The haunting coronavirus pandemic which has had such a devastating impact on all our lives has put the spotlight on the massive inequalities that exist in our world.
We in the developed world are coming to terms with the profoundly unsettling new reality we face due to COVID-19. The scale and speed of infection has been alarming, as has its devasting capacity to take lives, destroy economies, and put an enormous strain on resources and staffing in even the most capable healthcare-systems in the world.
A different Covid19 reality in the developing world
But whatever chance countries like Ireland have to cope with COVID-19, it has the potential to have a greater catastrophic impact on millions of vulnerable people living in the developing countries across Africa, Latin America and the Middle East.
These countries have weak or non-existent healthcare systems, with very limited testing kits, ventilators, ICU beds and medical staff. The World Health Organisation reports that there are fewer than 2,000 working ventilators to serve hundreds of millions of people in 41 African countries, compared with more than 170,000 in the United States. While ventilators are only required to treat those most critically ill, the absence of a reliable electricity supply to run hospitals and health care centres is a more fundamental threat.
Further compounding the crisis is the lack of food and poor access to water which is a barrier to good hygiene practice. One of the sad fallouts from this crisis will be an increase in hunger, malnutrition and diseases which are likely to further exacerbate the pressure on health services and mortality rates in poverty-stricken communities.
Another challenge is preventing the rapid spread of COVID-19 in high density communities. Millions live in informal urban settlements and internally displaced and refugee camps. Across Africa the vast majority of urban dwellers work in the informal sector where a daily wage provides the means to eat each day. Isolation and social distancing will be difficult to implement across such populations, and harsh enforcement measures are likely to be met with dissent.
Communities which have been ravaged by conflict face even more challenges. It is difficult to fathom the impact if COVID-19 takes a grip in Idlib in war-torn Northern Syria, where one million people are internally displaced in an area the size of Country Galway. COVID-19 interventions must be demonstrably sensitive to the conflict and those most at risk of violence must be protected. Social cohesion initiatives which seek to address the underlying causes of the conflict must be allowed to continue.
If the virus takes a hold in developing countries the local health systems will not be able to cope. And as the pandemic spreads in the coming weeks and months, it will become much more difficult to reach the affected areas and communities, and critically needed supplies will become more difficult to secure.
Finding a way forward
There is opportunity in the fact that the disease is spreading more slowly to the African continent and that many Governments were quicker to introduce travel restrictions, temperature monitoring and contact tracing than their European and North American counterparts.
Governments and NGOs can also draw on the extensive experience of emergency health work and infectious disease preparedness around the world to respond to COVID-19, in particular the response to the Ebola outbreak in Sierra Leone, Guinea and Liberia in 2014.
Central to that effort was community engagement. During the Ebola outbreak, GOAL and other international non – governmental agencies created a Community-Led Action (CLA) approach which saw the development of plans at local level to isolate and shield those most at risk, and manage cases of infection. This involved offering practical household hygiene guidance and supporting communities to plan controlling their movements and still be able to sustain their daily income.
Through the Community-Led Action approach communities overcame fear and disinformation. They worked together to find locally appropriate and sustainable solutions to contact tracing, isolation and safe burials. This evidence-based CLA must be central to our COVID-19 response as countries work to minimise the capacity for transmission.
GOAL is proud that since the COVID-19 crisis emerged we have reached more than nine million people in our countries in Africa, the Middle East and Latin America with awareness raising and preparedness messaging. We are on the ground, providing support and helping communities prepare for the worst.
Yet more can be done
But the scope and gravity of the situation also requires an ambitious multi-layered and indeed multi-lateral response. This is a time for countries to show solidarity with the most vulnerable communities and nations, in the interests of humanity as a whole. Short term measures will not be enough. This health crisis will have a devastating impact on every aspect of life in countries of the Global South, including access to food, sustainable livelihoods and social and financial security.
Thus the response must also include long-term commitments from the international community to invest in national health systems and focus on building sustainable communities and economies that are resilient to pandemics.
This battle will be won or lost depending on our ability to engage communities to understand and adapt behaviours. But it won’t be easy. In the countries where we work families are vulnerable, hunger is a real issue, While governments in developed countries will support families who see their livelihoods suspended, the challenge in the developing world is more acute and the consequences too serious to even contemplate.
The one thing that the COVID-19 crisis has exposed is how unequal our world is.
Mary Van Lieshout is Deputy CEO at Goal and Head of Goal's COVID19 Task Force.