July 5, 2020

Community Resilience: Building Capacity to Combat COVID-19

COVID-19 is no longer the traveler’s disease, it is now transmitted at the community level. A community driven response is therefore inevitable. AICS has been at the forefront of sharing information to build capacity of various stakeholders responding to COVID-19, especially in low income settings, Follow this page for updates on how our model community driven COVID-19 intervention is evolving, lessons learnt and how you get involved. The model project is implemented by AICS and partners (Kamili Organization and Kenya Association for the Intellectually Handicapped) in Kajiado, Nairobi, Meru Counties. This funded by the Open Society Foundation and Open Society Initiative for East Africa (OSIEA).. The consortium of KAIH, Kamili and AICS jointly implementing above project, recognize the threat to life and livelihood posed by the Coronavirus (COVID-19). We are aware that persons with mental disability, who we serve, have greater vulnerability to the virus. While we are taking measures to keep our staff and beneficiaries safe through encouraging stay home, we have identified gaps in the response by both national and county governments. We have conducted COVID-19 risk assessment on PWMD; held consultations with representatives of county health management teams in our project sites (Meru and Kajiado County) and identified additional intervention required to enhance their protection.  The risks, action required and estimated cost are summarized in the table below. We recognise the limited access to information in forms that are easy use by PWMD (including non-verbal visual cards for use by caregivers). We are responding by adopting existing Information, Education and Communication Material for general public with emphasis on care for PWMD in COVID19 context.  There is limited sensitivity training and psychosocial support for health care workers and caregivers of PWMD. To address this gap, we have develop a recorded video training material for use in Continuous Medical Education (CME) sessions. This is to be integrated in Kenya healthcare workers e-learning hub.  You can access the video and reuse them for training of healthcare workers and other frontline workers in your community  Support surveillance, reporting, case management and community care support system (includes for PWMD released from institutional care – prisons and health facilities such as Mathari) are essential in protecting most vulnerable populations. We are enhancing protection of organizing training sessions at community level for Community Health Workers and local administration leaders (Chiefs) in Kajiado and Meru Counties; and digitizing Ministry of Health data collection forms used by Community health worerks (MoH Form 513 and 514). In addition, we are training for caregivers in households pre-identified by this project (60 in Meru, 4 in Kajiado and 155 in Nairobi County) @ one-day training and linking the PWMD in the project to government support system for basic needs and stock of medication.

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Rights Upholders: Empowering People with Disabilities in a Crisis

There are reports of persons with mental intellectual disabilities being beaten by police for being out during curfew hours. They may not always understand what terms such as ‘curfew’ means, or may not be able to adhere to the same as a result of their impairment. An example is a case reported in Kakamega of a mentally ill man reportedly beaten to death by police enforcing curfew. Law enforcement officers should be sensitized about persons with mental disabilities and that may make it difficult for them to understand the current situation in the Country. In particular, police officers should be sensitized about persons with mental disabilities to avoid wrongful arrests simply because a person may not be coherent or may not understand jargon.  Provide information about curfews and other orders related to COVID19 in easy to read and plain language. Engage family members and other support networks in the community in providing information on curfews and other orders related to COVID19 and helping the identified vulnerable people to follow these orders. Public restrictions based on public health, and actions of law enforcement and security personnel, must not discriminate in any way against persons with mental disabilities. Psychiatric coercive measures must not be used as any part of the response to COVID-19. Human rights standards and mechanisms offering protection to persons deprived of their liberty and those in congregate settings, including those in psychiatric units and institutions, must remain in effect and not be reduced as part of emergency measures. The right to access information; There are barriers in accessing information on COVID-19 in accessible formats by all such as sign language, Braille, Easy Read; and also barriers in accessing information about mental health services and in members of the public being able to communicate with the Ministry of Health. Currently, there are barriers in accessing information on COVID-19, particularly by people in psychiatric units, and by people with intellectual disabilities who require information in easy to understand formats, people with dementia and children. Information about COVID-19 should be presented in ways that are accessible to all. This means providing information in plain language/easy to understand formats, ensuring that Deaf persons can receive information on COVID-19 on an equal basis with others and providing information in culturally sensitive child friendly formats. This may also entail providing education for parents on how to talk to their children about COVID-19 and its impacts. Additionally, the messaging on the virus should also be in local languages where possible and local media outlets should be used to disseminate the messages as a matter of urgency.

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Safeguarding Young Lives: A COVID-19 Response Framework for Vulnerable Children

The Coronavirus does not discriminate between the rich and poor communities. In low income countries, the cities have greater vulnerability due to high population densities with relatively poorer housing arrangement. This makes social distancing almost impossible. Worse still, these countries do not have the health infrastructure required to support emergency care for a large number of people simultaneously requiring this support. Children are likely to be more affected either due to contracting the virus, loss of caregivers or loss of protective environment such schools and playgrounds. There is therefore a need to enhance protection of children by promoting preventive approaches in the disease management and supporting families to secure livelihoods.  According to Prof. O’rielly of the Medical University of South Carolina and an AICS Associate consultant, “the basic logical principles of trying to contain an epidemic are really pretty simple and straightforward, the devil of course is in the detail. They vary in how they apply and the agent that they’re being applied to. These are basically trying to minimize spread by identifying how it’s being spread and try to minimize contact and the second is try to minimize the consequences by providing treatment to those people who are already infected.” He adds that “my number one message is that COVID responses in low income countries need to focus on social justice, the standard methods that are used to contain epidemics don’t work very well in the absence of social justice. We’ve also learned a number of lessons from other epidemics in Africa for instance we know that we need to engage local authorities because they can be an effective barrier to any kind of prevention activities that may be partaken in their communities, they can block things.”  Dr. Francis Oloo, a spatial data specialists and founder of Geopsy Research and another AICS Associate, “…geographic characteristics like population density, inequality in access to health care and income, vulnerability in terms of age and other ailments can fuel or even cause the impact of this virus to be more severe. There’s no strategy that fits every country for example South Korea and Vietnam have been able to manage the disease without hard lockdowns.”  These challenges that are specific to low income settings exasperate the need for clear guidelines for care of children in COVID-19 situation. Key elements of a child protection sensitive sensitive COVID-19 response are: Evidence informed through disaggregated children data Community driven response with local groups and solutions applied We must plan for effective case management systems in the best interest of children Reduce vulnerability to both the new infections and negative effectives of COVID-19 to children and their households, such as increased violence and risk of hunger. Here is a link to a video link to a virtual meeting with AICS Experts panel on COVID 19 Response in Low Income Settings and Mapping Civil Society Contribution to Community Driven COVID-19 Response in Kenya.

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