Dealing with disease in informal settlements

Recently in Kibera slum residents fighting for food donations despite the government directives in containing the Covid-19 spread.

The slums are mostly made of families of 2-5 people who live in single room shacks of around three metres by four metres, adjacent to each other, pit latrine shared between 5-10 families and with a single water tap if available, also with very limited public space for roads, open fields and pathways.

Practices like social distancing, staying at home and regular hand washing are not part of their daily life. The residents usually face repeated disasters cholera, fires, flooding and mudslides.

The global spread of Covid-19 poses a major risk for the one billion people live in the informal settlements where water for basic needs is in short supply let alone 20 seconds worth.

While the global populations are affected by the Covid-19 pandemic, not all populations are affected equally. Informal settlements and elderly individuals with underlying health conditions are particularly at risk.

Despite these challenges, this is an opportunity to forge new partnerships between different agencies that if they work together can reach the populations in need.

Tapping community organisations and faith-based groups will help convey these messages to fight myths and misinformation and to increase social pressure for behavioral change in fight of Covid-19. Over one billion (one eighth of the population) people lives in informal settlements with very little savings if any and they work in the informal economy, often as employees in informal enterprises, selling vegetables, cleaners, domestic servants, factory workers and guards.

Living hand-to-mouth, often bringing them into close contact with people, and simply cannot stop working because of the Covid-19 pandemic.

Measures to distribute foods in an organised way to keep them at home will help reduce the Covid-19 spread and cash transfers to the vulnerable citizens so that they have the means to survive.

Formal health services are rare in most informal settlements, the few available tend to be understaffed, underequipped, and are likely to be overwhelmed should the corona virus get out of hand. Also where these services do exist, charges for medicine put them out of reach for the residents. Households may supplement these services with traditional providers either because they do not trust the quality or because costs are lower.

Identifying high-risk locations and help those individuals who are health wise weak into isolation and providing them with access to emergency health services if required.

Equipped and staffed free mobile health facilities should be going around the informal settlements, to help and detect any Covid-19 and other diseases in the community. For those who test positive and face difficulties self-isolating at home, setting up isolation centers in stadiums and parks will be crucial.

According to the World Health Organisation, the provision of safe water, sanitation and hygienic conditions are essential to protecting people’s health during all infectious disease outbreaks, including Covid-19.

However, the more than one billion people lack access to hand washing and sanitation facilities, heightening the risk of the corona virus disease spreading rapidly in informal communities.

Establishment of free mobile water and sanitation station will help in reducing the risks, as well as educate and provide reliable information to the population of the importance of good hygiene.

As we wait for a vaccine to be developed and made widely available, there are immediate measures we can take to pre-empt the worst effects of Covid-19 on informal communities, such as strengthen routine immunization.

This ensures people are protected against the spread of many known infectious diseases and, by connecting them to health services, enables early detection of novel threats, which is critical to outbreak response.

Now is the time to change and ensure that informal settlements and their fragile health systems are braced to manage an epidemic. This means increased production and distribution of personal protective equipment and taking steps to enhance testing capacity at the community level

Ndirangu Ngunjiri, via email