It is difficult for residents of informal settlements to follow guidelines to prevent Covid-19 transmission, such as hand-washing, in the absence of access to water. It is governments’ responsibility to provide these basic services. (Lucky Tshuma)
After the outbreak of Covid-19 in Wuhan, China in November 2019, and it subsequently being declared a pandemic by the World Health Organisation (WHO), the organisation’s director general, Dr Tedros Adhanom Ghebreyesus, has frequently called for social solidarity from global institutions and governments to prevent the spread of the virus. In reflecting on such calls, I cannot afford not to think about sub-Saharan Africa. UN-Habitat reports that 238-million people in the region are living in informal settlements without adequate basic services and social amenities that would enable them to follow the prescribed Covid-19 transmission-prevention measures.
Although some people have observed that the call for solidarity implies the sharing of information, transparency and scientific data necessary to fight the disease, local forms of engagement at community level, especially in these informal settlements is an important part of this. The call for solidarity, therefore, evokes the question of how to catalyse informal settlements to be part of this solidarity; how to reinforce interventions such as increased hand-washing, physical distancing and self-isolation given their current poor conditions — water shortages, poor sanitation and waste management, and households sharing one-roomed shacks.
Researchers concur that these settlements are highly susceptible to communicable disease because of their poor infrastructure. Although science plays a critical role in responding to the pandemic, people’s responses are an indispensable element in navigating uncertainty and fighting a pandemic successfully, as shown in the work of Hayley MacGregor. It is, therefore, important to interrogate the responses of the different actors to the pandemic in relation to this call for solidarity.
During a two-day WHO forum for health researchers, Ghebreyesus remarked that:
This outbreak is a test of solidarity — political, financial and scientific. We need to come together to fight a common enemy.
Unlike previous epidemics that have tragically affected the people of Africa, such as the Ebola crisis in West Africa, Covid-19 was rapidly given pandemic status. In addition, United Nations general secretary António Guterres, launched the $2-billion Global Humanitarian Response Plan to combat Covid-19 in vulnerable countries. This fund epitomises solidarity efforts. Similarly, UN-Habitat supports the call for solidarity. In its key message on Covid-19 the organisation laments the poor conditions of informal settlements and advises governments to work with their residents as a priority.
The African response to Covid-19
African governments are responding relatively swiftly to the coronavirus pandemic; some have developed Covid-19 country preparedness and response plans. Many are declaring a state of national disaster emergency. For instance, President Cyril Ramaphosa declared a national state of disaster on March 15, and tightened measures to fight back the coronavirus. At the time 61 coronavirus cases had been reported in South Africa. This measure was followed by a countrywide total lockdown on March 27. Kenyan President Uhuru Kenyatta did not wait for an increase in the number of cases, but instead put the country into a partial lockdown immediately after the first case of coronavirus was confirmed. Uganda’s President Yoweri Museveni devised a comprehensive and proactive response before any confirmed case, and that country’s health minister, Dr Jane Ruth Aceng, asserted, “Evidently, we have seen how fast the coronavirus disease spreads.” Following suit, Eswatini and Zimbabwe (to mention a few other countries) have also embraced a lockdown to limit the spread of the disease.
However, on the ground many African governments are “firefighting” in the face of growing pandemic realities and panicking populations. Access to water is emerging as a key breaking point to the Covid-19 response. As the health guidelines dictate, this is critical in slowing the transmission. Access to water is a human right and it is the responsibility of governments to provide it. This right and responsibility is directly linked to the science-based statements made by the international organisations and government leaders about cleaning hands and surfaces frequently to achieve safe hygiene and limit chances of transmitting the threatening coronavirus.
Undoubtedly, interaction between governments and the communities has become a pressing point as some communities grapple with adhering to the solidarity message in practice. “We are all in this,” to borrow a phrase from the WHO director general’s media briefings on Covid-19; but this implies that we are all equally affected by the current situation. It seems people living in informal settlements understand that hand- and surface-washing is an important practice in a world devastated by the pandemic but conditions restrain their compliance.
A triple burden for impoverished people
But nongovernmental organisations (NGOs) executing interventions such as capacity-building, social audits and litigation against municipalities for evicting residents of informal settlements, are aware that this messaging presents a dilemma for these communities. They are now faced with a triple burden: first, the threat presented by the coronavirus; second, the poor water supply, waste management and sanitation, which put them at higher risk; and, thirdly, the poor ventilation and constrained spaces in their shacks, not to mention their long-standing insecurity of tenure. Development practitioners and some academics have called for inclusive upgrading projects. Yet these efforts continue to receive minimal attention from many African governments and municipalities.
We need to be critical of the resources and energy directed towards addressing the living conditions of vulnerable and poor people in society. The current urban development approaches and models that have perpetuated marginalisation of informal settlements. Yet a study conducted by Jiangzhuo Chen, Shuyu Chu, Youngyun Chungbaek et al, “Effect of modelling slum populations on influenza spread in Delhi” finds that ignoring the influence of slum characteristics may catalyse the speed of an outbreak and result in inappropriate interventions. Thus, engagements between governments and informal-settlement communities will be critical in addressing these challenges and improving their co-operation to the solidarity efforts against the scourge.
In the current crisis, we commend some African governments’ policy responses to the threat of the coronavirus, especially the temporary measures they have taken to provide informal settlements with water. For instance, in South Africa, the declaration of a national state of disaster is accompanied by a plan to provide water tanks and additional sanitation facilities to informal settlements, as well as providing food packages in response to the loss of livelihoods. Certainly, a nationwide government response to Covid-19 remains important, not to mention supporting people living with disabilities, women and children, who are among the most vulnerable.
Lessons for the future
But such efforts are also needed in the post-coronavirus era. Although such temporary measures are essential, the weaving together of Covid-19 responses and much-needed permanent solutions is required. Such a co-ordinated response could mitigate future “firefighting” measures, which will be costly in an era of increasing economic crisis. This is the time to embrace the people-centred development and for the African Union to aggressively implement one of the aspirations enshrined in the Agenda 2063: The Africa We Want, namely, inclusive growth and sustainable development. Sadly, this agenda is, in my view, less popular than the UN’s Sustainable Development Agenda and scarcely cited, not even by the African leaders themselves. However, the role of constructive dialogues between governments and communities is crucial to all these development agendas and the fight against Covid-19. Only through dialogue can we minimise anxiety, build trust and consider local, contextualised interventions.
The lesson we are learning during this challenging time, which governments need to build on, is the necessity of directing significant efforts and resources towards providing inclusive urban infrastructure and basic services. This is because basic services and people’s health are unequivocally linked. In the spirit of contributing towards permanent solutions and prevention of the spread of Covid-19 crisis, we propose that governments should prioritise working closely with informal-settlement communities to increase their adherence to the important health interventions and develop long-term interventions. This call for solidarity, reiterated by some African leaders, is important and warrants community involvement and inclusive development.
Dr Hloniphile Simelane is a development practitioner at Planact, an NGO promoting inclusive local governance processes. She is also a visiting researcher at the University of Witwatersrand’s School of Architecture and Planning.