The Impact of COVID-19 in Informal Settlements – Are We Paying Enough Attention?

Drawing on insights from an ESRC research project on post-Ebola urban health in Sierra Leone and a new GCRF funded hub on Accountability for Informal Urban Equity – ARISE implemented by IDS and SLURC, this opinion piece explores what potential lessons can be learned and applied to fighting COVID-19 in informal settlements.

© Cities Alliance 2020

The coronavirus pandemic has everyone around the world deeply concerned. How should the crises be dealt with? How can we protect ourselves? New recommendations on how to minimise the probability of infection are updated daily:

Avoid face-to-face conversations or travel to risk areas, wash your hands with soap for at least 20 seconds, stay at home when you have light flu symptoms, disinfect work surfaces regularly, consume healthy nutrition, avoid touching your face, strengthen your immune system, etc.

In most cases people follow these sanitary guidelines in order to ensure the best possible protection for themselves and others. But what if the conditions that you live in do not allow you to comply with these regulations?

One billion people live in slums or informal settlements where access to appropriate health care services is limited and water and space are scarce. How can these settlements become more resilient towards the highly pathogenic virus?

In her opinion piece Annie Wilkinson, research fellow at the Institute of Development Studies (IDS), prompts us to consider how COVID-19 could impact people living in densely populated and unsanitary environments, and what could mitigate the worst of these impacts.

Important lessons can be learned from the Ebola outbreak in Sierra Leone from 2014. According to IDS’ and SLURC’s research significant data gaps make it difficult to draft epidemiological plans for informal settlements for which the number of residents is unknown. Response planners should thus try to raise data to get a better understanding of the realities and challenges of disease control in informal settlements and in order to substantiate their response plans.

Moreover, slum-wide quarantines were very hard to implement in the Ebola case and as a result hardly effective. IDS and SLURC therefore do not recommend such an approach.

Additionally, the poor often rely on informal health providers as first responders to their illnesses. These informal health networks can therefore be of great value in terms of raising awareness and providing basic health care services.

Lastly, informal settlements are characterised by multi-layered governance structures, which in contrast to formal institutions operate on a more personal level. Thus, existing action groups that tackle other challenges such as flooding, mudslides or cholera may be met with more trust by residents. Hence, they should be included in any outside interventions.

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