Opinion: COVID-19 in rural communities — building back better in the global south

A community facilitator hangs a poster to raise awareness about hand-washing and personal hygiene amid the coronavirus pandemic in Dhaka, Bangladesh. Photo by: UN Women Asia and the Pacific / CC BY-NC-ND

As the COVID-19 pandemic has flooded the world and infiltrated many of the global south’s most rural, most impoverished communities, attention has turned to what the future will look like.

Notions of building back better, or BBB, and definitions of a much-discussed new normal are circulating among key development actors and news outlets. Going forward, it is critical to consider the true inclusivity of proposed global responses and take a closer look at who gets left behind.

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Without mitigation measures, urban settings provide the coronavirus with an environment to reproduce unimpeded. Yet globalization has also allowed viruses, including the coronavirus, to likewise prosper in the world’s rural communities.

With 79% of people in poverty also living in rural areas, these communities often lack adequate resources to mitigate the physical health threat of COVID-19. Additionally, accompanying mental health and governance challenges complicated the response in rural areas.

It is imperative that these communities are provided with the resources, assistance, and educational tools to build back better and become more resilient in the future. Countries’ COVID-19 response plans need to adequately account for their rural communities, whose infrastructure tends to have a lower capacity and to be less equipped to confront a pandemic.

Building back better

When applied to the Indian Ocean tsunami of 2004, key components of BBB included promoting equity, preparing for future disasters, and devoting more resources to local governments, among other planks. The current intentions of BBB remain rooted in climate resilience. This is an important component for many of these rural communities that are particularly vulnerable to climate change.

Countries that have the financial resources — typically those in the global north — can start planning, building, and implementing now. They can at least attempt to prepare for the next epidemic or the next pandemic. They can postulate COVID-20 and beyond.

However, the question remains: How can the global south prepare to live with pandemic potentiality — specifically when it comes to their rural and impoverished communities? While interdisciplinary conversations looking at the intersection of human health and the economy are taking place, they have not been highly inclusive of the global south.

There is merit in these conversations and approaches in the global north, as they lay the groundwork for BBB, but we need to be conscious of their limitations and work to adapt them for the rest of the world.

Community-managed response

A community-managed response is important in rural areas, as it can adapt to and value the unique characteristics of each community. A particularly challenging factor for responding to a pandemic in these areas is the potential for feelings of social disconnectedness. As humans, social contact is not just an idea but a necessity for well-being.

In areas with limited or no access to telecommunication methods, feelings of isolation are likely rife. Even if a pandemic response requires fewer gatherings or increased distance between individuals, an approach that incorporates and responds to the community will limit feelings of social disconnectedness.

To build back better at the community level, there are a number of development issues that need to be addressed. Some aspects particularly relevant to COVID-19 include:

1. Education and communication about physical health risks. It is particularly challenging to be prudent about reducing the spread of disease when widespread and consistent information is not available.

Community-managed disaster risk reduction, as described by the International Institute of Rural Reconstruction, allows for raising awareness of symptoms and early warning signs, as well as the creation of a disaster risk mobile system. This system would assist in the early detection of any symptoms or signs that may arise.

2. Access to mental health resources. At the same time that access to mental health services is being disrupted in many lower-income and middle-income countries , there may prove to be an increased demand for such services. Additionally, there may be a stigma associated with disease and stressors, such as socioeconomic challenges that could exacerbate mental health problems.

In a time of widespread need for mental health services, using a community mental health care system may prove more effective and efficient than numerous individualized plans.

3. Safe interactions with public places. Food shopping is a useful example of a necessary trip to a public place. However, such trips could present physical health risks by way of COVID-19 exposure and prompt mental health issues, such as anxiety.

Some grocery stores in the global north are addressing this challenge by introducing one-way aisles that serve as a constant reminder to be diligent. Yet direct policy transfer may not be feasible in territorial markets in the global south. To maintain consistent food access, some options include humanitarian food assistance for the most vulnerable families, direct cash transfers, and assurance of mobile delivery.

With the current pandemic response in the global south, it is important that actions be taken with communities and at the community level. There has been a disproportionate amount of focus on the maintenance of wealth in the global north, as evidenced by countries reopening too quickly per the “needs” of the economy.

As COVID-19 has been exacerbated by globalization and provides insight into what shape future pandemics may take, it is imperative that the global south be included in responses to build back better.