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Stop Pandemic Special Care Is Needed In Slums

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Md. Abdullah Al Zobair, Saif Iqbal & Masud Ahmad :
Urban poor are on the double-edge sword as they live in dense areas where maintaining social or physical distance and frequent hand washing are big challenges, while their income generation halted due to the government imposed unofficial lockdown. Since the "general leave" daily wagers have been suffering an acute food crisis and living on starvation or half-fed.  After the announcement of general leave home-bound rush from Dhaka and other big cities clogged the highways and vacated the cities that may convey the contagion to the rural areas, where healthcare facilities are too poor. The poor who have no fixed term job, like rickshaw pullers, drivers, street vendors, beggar, hawkers, small shop owners, domestic workers etc. are feeling the pinch of the shutdown. Besides the government, NGOs, social and community organisations, and many individuals have come forward with assistance and aid, but how long can the poor endure?
World Health Organisation (WHO) has asked to hand wash frequently, clean the surrounding, wash clothes every day, maintain a physical distance but when access to safe water, proper sanitation facilities, and essential living space remains big challenges for the poor people living in urban informal settlements, how the state contain the spread of contagion in slums? Furthermore, when health facilities in most of the 14000 slums across the cities and towns with 7 million people are solely ignored, how we fight against the pandemic, which defeats the developed health care systems in Europe and America. The exclusion of any segment of the population from essential healthcare and water, sanitation and hygiene services not only puts that individual at risk but creates an unnecessary and unacceptable risk to the entire population by allowing the highly communicable diseases to spread more easily. To maximise access to health services for the urban poor, it will be important to map and coordinate COVID-19 mitigation measures with government, public-private, non-profit and for-profit health, and water and sanitation providers. This will be critical to avoid gaps in service delivery, particularly in densely populated slums where the outbreak could sweep through and place a heavy burden on existing infrastructure.
Slum-dwellers who are casual labourers or self-employed may prefer quick and easy healthcare that doesn't interfere with their ability to earn their daily income. In these instances, governments could consider investing in mobile clinics to deliver health services where they are most needed. They could also erect semi-permanent structures for COVID-19 outreach, although these may still end up being in short supply in overcrowded slums. Luckily, the novel coronavirus has not yet reached epidemic proportions in the slums. Taking these pre-emptive actions now could help protect millions of people who are already grappling with complex, layered socio-economic challenges.
Recently, the government has announced some initiatives taking the plight of these people in consideration, including measures to reach food to them and to encourage them to stay indoors. The Ministry of Disaster Management and Relief has a stock of about 24,717 metric tonnes of rice and Tk 7.58 crore under its Humanitarian Assistance Programme to deal with the crisis. On March 24, the government allocated 6,500 metric tonnes of rice and Tk 5.5 crore to the deputy commissioners of the 64 districts so that the DCs can help those in need. The DCs are preparing packets of relief materials -- each containing 10kg rice, 5kg potato, one kg lentil, one kg salt, one-litre soybean oil, and a piece of soap -- for the distribution. The relief materials have been provided to the homes of the beneficiaries to push them to stay at home. Like many other NGOs and social organisations, BRAC has extended relief activities across the slums and low-income communities across the country with hand washing, hand sanitising, public place disinfecting and awareness building initiatives.
Several support measures have been announced for the marginalised people, which include the operation of Vulnerable Group Development and Vulnerable Group Feeding programmes, operation of open market sales services, selling rice at a subsidised price of Tk 10 and food support for six months under the social safety net programmes at the district levels. Despite all these initiatives, the outreach to the target people would be less than the requirement. It is apprehended that a section of the marginalised people would be out of these benefits, who may fall below the poverty line. The informal sector employees constitute 87% of the total employee of the country that needs social safety coverage. The government should extend the coverage by including lower-middle-income people as laid off or economic shutdowns will push them under the poverty line if the shutdown lasts more days.  The revised budget for fiscal 2019-20 may consider further allocation under social safety net programmes to extend the above-mentioned programmes across the country.
It is well-understood that Bangladesh needs to get prepared not only to address the immediate necessities of the marginalised group but to get prepared for the short, medium and long-term adversities that are invariably on the way. In this backdrop, the announced programme of the government is just the start in addressing the immediate and some short-term necessities. The government should extend the social safety net schemes incorporating the people, who are now jobless or have seen their income dwindle. Many of the low-paid and low-income groups have no jobs now. Moreover, they are not under any social safety-net programmes of the government.
With no delay, the government must deploy mobile clinics to all low-income settlements, ensuring poor people's access to healthcare systems to contain the deadly virus. Access to safe water, sanitation and hygiene facilities must be addressed quickly before the pandemic outbreak in the slums. Besides, the government should identify those people with the help of local government agencies and NGOs and provide some cash or income support in the next six months or until normalcy is restored.
(Md. Abdullah Al Zobair, Manager, Knowledge Management, Innovation & Communication; Saif Iqbal, Programme Manager; and Masud Ahmad, Senior Programme Manager; at Urban Development Programme, BRAC; email: abdullah.zobair@brac.net)

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