The Urban Poor in Sub-Saharan Africa under the Corona virus Pandemic: a View from Dar es Salaam, Tanzania

Dar es Salaam, 7th May, 2020

By: Priscila Izar, Albert Nyiti, ElinorataMbuya and Daniel Mbisso

Originally posted by the African Center for Cities

In poor and informal communities of Sub-Saharan Africa, like in other countries and regions of the Global South, the new corona virus pandemic highlights a long lasting urban crisis. This crisis is manifested through a lack of water and sanitation, and adequate shelter, as well as food insecurity. Mitigating the risk and the effects of this pandemic in these poor communities must combine social isolation with protection of livelihoods through free access to clean water, adequate shelter, food security, and the provision of context-based information to local communities about the disease and how to protect from it.

In this brief article, we argue that asking whether communities living in poor and precarious conditions can survive the isolation and social distancing that are required to address the corona virus crisis, is the wrong approach. Instead, the question to be asked should be how can these communities cope with these measures that will substantially disrupt their livelihoods on the one hand, but which are required to save lives on the other hand, as long as testing and contact tracing are not available. In the following paragraphs we draw from our knowledge of the conditions on the ground in Dar es Salaam, as well as experiences in other countries of the Global South, in order to discuss some possible solutions to ameliorate the effects of the Covid-19 crisis there. In Tanzania, with over 70% of the population living in unplanned settlements and 50% of the entire population being low income earners, critical thinking on how to counteract the pandemic is urgently needed.

If the Corona virus pandemic has highlighted a healthcare crisis in more economically developed contexts, it also highlights an on-going urban crisis in less developed contexts.

The world has been watching in astonishment the escalation and the terrible effects of the Corona virus global pandemic. In January 2020, the reports of the spread of a new disease and the shutdown of the city of Wuhan in China sounded like a very far away reality. When months later the corona virus pandemic hit Europe and North America, it became clear that a lack of preparedness can quickly overwhelm a country’s health care systems. In early April, Italy and Spain had the highest death rates in the world due to Covid-19 and their health care systems were overwhelmed. Since then, the United States has surpassed these countries in the number of confirmed cases and deaths. As of May 2nd there have been over 1.1 million cases in the United States, with a death toll of 64,943, or 19.85 deaths per 100,000 residents.There, it has also become clear that Covid-19 has a disproportionate effect on ethnic and economic minorities, with African-Americans being affected at a higher rate than the overall population, due to underlying health conditions.[1]

Another effect of this global pandemic is becoming evident in countries with large populations living in extremely poor and precarious neighborhoods, mostly in the Global South. In these contexts, social isolation alone puts local communities in an impossible situation as families rely on daily work to sustain their livelihoods. Quite often these communities also lack access to running water and proper sanitation. Households are overcrowded and neighborhoods lack facilities such as health care centers to support the community at a time of crisis.

In Brazil, community leaders of especially impoverished urban settlements, known as favelas, have denounced a lack of consideration of their neighborhoods in the government’s early responses to the pandemic. On March 21st , Gilson Rodrigues, a community leader of Paraisópolis, the second largest favela in the city of São Paulo, with an estimated population of 100,000 people, announced on social media a plan for community self-organizing for the delivery of food baskets and provision of basic health care. By April 2nd, eight thousand food baskets had been delivered, according to information in the association’s Facebook page.[2] Because overcrowding is prevalent in the households of Paraisópolis, a solution that the community devised was to create special quarantine areas for confirmed cases not requiring hospitalization. Through a partnership with a large private hospital with long term ties in the community, and the State of São Paulo Education Department, two public school buildings in the neighborhood were adapted to receive Covid-19 patients requiring quarantine, starting on April 27th. In Rio de Janeiro, RioOnWatch, a local NGO dedicated to reporting the lives and voices of the favela residents, has described how these communities have also been left out and how residents have organized responses, from delivering food baskets, to demanding the delivery of water free of charge, in a short time of less than two weeks. Solidarity networks have been set up so that individuals can make financial donations to local communities through crowd sourcing. If, on the one hand these experiences illustrate the resilience and creativity of local communities in responding to a crisis and the willingness of the middle class to contribute to it, on the other hand these also demonstrate how, as RioOnWatch describes, “the corona virus pandemic is poised to dis proportionally affect the urban poor.”[3] This is true in Brazil and elsewhere.

Currently, Brazil is the 8th most affected country worldwide, with over 92,000 Covid-19 reported cases and 6,412 deaths as of May 2nd . Specialists continue to argue that, without the ability to test and do contact tracing, the only available option to contain the spread of the disease is through strict social isolation measures. Early State-government efforts to impose isolation in Brazil’s largest urban centers, contrary to the President Jair Bolsonaro’s orders for the population to keep working, have contributed to a decrease in the rate of the spread of the disease. An article on the newsletter of the São Paulo Research Foundation (FAPESP) estimated that social isolation measures imposed in São Paulo state on March 16th decreased the rate of infection by one third after four weeks.[4] Since then, the central government’s pressure for businesses to reopen has led to a decrease in the rate of isolation throughout the country and a new surge in the rate of transmission. In doing so, the Central Government overshadows community-based efforts such as those of Paraisópolis and the favelas of Rio de Janeiro, as well as policy efforts to provide relief to poor households and small businesses that could allow them to stay home.

What about the Sub-Saharan African region?

While so far, the spread of the Corona virus in Sub-Saharan Africa has been more limited, concerns with the possible effects of isolation on poor and vulnerable communities are growing. The first case of COVID-19 in Sub-Saharan Africa was reported in Nigeria on the 27th of February 2020. Other neighboring countries have thereafter reported cases. In all cases, the first patient was either a foreigner travelling in the country or a citizen returning from international travel. However, current trends of reported cases have indicated that the virus is already spreading to residents of Sub-Saharan countries who showed no records of international traveling at all.  Meanwhile, there is no clear evidence that elements such as the warm weather and a younger population can help lower the rate of critically ill Covid-19 patients. High rates of tuberculosis, HIV infection, and overcrowding in public transportation systems and at home might overshadow those potential deterrents of the disease in its most critical form.

A nationwide shutdown was enforced in South Africa as early as March 26th . Without sufficient testing and with most cases being from international travelers bringing the virus into the country, the idea of an early isolation was to contain the spread of the virus at an early stage, similarly to Brazil.[5] As of May  2nd , with 6,336 confirmed cases and 123 deaths, South Africa started to reopen some sectors of its economy. However, through this process, measures to protect the poor, such as providing lunch to children staying at home and who usually depend on their school meals as their main form of nutrition, were not thought out as the lock down went into effect, indicating a lack of preparedness of policy makers in recognizing how differently the corona virus crisis can hit poor and precarious communities and their populations in that country as well. In hard hit areas such as Cape Town, there were reports that makeshift homeless shelters did not provide adequate food and water provision to the population being placed there.[6]

Combining social isolation with access to clean water, adequate shelter, food security, and context-based information

Poor shelter conditions increase the risk of transmitting the corona virus to local households. While the requirements to address the Corona virus crisis are too immediate, it is paramount that national policy goals of redistribution and achievement of minimum living standards to all people are considered. In other words, relief efforts now must guarantee that the most vulnerable are able to have access to minimum living conditions even if lacking the financial means. In response to the crisis generated by the Corona virus pandemic, national governments in France and El Salvador have declared a moratorium on utility bills. In the US, social movements are calling for a moratorium on rent. In Brazil, free access to water is a major demand of social movements combating the Covid-19 crisis. Similarly, central governments and international organizations operating in Sub-Saharan Africa must insure that these basic needs are provided and addressed, at no cost to the local communities. 

In Tanzania, facilitating the provision of adequate shelter to all income groups is one of the overall goals of the National Human Settlements Development Policy of 2000.[7] The use of modern materials for roofing, walls and flooring in urban housing units has been reported to be at 97.6%, 94% and 85.6% respectively [8] (URT, 2019). However, with the average urban household size of 4.6 and 58.8% of the urban population using shared un-improved toilet facilities, (ibid) achieving social isolation and accessing running water proves to be a challenge. Economy slowdown due to social isolation has a disproportionate effect on informal workers. In Sub-Saharan Africa it is estimated that 80% of employment is in the informal economy. In Tanzania, 88% of employment growth between 2002 and 2012 was in the informal sector.[9]

While official reports are that currently, 87.6% of the urban population has access to clean and safe water (WSSR, 2018), this information is misleading in that it does not clarify that poor households, in order to have access to such clean water have to purchase it from third parties. Moreover, access to such clean water is uneven in Dar es Salaam’s poor neighborhoods. During this time of pandemic, it is extremely important that poor households have free access to water so as to practice the hygiene required to combat the spread of the coronavirus. The distribution of water buckets to households in need can be organized locally, similarly to what is being done in the favelas of Brazil with the delivery of food baskets. However, local and regional authorities must support the free delivery of water. Local-level solutions to the Covid 19 crisis should rely on networks involving international donors, government, local NGOs and community-based organizations, as long as actions on the ground are not delayed by bureaucratic processes. In Dar es Salaam, the Federation of the Urban Poor and the Center for Community Initiatives, CCI, are, respectively, community-based and a non-governmental organizations already working on a number of communities and with the capacity to transfer knowledge to residents about COVID-19 and to help deliver what is needed at the local level. 

At the neighborhood level, there is also a lack of understanding about what is Corona virus and COVID-19, how it spreads and how it can be prevented. Often information is not produced in local languages. Visual representations are out of context, describing the spread of the virus at shopping malls and airports, which are often realities very different from the residents of low-income neighborhoods. This has been leading to misinformation, such as that the disease only affects the wealthy part of the population, or the wealthy neighborhoods. Proper hand washing techniques are not known, nor is the importance of social distancing, in other words, maintaining a safe distance from one another as a way to avoid transmission from person to person. These are issues that must be explained to local communities in their local languages. Adequate campaigns must be launched through mass media as well as through community organizers working on the ground. As public, private, not-for-profit and research organizations have diminished their actions on the field, resources can be directed to designing and disseminating these campaigns.

For communities that rely on daily labor to put food on the table, isolation alone will quickly lead to starvation. Even if isolation is not imposed, the slowdown in the economy and decrease in daily foot traffic has a significant impact on the daily activities and earnings of the informal workers. Hence, in addition to education and water distribution, assistance must also include food distribution. This can also boost, rather than hurt, the local and the national economy. International finance and development institutions have expressed concern that a Covid-19-led economic slowdown can be more dangerous than a financial crisis.[10] Therefore this is the time to avoid having small producers shut down by facilitating access to credit and grants. If local systems of food delivery are well thought out, upcountry farmers and food suppliers, who are now running the risk of having their produce rot or just shutting down operations, can put their production to good use. One possibility is that food baskets with daily or weekly supplies are prepared at warehouses or local food markets and distributed to households, similarly to what is being done in São Paulo and Rio de Janeiro, in Brazil. Usually, household members in Dar es Salaam’s urban neighborhoods buy street food since they lack the time to cook at home. If families are spending the day at home without the possibility to work, home cooking would be possible. It is also possible to consider that the mama lishe, or female food vendors who sell homemade food on the street, can maintain and even expand their business at the extra open space on street markets, which will be emptied of customers due to self-isolation. Since these street markets are adjacent to well-populated neighborhoods, the food that mama lishe produce can be delivered to local communities relatively easily. The key is to maintain the livelihood of the urban poor affected by the pandemic, including by ensuring food availability on their table every day.

As countries, cities, and communities prepare for the crisis at the local level, other local solutions can and should also be thought out to keep small business afloat, local distribution systems running, and low-income families financially secure. For example, affordable, homemade sanitizers can be produced, with water, soap, and bleach, and put in recycled bottles to be used at home or distributed. There are already on-going efforts in Dar es Salaam to make and deliver masks and gowns to doctors and nurses working on the frontline. Economically well-off families have been contributing to the preparation of daily meals that are delivered locally to those in need. Local companies can also work towards retrofitting their production. For example, small and even large beer brewers can retrofit their systems to produce hand sanitizers. These can be very practical in communities that have limited water. The local-level textile industry that is already suffering with the slowdown in business can also adapt and produce masks and hospital gowns. These adaptations in the production systems require coordination by the central and regional governments and donor organizations, but can also work well independently once a system is put into place. It is important that small innovators have financial support to switch their production systems. This is where private organizations should also play a part, helping finance local business and the delivery of products (such as hand sanitizers and masks, for example) to local populations and to local hospitals for free.

A celebrated idea, innovation is required now, and with a focus on increasing the welfare and security of the most vulnerable groups. Understanding that the Coronavirus crisis is also an urban crisis that disproportionately affects the poorest and most vulnerable population is an important step in devising systems that mitigate these most detrimental effects and avoid major social and environmental disruptions in Sub-Saharan Africa as a whole and in Tanzania.

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About the Authors:

Priscila Izar (contact author, Izarpriscila@gmail.com) is a Postdoctoral Research Fellow at the Institute of Human Settlements Studies (IHSS) at Ardhi University and the Acting Head of the Dar es Salaam City Lab. Albert Nyiti (nyitialbert@gmail.com) is IHSS Assistant Research Fellow and a member of the Dar es Salaam CityLab. Elinorata Mbuya(angelambuya@yahoo.co.uk) is IHSS Research Fellow and a Senior Researcher of the Dar es Salaam CityLab. Daniel Mbisso (mbissod@gmail.com) is the Head of the School of Architecture at SACEM, at Ardhi University.

[1] Centers for Disease Control and Prevention. COVID-19 in Racial and Ethnic Minority Groups. Retrieved fromhttps://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html.

[2] Nova Paraisópolis. Retrieved from https://www.facebook.com/ParaisopolisSP/?__tn__=%2Cd%2CP-R&eid=ARABZh8Rw6CO8m4en552ZJJz05HV_Fa_BIShNJnKszYCjArV5Zme_ePSXFSM6UrfosPUj6L46JhGgCxc.

[3] Rio on Watch. Community Reporting in Rio. Six Coronavirus Realities in the Favelas: From Lack of Information to Lack of Water. Retrieved from https://www.rioonwatch.org/?p=58388.

[4] Research FAPESP. Social isolation reduces coronavirus transmission rate in São Paulo. Retrieved from https://revistapesquisa.fapesp.br/2020/04/08/isolamento-social-reduz-taxa-de-transmissao-do-coronavirus-na-grande-sao-paulo/.

[5] Business Live. Coronavirus lockdown to leave SA’s poor high and dry. Retrieved from https://www.businesslive.co.za/fm/features/2020-03-19-coronavirus-lockdown-to-leave-sas-poor-high-and-dry/).

[6] Eyewitness News. City of CT provides tents for homeless people during the Covid-19 lockdown. Retrieved from https://ewn.co.za/video/11351/city-of-ct-provides-tents-for-homeless-people-during-covid-19-lockdown.

[7] United Republic of Tanzania, (2000) National Human Settlements Development Policy, Ministry of Lands and Human Settlements Development, Government Printer, Dar es Salaam.

[8]  United Republic of Tanzania, (2019) Household Budget Survey 2017-18, Key Indicators Report, Government Printer, Dodoma.

[9]Diao, X., Kweka, J., McMillan, M., & Qureshi, Z. (2020). Economic Transformation in Africa from the Bottom Up: New Evidence from Tanzania. The World Bank Economic Review, 34 (Supplement_1), S58-S62.

[10] CNBC. Coronavirus pandemic economic fallout ‘way worse than the global financial crisis,’ IMF chief says.Retrieved from https://www.cnbc.com/2020/04/03/coronavirus-way-worse-than-the-global-financial-crisis-imf-says.html.