Monthly Archives: March 2020

Social distancing is a privilege of the middle class

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Social distancing is a privilege of the middle class. For India’s slum dwellers, it will be impossible.

For two days, Jeetender Mahender, a 36-year-old Dalit sanitation worker, has dared not leave his family’s shanty in the Valmiki slum of northern Mumbai, India, except to go to the toilet. Mahender is trying to comply with Prime Minister Narendra Modi’s 21-day nationwide lockdown, His situation is desperate. The tiny home has no running water or toilet, his family is low on food — and when he doesn’t go to work, he doesn’t get paid. 

Social distancing might work for India’s middle and upper classes, who can hunker down in their condos and houses, preen their terrace gardens, eat from their well-stocked pantries and even work from home, using modern technology. But for the 74 million people — one sixth of the population — who live cheek by jowl in the country’s slums, social distancing is going to be physically and economically impossible.

“The lanes are so narrow that when we cross each other, we cannot do it without our shoulders rubbing against the other person,” said Mahender. “We all go outdoors to a common toilet and there are 20 families that live just near my small house. We practically all live together. If one of us falls sick, we all will.”

In Dharavi slum in Mumbai, there is only one toilet per 1,440 residents, according to a recent CFS study — and 78% of community toilets in Mumbai’s slums lack a water supply, according to 2019 Greater Mumbai Municipal Corporation survey.

Water is one of the biggest reasons India’s poor need to leave home every day. Sia, a slum dweller and migrant construction worker in Gurugram, near New Delhi, wakes up at 5 a.m. and defies the call to stay indoors. The reason? She needs to walk 100 meters (328 feet) to a water tank that serves her slum of 70 migrant construction workers. Most women from the construction site slum wash together there every morning and collect water for the day. With no showers or bathrooms in their homes, this communal tap is their only water source.


Locked down Indian migrants who want to go home

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As Coronavirus panic grows among India’s most vulnerable, thousands of migrant workers tried to flee the slums for their rural homes, by bus and even by foot, sparking fears they will import the virus to the countryside. 

Over the weekend, tens of thousands of India’s 45 million economic migrant workers began long, arduous journeys back to their rural villages. With India’s rail network temporarily shut, many had no choice but to try walking hundreds of miles home.

There was little reason to stay. Most had lost their jobs in the cities due to the lockdown, and the slums have the potential to feed the spread of the virus.

As the slum exodus began, on Saturday the state governments of Uttar Pradesh, Bihar and Haryana arranged for hundreds of buses to ferry migrants home, causing chaotic scenes as thousands descended upon stations trying to claw their way onto buses.

On Sunday, however, Indian Prime Minister Modi urged all states to seal their borders to stop the virus being imported into rural areas. Officials are now scrambling to find millions of migrant workers who had already returned to small towns and villages across the country, in order to quarantine them for 14 days. 

Researchers from the Center For Sustainability said last week that while the reproductive ratio for Covid-19 globally is between two and three, in India’s slums it could be 20% higher due to the dense living conditions. 


The dilemma of migrant workers during the coronavirus lockdown

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Daily wage migrant workers generally live hand-to-mouth, earning between 138-449 Indian rupees ($1.84-$5.97) per day, according to the International Labour Organization. 

Such workers are faced with an agonizing dilemma: go out to work and risk infection, or stay home and face extreme hunger.

Some workers have no choice. Cleaners, for example, are considered to provide an essential service, and are therefore exempted from the lockdown. “Some even collect hospital waste and then come back and live in these crowded chawls (slums),” said Milind Ranade, the founder of Kachra Vahatuk Shramik Sangh, a Mumbai-based organization focused on labor issues.

They are not given any protective gear, such as masks or gloves, said Ranade, and there has not been an awareness campaign to educate them of the dangers of coronavirus transmission. “What will happen when they fall sick?” Ranade asks.

Mahender is a cleaner for a residential community in Mumbai, earning 5,000 rupees ($66) a month, which he uses to support his wife, three children and his 78-year-old father. “The residents of the building where I clean have been calling me back to work,” he said. “But I have to go into the building, outside each person’s house and collect their trash. I have not been given a mask or gloves, not even a soap to wash my hands before my meals. But I know if I don’t go today, they will hire someone else?” 

As of today, India had conducted 34,931 tests, according to the Indian Council of Medical Research — or 19 tests per million people.


The capacity for innovation in Africa and the Indian Subcontinent

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South Africa put its 57 million citizens into lockdown starting Thursday evening as cases there grew to 709 — the highest of any nation on that continent. South Africa’s President Cyril Ramaphosa deployed police and the military to enforce the measure.

The West African nation of Senegal — which was among the countries hit by the 2014 Ebola virus outbreak — also declared a state of emergency earlier this week and imposed a curfew after more than 80 cases of the coronavirus were confirmed.

“The rapid evolution of COVID-19 in Africa is deeply worrisome,” Dr. Matshidiso Moeti, the World Health Organization‘s regional director for Africa, said. “We can still change the course of this pandemic,” she added, but said that “governments must draw on all their resources and capabilities and strengthen their response.”

“The need of the hour as countries like India … and now parts of Africa enter a lockdown phase is to consider these kinds of scenarios and maybe build temporary quarantine facilities for those living in shantytowns,” said Dr. Priya Balasubramaniam, a senior public health scientist for the Public Health Foundation of India.

There is a silver lining to the emergency, Balasubramaniam added. How these countries ultimately cope with the pandemic could be a lesson to the rest of the world. Already, many low-income countries experiment using technology and community health workers to improve access to health care where there had been none.

“There is a lot of capacity for innovation in these countries,” she said.

[Reuters/NBC News]

Lockdowns are fine for the rich, but millions are too poor to shelter from coronavirus

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Lockdowns are being championed as a way to help contain the coronavirus, but experts warn this will not be easily achieved in developing countries, where crowded cities and slums could see the virus spread “like fire.”

Questions over how the world’s poorest will survive the coronavirus pandemic surged Wednesday, a day after India’s Prime Minister Narendra Modi announced a 21-day lockdown of its population of 1.3 billion people. Around 50 million Indians are thought to be living in extreme poverty.

“It’s a disease that makes disparity seem more obvious than any other,” Dr. Angela Chaudhuri, director of the nonprofit Swasti Health Catalyst, which works in slums and rural poor communities across India, told NBC News in a telephone interview. “We’re saying wash your hands with soap and water or sanitizers and keep at a distance — none of these are available in the slums.” “If there is just one case, it’s going to be a flash fire,” Chaudhuri said, but the economic and social repercussions for the poor will be severe in a nation of stark wealth disparities.

It is estimated that with the clampdown in India, around a third of the world’s population is living under some form of lockdown. But across the world, for millions living in shantytowns with access to only the most basic sanitation, there is no way to self-isolate.

“The need of the hour as countries like India, the Philippines and now parts of Africa enter a lockdown phase is to consider these kinds of scenarios and maybe build temporary quarantine facilities for those living in shantytowns,” said Dr. Priya Balasubramaniam, a senior public health scientist for the Public Health Foundation of India.

[Reuters/NBC News]

What keeps humanitarian aid workers up at night

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With borders now closing around the world and health services coming under huge strain as COVID-19 spreads, the humanitarian sector is scrambling to adapt to new challenges while continuing to provide assistance in ongoing emergencies and disasters.

UN Secretary-General António Guterres has emphasized that “humanitarian needs must not be sacrificed.” But many worry this is exactly what might happen, as attention and resources could shift away from some of the world’s most vulnerable populations, even as COVID-19 presents a new threat to them.

Top of mind for most organizations is how to carry on deploying staff to keep existing operations going, as well as making sure the aid itself could still be made accessible to those who need it.

 ICRC President Peter Maurer said the new travel bans would hurt. Around half of the Médecins Sans Frontières (MSF) staff coming from abroad to work on international projects are from Europe, where most countries have put checks on foreign travel due to the pandemic.

Christos Christou, the president of MSF, said he was now worried he wouldn’t be able to deploy enough specialist medical staff to the places where they are needed. “Our human resources have been trapped in their own countries,” he said. “We need these people to go back to the field.”

Even within the EU, migrant centres in places like Greece are filled beyond capacity. “The idea of self-isolation is a luxury,” explained Christou, adding that, in addition to the Greek camps, he had “extreme concerns” about the Rohingya refugees in Cox’s Bazar in Bangladesh, and those currently in the Syrian frontline region of Idlib.

Meanwhile, Matthias Schmale, UNWRA’s operations director in Gaza, expressed his frustration that political paralysis and geopolitical preoccupations among donor countries were already leading to a reduction in funds that is affecting those most in need, particularly in the Middle East. “Even before corona, Gaza was collapsing,” Schmale said, complaining that while the humanitarian situation in the Palestinian territory is becoming increasingly dire, “no one talks about it anymore”.

Carola Rackete, a German ship captain arrested in Italy in June 2019 for her work for the Mediterranean rescue organization Sea-Watch, said she feared that border closures may feed growing nationalism, to the detriment of poor and vulnerable migrants.

[The New Humanitarian]

An aid worker’s letter from coronavirus-stricken Italy

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Two weeks ago, I flew from one crisis to another, in my pajama top, praying the plane would take off and I would make it to my family in Italy. (I work for an aid agency that supports Libya, where fighting is forcing people to flee their homes, and more and more people rely on international assistance to get by.)

I wanted to get to my aunt, the fierce and infinitely gentle woman who raised me, and who still smacks sense into me when I do something silly (which is often). She is 94 years old. I don’t need to tell you what that means in terms of COVID-19; how vulnerable that makes her. I made it to Rome but couldn’t get close for fear of exposing her; but it was a relief to see that she was there, and she was alright, and she was asking why I was wearing my pajama top. The world was falling apart around me, but I was home.

But not everyone gets to be with their loved ones. What about the people who never get to have a home, who live day to day fleeing conflict or poverty?

I see, even in an outing to buy food, people being either incredibly kind or completely dismissive of others.

I understand why some people are turning inwards right now. At first, my aunt’s age made me feel the same, and vulnerability almost always brings along its friend: fear. There’s an urge to stop thinking clearly, and just protect what you fear losing the most.

But I get to choose how I respond right now, and so does the rest of the world. We can choose whether we disregard the pleas… whether we send medical supplies and assistance where they are needed; whether we want to be the kind of society that shields its vulnerable and embraces that we are all, truly, inextricably linked; whether this will make us kinder.

Borders mean nothing to this virus, so perhaps it’s time that we too define ourselves by them less. We can push past that initial urge to protect only that which immediately surrounds us, and apply that feeling outwards so that this renewed sense of identity we’re feeling now encompasses everyone. As a global community, when we eventually see the back of COVID-19, will we remember what it was like to feel unwanted? Will it change how we treat each other, first from day to day, and then from country to country?

[The New Humanitarian]

Ten-minute coronavirus test for $1 could be a game changer

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Already exhausted from testing for monkeypox and Lassa fever, Nigerian molecular bio-engineer Nnaemeka Ndodo had to work well past midnight earlier this month to find out if six Chinese construction workers were infected with the coronavirus. Ndodo had to collect samples from a hospital an hour away in Nigeria’s capital, Abuja, then wait for six hours to get the results in what’s one of only five laboratories able to test for the virus in Nigeria, Africa’s most populous nation.

In about three months’ time, U.K.-based Mologic Ltd., in collaboration with Senegalese research foundation Institut Pasteur de Dakar, could shorten that wait to 10 minutes with a test that will help a continent with the world’s most fragile healthcare system cope with the pandemic.

With few resources and staff, authorities are racing to contain the spread of the disease in Africa, which accounts for 1% of global health expenditure but carries 23% of the disease burden, including hundreds of thousands of deaths each year from malaria, HIV/Aids and tuberculosis.

Thirty-six of 54 countries on the continent have the capacity to test for the coronavirus, but a spike in cases could overwhelm laboratories. Ethiopian Prime Minister Abiy Ahmed said Sunday he struck a partnership with Chinese billionaire Jack Ma to distribute between 10,000 and 20,000 test kits and 100,000 masks per African country, as well as newly developed guidebooks for treatment.

Separately, the Ethiopia-based Africa Centres for Disease Control and Prevention expects to distribute 200,000 tests across the continent next week, mostly from Berlin-based TIB Molbiol GmbH, according to the group’s head of laboratory, Yenew Kebede.

“There is no shortage of lab tests in Africa, but what we want is the faster, cheaper test to quickly confirm if there is an outbreak and contain it before it gets bigger,”said Rosanna Peeling, chair of diagnostics research at the London School of Hygiene and Tropical Medicine.

Using technology from home pregnancy and malaria tests, Mologic’s saliva and finger-prick kit could be ready for sale by June for less than $1 apiece.

“We are ensuring that these tests are made accessible at the cost of manufacture,” said Joe Fitchett, medical director of Mologic, which received a $1.2 million grant from the U.K. government to develop the test.

The current Covid-19 tests, known as PCR tests, detect the genetic material of the pathogen in a laboratory process that can take several hours and cost over $400 in some private facilities.


African countries confirm coronavirus cases as Jack Ma pledges aid

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More African nations confirmed their first cases of the coronavirus and shut borders amid fears of the disease’s impact on fragile health systems, as Chinese billionaire and Alibaba co-founder Jack Ma pledged to donate to the continent.

Thirty African countries – more than half the continent – are now treating nearly 400 patients with coronavirus, after Tanzania, Liberia, Benin and Somalia said they registered their first cases. Health experts are concerned the continent’s often dilapidated health infrastructure will struggle to cope as cases mount.

“We cannot ignore the potential risk to Africa and assume this continent of 1.3 billion people will blissfully escape the crisis. The world cannot afford the unthinkable consequences of a COV-19 pandemic in Africa,” Ma’s foundation said in a statement.

The foundation will send 1.1 million testing kits, 6 million masks and 60,000 protective suits and face shields to Ethiopia for distribution to Africa’s 54 nations, it said.

Many African nations, including some without reported cases, have ordered tougher control measures, including bans on public gatherings, halting flights and closing schools and universities.


Poor nations may see higher coronavirus deaths, warns UN official

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Governments and health systems in wealthy nations are struggling to cope with the coronavirus pandemic, suggesting the poorest countries may be hit far harder if the virus gains a foothold there, a top U.N. official warned.

Mami Mizutori, head of the U.N. Office for Disaster Risk Reduction (UNDRR), said even in developed countries, health services were under stress and did not have enough equipment to treat people in need as the numbers infected rose rapidly.

“It is easily imaginable that if this becomes the case in a country where the health system is not as sophisticated, then that could lead to possibly higher mortality,” she told the Thomson Reuters Foundation from Geneva.

People living in poverty and lacking health insurance or secure employment cannot afford to be sick or miss work, she said, pointing to the virus as an “equity issue”.

If coronavirus expanded in poor countries, the economic impact on individuals would likely be greater as economic losses would be a bigger share of gross domestic product, she added.

The slower spread of the virus to Africa, however, may have bought the continent valuable time to take preventive measures. Some African countries, like Rwanda and Uganda, are implementing strict controls at airports as well as simple hygiene practices such as setting up public sinks to wash hands.