Let us all first admit how privileged some of us are. We have a roof above our head, a salary coming to our bank accounts, we can afford to work from home, our deliverables can get emailed, we have stocked up our essentials, we have a separate room, a separate sleeping space, running water, a supply of soap, electricity, and so on.
We can even order groceries and food online which get delivered to our doorsteps. Social distance, lockdown, and work from home are privileges not available to everyone. While we grapple with the meanings of social distance, quarantine and isolation, we expect others to understand them and to be able to start applying them immediately.
While we express mass anger at people (and vent out on Facebook) for not maintaining social distance, we forget not everyone can afford to do the same. We also blame a certain population for taking the train the next day to go home the moment the “chhuti” was imminent. Imagine you are living alone, in a mess or a hostel, or a shared apartment, you are not going to work, neither you have work that you can do at home nor you are certain whether you will even have a job the next day. You have families who do not live in the same city. You start fearing for yourselves and them. You wonder who is going to look after you should something happen. Who is going to look after your family? How would you pay the rent if there is no salary? I will be honest. I too will board the next train/bus/plane to go home to my parents in Chittagong if I were living alone.
We are not wired to be socially distant. Being Bangalees, we love addas, we love gathering at parties, tea stalls, with cha-nashta, cigarettes in our hand, and we spend hours talking about politics. Instead of telling people to be socially distant, to wash hands and that too for 20 seconds following all those steps of WHO, we should tell people why each of these components is important, what happens when hands are not washed in a certain way, why a one-metre distance is important, and frankly, how would one know what is a one-metre distance. We public health professionals always say interventions need to be contextual. This reminds me of my PhD thesis which allowed me to look at how people with tuberculosis need to adapt to their living arrangements post-diagnosis to prevent transmission. I found that the messages they get from health workers are not easily applicable to their living reality. What’s the point in telling people in slums to have a separate sleeping arrangement when all they have is a tiny space in their one-room shack where they have somehow managed to cram in a bed which they need to share with kids and spouse? There is barely enough space for walking, let alone a separate sleeping arrangement! If the health workers instead focused on ways such as using masks when sleeping with others, the same message would be delivered and would save them the trouble and the guilt from not being to follow instructions. In a world where diseases are predominantly medicalised, who would want to be a bad consumer?
Well, both diseases, TB and COVID-19 are different, and the latter is a super spreader, as we all know. TB is airborne and can only enter the body through inhalation. Hence people with TB are advised to use masks, to maintain coughing and sneezing etiquette and to dispose of their sputum in a pot that should be buried underground. But for COVID-19 that spreads through contaminated surfaces, challenges are extreme. As if the list of problems for slum dwellers was not big enough, now there is a growing fear of the coronavirus spreading in slums. Even a single case would be detrimental. Recently, some newspapers such as Dhaka Tribune and The Business Standard have reported mass unawareness about coronavirus among dwellers of various slums . On top of that, there are low supplies of hand sanitizers in pharmacies at such places, and pharmacy owners are reluctant to stock up because people don’t buy . What’s worse, there is a lack of cleaning and maintenance by the city corporation . Although the distribution of leaflets has been promised by a Chief Social Welfare and Slum Development Officer to Dhaka Tribune to raise mass awareness , it will certainly not be enough.
Social distancing is next to impossible in slums. It is as simple as that. People in slums have to go to work, queue for water, share bathrooms and latrines, and even stoves. The least the dwellers can do is wear a mask, follow the coughing/sneezing etiquettes and wash hands. Although there is a global uncertainty about the use of mask and its effectiveness, after reading some newspaper articles online it seems masks can minimise the spread, if not prevent it. Since handwashing is the best way to prevent the spread and soaps are luxuries most people in slums cannot afford, a DIY cheaper soap solution invented by the icddr'b could be useful . Unfortunately, slums have limited water supply too, and therefore in this scenario, a generous donation of hand sanitizers could be useful. Of course, there is a need for mass awareness regarding handwashing, coughing/sneezing etiquettes, the prohibition of spitting and avoidance of mass gathering whenever possible. This could be done by miking, posters, demonstrations and television advertisements. Also testing facilities need to be available to them should the need arise.
In India, there are reports of drones deployed to disinfect slums in Gujarat . I do not know how effective drones would be but Bangladesh certainly could think about disinfecting slums too, particularly the narrow alleys. However, we have to ensure such a drive do not cause harm to others as it happened in Uttar Pradesh where migrant workers were drenched in bleach disinfectant liquid . Call it ignorance or fear, that is purely inhumane. The government of Bangladesh needs to partner with private organizations and NGOs and act quickly upon the timebomb that is ticking away in this vulnerable population.
Finally, what I would like to say is that we are all passing a terrible phase but some have it worse than us. So let us do what we can to help others. Spread messages, donate, whatever it is we can do. We do not have to start anything new, we can just add to the initiatives already going on. I am grateful to organizations like Bidyananda who is already doing amazing work, and I feel good to have contributed a little amount of money. But let us not stop there. When the COVID phase is stable, settled down, over (which I am sure it will one day), let us continue to help others, especially those facing economical adversity, help them pick up their life that has shattered in pieces, so that we do not have to hear again “amra corona te morbo na, na khaiya morbo” from any rickshawala, or anybody for that matter.
And while we wait for the good days to arrive, let us all reflect on what we did as terrible humans that the moment we are gone, the skies have gone blue again, dolphins are dancing in the seas, crabs are returning to beaches, and trees are happy. But first, let us be empathetic and supportive towards all in this crisis, especially the most vulnerable.
* The writer is a senior research fellow at BRAC James P Grant School of Public Health, BRAC University