Pandemic lessons from Karachi
Our guest bloggers reflect on what was learned about COVID-19 in Karachi, about responses and their limitations – responses done badly, not at the scale needed, or not at all – as if the pandemic were no longer an issue.
The blog draws on the experience of the Urban Resource Centre (URC) in implementing relief and post-relief initiatives – whose efforts and systems will of course now be thrown into sharp relief with the current, devastating floods in the country. The incidence of flooding in Karachi and the policy changes required to mitigate floods was the subject of a previous blog by Arif Hasan.
Karachi is the capital of Sindh, one of four provinces in Pakistan. Official figures suggest a city population of 14,916,456. But unofficially it’s estimated at anything between 20 and 25 million, with 62% living in informal settlements.
COVID-19 was first detected in Pakistan on 26 February 2020, but lockdown was not imposed until 1 April. To date, Pakistan has experienced three COVID-19 waves and has recorded the 35th-highest death toll in the world, reporting 30,542 deaths and 1,564,231 confirmed cases.
Responses to the pandemic
This section describes the responses by government, national and local NGOs, and community organisations. Various programmes provided relief during the lockdowns as well as for the subsequent massive loss of jobs and incomes.
Support was provided mainly through existing government poverty alleviation initiatives, such as the Benazir Income Support Programme which provides relief through cash transfers and whose main beneficiaries are women, and the Ehsaas Emergency Cash programme which targeted those worst-hit by COVID-19 lockdowns and subsequent unemployment.
The completion of the National Socio-Economic Registry 2021 meant there was data about each person’s socio-economic conditions. This provided the underpinnings for many benefit programmes – such as the Ehsaas Education Conditional Cash Transfers, undergraduate scholarships, the emergency cash programme mentioned above, and Nashonuma (conditional cash to address stunting in children). It has support programmes for micro finance, savings, livelihoods, and for the disabled.
Pakistan has a number of large NGOs that regularly support communities by providing food, healthcare and jobs. They have the necessary physical and social infrastructure to provide long-term relief. They also received a lot of financial support from the corporate sector, citizens and local NGOs and banks.
- Alkhidmat Foundation, an organisation of an Islamic political party that provides support to all ethnicities and faiths
- Edhi Foundation, which runs a host of services including health, child protection and funerary services, as well as emergency services and relief during disasters
- Saylani Welfare, which provides food to the hungry, health services and support for funerals and weddings, and
- JDC Foundation, which provides ambulance services and food distribution among the needy. It also runs homes for the elderly, and education centres.
With the onset of COVID-19 and lockdowns, a number of Karachi-based NGOs, community-based organisations, professional organisations and concerned citizens started to provide relief.
In the process, the URC worked with, among others: the Robin Hood Army, Imkaan, Technical Training Resource Centre (TTRC), Karachi Relief Trust, JDC, Saylani, Edhi Foundation and Jibran Nasir (a politician).
Representatives of political parties also arranged relief in their constituencies, but these were usually one-off efforts.
During the first lockdown, various community organisations that had worked with the URC requested assistance. It responded by establishing a three-member team to work with these organisations in collecting and supplying relief.
They contacted various organisations that were supplying relief rations including those listed above. Supplies were then delivered to the locations identified and recorded by the URC team.
Every visit to the community was also documented along with the estimated number of beneficiaries. A system for distributing and monitoring the rations was developed to ensure these reached those in need. The URC was able to provide rations to 20 communities comprising over 2,000 households.
So what lessons were learned?
The problems identified during the relief and post-relief period were discussed with the URC team and the support organisations. Some also emerged from the press, social media and academic writings on the pandemic in Karachi.
The vaccination drive: in Pakistan it has been very successful (78,860,543 people fully vaccinated) for a number of reasons. First, all information regarding vaccination was made available on mobile phones since the vast majority of Pakistanis own one. An individual’s vaccinations were then registered on their phone.
To pressurise citizens the government threatened to cancel the SIM cards of those who remained unvaccinated. In addition, entry to most malls, shops, offices and cinemas required proof of vaccination.
The motorbike issue: to promote social distancing during lockdown, the government banned more than one person travelling on a motorbike. But motorbikes are the most common form of travel in Karachi, including taking unwell persons to medical facilities and shopping for provisions.
Local government: COVID-19 took hold at a time when local government had been dissolved in Karachi. Had it been active, there would have been better coordination in the relief effort as much depends on the Nazim (mayor) and Naib Nazim (vice-mayor). A strong case for an empowered Union Council has supported the contention that had local government been active, the relief and subsequent operations would have been much better managed.
Other issues: there was an increase in home-based businesses, especially those run by women, and the rise of the gig economy. There was a large migration of single males back to their villages, while women often stayed in the city as they were employed as maids. Some families migrated but in much smaller numbers.
The limitations in healthcare provision were highlighted including: constant complaints about insufficient mid-level and paramedic staff, the location of health facilities far from low-income settlements, and the absence of space for treatment and quarantine. As a result hotel, exhibition, entertainment and other cultural spaces were converted into quarantine centres.
The lack of open spaces meant social distancing was difficult, while an absence of warehouse space led to storage problems for the large volume of relief goods. Community dissatisfaction meant that the logistics of relief supplies was transferred to local school and community management committees.
The disruption to children’s education was compounded by a lack of Wi-Fi and computers, particularly in low-income areas. Also many teachers did not have access, so online classes were impossible.
The deficiencies in the piped water system and the high price of water from tankers meant all the official advice about regular handwashing was impossible to take.
A new normal?
The URC noted that domestic and social relations have undergone a change, especially related to gender, including the extraordinarily large number of women seeking divorce during the pandemic.
Due to lockdowns and the special manner in which coronavirus victims had to be buried, changes in funeral ceremonies made these much less expensive.
COVID-19 is still very much a part of life in Karachi. A large proportion of the city’s population just accepts it as normal. However, the pandemic has changed social and family relations, relations between teachers and students, and between employers and their employees. These changes have so far not been understood and they deserve our attention.