[an update from our Covid Response Group]

Background

Lockdown affected the poor in India and the Philippines terribly as our poor neighbours weren’t able to work and earn. Many became reliant on government food handouts.  In April and May our teams, in the slums in which they live, helped fill the gaps to cover people who somehow missed out on the government assistance. So far our workers have made an incredible effort of distributing about $55,000 worth of food.

Over recent weeks the lockdowns have eased. This has meant neighbours have been able to get back to work. Thus the need for economic and food relief has also eased.

Unfortunately, the infection rates are still growing in each country with about 15,000 new cases each day in India, 1,000 in Indonesia, and 500 in the Philippines.

For the first couple of months there were no recorded cases of Covid in the slums where our workers live. Manila had the first, then 3 weeks ago the first case was detected in our Indian slum. So far, thankfully, there is still no recorded case in our slum in Jakarta. However, it only seems a matter of time.

Now that it has ‘arrived’ in Manila and the Indian slum and, with residents not socially distancing or wearing masks, the virus is likely to spread rapidly. Evidence from Mumbai suggests that it may spread quickly and cause many deaths within slums due to lack of ability to physically distance, lowered immunity and pre-existing conditions. Given this dire situation, how are we to respond in a way that helps contain the spread and/or lower the mortality rate?

Possible Responses

There are several ideas:

  1. Distribute materials, like masks, soap and sanitizer, to families in ‘our’ slums. Many people are struggling a lot financially and, understandably, may not be able to prioritise buying these important items. One question is whether we should just target such distribution to high risk people (elderly, existing medical conditions) or give to everyone in a household.
  2. Conduct training on recognising typical symptoms of Covid-19, and on prevention measures. Training would probably be labour intensive, as we may need to go household to household.
  3. Facilitate testing. Visit house to house and encourage people to go for testing if they are displaying Covid symptoms. Many people are a bit afraid of going for testing, partially due to fear of the medical system and of being isolated if they are found to have Covid.
  4. Shielding at-risk people. High risk people (elderly, existing conditions) are likely to get infected even if they stay at home, as younger people go out to work and may bring the virus home with them. One possibility is, when travel is possible again, (it still isn’t allowed in most places) encouraging older people to go back to their ‘village’ from where their family migrated years ago and where there are other relatives still, as infection rates may be lower there. Another idea is to rent rooms to set up ‘green zones’ for high-risk people to live in, with rules to minimise visitors, ensure handwashing etc.

Involving the Community

We are well aware that any interventions, without significant ‘buy-in’ from the community will be ineffective. Furthermore, some of the above interventions (eg 1, 2, 3) could easily be done by local volunteers. A suggestion is to discuss these options with local leaders, hear their hopes/fears, and try to get their buy-in.

A key limitation is people’s attitudes towards Covid-19. Unfortunately quite a few people are downplaying the risks “It won’t affect me”, or alternatively being fatalistic “What will be will be”. People’s attitudes may be difficult to change until they see people dying of Covid – by which time it may be too late.

A key dilemma is that all of these interventions involve a lot of being out talking to people! Our workers are already experiencing this trade-off between ‘service’ and ‘safety’ on a daily basis and likely will continue to do so until they actually get Covid (at which point they will achieve some degree of immunity).

If you have any thoughts on these options feel free to tell us!

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