Over the past few weeks, the Covid-19 pandemic infection, as well as mortality rate, has exploded. During the initial phases of the pandemic, it was assumed that the pandemic would not significantly affect rural, peripheral regions of the country. But the worrying spikes in infection rates in the rural, non-urban regions of the country proved otherwise.
In response to this new reality, several containment measures have been introduced by the government, including a strict lockdown from 1 July to 14 July, as well as the deployment of the Bangladesh Army along with law enforcement agencies to implement the lockdown regulations more effectively. However, these initiatives also do not appear to be fruitful due to their urban-centric nature and lack of awareness of the people on heath protocol.
That is, Covid-19 containment policies like lockdown are not being properly implemented in the non-urban, rural, peripheral region and subsequently, we are failing to control the outbreak of the Delta variant in Bangladesh.
Therefore, it is high time we upgraded the outdated modality of urban-centric preventive measures and evolved to face the new challenges with a more decentralised, community-based modality.
What're the limitations of the current modality?
In terms of fiscal incentives, most of the initiatives taken by the government are primarily credit support programmes – programmes aimed at easing the burden of debt.
For example, the central bank recently extended the loan-repayment moratorium up to August 31, provided that the borrowers have repaid at least 20% of the total due amount by June 2021. Also, the government announced a Tk20,000 crore SME package as well as a Tk3,000 crore agricultural incentive package.
Apart from the Tk26,000 crore cash-incentive package, most other initiatives taken by the government can be categorised as some form of credit support programmes.
On top of that, most of these approaches are more or less urban-centric and they would have made sense a few months ago when the urban-industrial sectors, with high population density, were the most affected regions of the country.
Now the underlying circumstances have drastically shifted both in terms of health and in terms of livelihood. The pandemic has now reached rural communities. Most of the poor people and vulnerable communities have limited earnings for a living now and even limited scopes for borrowing, as their traditional sources of borrowing have dried up. So, the government needs to incorporate these recent developments into its decision-making and adapt policies accordingly.
For instance, credit support programmes are unlikely to be effective in rural and peri-urban regions. Even if the 100% implementation of the Tk 20,000 crore SME support programme would have been realised, that would reach only 6% of total SMEs of the country. Moreover, the repayment capacity of these poor SMEs is now under strain. Instead, a more cash-centric approach should be adopted by the government – either cash support or withdrawal of payment of fees, charges, which would keep them alive. Unfortunately, ensuring the accessibility of fiscal incentive programmes to the people of rural and peri-urban regions is becoming increasingly difficult due to limited authentic data.
In broader terms, most of the present schemes of the government can be referred to as 'administrative schemes' or 'administrative support mechanism', in terms of maintaining businesses, livelihood as well as in terms of health.
To a certain extent, these initiatives have been successful in alleviating the adverse economic conditions facing the poor and the marginalised communities. For example, the government has undertaken many Open Market Sales (OMS) operations under the TCB, where the consumers can buy essential goods like rice, oil, onions, potatoes, pulse etc. at a reasonable price.
Under the VGF (Vulnerable Group Feeding) programme, the government will provide 10 kg rice free-of-cost to more than 10 million families, on the occasion of Eid-ul-Azha. In addition, vulnerable families can now call 333 to inform them about their conditions and seek help from the government. However, these programmes need to be continued for a longer period – several times a year.
The army as well as the police forces have also been deployed to donate rice and other staple foods to the at-risk population. Furthermore, government bureaucrats have contributed significantly to the 'Ashrayon' project, aimed at building houses for the vulnerable.
Apart from these administrative support programmes, there were many NGOs, private enterprises as well as voluntary organisations that used the online social media platforms to raise funding and utilise the money to deliver food to the poor, albeit at a limited capacity.
Most of these programmes are largely urban-centric – both livelihood support and health measures - and hardly accessible to peripheral communities. In the rural regions, government and administrative schemes to ensure the supply of essential products at an affordable price were sparsely available and could barely meet the demand. Given the changing nature of the spread of the pandemic across the country, these health and livelihood support programmes need to be widened outside major city areas - more in district, upazilla and village levels.
Community-based initiatives to engage peripheral communities
Therefore, fresh community-based initiatives must be introduced to address the newly Covid-19 affected regions, outside of urban centres. Taking a community-based approach may help in tackling the adverse effects of the pandemic in several different ways.
First of all, administrative processes could be better handled by engaging communities such as local government offices (city corporations, pourasavas, thanas and union parishads), NGOs/CSOs, local political leaders, community leaders such as school teachers, madrasa's imams, youth clubs, self-help groups, local-level business associations (chambers, samities, workers unions). Given the better access to information of the vast communities living outside the purview of the administrative process, better identification and better enforcement of different public support programmes would be possible.
Second, given the limited fiscal and financial capacities, a part of resources need to be generated at the local level for social support programmes. Engagement of the local communities would make it easy in generating resources at the local level – both under public and private-led initiatives.
Third, most people in the rural regions feel somewhat reserved in expressing their problems themselves to the relevant authority, either out of reluctance or out of embarrassment.
In such cases, the government or relevant local authorities should employ volunteers who would go from door to door to collect information on and provide information to households, i.e., what they need; how they can take precautions against the pandemic: how they can get vaccinated; where they can get medical and financial assistance etc.
Based on this information, relevant local authorities can act more efficiently and promptly to alleviate the conditions of these households. Local authorities can also take other initiatives that may include raising funds for the poor, collecting crops from relatively affluent families and redistributing these crops to the ones in need.
The government may recruit 3-5 volunteers from each village from these communities across the country. A total of 2-3 lac volunteers need to be recruited across the country. Otherwise, the existing local-level community groups could be deployed for this initiative.
These volunteers will ideally be youngsters from ages between 18-35 years. They can be trained for fifteen days and then deployed in the field to provide service to their communities. The duration of these volunteers' jobs will be initially three months and they could be re-employed as and when necessary. A lump-sum amount of monthly payment for these volunteers will be required. However, their activities need to be monitored regularly by local-level committees.
These volunteers can play a crucial role in terms of healthcare as well. First, let's look at vaccination.
The vaccination programme would be difficult to implement across the country without the engagement of the local communities. More use of community health clinics would be required. These local communities could easily create a link with the EPI services and would support the smooth implementation of the programme.
While we follow preventive measures like wearing a mask in public, vaccinating the majority of the population is the only way to truly recover from the Covid-19 pandemic.
However, in rural regions, most people are not aware of the vaccines or the vaccination process. A lot of them do not know how to register for vaccines while others remain reluctant about getting vaccinated. Their behaviour exhibits a similar pattern of illiteracy or reluctance when it comes to maintaining Covid-19 guidelines like wearing a mask, maintaining social distancing, staying quarantined for 14 days etc. Many of them deny the very existence of the virus while others consider it to be a conspiracy of the West to destroy their religion.
But if we really want to get out of this pandemic, we need to incorporate the rural communities and get them on board. As mentioned earlier, government-appointed volunteers can educate and inform these communities about the pandemic, the vaccination process; collect information on families where a patient has been diagnosed with Covid-19 and so on.
The government can also supply masks at a low price, launch awareness campaigns informing people about the Covid-19 pandemic, the vaccination process etc.
One worrying sign of the recent wave of the pandemic, especially in the rural regions, is that they are only coming to the hospital when the infection has already reached a critical stage. All of a sudden, the patient's relatives start scrambling for medical supplies like oxygen, ICU beds and other essential services. Community-based volunteers can play a key role here by keeping tabs on these households and/or managing ICU beds in times of crisis.
In short, we must engage the rural, peripheral, marginalised communities with a more localised, decentralised approach, instead of only a centralised one. To do so, the government can involve local politicians, teachers, religious leaders, Union Parishad Chairmen, community clinics, NGOs, local voluntary organisations, school teachers, madrassa imams, cultural and sports clubs, etc.
In conclusion, the current top-down administrative approach needs to be complemented with a bottom-up, decentralised scheme, to be successful at tackling the Covid-19 pandemic. Hence, implementing a volunteer-driven community-based approach alongside the existing administrative approach, cash incentives, as well as credit support programmes, should be a top government priority.
Dr Khondaker Golam Moazzem, research director at Centre for Policy Dialogue (CPD).