FACILITIES IN POOREST AREAS DEMAND FOCUS
TOWARDS the end of last year, the world witnessed the outbreak of a new strain of virus that had not been identified in humans before.
The novel coronavirus was detected in the Chinese city of Wuhan. The World Health Organisation swiftly declared a public health emergency of international concern at the end of January this year, as infections spread rapidly within China.
Since then an increasing number of cases have been confirmed outside of China, including South Africa.
The first line of defence against the pandemic is surveillance: monitoring human and animal populations to spot outbreaks and contain them quickly. The South African government has urged its citizens not to panic, as they are prepared to fight to contain the coronavirus outbreak.
Now that South Africa has confirmed at least 1 326 cases of coronavirus infections and three deaths, we are at a crossroads: Covid19 has not yet reached (or at least we don’t know if it has reached) epidemic proportions in South Africa. Despite the government’s efforts, significant gaps and challenges and unevenness exist with regard to pandemic preparedness. Progress towards preventing the spread of coronavirus has been uneven, and many parts of the country have been unable to meet basic requirements for compliance.
Epidemics or pandemics usually hit the poor first and worst. History has exposed gaps related to the timely detection of disease, availability of basic care, tracing of contacts, quarantine and isolation procedures, and preparedness outside the health sector, including co-ordination and response mobilisation.
In a country with high inequality like South Africa, the gaps are especially evident in resource-limited settings of townships and informal settlements, and threaten to pose dire implications for what may happen during an outbreak.
The coronavirus outbreak is also a town planning issue and planners can influence the trajectory of the virus. Given the variable, the strategy that South Africa is employing is not sufficient to contain the virus.
The strategy needs to be recalibrated. We must start moving beyond national systems and prioritise interventions in hard-toreach areas. Many of the locations might be remote, with health facilities and other services beyond the reach of people.
Urban informal settlements are hot spots for the spread of diseases. Targeting areas of extreme poverty through health interventions, alongside provision of proper water and sanitation services and other forms of sustainable developments, would offer a longer-term solution to preventing the spread of the outbreaks.
All of this points to a critical need to situate the response to the coronavirus within wider riskinformed development strategies to ensure the inclusion of those furthest behind, who might otherwise face the worst effects of the pandemic.
Covid-19 surveillance remains weakest in marginalised areas at greatest risk. Such areas are short of water and sanitation infrastructure and health facilities.
They struggle for clean drinking water daily. Water to wash their hands regularly might seem to be a luxury they cannot afford. The underinvestment in preparedness in these communities reflects the painful choice facing poor and marginalised communities with high disease burdens.
The weaknesses mean that in poor communities, isolated outbreaks will probably go undetected for a longer time and, thus, smoulder and spread. Under such circumstances, we will all be doomed.
Regardless of where a pandemic starts, once under way, the poor tend to bear the brunt.
These areas need to be paid attention to, lest they serve as a ticking time bomb for us all. Without vigorous efforts to secure equitable access to basic services for everyone, we are doomed to face the worst pandemic ever seen in the history of this country.