Fault-Lines in the Public Health Approach to Covid-19: Recognizing Inequities and Ground Realities of Poor Residents Lives in the Slums of Dhaka City, Bangladesh
24 Pages Posted: 15 Jun 2020 Publication Status: Under Review
In this paper we aim to better understand the lived experiences of the slum dwellers in Dhaka, Bangladesh and the social, economic and health and well-being constraints resulting from the nationwide shutdown due to COVID-19 pandemic. We undertook rapid qualitative research telephone interviews (51, 44 women and 7 men) with slum dwellers. We analyse the data using intersectionality theory. Findings draw on direct experiences on the impact of the shutdown on vulnerable groups living in informal settlements in Dhaka city. Highlighting the tensions between the current shutdown to address the spread of COVID-19 and the immediate and urgent (food and other) needs of poor and vulnerable groups. Slums are overcrowded, steeped in deprivation, with residents using communal latrines, water sources, cooking spaces, with many slum dwellers unable to follow the recommended guidelines for preventing COVID-19. Most were living in panic and fear of getting infected. Stress and anxiety were reported as their precarious existence deepens with the continued containment measures and were particularly reported by women, who were also experiencing increasing levels of violence. Food relief distribution remains uneven and beset with irregularities. While health risks are a very real concern, their overriding insecurity is starvation. We frame our discussion within recommendations made on C-19 and intersectionality highlighting the importance of learning from qualitative testimonies with women and men within the context of informal settlements at this point in lockdown; the need to move beyond a deficit model and recognize and support resilience; and the importance of broadening bailout and stimulus packages to prioritize those most at risk and ensure multi-sectoral action approach to this pandemic in Bangladesh and elsewhere needs to be accompanied by a socially just model that recognizes the ways in which structural, patriarchal and social inequalities interplay to place the poorest most at risk to multiple threats.
Note: Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This research was supported by the core fund of the BRAC James P. Grant School of Public Health, BRAC University.
Ethical Approval: Considering the urgency and importance of this type of rapid research in the current pandemic situation, the independent Institutional Review Board (IRB) at BRAC JPGSPH has established a rapid review system with a short application submission and quick review process within a shortest possible time. A concept note with detail methodology, ethical considerations and interview guideline was submitted to IRB and received approval. Verbal informed consent were taken from all respondents.
Declaration of Interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Keywords: vulnerability, shutdown, COVID-19, Bangladesh, informal urban settlements, intersectionality, socially just model
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