Article by Dr Muhammad Musa, Physician, Public Health Expert, and Executive Director of BRAC International, a Bangladesh-based NGO.
As the COVID-19 pandemic wears on, more and more people around the world are struggling during lockdowns and economic shutdowns.
The coronavirus could nearly double the number of people facing acute hunger, according to the World Food Programme. Recent data collected by BRAC reveals that many families across the Global South can only sustain their food needs for seven days or less; many are trying to cope by eating less.
Top-down measures to curb the spread of the virus – dramatic steps like lockdowns and bans on large gatherings – pose an immediate threat to families in the poorest communities.
Even in developed countries, local opposition to top-down decrees is undermining the impact of public health initiatives. Resistance to these mandates will only grow if they are not tempered with solutions and leadership from the hardest-hit communities.
The key to turning this resistance around, and dealing with a pandemic long term, lies in the Global South. What’s needed is a renewed commitment to community engagement, rather than top-down mandates. The Global South has great experience on which to draw. Here are three examples that have proven effective.
First, local leaders – elected, civic, or religious, in various combinations depending on the community – must be consulted when creating public health strategies. Their concerns must be heard and addressed. In the Rohingya refugee camps in Bangladesh, for instance, many Rohingya religious leaders are working with BRAC to use their platforms to share life-saving information and dispel myths about COVID-19.
This is an age-old principle of community development, but in the rush to stop the spread of the virus too many officials around the world forgot about it and simply issued decrees. In India, for instance, when the government called on 1.3 billion people to stay home for three weeks, millions were left stranded, without work, and potentially hungry.
Second, existing community networks must be engaged. Community health workers are a great example: These are trusted, trained workers who live in the communities they serve. They can be especially persuasive in informing residents and convincing them to adopt needed measures such as mask-wearing, social distancing, and hand-washing.
Non-governmental organisations and other civil society groups have a crucial role to play. They are a vital link between centralised policy conversations and grassroots networks.
Half of BRAC’s 100,000 frontline staff and volunteers across 11 countries are community health workers. During the pandemic, we’ve found they’ve been vital in working with local leaders to raise awareness about COVID-19 and to enact preventive measures.
Non-governmental organisations and other civil society groups have a crucial role to play. They are a vital link between centralised policy conversations and grassroots networks.
Third, hard-won experience with health crises is a powerful asset. In West African countries with a history of Ebola, for instance, adopting social distancing and other public health measures has been far easier. People who went through that emergency – both decision-makers and the public – understood more quickly what was at stake and what was needed. People knew where to turn for trusted information and how to respond.
COVID-19 isn’t the first public health crisis we’ve seen, and it won’t be the last. Large populations depend on daily wages to put food on the table. Economic activity and public health measures must co-exist.
We need to involve local leaders in crucial public health decisions to develop interventions that work. Solutions that rise up are better than those that dropdown.
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