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COVID-19 Relief Provided to More Than 300 Fellows, but More Help Needed

September 10, 2020

To counter the negative impact of COVID-19, the Sylff Association secretariat is providing emergency financial support called “COVID-19 Relief for Sylff Fellows” to ensure that fellows are able to continue their studies toward their degrees at their home Sylff institutions.

So far, we have mobilized internal resources to provide relief to more than 300 fellows to cover their living expenses for about three months. However, we require more financial resources to complete this relief effort. Under the circumstances, we are asking the members of the Sylff community for donations.

The secretariat hopes that former Sylff fellowship recipients and others affiliated with Sylff institutions will take this opportunity to show their generosity and support for current fellows.

Some comments received from relief recipients:

Your letter comes as a bright light in the darkness. […] I am right now moved to tears. Thank you for caring so much about us, the Sylff Fellows, and for giving us hope!

 “This funding will help me in my daily life […] With this help, I can cover my daily expenses and to continue my studies in the best possible conditions during this difficult time.”

 “The […] letter from Mr. Sasakawa, Association's Chairman, and Ms. Kadono, the President of the Tokyo Foundation for Policy Research has left me speechless and in deepest appreciation of your association's generous contribution to the continuation of my future research.”

I wish to express my deepest gratitude for the consideration to offer me financial assistance during this rather difficult period. I really have no words to just say how grateful I am - THANK YOU SO MUCH!!

This money will be of great help to me and my family, this period has been very difficult because [of] the pandemic […] and we were trapped there for three more months.”

 “[Y]ou have lightened my financial burden even in a pandemic which allows me to focus more on the most important aspect of school, learning.

We wish to thank all those who already contributed to our fundraising initiative.

[How-to-Give] Our online donation now accepts credit cards - VISA, MasterCard, JCB, American Express and Diners. Please give today! (Donation campaign closed on November 13, 2020.)

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What COVID-19 Can Teach Us about Prison: Reflections on Criminal Policy and the Words of Albert Camus

August 31, 2020
By 24051

Rui Caria, a PhD candidate in criminal law at the University of Coimbra, summarizes the ongoing discussions about the confinement of prisoners under the COVID-19 pandemic. He discusses the human dignity of prisoners and the purpose of prisons and punishment by drawing on ideas that Nobel Prize winner Albert Camus describes in his famous novel The Plague.

* * *

Introduction

During my second semester, like many others, I had my life put on hold by COVID-19. I was sent to work from home, and class lectures were provided by Zoom, allowing me to keep studying by looking through the tiny box that is my computer screen. As much as one tries to halt the fall of productivity, it eventually gives way to reflection; one that is personal as much as social. By looking at the other tiny box that is my TV, I could watch the news and learn about all the people who found themselves confined.

During quarantine, I found it fitting to reread a novel by one of my favorite authors: The Plague, by Albert Camus. It made me realize that the most fortunate of us were confined at home; others, not so fortunate, were confined in the places where they had made their travels. But there was a third category of confined, one that is seldom talked about: prisoners.

 

To Release or Not to Release?

Across the world, there was a great discussion about what to do with prisoners during the pandemic, the question being whether they should be released or not in order to minimize the risk of a health catastrophe in prisons. The importance of the issue was highlighted by various entities, from the World Health Organization (WHO) to the Council of Europe. The debate had to grapple not only with the big question itself—to release or not to release—but also, if the question is to be answered affirmatively, on what grounds they should be released.

In my country, Portugal, legislators approved an extraordinary regime of prison flexibilization in the midst of the COVID-19 pandemic. This new law (no. 9/2020) allowed for a partial pardon of prison sentences, a special regime of reprieve of sentences, an extraordinary regime of licenses for administrative leave of inmates, and extraordinary anticipated parole.

The Portuguese Parliament (Assembleia da República).

On the other side of the world, in the United States, which has the world’s largest number of infected combined with the world’s largest prison population, policy solutions have been suggested to reduce the number of people in jails, as well as in state and federal prisons. These focus not only on increasing the number of releases but also on restricting the number of admissions.

Regarding increasing releases from federal and state prisons, some suggest considering the following for immediate release: inmates nearing the end of their sentence (who are expected be released in the next few months); those in minimum security facilities and who are on work release; those who are medically fragile or are older; and those whose offense is considered “minor” or have a “low likelihood” of committing another serious offense.[1]

Many prisoners have sought compassionate release—the release of people who are facing imminent death and who pose no threat to the public. But this has proven a lengthy and cumbersome process, some of the shortcomings being the requirement that a person be extremely close to death or so incapacitated that they do not understand why they are being punished; the requirement of a statement from a medical professional; and the ability of decision-makers to overrule recommendations from medical professionals and prison staff.[2]

Some have pointed their finger at the new policies to release prisoners, calling them opportunistic political moves to try to solve the problem of prison overcrowding that preceded the pandemic. But this was only one of the many outcries from the public regarding the release of prisoners.

 

Why Release?

The WHO has pointed out that due to the concentration of people that is inevitable in prisons, inmates find themselves in a state of special vulnerability regarding COVID-19.[3]

However, the virus is not the only problem, or it would be a smaller problem if it were not for the poor health of inmates. The WHO has also noted that inmates, regardless of the pandemic, already tend to suffer from graver health issues than the general population. These health issues stem from weakened immune systems, caused by lack of sunlight, stress, malnutrition, and such diseases as tuberculosis, from which inmates particularly suffer.

One of many overcrowded prisons in the world.

Adding to the health problems that exist—and have existed for a long time—in prisons, the environment itself makes social distancing impossible. Compared to cruise ships and nursing homes, two other types of environments considered prominent incubators for the virus, prisons possess comparable or smaller quarters and people do not have in-room access to the necessary hygiene products and water.[4] 

This situation is made worse by the fact that many prisons suffer from overcrowding and poor overall conditions and that prisoners are put in collective cells that are too small. Many of these situations have already reached the European Court of Human Rights and suffered their condemnation.[5]

 

Why Punish and When Do We Stop?

The discussion also made the public ask itself, even if subconsciously: Why do we punish? What are the limits of punishment? When is punishment over?

In Portugal, when the state intervenes by utilizing criminal law—that is, when it criminalizes any behavior and punishes it—it must do so in obedience to the constitutional principle of necessity. This means that criminal law comes forward not arbitrarily but only to protect lawful values inscribed in the constitution or derived from it. These are values that correspond to the necessary conditions for the individual’s free development, to the realization of his fundamental rights, and to the sound functioning of a society built around these goals.[6]

This means that criminal sanctions serve the purposes of protecting lawful values and aiming to socially rehabilitate the offender. Both these purposes are considered when determining the length of the prison sentence.

Prison of Coimbra in Portugal.

Despite being inscribed in the criminal code as one of the purposes of the prison sentence, social rehabilitation often seems not to be a priority, its failure being one of the weapons utilized to argue the failure of criminal law. One needs only to look at the lack of conditions from which prisons suffer to observe, as many criminologists have already noted,[7] that in many cases it dissocializes more than it socializes.

This fact, combined with the perception that the public has of prison, helps cement the popular idea that people should not leave prison before the time prescribed in their sentence, that they should be punished until the end, for there is no chance they will be rehabilitated before that. With these ideas in mind, it easily arises in the public discourse that someone who has committed a crime is a criminal forever and so should be forever punished, without the opportunity for rehabilitation, for there is no chance of it happening.

 

The Prison and Plague

In his famous book The Plague, first published in 1947, the Algerian-born French philosopher and Nobel Prize winning writer Albert Camus tells the story of the fictional town of Oran, which is stricken by the plague.

In his story, the people of Oran are confined to their town and homes because of this plague. At one point, Camus reflects on how their condition is equal to that of exiles and prisoners: “Thus, too, they came to know the incorrigible sorrow of all prisoners and exiles, which is to live in company with a memory that serves no purpose. . . . Hostile to the past, impatient of the present, and cheated of the future, we were much like those whom men’s justice, or hatred, forces to live behind prison bars.”[8]

Albert Camus

There could not be a better description of what many of us went through in the past months of the year 2020 due to the pandemic. However, even if we felt like this, with different words but with the same feeling, parted from family, friends, and lovers, did it serve to make us reflect? Did it make us more compassionate and understanding of our fellow man?

The discussion surrounding the release of prisoners during the pandemic is, in my understanding, of special importance. It had the capacity to bring the topic of prison and inmates back into the public eye—even if briefly and amid the greater concerns of the pandemic, in which we are still living. In this way, it allowed for the public to be made aware, once more, of the special vulnerability of inmates that derives from their poor health and the poor prison conditions in which we keep them, even in the twenty-first century.

However, despite being made aware of the problems faced by inmates, and sharing the feeling of confinement, the public response to releases during the pandemic was still stained, for the most part, with intolerance. Besides the already mentioned accusations of releases being a “quick fix” for the prison overcrowding problem, less elaborated arguments could be summed up in the following statement: “Prisoners should stay in prison.” It was even possible to hear some people saying that not only should prisoners not be released earlier, or on time, but they should stay in prison forever.

This sort of speech was not novel or exclusive to the pandemic. That specific discussion was only a symptom of a greater problem: the way society still conceptualizes punishment. I had the opportunity to witness this firsthand. In the summer between the two years of my master’s degree in criminal law, I worked as a tour guide in an exhibition dedicated to celebrating 150 years since the abolition of the death penalty in Portugal. It was not uncommon to hear people say that it was a mistake to abolish it and that it should be brought back.

Of course, this is the extreme end of that sort of speech, but it is common for people to think about prison as nothing more than punishment, as if the more suffering is inflicted, the more justice will be done. In today’s criminal doctrine, at least in the European continental tradition, the conceptualization of prison as pure retribution is largely obsolete. Prison is not supposed to aim at the past, punishing the offender as an incarnation of divine retribution, but should be aimed at the future, in helping him live his life responsibly without committing crimes by socially rehabilitating him.

Offenders, despite having committed crimes, are meant to be treated as human beings, being recognized for their dignity as well as granted a chance for recovery and redemption. How would we have felt if someone had told us that never again should we leave our homes? Should we never see our loved ones again? Should we never hope for the future?

As much as we need a change in public and criminal policy, we need a change in the public conscience about the purpose of prisons and the value of human dignity. We certainly had, and still have, the opportunity to let the virus teach us something about prison and about humanity.

 

[1] Peter Wagner and Emily Widra, “Five Ways the Criminal Justice System Could Slow the Pandemic,” Prison Policy Initiative (website), March 27, 2020, https://www.prisonpolicy.org/blog/2020/03/27/slowpandemic/.

[2] Emily Widra and Wanda Bertram, “Compassionate Release Was Never Designed to Release Large Numbers of People,” Prison Policy Initiative (website), May 29, 2020, https://www.prisonpolicy.org/blog/2020/05/29/compassionate-release/.

[3] WHO Regional Office for Europe, “Preparedness, Prevention and Control of COVID-19 in Prisons and Other Places of Detention: Interim Guidance,” March 15, 2020, 1.

[4] Aleks Kajstura and Jenny London, “Since You Asked: Is Social Distancing Possible behind Bars?” Prison Policy Initiative (website), April 3, 2020, https://www.prisonpolicy.org/blog/2020/04/03/density/.

[5] Recent cases include J.M.B. Et Autres c. France [J.M.B. and Others v. France], 9671/15, May 30, 2020, https://hudoc.echr.coe.int/eng#{%22itemid%22:[%22001-200446%22]}, and Sukachov v. Ukraine, 14057/17, May 30, 2020, https://hudoc.echr.coe.int/eng#{%22itemid%22:[%22001-200448%22]}.

[6] Claus Roxin, “O Conceito de Bem Jurídico Como Padrão Crítico da Norma Penal Posto à Prova,” Revista Portuguesa de Ciência Criminal 23, no. 1 (January–March 2013): 12.

[7] One of the fundamental works in this regard is: Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (London: Penguin Books, 1991).

[8] Albert Camus, The Plague (Harmondsworth: Penguin Books, 1960), 69.

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SLI Awards for Projects to Increase Mindfulness among Educators in South Africa and Promote Mother and Child Health in Puerto Rico

August 5, 2020

Two Sylff fellows have been selected for a Sylff Leadership Initiatives (SLI) award. SLI supports Sylff fellows’ initiatives to change society for the better with awards of up to US$10,000. (Their applications were received last fiscal year and reviewed before the suspension of new applications for SLI.)

The two winners are Liza Hamman and Holly Horan.

Liza Hamman

Liza Hamman completed her PhD at the University of the Western Cape as a Sylff fellow and is currently working as a department head at a vocational education college in South Africa.

With this grant, she will address the social and emotional challenges faced by both educators and students in South Africa by developing an online, mindfulness training course. “It is my hope that this award will benefit many South African teachers,” said Hamman.

 

Holly Horan

Holly Horan, a Sylff fellow in 2015–16 at Oregon State University who was also awarded an SRA grant in 2016, is a clinical biocultural medical anthropologist at the University of Alabama in the United States.

With the SLI grant, as an academic and a birth and postpartum doula, she will promote a model of integrated maternity care in Puerto Rico by organizing an international conference for multiple stakeholders. Over the long term, she aims to launch a political and economic movement for health systems reform.

The Sylff Association secretariat is excited to provide support to fellows who are taking social action by applying their ideas and expertise to build a better world for all.

Congratulations to the two Sylff fellows on winning the award. Barring disruptions due to the COVID-19 pandemic, the projects will be carried out over a year in their respective countries.

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Applications Closed but Fundraising Continues for COVID-19 Relief for Sylff Fellows

August 3, 2020

The Sylff Association secretariat would like to inform you that no new applications for COVID-19 Relief for Sylff Fellows will be accepted after August 2, 2020. Our budget for the relief is running short as there are continuing demands for support even after we disbursed our relief funds in mid-July. The applications that we received before the above date are now being reviewed and may be supported contingent on our fundraising results.

On this occasion, the secretariat would like to ask the Sylff community to pitch in to increase our funding resources to support more fellows who are struggling to continue their studies and research towards their degrees. Please click How to Give for your donation. (Donation campaign closed on November 13, 2020.)

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Online Fundraising Launched to Enable Sylff Fellows to Continue Their Studies

July 29, 2020

The Sylff Association secretariat has launched an online fundraising system to accept donations via credit card in order to help finance COVID-19 Relief for Sylff Fellows. As already announced, donations may also be made via bank transfers. (Donation campaign closed on November 13, 2020.)

This relief is intended to help defray Sylff fellows’ living expenses and encourage them to continue their studies and research at their home Sylff institutions despite the current difficulties due to COVID-19. (For details, please refer to the relief initiative page, https://www.sylff.org/covid-19-relief-for-sylff-fellows.)

The secretariat hopes that the online fundraising system will facilitate the process of donation.

 

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Action to Address a Stakeholder-Identified Need: Development of a Questionnaire to Improve Resolution after Medical Injury

July 27, 2020
By 25572

Associate Professor Jennifer Moore, a former Sylff fellow at Massey University in New Zealand, implemented a research project to assess the needs of injured patients and their families after medical injury with funding from Sylff Leadership Initiatives (SLI) from January 2019 to April 2020. The survey tool she developed and refined throughout the project is expected to facilitate better and happier reconciliation processes between healthcare organizations and injured patients and families after medical injury.

* * * 

“I wish there had been a questionnaire like this that was given to me after the hospital injured me! I recently had a hip replacement, and the provider posted a survey to me. It was so bad that I didn’t complete it. I thought, ‘Do these people have common sense? What does this mean?’ I wonder if they didn’t do what you are doing and [trial] the survey with the actual patients. I think it is so important to actually trial test it on patients first.” (Injured patient from New Zealand, comments during a cognitive interview, January 2019. The word in brackets in the quotation was edited by the author).

 

Introduction

This project was the first to attempt to develop a questionnaire to assess injured patients’ and families’ needs after medical injury. We pretested a draft version of the questionnaire with injured patients and families in New Zealand and the United States. In the quotation above, the injured patient highlights the importance of pretesting questionnaires to increase the likelihood that it will be an effective tool.   

Medical injury is unexpected harm caused by medical care. After heart disease and cancer, medical injuries have been identified as the third leading cause of death in the United States; this conclusion is consistent with findings from research undertaken in other countries, such as Canada, Japan, and New Zealand, and these statistics have generated calls for “greater attention” to medical injury because of the scale of this global issue.[1] An additional well-documented issue is that healthcare institutions’ responses to medical injuries, particularly their attempts at resolution, frequently fail to meet patients’ expectations and needs.[2] The literature also highlights that poor responses from healthcare organizations exacerbate the psychological, physical, and financial effects of medical injuries.[3]

During my recent research about the resolution of medical injury, the key stakeholders and participants identified another important social problem that requires action. Most healthcare organizations are interested in doing a better job of meeting injured patients’ and families’ emotional, informational, and practical needs after medical injury but currently lack tools to evaluate how well they met those goals.

Jennifer with her daughter Rebecca and two research participants

Research Objective, Methods, and Dissemination

Therefore, this project’s key objective was to address that gap, and stakeholder-identified need, by developing a questionnaire that healthcare organizations can use to assess how well they met the needs of patients who suffered medical injuries during their care. To develop the questionnaire, we undertook the following steps.

  • We designed a draft version of what we call the Medical Injury Reconciliation Experiences Survey (MIRES). This draft was based on findings from our two previous studies of injured patients’ experiences of nonlitigation approaches to resolving medical injuries.
  • We performed a content analysis of transcripts from a stratified random sample of interviews conducted with injured patients in New Zealand and the United States in 2015–16.
  • We extracted themes describing what is important to patients following medical injury and developed a draft questionnaire with question domains and items corresponding to these themes.
  • We revised the draft questionnaire following review and feedback from expert clinicians, risk managers, and patient advocates.
  • We pilot tested the revised questionnaire on a sample of 24 injured patients and family members in the United States and New Zealand, conducting cognitive debriefing interviews focused on the comprehensibility and completeness of the questionnaire.
  • We further revised the instrument based on this feedback. Thirty-seven revisions were made in response to their suggestions.
  • We traveled to New Zealand to disseminate and implement the questionnaire to key stakeholders in New Zealand, such as district health boards' public hospitals, the Ministry of Health, the Accident Compensation Corporation, and the patient advocacy group Acclaim. I traveled around New Zealand (particularly Christchurch, Dunedin, and Wellington) to meet with representatives from the key stakeholder organizations to explain the questionnaire to them and to discuss how best to implement it in their organization.
  • We are in regular, ongoing contact with the representatives of the key stakeholder organizations in New Zealand to answer their questions about the questionnaire and to ask about their initial experiences using it.
  • We submitted a paper to an academic journal that reports the results of the survey development.
  • After the COVID-19 travel bans are lifted, we will travel to New Zealand again at the stakeholders’ request to discuss implementation progress and to undertake any further edits to the questionnaire that may be required.
  • Once the COVID-19 travel bans are lifted, I will also travel to the United States again to discuss implementation progress at the participating hospitals. The intention was to visit the United States in May 2019, but that trip was canceled because of COVID-19. (Sylff funded the New Zealand part of the project, not the US part. We are very grateful to Sylff for their support.)

Once our research paper is accepted, it will be important to disseminate the paper, because our project is the first to attempt to develop a questionnaire to assess injured patients’ needs after medical injury. Further research could use our questionnaire to undertake a full validation study.

The final version of the questionnaire included the following domains:

  • perceptions of communications with healthcare providers after the injury (11 items);
  • perceptions of remedial gestures, such as apology and compensation (12 items);
  • indicia of the patient’s overall satisfaction with the reconciliation process (3 items);
  • the nature and impacts of the injury (5 items); and
  • characteristics of the patient (5 items).

 

Conclusion

Jennifer with a patient's research participant's puppy during the cognitive debriefing interview about the draft questionnaire.

Injured patients and their families expressed the view that they appreciated the opportunity to assist with the survey design process. The survey was feasible to administer with pencil and paper, taking around 10 minutes to complete. The MIRES appears to be comprehensible and acceptable to patients and offers a practicable means by which healthcare organizations can assess how well their reconciliation processes are meeting injured patients’ needs. One of the US patients who participated in this project observed that the “questionnaire has the power to help so many other patients like me.”    

[1] Martin Makary and Michael Daniel, “Medical Error—The Third Leading Cause of Death in the US,” British Medical Journal 353 (May 2016): 2139, https://doi.org/10.1136/bmj.i2139.

[2] Frederick S. Southwick et al., “A Patient-Initiated Voluntary Online Survey of Adverse Medical Events: The Perspective of 696 Injured Patients and Families,” BMJ Quality and Safety 24, no. 10 (October 2015): 620–29.

[3] Elaine O’Connor et al., “Disclosure of Patient Safety Incidents: A Comprehensive Review,” International Journal of Quality in Health Care 22, no. 5 (October 2010): 371–79.

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Support Programs and COVID-19 (Updated July 22, 2020)

July 22, 2020

The Sylff Association secretariat regrets to inform you that no new applications for support programs (including Sylff Research Abroad, Sylff Leadership Initiatives, Sylff Project Grant, and Local Association Networking Support) has been accepted since July 22, 2020. This is in light of the difficulty of conducting activities entailing long-distance and overseas travel as well as convening gatherings of large groups of people under the current COVID-19 situation. We will continue to monitor the situation with the COVID-19 outbreak, and update you if there are any changes in support programs.

For current support program participants, there is no change in the operation as announced on April 6, 2020. If the current situation prevents you from completing your activities as proposed, either partially or entirely, please contact sylff[at]tkfd.or.jp (replace [at] with @) to share details and discuss ways to deal with the situation.

During this period, the secretariat will reshape the support programs in such ways as to promote fellow’s academic advancement and leadership development so they may better fulfill Sylff’s mission in spite of changing social conditions.

The secretariat also welcomes new ideas on programs from Sylff Association members that may be implemented not just during a pandemic but also as we return to a reality that is likely to have been vastly transformed by the events of this year. Please share them with the secretariat by the end of September 2020 so we can take them into account during our review.

We continue to be committed to supporting Sylff fellows. We regret having to suspend and reshape the support programs but hope to come up with innovative ways to move forward in the face of these unprecedented challenges.

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Fundraising Launched to Enable Sylff Fellows to Continue Their Studies

July 21, 2020

The Sylff Association secretariat has launched a fundraising campaign-How to Give- to help finance COVID-19 Relief for Sylff Fellows. As already announced, this relief is intended to enable currently enrolled Sylff fellows to continue their studies and research toward their degrees without worrying about their finances due to COVID-19. For details, please refer to the relief initiative page.

We are seeking donations to help defray Sylff fellows’ living expenses and encourage them to continue their studies and research at their home Sylff institutions despite the current difficulties.

Donations may be made via bank transfers or through an online system using credit cards. Bank transfers can be made as of today. The online system will be launched and announced shortly. For details, please visit How to Give.

The secretariat hopes that members of the Sylff community, not only Sylff fellowship recipients but also others affiliated with Sylff institutions, will take this opportunity to show their support for current fellows and increase their engagement with our community.

Fellows eligible to receive support have been identified in collaboration with the Sylff steering committees of all 69 Sylff institutions.

(Campaign closed on November 13, 2020.)

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Start of COVID-19 Relief for Sylff Fellows

July 17, 2020

The Sylff Association secretariat is pleased to announce that disbursement of relief funds to Sylff fellows has begun.

More than 300 fellows were identified as eligible for COVID-19 relief* by the steering committees of Sylff institutions. They will be contacted by the secretariat regarding the details of the relief, equivalent to three months living expenses.

This initiative is intended to enable currently enrolled Sylff fellows to continue their studies and research toward their degrees without worrying about their finances due to COVID-19.

In a related matter, we will soon make an announcement on ways that members of the Sylff community can join and support this initiative by making donations.

 

* Fellows eligible for COVID-19 relief are those who are currently enrolled in a master's or doctoral program at their home Sylff institutions and who will still be enrolled in the degree program at that institution in September 2020. If you meet this eligibility criteria but have not been contacted, please inquire about your status with the Sylff steering committee of your institution. Also please read the FAQs at https://www.sylff.org/covid-19-relief-for-sylff-fellows/.