No refuge: the impact of coronavirus on the world's most vulnerable

The health and economic impact of the COVID-19 pandemic has been felt around the world, but the virus could have a devastating effect on developing nations that are home to some of the planet’s most vulnerable communities.

As a guest on the World Economic Forum’s World vs Virus podcast, David Miliband, former British foreign secretary and current head of the International Rescue Committee – a global aid organization for people displaced by conflict, persecution and natural disasters – lays bare his fears for the world’s poorest people as the virus approaches.

“If you think it is really terrifying to face the prospect of COVID-19 in an advanced industrialized country, if you're worried about ventilators in New York City, if you're concerned about the health system in Italy, just imagine what it's like to face the prospect of a virus where there isn't running water, where there isn't a proper health system,” says Miliband.

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That’s the situation facing people living in Cox’s Bazar, Bangladesh. It’s the world’s biggest refugee camp, with around 1 million refugees from Myanmar living in severely cramped conditions with little more than 10 square metres per person.

There will be death on “an appalling scale” unless urgent action is taken to limit the impact of the virus in such places, Miliband warns.

No refuge for refugees

Asif Saleh, the head of development organization BRAC in Bangladesh and one of the World Economic Forum’s Young Global Leaders, knows only too well the difficulties refugees and other vulnerable people face. While for many countries the imposition of lockdown restrictions can help slow the spread of COVID-19, in poorer nations such measures may have less of an impact.

In the capital, Dhaka, millions of people are slum dwellers, many living a hand-to-mouth existence working in the country’s informal economy. Like its refugee camps, the slums are densely packed, leaving occupants exposed to rapid spread of disease.

Around 90% of workers, such as rickshaw drivers or van drivers, depend on the local economy to survive. If they don’t work they don’t receive any income, leaving them little choice but to go out to seek a living and ignore the national lockdown.

With no health insurance or social protection available, vulnerable people have no safety net to fall back on. Working from home or applying for unemployment wages, like in some developed economies, are not realities for people in Bangladesh.

“So oftentimes in countries like ours, because you don't have these kinds of social protections in place, if you don't pair up economic support or assistance with the lockdown, it's not gonna work,” explains Saleh.

“We need to think of something which actually works locally,” he continues, “to figure out what is the best solution beyond shutting down the economy completely.”

Distancing is impossible

Far from Bangladesh, Mohammed Mahmoud is also concerned about the threat posed by the coronavirus pandemic. In search of work, he left the Kakuma Refugee Camp in Kenya for the country’s capital city, Nairobi. Despite spending his entire life in Kenya his refugee status leaves him legally unsettled.

For Mohammed and his neighbours, staying safe in the crowded building they live in is a challenge. With access to water only once a week, it is difficult to follow healthcare advice to wash your hands in order to slow the spread of the coronavirus pandemic.

“People are using one toilet. For a whole floor, you have 100 people using this one toilet. How do you stay clean? People don't have gloves. People don't have soap,” he says.

The search for work involves avoiding the authorities. Mohammed has no access to healthcare workers, so getting sick and reporting his illness could result in being deported or put in prison. Living in such cramped conditions also makes quarantine or social distancing virtually impossible, exacerbating the dangers of COVID-19 for the wider community.

Time is running out

The message is clear, according to David Miliband: time is running out to prevent a humanitarian crisis. Cases of the disease have been recorded in some of the world’s poorest countries, including conflict hotspots, such as Syria and Afghanistan, which mostly have healthcare systems that could be quickly overwhelmed.

“So we're talking a matter of weeks before this disease, if unchecked, becomes really rampant,” says Miliband.

At a time when governments around the world are making available huge stimulus packages to support flailing economies, money is being spent, he says, but not in the countries where the disease could spread unchecked.