Creative and practical ways to help people in poor communities respond to COVID-19

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As I write, we will be living in a wide variety of situations. We may be at the front line, exhausted and overworked. Or, at the other end of the spectrum, being in lockdown and enjoying more time with our families. And of course, many situations in between.

But perhaps on the mind of many of us will be these two things.

First, what can be done to help those in the most difficult circumstances especially in poor urban settlements, slums, and IDP and refugee camps?

Second, how can the church, Christian leaders and congregations provide wise, collaborative and compassionate leadership based on truth?

For those of us living in higher-income countries and settings, it’s not that difficult to follow the well-known rules: keep at least two metres apart, frequently wash hands with soap and water and stay inside if possible.

But as many of us know and all can imagine, it’s entirely different for the one billion people who live in slums or resettlement camps. That’s one person in eight in the world. And in addition, 5% of the world who live in indigenous communities have very high risks (eg in Peru, Brazil and Bolivia).

Here are a few suggestions from the wide variety of people we come across in Arukah Network from different countries, and from patients and contacts who some of us see in our daily work.

Listen to the community

I was delighted to see this summarised advice from the London School of Hygiene and Tropical Medicine which is just the approach we are trying to follow in Arukah Network:

• Community members, including the marginalised, should identify solutions that work best in their situations
• They then use their capacity to mobilise wider networks
• Because ideas are community owned, people will be more likely to follow them
• Grassroots responses have been effective in HIV and Ebola
• But models are now needed to help communities come together, collaborate, and receive nurture and accompaniment
  (LSHTM DEPTH Group Lancet 2020;396:1676-1677 (30 May))

Some ICMDA members will be in an ideal situation to encourage such models and give advice where needed.

Help to set up leadership structures

Where the government is not adequately providing this, civil society including faith and church-based groups can help set up or strengthen functioning structures at neighbourhood, community or sub-district level, ideally with support from health care professionals. This can enable two valuable approaches, below, which can save lives, providing some community structures are largely in place.

1. Setting up or speeding up track, trace and isolate

This is essential to prevent spread. Where testing is not available a ‘syndromic approach’ can be used instead, in other words identifying those with likely symptoms, so that trace and isolate can still proceed.

2. Shield vulnerable people

Sometimes known as ‘green zones’, these are areas at a family, neighbourhood or community level where those most at risk can be ‘shielded’ from the risks of being infected by others who may be infectious without even knowing it. Evidence shows this is more effectively done by ‘institutional shielding’ in other words by using a ‘neutral area’ where vulnerable people can come rather than self-isolating in homes, where risks are often greater. Of course, this must be done with community agreement and support, and in a compassionate and inclusive way. Christian congregations can be well placed to lead the process. It’s not always easy but it’s proving possible in some areas as shown by this report from the London School of Hygiene and Tropical Medicine: Guidance for the prevention of COVID-19 infections among high-risk individuals in camps and camp-like settings.  

Ensure accurate information is available

Use posters and community WhatsApp groups, radio and all other means to make sure community members have accurate health information. It ideally needs to be government-sourced or government-approved to avoid confusion but must be based on science.

Frequently providing correct information gradually dispels fake and sometimes deadly rumours and conspiracy theories, which quickly spring up when fear from a new danger takes hold. I’m sure all of us will be aware of fake news that is common in our community. This article is helpful.

We must be sure that our information is accurate, easy to understand and use, and written in cultural and language-specific ways. Videos, images, stories and quotes from respected role models can help to reinforce the message

Again, the church can help here providing it is giving truthful information backed up by compassionate care of those in the community, based on need not creed.

Let the communities’ needs and responses speak

Discover from local communities what current issues and fears people are facing. Many are saying that the biggest problem is not COVID itself, but the effects of lockdown, such as lack of food, increased poverty, police brutality and the difficulties of needing to live together in confined spaces.

Communities are doing amazing things. Here are just a few examples:

In ASHA project, Delhi, which works in more than forty slum settlements, community health workers and others have been visiting homes to ensure that people have sufficient food and money to survive; and in response to requests are also providing menstrual hygiene packs for adolescent girls.

In Rwanda, an Arukah Cluster has identified 40 families most in need and have provided beans, maize flour, rice and soap.

Many communities are encouraging families to celebrate the good things together, for example using music, humour and the wonder of nature.

Churches are streaming services which often reach more people than would attend a church service. This is a great opportunity for church leaders or others in their congregations to add valuable health advice and mental health guidance as part of the service.

Many projects where any form of distancing is impossible, are working hard to make sure families, neighbours and members of the community have masks and soap and know how to use both.

Showing special kindness and creative support to those with disabilities and other vulnerability.

In one area of Kenya, women have been cooking meals and giving them to police officers as they recognise they become hungry from such long hours on the streets. In the Kericho areas and other parts of the country, tribal groups are putting aside their differences to support each other and thereby creating new models of friendship.

Those from different religions are working together successfully as they find areas of common ground, as was done so successfully in Sierra Leone at the time of Ebola. 

In Jamkhed, Maharashtra, India, a rural health programme has treated almost 150 COVID-19 and quarantined individuals, and in the process serving 5,600 free hot meals.

An appropriate response from faith leaders

With faith leaders often being those most listened to and respected, we must provide easy-to-grasp information so they can help their congregations to understand.

Faith leaders can take a leading role in all the ideas already described. One thing is important. They need to be skilfully guided into the more truth- based, less extreme spectrum of their religious teachings. This is especially relevant for Christians and Muslims, both of whom default to say that God and prayer alone will be enough to prevent or cure COVID.

This is a unique opportunity for faith leaders in general, and church leaders and congregations in particular, to model and lead compassionate, collaborative and scientific responses.

One final suggestion

Some of the biggest family tensions occur during self-isolation. Past hurts and grievances can come to the surface and add greatly to mental ill-health, abuse or even violence. The gift of forgiveness, better still mutual forgiveness, can be amazing. A family leader or respected family member suggests that all agree to forgive past grievances and give a sense of absolution from what has occurred in the past.

Explaining this can be difficult and needs to be authentic. But if it is done with kindness and sensitivity, in the presence of God, and with a short, gentle prayer, it can bring new blessings and peace to the family.

Ted Lankester is Director of the Arukah Network