Weekly Briefing, Vol. 27, No. 3 (MK), March 2020
Socio-Political Realities and Humor in the Time of Coronavirus
The romantic description of laughter as the “cheapest medicine”[1] may appear unsavory in social contexts preoccupied by the various challenges of the coronavirus epidemic. Yet, even in the midst of the crisis, humor has continued to play important social roles. It has acted as a psychological relief and a coping mechanism against the numerous obstructions on daily routines caused by the pandemic. Additionally, it has served to bond people at a time when physical social distancing is advised and practiced. But it has also functioned as a “looking glass” – allowing us to look at the socio-political world in revealing ways.[2]
Each of these functions has been apparent in the ways in which Macedonians joke about the challenges and responses provoked by this new reality on a daily basis. At the same time, the jokes that have been particularly popular have exposed the public opinion on existing social and political problems and contradictions. A witty remark circulated on social media on the 6th of March has been particularly revealing. It said: “Germany is on the 6th place in the world based on the number of patients infected by the coronavirus and yet they have no reported deaths. Well done to the Macedonian doctors”. It makes reference to the large number of medical doctors and other healthcare workers who have migrated to Germany and other Western countries in recent years. The Western European demand for skilled migrants has been matched by a corresponding supply from countries across the Balkans. According to Zhivka Deleva, an independent researcher at Berlin’s Interkulturanstalten Westend, the key reasons that push doctors and medical workers to emigrate away from their countries include: job stagnation, social insecurity, financial dependency, a system of political patronage, sub-par healthcare systems as well as discrimination towards vulnerable groups.[3]
According to statistics by the Macedonian Doctor’s Chamber, 1,200 doctors have left the country in the period between 2010 and 2018. In 2019, a total of 83 doctors have requested certificates from the Chamber for leaving the country, unlike the quarter in 2018 when there were 69 requests.[4] These figures are likely to be even higher as many leave the country without requesting the document provided by the Doctor’s Chamber. The country is also facing a severe nursing shortage, as most nurses are also looking to find their luck abroad. According to Gordana Beshliovska, President of the Union of Association of Medical Nurses, it is alarming that lately, apart from the young and inexperienced nurses, a lot of nurses with a work experience of 15–20 years are also looking to leave the country: “It is very difficult when you lose staff which is trained, such as nurses in operating rooms. All of the nurses are very important, but I am talking about nurses from critical units, where we need to provide the staff with a longer education. Basically, the ready-made staff is the one that is going away.” Beshliovska says.[5]
Even before the coronavirus outbreak, medical professionals repeatedly warned about the risks posed by the growing shortage of medical professionals remaining in the country. The Association of Specialist Doctors and the Association of Young Doctors has been particularly vocal on the issue. In July 2019, Dr Nenad Lazarov and Dr Miralem Jukikj from the two Associations said the following: “The healthcare has collapsed, there are no doctors in the hospital, and there are no stimulus measures for the young doctors.” Moreover, according to their analysis “if the current trend continues, by 2021 around 30 percent of older specialist doctors will retire. In a situation when we are already facing a deficit of around 700-800 specialists, after the retirement of the older doctors we will face a real disaster. The young doctors don’t want to work in a devastated system, they learn German and leave. It is about time for efforts to be made to change the matters,” urged Doctors Jukikj from the Association of Young Doctors and Doctor Lazarov from the Association of Specialist Doctors. They also mentioned that four of their colleagues from the public hospital in Debar, earn a monthly salary of 15,000 Macedonian denars (or 242 euros), which is just above the minimum wage in the country.[6] These figures are specifically concerning in the context of the coronavirus epidemic. Namely, the municipality of Debar has been one of hardest hit areas by the current Covid 19 epidemic. It was the first region in the country to have been declared to be under a state of emergency on the 13th of March, when 11 cases from the region were reported to be positive.[7] The second and third deaths in the country were persons from the area of Debar. As of the 25th of March, Debar remains one of the worst hit areas with 40 confirmed cases, second only to Skopje with 88 confirmed cases.[8]
With 177 cases confirmed on the 25th of March, and an exponential rise in cases (from 3 cases on the 6th of March to 177 19 days later) the spread of the coronavirus across the country is likely to further expose the structural weaknesses of the Macedonian healthcare system. On the 15th of March the public spotlight was placed on the Minister of Health, Venko Filipce who was expected to inform the public about the number of ventilators machines that are at the disposal of the Macedonian healthcare system. The medical devices, which help patients breathe, can be the difference between life and death for those facing the direst respiratory effects of the coronavirus. In the preceding days, information had spread on social media that only 8 ventilator machines are available across the country. At a Press Conference held on the 15th of March, the Minister of Health said: “There is no room for panic. The state has 120 (respiratory machines) ventilators at its disposal”. He then thanked the private hospitals for making available around 70 beds with ventilators.[9] Moreover, he added that efforts are made to mobilize all medical personnel, not only from the state health institutions, but also from the private hospitals. Nonetheless, social suspicions remained in the midst of existing public distrust in the preparedness of the healthcare system which in the past years has been described as one of the worst in Europe.[10]
Migratory Patterns and the coronavirus pandemic
In addition to shedding a new light on the deficiencies and vulnerabilities of the Macedonian healthcare system as a result of the migration of highly skilled medical workers, the coronavirus pandemic has also exposed the broader migratory patterns. Namely, according to World Bank statistics from 2017, almost half a (447,138) million Macedonians already live abroad. The “National Resolution of the Migration Policy of the Republic of Macedonia 2015‑2020” estimates that in 2010 there were approximately 553,000 citizens of Macedonia abroad, implying an emigration ratio of 26.8%. Available official statistical data from the US, Canada, Australia and New Zealand, which show an additional 105,707 citizens of Macedonia registered in these countries.[11] Most of these figures come from first or second generation immigrants with strong links to the home country. The figures of Macedonians living abroad are even higher when taking into account temporary economic emigration, in Europe but also globally.[12]
In view of this, the coronavirus has had two consequences: the spread of the virus has followed the migratory routes. The first three confirmed cases, a woman from Skopje and a couple from Debar, had all arrived from Northern Italy, where they had been visiting relatives. The second consequence has been that a great number of Macedonian nationals have found themselves stranded outside of the country. As reported by the Minister of Foreign Affairs, by the 24th of March, 5000 Macedonian citizens stranded outside of the country have asked for assistance in returning back to the country. The majority of them are likely to belong to precarious categories with an unresolved settlement status in the countries where they have found themselves (they are either a visitor, a temporary worker with visas approaching expiry, or students).[13] An additional challenge is posed by the need to organize a safe return for these groups of citizens, as many are likely to be arriving from high risk areas and pose the potential risk of wider social infections upon arrival if careful precautions are not made.
Social fears by the coronavirus are especially intensified in the context of the dire state of the Macedonian healthcare system- structurally devastated and underfunded throughout the past 30 years, suffering from large deficits of highly skilled medical staff who in the past years en masse emigrated to Germany and other western countries.[14] The characteristic Balkan humor may provide a temporary ameliorating “cheap medicine” against the pandemic. However, unless the Covid 19 pandemic serves as a wake-up call for comprehensive and serious structural reforms to be undertaken in the country, it will not only be remembered as a human but also as a political tragedy.
[1] “Always laugh when you can. It is cheap medicine.” is a quote by Lord Byron, one of the greatest English poets considered to be one of the leading figures of the Romantic movement.
[2] Giselinde Kuipers. 2008. The sociology of humor. In Victor Raskin (ed.) The Primer of Humor Research, pp. 365-402. Berlin/New York: Mouton de Gruyter.
[3] “Doctors flee hopelessness and nepotism in the Western Balkans” available at: https://www.dw.com/en/doctors-flee-hopelessness-nepotism-in-western-balkans/a-51708400
[4] “Macedonian doctors leave the country in the latest exodus” available at: https://www.minareport.com/2019/04/14/83-macedonian-doctors-leave-the-country-in-latest-exodus/
[5] “North Macedonia could soon face an alarming shortage of medical staff” available at: https://medium.com/@hasawatermark/north-macedonia-could-soon-face-an-alarming-shortage-of-medical-staff-9348a53fe4e8
[6] “From December, there will be a minimum wage of 14,500”, available at: https://www.brif.mk/od-dekemvri-minimalna-plata-od-14-500-denari-ke-vazhi-i-za-javniot-sektor/
[7] “State of emergency in Debar and Centar Zupa because of the coronavirus” available at: https://www.slobodnaevropa.mk/a/30486178.html
[8] “How the map of corona-infected cases looks like across macedonian cities” https://emagazin.mk/kako-izgleda-mapata-na-zaboleni-so-koronavirusot-vo-makedoni-a-po-gradovi/
[9] “Filipce- There is no room for panic” available at: https://puls24.mk/%D0%BA%D0%BE%D0%BD%D1%84%D0%B5%D1%80%D0%B5%D0%BD%D1%86%D0%B8%D1%98%D0%B0-%D0%B7%D0%B0-%D0%BF%D0%B5%D1%87%D0%B0%D1%82-%D0%BD%D0%B0-%D1%84%D0%B8%D0%BB%D0%B8%D0%BF%D1%87%D0%B5-15-3-2020-%D0%BD%D0%B5/
[10] “Research results: Macedonia has the worst healthcare system in Europe” available at:
https://meta.mk/en/istrazhuvane-makedonija-ima-najlosh-zdravstven-sistem-vo-evropa/
[11] “Macedonian emigrants estimated at more than 30% of population” available at:
[12] The German government is currently preparing a large-scale plan to recruit non-EU workers and speed up visa procedures, making it likely that the migration wave will continue.
[13] “Half of the citizens they have requested a return agreed to go into quarantine” https://telma.com.mk/dimitrov-polovina-od-graganite-koi-pobarale-vrakane-doma-od-stranstvo-se-soglasile-da-odat-vo-karantin/
[14] Some changes have been introduced in order to reverse the effects of the loss of high quality staff and the decay of medical facilities, but such improvements are currently not or little visible. Most of the general hospitals throughout the country were built in the 1970s, but some opened almost a century ago. Some of the hospitals have not been updated at all, or have received partial renovations, some of which were funded by foreign aid. “Cardboard for Curtains: Life in Macedonia’s Hospitals”, available at: https://en.scoop.mk/cardboard-for-curtains-life-in-macedonias-hospitals/