COVID-19: supporting vulnerable populations in Nepal

To date, the socio-economic fall-out of the COVID-19 crisis has outweighed the health impacts in Nepal. Deputy team leader Kiran Wagle explains how the Purnima programme pivoted quickly from post-earthquake recovery to pandemic relief.

Although Nepal appears a high-risk country for COVID-19 infection, with its open borders with India and limited infrastructure, the public health impact of the pandemic is still very low in comparison with most countries. However, the economic fall-out for its population, and especially the most vulnerable groups in society, has proved severe during the national lockdown and beyond. The pandemic put a temporary halt to Nepal’s long-term recovery from the devastating earthquake that shook the Himalayas in 2015. Restoring livelihoods will prove critical for protecting health and putting the recovery plan back on track.

The recent crisis has disproportionately affected those Nepalis closest to the poverty line. In times of hardship, people typically reduce their spending on food, and particularly nutritious food, which has a marked impact on the elderly, people with disabilities, women and children. As with many societies around the world, the lockdown and economic downturn have also heightened the risk of domestic violence and suicide.

The UK aid-funded Post Earthquake Recovery Project, known as Purnima and implemented by Mott MacDonald, has assisted with the country’s planning and rebuilding efforts in rural districts since 2017. As a post-disaster programme, Purnima was well-placed to pivot its activities and initiate new ones with the sudden onset of the pandemic. Our staff and partner network were well-established in many field locations, so we had a ready system of communication and implementation, as soon as the lockdown was partially lifted in May. We were a trusted source of valuable information for the local governments, especially for identifying vulnerable people and the impact of COVID-19 on them.

Support network

Working remotely, our first task was to devise an action plan and draft Standard Operating Procedures (SOPs) to keep our people and processes safe. In particular, we supported Palikas (municipalities) to continue delivering essential services during lockdown and helped provide relief to the most vulnerable people. We mobilised our existing helpdesks for local small businesses to help disseminate information at a district level around food availability and food supply chains. We have continued providing water, sanitation and hygiene facilities to communities and supplemented this with additional radio messaging around health, hygiene and infection control.

As part of our post-earthquake work, Purnima was already leading support activities for vulnerable groups within our project areas, including the elderly, people with disabilities, internally displaced persons, single-woman-headed households and the extreme poor. Despite the logistical complications, we worked closely with local governments through lockdown to facilitate relief distribution to affected households, reaching 4,500 vulnerable people (45% of the total 10,000 people reached through local government relief support) and helping more than 4,000 households to access the government’s social security programme during lockdown. Similarly, close to 3,000 vulnerable people were supported with livelihood recovery activities such as advice to farmers on growing high-value crops and increasing the quality of vegetables and poultry, and training tradespeople and on using technology to grow their businesses.

Good water supplies and understanding of hygiene are essential for control of COVID-19. As part of our ongoing reconstruction efforts, we have worked with quarantine centres at municipality level, and also provided water, sanitation and hygiene (WASH) facilities, so those quarantine centres are properly fitted out for the local populations that need to use them. We were able to quickly restart our programme of WASH, trail, and school rebuilding, which includes new COVID-19 awareness and control measures and will provide local employment to stimulate the economy.

Quick wins

The poorest households are typically dependent on informal, daily-wage labour. Many Nepalis lost jobs due to the lockdown and economic downturn, and found themselves forced into additional debt. In addition, migrant labourers were obliged to return home during the lockdown, causing a double burden for their families, who not only lost a valuable source of income and but also gained more mouths to feed.

Purnima pivoted from longer-term economic development, which was largely based on agriculture and market-generation, to provide quick income and livelihood recovery activities. For example, we helped to employ people in water schemes, school building and trail construction for a single month to keep income going after lockdown lifted.

One of our key roles is supporting local governments with technical assistance around planning. We have therefore helped them to adapt and implement the necessary COVID-19-related policies, processes and procedures that the federal government has asked them to put in place. In addition, we are helping them to integrate a COVID-19 strategy into their longer-term planning and budgeting.

Stopping the ‘infodemic’

Information was a vital consideration during the pandemic for two reasons. Firstly, vulnerable people who didn’t have access to information about the services were at high risk of being left outside the relief safety net – which ran contrary to our ‘leave no one behind’ mission. In addition, we helped to fight misinformation, which has proved a barrier to an effective response – not just here, but all over the world. In Nepal, vulnerable groups and poor communities are often stigmatised and marginalised, so when the pandemic broke out, vulnerable communities were singled out as carriers of the virus. We therefore designed a behaviour change communication programme related to public understanding of COVID-19 risks and control measures including hygiene and social distancing. Working with BBC Media Action, we shared life-saving health messages through 50 episodes of Milijuli Nepali (Together Nepal) – a daily radio programme broadcast via 55 local stations.

An earthquake is more visible than a pandemic, and while the socio-economic impact is more immediate with an earthquake, they are both economic disasters and many of the problems are the same. Despite the extreme restrictions on travel, Purnima succeeded in supporting local government and helped to increase their capacity for service delivery. Many NGOs and government agencies were unable to function and respond in the same way, even several weeks and months after lockdown was lifted. So, I look back on the last four months with a great sense of achievement.

We are a large programme, spread across four districts with over 100 staff – and we had to change very quickly. We were able to do that efficiently, mobilising and redeploying staff where necessary, while maintaining communications. Our SOPs and adaptive plan allowed us to keep our people and practices safe, while supporting local government to deliver services during this difficult time.

Truly, our local staff didn’t stop throughout the crisis. They went above and beyond whenever they could. The appreciation from local government officials is something we can all take great pride in.