We heal as one: Community participation in the fight against COVID-19
Bonface Beti and Angi Yoder-Maina, Green String Network
9 April 2020
Since the declaration of COVID-19 as a global pandemic, we have witnessed radical efforts by countries across the world to secure their population’s health. It is disrupting normal lives and paralyzing major world economies. The death rates specifically in Asia, Europe, and North America has alarmed countries in Africa.
In Kenya, it is feared a large outbreak will overrun our weak healthcare system. A mainstream reaction to the impending crisis from both government and citizens is the "ordinary" Kenyan citizen is either ignorant or lacks the requisite agency to make their own decisions or just needs to be "pushed” to be “saved”. It is a top-down mentality guiding almost all our policy decisions today. But the experience in other African countries during outbreaks shows us there is an alternative. When people own prevention it becomes the new norm.
The COVID-19 pandemic has caused a crisis in Kenya, a country already reeling under the weight of deeply divisive economic cracks among the classes and without a social support system for the citizens. The majority of city dwellers live hand to mouth. This reality challenges the World Health Organization (WHO) best practices such as wide testing, contact tracing, isolation and quarantine in stemming an outbreak.
The risk of deploying total lockdown by the state remains a real possibility in order to stop the deadly spread of the disease among informal settlements. The impending fear around such extreme measures being applied, continue to rattle the poor and elicit critical life and death questions as many are presented with the choice of either contracting the virus or fending for their daily bread. The city's informal settlements remain highly congested with large households often living in a small room. This alone poses a threat to quarantine and isolation as a public health response.
Additionally, due to high levels of poverty and poor access to basic services such as water, adequate housing, and food, the majority of city dwellers lack the power to choose safety over survival needs. This situation is made worse by the lack of basic healthcare services. Today there is an absence of initiatives directly engaging the poor as critical stakeholders in the fight against COVID-19. However, by building on the lived experiences of the population to create programs enhancing their capacities and tapping into their agency and resilience, the government can relegate the overall responsibility of preventing the spread of COVID-19 to her citizens. We each have to start to believe people do not wish to suffer and stop saying "Kenyans cannot be helped".
From a public health perspective, it’s important to point out how the majority of the poor in Kenya have struggled under the huge burden of other dangerous illnesses, such as malaria, HIV and tuberculosis. This lived experience has offered key lessons on how to build on the community's own resilience. For example, from Twitter chat on the first night of the Kenya curfews, a street family member had the following to say to a Kenyan journalist, "‘Karis” (his street name) said he doesn't think too much of COVID-19. I know tuberculosis, HIV, malaria, they have always been part of our life, so I just go about my business, as usual, we will meet with that disease when we meet.” His words speak for hundreds of thousands of poor families in Nairobi. The paradox is that the poor are living “normal lives” in dangerous times whereas middle-class and upper-class Kenyans are bent on “getting things back to normal”.
Communities must be central to their own recovery and should be supported by both civil society and government institutions. The 2015 Ebola crisis in Sierra Leone painfully revealed both the critical importance of engaging communities in crisis response and prevention and the reality that there were virtually no channels for doing so in practice in the early days of the outbreak. Given the historical context of mistrust, anger, and suspicion of the government, rumours were rife that the government was infusing the free government soap with the Ebola virus. Not only would the citizens not take it but also the unrests caused by the rumours were also developing into a larger security concern.
Given the deep levels of social mistrust towards the government, only community structures, such as Peace Mothers, were able to mobilize prevention and response initiatives within their communities. Once Peace Mothers began to make soap within the community, the community began to trust the soap was safe for them and their families. As the Peace Mothers handed out the soap, they were able to sensitize the community on the need for social distancing and other preventive measures communities could take to protect themselves. This was in contrast, to the pattern of the national and international response, which once again repeated harmful patterns that ignored community voices and missed the opportunity to mobilize local engagement and leadership.
Community ownership has been used successfully in Kenya with HIV and other health epidemics. Today such a process can enhance local level coping skills and develop social distancing rooted in the real Kenyan context. If we give the poor a chance to be a part of the solution they can do it, but we have to give them a chance. The starting point has to be different than in the past because we are now seeing the interconnectedness of our lives. The ordinary Kenyan citizen wants his family to be healthy and safe. She also has the required agency to make wise choices if given the right tools to do so. Let's find the right tools. And let's begin to believe in ourselves!
Views and opinions expressed are entirely our own.