Effects of the pandemic on the marginalized communities

Prior to COVID-19, a lot of regions around the world were already in mid-war phases and deeply affected with humanitarian crisis. Upon the advent of the pandemic, situations have only turned worse and risky to thrive for inhabitants of such geographies.
Focusing on healthcare system of Yemen, the country going through one of the largest humanitarian crisis in the world, has only half of health facilities functioning, mainly due to war, and many that remain operational lack basic equipment like masks and gloves, let alone oxygen and other essential supplies to treat COVID-19.(1) There is limited medicine, equipment and personal protection equipment available and only two testing sites as known in March 2020. [6] The fragile health system has extremely limited capacity to adopt and implement effective preparedness and response measures to the COVID-19 outbreak. [5]

The humanitarian situation in Yemen continues to deteriorate, where nearly half of the population is in an acute need for health care [2]. Condition further worsened by re-emergence of malaria, cholera in Yemen bringing in double burden during COVID-19 pandemic. The households’ out-of-pocket payment toward health care, which exceeds 80% of health expenditure in Yemen, hinders access to health services [3]. Poor media and lack of trust in public institutions makes it challenging to deliver behaviour change messaging. [6] Lack of access to adequate sanitation and hygiene facilities reduces the ability to follow recommended steps in reducing COVID-19, such as washing hands with soap. Moreover displaced populations are often confined to overcrowded camps or cities where diseases can spread rapidly through the population and they often face restricted access to health care, which may make them more vulnerable to COVID-19. [7] [8]

A significant blow to the already weakened public health condition in Yemen was recent announcement by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) [2] on shutting down lifesaving interventions in Yemen, which included health projects due to lack of funds. This could further deprive Primary healthcare in the country and the spread of COVID-19 would not be possible to control. Donor countries need revision of this particular withdrawal. [4]
Also, international humanitarian organizations should dedicate a high level joint action to implement a series of well-coordinated measures emphasizing both whole-of-government and whole-of-society approach to protect Yemenis’ right in life and health.[5]
 
REFERENCES FOR FURTHER READING:
1. //www.unicef.org/emergencies/yemen-crisis
2. United Nations Office for the Coordination of Humanitarian Affairs, (OCHA) 2019. Yemen: 2019 Humanitarian Needs Overview. //reliefweb.int/report/yemen/yemen-2019-humanitarian-needs-overview [Internet] Available from: [Google Scholar]
3. Qirbi N., Ismail S.A. Health system functionality in a low-income country in the midst of conflict: the case of Yemen. Health Pol. Plan. 2017 Jul 1 //academic.oup.com/heapol/article/32/6/911/3591753 [Internet] [cited 2020 Apr 20];32(6):911–22. Available from: [PubMed] [Google Scholar]
4. //www.ncbi.nlm.nih.gov/pmc/articles/PMC7250073/#bib3
5. //equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01231-2
6. //reliefweb.int/sites/reliefweb.int/files/resources/20200409_acaps_risk_report_covid-19_impact_on_yemen_update.pdf
7. //www.nrc.no/news/2020/march/10-things-you-should-know-about-coronavirus-and-refugees/
8. //www.rescue.org/press-release/international-rescue-committee-mobilizes-global-response-combat-spread-coronavirus

Effects of the pandemic on the marginalized communities

COVID-19 came as an unprecedented blow to the world, starting from the healthcare infrastructure to the daily lives of the common people. Several inequities had existed in society. These fault lines were exposed by the pandemic. Survival had become difficult for many sections of society, and it is important to address their problem so as to build a robust public healthcare system. 

The lives of People Living with HIV (PLHIV) were affected detrimentally. A study published in July 2020, showed that 252 PLHIV, receiving Anti-Retroviral Therapy (ART) had been infected with the SARS-CoV-2 virus. ^[1] Sporadic studies have been conducted worldwide to explore the effects on the PLHIV. This piece will elaborate on the few aspects of the repercussions of the pandemic in the lives of PLHIV.

A study conducted in China during the first wave of COVID-19 focused on the PLHIV starting from the age of 18 years and who have started with ART. The main challenge which came up in the article was a lack of public health infrastructure. The participants struggled with their ART refills and were not aware as to where to go for assistance during the lockdown. The dearth of Personal Protective Equipment (PPE) was another concern for the PLHIV residing in China. ^[2]

In another study, the evidence showed that the care continuum was potentially disrupted by the pandemic. The biggest threat was the COVID-19 infection itself, the other threats being changes in the financial status, unemployment, unavailability of the PPE kits, sanitizers, masks, etc. The same crisis as China was seen i.e., unavailability of the ART medicines, not being able to adhere to the regimes. The State AIDS Drugs Assistance Programs (ADAP) has renewed the regulations to keep up with the problems faced by the PLHIV. Different social workgroups have taken up the initiative to supply groceries and food coupons to do away with food insecurity and uplift the sense of a community during tough times. ^[3]

There are many more studies highlighting the effects on the PLHIV, which need to be addressed with research and active public health volunteering.

Reference

1. Mirzaei H, McFarland W, Karamouzian M, Sharifi H. COVID-19 among people living with HIV: a systematic review. AIDS and Behavior. 2020 Jul 30:1-8.

//link.springer.com/content/pdf/10.1007/s10461-020-02983-2.pdf

2. Guo W, Weng HL, Bai H, Liu J, Wei XN, Zhou K, Sande A. Quick community survey on the impact of COVID-19 outbreak for the healthcare of people living with HIV. Zhonghua liu xing bing xue za zhi= Zhonghua liuxingbingxue zazhi. 2020 Mar 30;41(5):663-7.

//europepmc.org/article/med/32223840

3. Ridgway JP, Schmitt J, Friedman E, Taylor M, Devlin S, McNulty M, Pitrak D. HIV care continuum and COVID-19 outcomes among people living with HIV during the COVID-19 pandemic, Chicago, IL. AIDS and Behavior. 2020 Oct;24(10):2770-2.

//link.springer.com/content/pdf/10.1007/s10461-020-02905-2.pdf

Other articles –

1. //www.ncbi.nlm.nih.gov/pmc/articles/PMC7447002/pdf/qai-publish-ahead-of-print-10.1097.qai.0000000000002414.pdf
2. //www.ncbi.nlm.nih.gov/pmc/articles/PMC7309641/pdf/aids-publish-ahead-of-print-10.1097.qad.0000000000002555.pdf
3. //link.springer.com/content/pdf/10.1007/s10461-020-02871-9.pdf
4. //link.springer.com/content/pdf/10.1007/s10461-020-02869-3.pdf

The COVID-19 pandemic, and the resulting changes in society due to social distancing measures, has showcased inequities in access to decent work and experiences of discrimination resulting in many of the vulnerable population

The virus has infected over 16 million people worldwide, and there is no end in sight. Many people have been affected in various ways, with some being more affected than others. People have lost their lives, livelihoods, and loved ones. Stress, grief, anxiety, and depression are all common occurrences these days. People are struggling to get through the day. People in states with strict lockdowns can't even buy necessities; food and amenities are scarce. Farmers and daily wage workers are suffering from poverty; many cannot afford to buy a packet of milk for their children. Though the disease has claimed many lives, many others have died as a result of starvation or suicide.

Posted by: @ashishjoshi

Let's share your thoughts on impact of COVID-19 on marginalized communities.

Marginalized communities are not only more at risk of contracting coronavirus, but they are highly susceptible to economic struggle, lack of food and shelter during this difficult time. It includes women, children, people with disabilities, refugees, migrants and minorities. Because these vulnerable population depends upon economy and more often paid under the table and without employment benefits as they have less protection when there is an economic crisis. these areas are more prone to coronavirus because they often inhabit areas that are more densely populated to keep cost low and stay in low proximity to job opportunities. Stress, anxiety along with depression are more common during this pandemic. People also struggling to buy food items in the areas where have strict lockdowns. though many lives are lost due to this disease and many died due to starvation and suicide. Many pregnant women lost their lives due to lack of access to healthcare and refusal of admission in hospitals. Many people cannot afford to visit hospitals due to lack of money. The impact of this pandemic has been severe. Although a lot of states are opening up, we have to take precautions, and the government needs to assess the healthcare system in India closely and make drastic improvements to the welfare and recovery plans to help marginalized people survive these difficult times. As citizens, we should help each other out through these tough times, and follow the rules and regulations that have been set for our own safety and the safety of others around us.

COVID-19 has been challenging for all of us and the most affected people during this hour are the marginalized communities.

marginalized communities have been facing challenges since ages even before the Pandemic and now this COVID-19 have worsen their condition.

they are the people who meet their daily needs after working all day. they may be working children, people with low socio-economic background, Specially-abled people, Victims of Vulnerable groups etc. 

since the Pandemic has begun there is Lockdown and Restrictions almost in every part of the world and this has led to stoppage of Income among Marginalized communities because everything is shut down; the only source of meeting their needs- their job is on halt with no idea when they will be able to resume their work and bring food to the table.

if the COVID_19 infects them it is possible that it would be seriously affecting them because in order build an immunity to fight against any disease or infection you need to have good nutrition, good immunity and sound mental ability along with the finances which is possibly lacking here making them the most vulnerable groups even before children and elderly of other walks of life.

bringing food and providing shelter to the family is a challenge during this hour so they won't be accessing healthcare facilities if they wish to access.

therefore, many lives have been lost unwillingly as there was no support and facilities provided

The crisis that occurs due to the Covid-19 pandemic often highlights inequalities in the labor market either at the national level or international level. The people who belong to marginalized backgrounds are affected disproportionately. The Covid-19 pandemic has affected access to decent work. People experience discrimination which will further show various impacts on the economy and work-related factors. 

They were already poor, earned less, and suffered hunger in pre pandemic days. but during pandemic their income stopped, earned nothing,

and still suffering from hunger. what i can say is that RICH became more richer and POOR became more poorer !!

Although the COVID-19 pandemic has been described as a “great equalizer”, the individual, community, and structural impacts it has on workers are not equal in any capacity. Similar to other crises, the COVID-19 pandemic has shed light on not just income inequalities but very large inequalities in access to decent work in the country. While there is a workforce that has the opportunity to work safely from home, that privilege is not accessible to all workers, many of whom are already vulnerable to economic and structural inequalities and who have historically experienced marginalization and discrimination in the workforce. 

 Effect of COVID-19 Pandemic:

   • Nearly 20 million people were affected due to this Pandemic 

  disease. 

   • It leads to minimum availability of medical treatment. 

   • It also mostly leads to stressful situation.

   • It mainly affects the people who depend on daily salary basis. 

   • It mainly affects the world 🌎wide economy. 

Covid-19 pandemic has created a vacuum in the lives of many people all over the world and marginalized community are mostly effected among all of them. Marginalized community includes homeless people, migrant workers, people who use drugs, third gender(LGBTI),prisoners etc. They are effected socially, financially and health wise. Many are generally homeless and lay road side or in very crowded areas(slums)which are very unhygienic in condition, which led to the increased spread of the covid-19 infection. Mostly they are uneducated ,so they have no knowledge/idea regarding spread of covid-19 or following any measures like social distancing, wearing masks, sanitation which indirectly led to the increase spread of viral infection. Due to this pandemic many daily wage workers or migrants loosed their employment leading to financially instability, so they are unable to satisfy their basic needs of life i.e unable to feed themselves(starving) which led to deterioration of their health condition, lack of shelter etc. They even doesn't have social security/protection and they are treated unequally which ultimately led to the unequal access to the health care services especially to covid-19 treatment during this pandemic.

The COVID-19 pandemic has posed significant risks to particular communities and individuals, including indigenous communities, migrant workers, refugees, transgender individuals, and the homeless population. This marginalized communities is overwhelmed by deprivation, inequality, unemployment, and COVID-19 and its negative consequences. These marginalized groups struggle to obtain an admirable political representation and face marginalization and lack of access to health, education, and social services . It is imperative that these marginalized groups and their right to life and their livelihoods are supported during global crises ( COVID-19).

COVID often reinforce and exacerbate disparities because resources are limited and people are fearful , which has triggered increasing unemployment and major economic losses that leads not only in food insecurity but also cause mental trauma , domestic violence . During crisis this group are more vulnerable due to factors such as their lack of access to effective surveillance and early-warning systems, and health services.

The marginalised sector of our society is the one which is amongst the worst affected due to the pandemic. The reason for the same is clearly them being neglected by the government wherein they should have been the ones who should have received special care and attention. Due to a nation-wide lockdown, most daily wage workers had lost their jobs, others who could retain their jobs were working on partial or no wages at all just to sustain the job. Migrant workers who couldn’t keep their jobs were lacking all the basic necessities in a city away from their home town and their families were suffering back in the villages. Since, the rail lines and buses were also shut, they couldn’t even travel back. It was the government’s responsibility to look after them, however some protocols set by them left the people of the marginalised sector devastated, fighting for their lives in these difficult times. These people were lying helpless on the roads and streets, screaming for help and instead they were prosecuted for breaching the protocols. Lockdown did impact the economy in the worst way possible, people were begging for food, shelter and most of all for medical aids and supplies. The norms set by the government were not in favour of the people from the marginalised sector and instead of helping them in such difficult times, situations were only made worst. They couldn’t even access the government’s relief packages or food grain allotment system as most of these people were engaged in domestic work which fell within the category of non-registered and unregulated work.

Ref: //sabrangindia.in/article/cjp-against-covid-cjp-steps-ground-provide-relief-most-marginalized-amid-covid-19

//blog.ipleaders.in/situation-marginalised-sections-amid-lockdown-legal-relief/

Marginalized communities were evidently affected more by the pandemic, than the people of more privileged and upper class communities, several instances of inequitable distribution of healthcare services came to light during the 1st wave of the pandemic in India, even more so during the 2nd wave.

Few of the problems which aggravated this inequality of distribution were : 

1) Patchy record keeping by officials, specially in marginalized areas, which led to people believing the fact that the spread of the virus has been halted, and led to the people letting their guard down. the figures reported regarding active cases and the daily deaths was nowhere near to the actual figures.

 2) Lack of awareness regarding the disease, it's transmission, what the disease does to your body, and the methods used in order to break the transmission chain such as practicing social distancing, maintaining hygiene of the hands, wearing a mask that properly seals the mouth.

3) If one did contract the disease, the access to medications, doctors, pathological aids, were just not present for a few marginalized communities, even if they were there, the healthcare infrastructure was just not adequate for the sheer number of people which required medical assistance, the entire cost of treatment for treating a patient who had a moderate to severe infection was too exorbitant to be paid by a person belonging to a less privileged community  .

4) After a point in time, contract tracing was just not possible. this holds true for all communities alike

5) Unequal provisions provided for vaccination, specially for remote areas, the vaccination booking could only be done online, and some people just didn't know how to make the bookings for the same.

Source - Pointers taken from a WION news report.