontline doctors and community workers, and the general public even though the physical ailment would be cured?

When you are a medical professional or community worker, your aim is to help and care for affected individuals and communities. Not just in COVID-19 situation, but in any crisis, the caring professionals are also relatively helpless and powerless to save everyone. When you realise that, it can be a big shock. Even in this realisation, when you see a lot of suffering of your fellow humans and witnessing them dying is a huge mental challenge. These memories can trouble you even in the long-term. That is why it is important that the people who are in caring professions seriously needs to think about their own wellbeing.

In terms of the general public, it is the challenge of not knowing what to do. These days with internet and social media, we find many commentaries of situations without proper understanding. In these reactions in social media or internet can be very problematic. However, at the same time, social media can bring people together and build solidarity among affected people. As I mentioned before, realising how uncertain and dangerous our lives can be very discouraging. That is why after a major crisis, encouraging people to take control over their routines again can help.

4

什么是灾难援助的本地化，它的重要性体现在哪里？

在任何危机中，受影响的人群都总是第一反应者。我们一般认为，专业服务提供者会进行首要干预，而事实上，母亲、父亲、我们的邻居和朋友才是第一反应者。在大多数危机情况下，认识到这一点并在受影响社区和专业服务之间建立合作关系是非常有必要的。其重要性在于拥有一个愿意以积极方式应对危机的群体，更加有助于专业援助。

What is localisation of disaster assistance and why it is important?

In any crisis, the affected populations are the first responders. We generally think that the professional service providers make the first interventions, it is actually mothers, fathers, our neighbours and friends are the first responders. In most crisis situations, to recognise this and establishing collaborations between the affected community and professional services is what we need. The importance of this is that having a population that is willing to respond to a crisis in a positive manner help the professional assistance.

5

灾后公民援助和降低未来风险的要点是什么?

增强社区应对灾害的能力和减少未来风险的措施有许多。然而，在我看来，教育在这里扮演着至关重要的角色。我指的不只是正规的学校和大学教育，还包括关于灾害和危机的非正式和非正规教育。当每个人都明白我们均对降低风险负有一份责任时，我们就能有效地应对危机。此外，社区可以拥有自己的一套风险降低流程，这对于缓解未来的危机也非常重要。

What should be the main focus of post-disaster citizen assistance and future risk-reduction?

There can be many things that can be done to strengthen communities and future risk-reduction. However, in my perspective, education play a key role here. I am not just talking about formal school and university education but including the informal and non-formal education about disasters and crises. When everyone understand that we all have a responsibility reduce risks, then we can effectively deal with crises. Further, the communities can own their risk reduction processes, which is very important in relation to mitigation of future crises.

6

如何通过构建新的知识基础以改善社区福祉和健康指数?

我认为我们目前只关注应用新兴的科学知识去处理危机问题。然而，有时我们会忘记，古老的知识基石，如阿育吠陀（印度传统医术）和中医也有很多先进的干预手段和实践先例。我认为新兴与古老的知识需要建立平等的合作伙伴关系，这样我们才能构建起对改善社区福祉和健康有意义且有效的创新知识体系。在深入受危机影响社区的研究与实践工作中，我总是试图将新的科学知识和传统知识结合起来，从而形成新的方法和框架。我们需要记住，道教、儒教、印度教、佛教以及其他许多文明的古老哲学可以为当代挑战带来一些启示。

What are the methodologies of establishing new knowledge foundations that improve community wellbeing and health?

I think that we are only focusing on the new scientific knowledge in dealing with crises. However, we sometimes forget, the ancient knowledge foundations such as Ayurveda and Chinese Medicine have much advanced interventions and practices. I think that the new knowledge and ancient knowledge needs to collaborate as equal partners, so that we can establish new knowledge that are relevant and effective in improving community wellbeing and health. In my research and practical work with crisis affected communities, I always try to bring the new scientific knowledge and traditional knowledge together, so we can develop new methodologies and frameworks. We need to remember that Daoism, Confucianism, Hinduism, Buddhism as well as ancient philosophies from many other civilisations can shed some light into contemporary challenges.

7

您如何评价迄今为止中国针对COVID-19采取的防控措施？

作为一个局外人，我主要通过信息的阅读来了解中国正在发生的事情，所以，这是一个局外人的观点。令人印象深刻的是，中国在这个关键时刻正在尽其所能，与“非典”等以往危机相比，此次疫情的应对措施更加先进、目的明确。我不认为任何人有100%的准备去预防或应对这样的危机。我在此次经历中看到的是应对措施的灵活性与强烈的学习意愿，这是令人钦佩的。看到人类同胞遭受苦难总是令人感到不幸的，现在是鼓起勇气和耐心坚持的时候，我们需要团结和支持每一个正在经历这场危机的人。

在未来，我们需要从这次危机与其应对经验中吸取教训。我认为，这场危机结束后，中国可以把这次经验作为一个案例研究——不仅从科学角度，还可以从社会、文化和环境的角度出发。中国的城市正在快速发展，城市的福祉和健康正成为其中的一个重要方面。此外，我相信培养符合中国社会、政治、文化、经济和环境背景及需求的人道主义专业人员将会是对未来的重大投资。中国的大学和高等教育机构应该考虑这一点。正如那句格言所说:

“我们最大的光荣不在于从不跌倒，而在于每次跌倒之后都爬起来”

How do you comment the measures taken by China on COVID-19 so far?

As an outsider who is looking at what is happening in China is through my readings. So, this is an outsider’s view. It is quite impressive that China is doing all what can be done in this juncture. Compared to previous crises like SARS, the response to this crisis is much more advanced and relevant. I do not think that anyone can plan 100% to prevent or respond to a crisis like this. What I see is the flexibility and willingness to learn from this experience, which is admirable. It is always unfortunate to see human suffering. These are times to gather the courage and patiently persist with the efforts to deal with this situation. We need solidarity and support for everyone that are suffering from this crisis.

In terms of future, we need to learn from this crisis and experiences of the responses. I think, when this crisis is over, China could establish this experience as a case study – not only from a scientific perspective, also from a social, cultural and environmental perspective. Chinese cities are growing, and urban wellbeing and health is becoming an important aspect in that. Further, I think that training future humanitarian professionals that suits the social, political, cultural, economic and environmental context and needs of China is a significant investment for future. Universities and higher education institutes within China should think about this.

As Confucius, one of the greatest Chinese philosopher and politician of the Spring and Autumn period said, our greatest glory is not in never falling, but in rising every time we fall.

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* 封面图片来自于网络

西交利物浦大学（简称“西浦”）是经中国教育部批准，由西安交通大学和英国利物浦大学合作创立的，具有独立法人资格和鲜明特色的新型国际大学。她是中国第一所以理工管起步，强强合作，拥有中华人民共和国学士学位和英国利物浦大学学位授予权的中外合作大学。

   西浦城市与环境校级研究中心（UES）旨在成为一个以研究中国地方发展和城市化为导向的国际知名研究中心，致力于环境、经济、社会、人口和健康变化趋势等多方面的议题研究。通过整合西交利物浦大学多学科、国际化的研究力量和科技平台，总结中国城市发展变化的经验，探索更加智慧、可持续和高质量的发展范式。中心与社会公共部门紧密合作，进一步为科学研究提供坚实基础，为扩大社会效益开拓有效渠道。

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