Community-level intervention is the answer
On April 16, as coronavirus continued to spread through the country, the government declared all of Bangladesh to be at risk from the pandemic. The declaration was a tacit admission that Bangladesh is now deep into the stage of "community transmission"—meaning the virus has quietly spread to every corner of the country, remaining undetected because of inadequate testing and many infected but asymptomatic persons. None of us are safe now. Unless effective measures are taken urgently, we may be unable to prevent large-scale deaths.
We were unable to contain the spread of the coronavirus because we failed to take effective measures early on. We could have prevented the virus from going beyond the first stage—during which it is imported by people traveling from coronavirus-affected countries — through aggressive quarantine of incoming travellers (citizens, expatriates and foreigners alike) and isolation of those with symptoms. However, our lax quarantine policy and the repeat travel of millions of Dhakaites to and from their villages led to a lost opportunity for us to stop the virus in its tracks. Now, as no approved treatment or vaccine is available, we can only concentrate on mitigation, which will require resisting the virus locally, at the community level and to the last person—our very last line of defence. With a local solution, based on community solidarity and action, we should be able to flatten the curve.
But, if we fail to take appropriate community-led measures, the virus can spread like wildfire, quickly turning our country into an inferno. Once it reaches the final "epidemic" level, Bangladesh will experience large numbers of deaths.
About two-thirds (63 percent) of Bangladesh's population is rural. The majority of Bangladesh's cases are concentrated in Dhaka and the surrounding areas, although the virus has already spread into the villages, by the government's admission. Therefore, preventing the further penetration of coronavirus into our villages is now of utmost urgency. We must turn our villages into fortresses against this invisible enemy, as we did in 1971, to protect our motherland.
We must appeal to the self-interest of our citizens who, in order to safeguard themselves and their loved ones, must safeguard their neighbours. The wellbeing of one household depends on the wellbeing of the surrounding households. This self-interest-driven, society-wide initiative must be undertaken primarily on a voluntary basis, especially by the youth. The voluntary organisations can inspire and mobilise villagers in their own work areas using their facilitation skills, offering the villagers a sense of ownership of the initiative. The driving force at the heart of it must be neighbourly feeling combined with self-preservation. The voluntary organisations, using their local volunteers and staff, can also build bridges using mobile and information technology. The Union Parishad chairs and members, as local leaders, can play catalytic roles in this effort. For successful implementation, the government must partner with voluntary organisations and involve them in coordinated action for preventing further spread of the virus.
Three specific actions must be taken by the volunteers to prevent the further outbreak of the coronavirus in their villages.
First, in the absence of any approved treatment or vaccine, our most important tool for saving lives at this time is awareness creation—promoting life-saving health and hygiene behaviour, including frequent hand-washing and social distancing. Volunteers conducting awareness activities must also maintain social distancing to protect themselves. Union Health Clinics can assist in creating awareness among the villagers, but only if their personnel are adequately equipped. Concerns have been raised that some of these workers are already infected due to lack of protective gear.
Second, those who are infected or suspected of being infected must be identified, offered medical support, and isolated. Isolation is necessary to protect others from being infected, but it must be explained so as not to create fear. The volunteers must also work to prevent stigmatisation and harassment of infected people. This can only be done at the local level, by appealing to villagers' social/family connections and brotherly spirit—every infected person is the loved one of another villager. The villagers must also be vigilant in preventing violence, especially against women. To speed up testing, the Upazila Health Office should be engaged in collecting samples from suspected people, which would require enhancing its capacity and equipping a small laboratory on premise.
Thirdly, we must remember that the coronavirus pandemic is not only creating a health emergency but also an economic crisis. Already, innumerable Bangladeshis have lost their livelihoods, the vast majority from the informal sector. Most live hand-to-mouth and have little or no savings. Due to the lockdown and lack of work, many now face food insecurity. Unless help is urgently provided, some may die of hunger, if they are not already killed by the virus. The villagers must stand by their neighbours—including migrant labourers returning to their place of birth—who, having lost their livelihoods, are on the verge of starvation. The volunteers can make a list of everyone requiring assistance and help those eligible to enrol in government's social safety-net schemes. Others may be helped by community philanthropy or mutual aid efforts organised by volunteers.
By capitalising on the inherent empathy and goodwill human beings have for one another, we can bring together all the "forces of good" in our society, ultimately saving many lives from coronavirus' aggression. Thus, "ashun shobai milay shopot kori, sthaniyabhabay coronaviruskay protihoto kori," (Let's all commit to resist coronavirus locally)—such an initiative will not only protect people at the grassroots from possible death from coronavirus, but also protect them against food insecurity and death from starvation. We are pleased that volunteers of The Hunger Project have already undertaken such initiatives in about 1,500 villages to resist coronavirus in their villages and the leaders of SHUJAN are assisting.
Dr Badiul Alam Majumdar is Secretary at SHUJAN: Citizens for Good Governance.