An update from the Ghana SDI Alliance, comprised of Ghana Federation of the Urban Poor (GHAFUP) and People’s Dialogue on Human Settlements – Ghana.
Following the confirmation of positive Covid-19 cases in Ghana, the Alliance quickened plans to establish the Community-Led Response and Management of the Coronavirus Disease-19 (CLeRMoC-19) response teams in slums, mostly in the Greater Accra Region of Ghana where a high number of positive cases were recorded.
CLeRMoC-19 Mitigation Responses
The Ghana Alliance’s response to the pandemic was purely community led and involved establishing community coordinating committees, community volunteers, community coordinating centres, pre-triggering meetings with community leaders, municipal and metropolitan health officers, supply of PPEs and community sensitisation activities.
The initiative covered mostly Zongos, inner-cities and slums in the Greater Accra Region, with the aim of creating community level response structures to compliment national level efforts to calm to pandemic.
Supplies such as Veronica buckets, face masks, hand gloves, hand sanitisers, sanitary wipes, hand wash stands and other PPEs were given out in the communities. Cooked and non-cooked food were shared on daily basis, especially to persons with disabilities in the communities. Community sensitisation on behaviour change education campaigns were carried out as well to ensure residents become aware of the situation and prepare towards any effect.
The rapid spread of the virus revealed that case management activities were not sufficient to control the disease, and that social mobilisation and community engagement were essential to all aspects of the coronavirus response. Prevention responses in the communities included: proper hand washing with soap under running water, wearing of face mask, avoiding crowded spots, self-quarantine, isolation of infected persons, early reporting of symptoms, and establishing hand washing kits at hotspots in the target communities.
Our prevention responses took cognisance of the high densities of populations in the Zongos, inner-cities and slums, which do not have adequate health or other infrastructures to support community resilience against Covid-19. For example, the settlement of Old Fadama is home to over 120,000 people, Sabon Zongo has over 6,500 residents, Osu Klottey is heavily occupied with over 80,000 people, and Amui Dzor in Ashaiman is equally densely populated settlement. Though resources were limited, CLeRMoC-19 intervention responses reduced the vulnerability of the target communities to the pandemic by bringing preventive support services closer to the people.
Outcome of Activities Implemented
One most important results of the CLeRMoC-19 are the great engagement of the community in activities resulting in the identification and preparation of measures to decrease risks and protect vulnerable groups, including older people and those with underlying health conditions.
Secondly, CLeRMoC-19 served a critical role in securing the continuity of the supply chain for essential commodities and services in the communities. The intervention advocated and ensured that the fundamental rights of vulnerable groups are safeguarded, that they have access to testing and health-care services, and that they are included in national programmes to receive information and assistance. It further prevented, anticipated and addressed risks of violence, discrimination, marginalisation and xenophobia towards people of concern by enhancing awareness and understanding of the COVID-19 pandemic at community level, ensuring responsibility and management.
Generally, CLeRMoC-19 has demonstrated to be a modality for the communities to take ownership of their safety by creating and sustaining their own response and management strategies against Covid-19.
Results and impact of CLeRMoC-19
- The initiative established Corona Virus Disease coordinating centres in Zongos, Inner-Cities and Slums (ZINCS) plus monitoring surveillance groups in some markets and support persons with disability (PwDs).
- CLeRMoC-19 identified and selected responsible persons from within ZINCS as Covid-19 coordinating committees and volunteers to partner with environmental health officers of the assemblies inside their communities.
- CLeRMoC-19 provided the communities with the means to conduct their own appraisal and analysis, their safety regarding the disease, and the consequences if nothing is done.
- The community-led initiative instilled a feeling of urgency in engaging in community actions that will prevent the community experiencing infections.
- To complement national efforts, CLeRMoC-19 supported the National COVID 19 team in the implementation of the identified solutions and actions adopted.
- CLeRMoC-19 also supported Community Health Nurses and Environmental Health Officers to embark on sustained and intense hygiene promotion campaigns at the community level.
- CLeRMoC-19 has been the most prominent and popular provider of hand washing materials at community level, creating centres at vantage places using local technology such as tippy taps, veronica buckets etc.
- Other PPEs provided under the initiative include face masks, hand gloves, sanitary wipes, medical overall and medical goggles for front line workers.
- Provided education and training on prevention
- Scaled up using social support system and provision of essentials such as food and water to reach out to the most vulnerable such as Persons with Disability and Kayaye
- The community-led response team provided onsite education and training on prevention of COVID-19 to residents. But broadly, the intervention sought to achieve the following:
- Provide PPEs for community use
- Encourage the youth to develop community level hand washing kits
- Ensure early community detection of symptoms and seeking early treatment to health services
- Ensure social distancing and other protocols are observed in the target communities
- Avoiding any body contact and body fluids by community members
- Ensure constant hand washing with soap under running water in the target communities
- Community compliance to contact tracing and quarantine protocols
Community entry and pre-triggering meetings – CLeRMoC-19 initially started with community entry meetings lead by PD in collaboration with the federation in all the target communities. The meetings enabled the communities to mobilise support through public announcements using gong-gong, the religious groups, tribal chiefs, transport associations, food vendors, scrap dealers and facility managers (toilet/bath house). Six community entry and preparatory meetings – one in each target community were organised.
Partnerships and Collaborations
The Ghana Alliance collaborated effectively with local and international partners to carry out the activities. Metropolitan/Municipal Assemblies provided Environmental Health Officers to train community coordinating committees and volunteers to carry out community education. International NGO OXFAM donated PPEs for supply to the communities. Some religious institutions based in South Africa but with branches in Ghana also donated food items and PPEs to our course. Other individuals in their own small ways donated sanitisers to the Alliance for distribution to communities.
The Alliance is currently exploring further partnership with UN Habitat, WIEGO, National Board for Small Scale Industries (NBSSI) and others in the Covid-19 fight.
In conclusion, the Community-Led Response and Management of Covid-19 ensured that material supplies such as face masks, hand gloves, medical overall, tissues, tip-taps, veronica buckets, soap and hand sanitisers were provided in Zongos, inner-cities, slums, markets and other vulnerable groups as a prevention against the spread of Coronavirus.
Additionally, implementation of community-led campaigns on hygiene promotion, logistical support to environmental health officers, and community collaboration have been successful. The campaign built community knowledge, encouraged involvement, responsibility and a sustainable process on hand washing, use of sanitisers, social distancing and instilled confidence in community members to stand against COVID-19 pandemic.