While fighting the coronavirus, medical professionals have offered a strategy now seen everywhere in America, Europe and other developed areas.
Here’s the battle plan: Stock up on food and other essentials and then stay home. Wear masks when in public, and practice safe social distancing. Everyone should wash their hands frequently for 20 seconds using soap and hot water. People with fevers or other symptoms should go into quarantine.
There’s more: City and state lockdowns are essential to “flatten the curve” of new cases. Governments encourage waves of coronavirus tests. Hospitals collect ventilators to save critically ill patients. Mass transit is discouraged. Scientists rush to create a vaccine and develop new treatments, such as transfusions of antibody-rich blood serum from recovered COVID-19 patients.
Now, imagine selling those plans to the million-plus people jammed into the Kibera shantytown near Nairobi, Kenya — Africa’s largest urban slum.
“Our solutions are primarily for those who can afford it,” said Dr. Mike Soderling, organizer of the Health for All Nations network for the Lausanne Committee for World Evangelization. “To whose advantage? ... The big question: What are we going to do — what can be done — in the slums of Kibera?”
In America, news coverage of the crisis continues to be dominated by infection rates and death statistics, while politicos focus on the New York Stock Exchange and political polling about the 2020 elections. The lockdown-weary public celebrates any signs of normality witnessed in restaurants, big-box stores and sports stadiums.
Missionary doctors and activists in developing lands have a different point of view. Thus, 200 or more took part in a recent Lausanne webinar focusing on strategies for the COVID-19 battles they know will eventually reach the people they serve. Participants in this discussion kept asking painful questions, such as:
— How do slum-dwellers practice “universal hand-washing hygiene” without running water?
— Is it possible to practice respiratory hygiene in cultures in which masks are a stigma — signs that individuals are carrying a life-threatening disease?
— Can migrant workers effectively shelter-in-place while moving from one temporary community to another?
— Does social distancing work in one- or two-room dwellings containing five or six people, or more, of all ages? How do poor people quarantine elderly family members who are sick?
— Will testing programs work in communities that have few, if any, modern labs and hospitals? Should COVID-19 programs trump efforts to fight other serious diseases?
— Are lockdowns for three to four months possible in cultures in which many people live hand-to-mouth, struggling to feed their families? As Viv Grigg of the global Urban Leadership Foundation put it: “Starving people in slums is not the best solution for a pandemic. ... People who are starving will risk getting COVID in order to get food.”
— Will government leaders resort to locking the poor in isolated zones, with the wealthy and powerful in others, thus creating COVID-19 “red zones” that turn into death camps?
— What about church life? In some modern cities, clergy quickly moved online, noted Gladys Mwiti, chairperson of the Kenya Psychological Association. But in Africa, locking churches will, for many people, strip away their only mental-health support systems as they struggle with trauma, exhaustion, depression, fear, stress, anger and grief.
“Those who are losing their loved ones ... can’t believe that you cannot do a funeral,” she said. “Funerals are big events. We gather together. We mourn together. We bury our dead.” She hears Kenyans asking: “How do you bury my mother when I am not there?”
The bottom line: Those who support international aid programs and mission projects need to understand that familiar middle-class COVID-19 answers may not work for suffering people in other parts of the world, said Dr. Santosh Mathew, who works with a network of 20 hospitals and 40 community health programs in North India.
“Tech answers” are not enough in poverty zones with few resources. Preventative care and aid will have to reach suffering people through flexible programs in their own homes and community groups, said Mathew.
“What is our role? Do we tell them what to do or do we come alongside and help them to find the right answers? ... We think that we know. I think that they may know better.”