Overwhelming risks for vulnerable groups as coronavirus spreads

The spread of the novel coronavirus has left the vulnerable and marginalised in grave peril as daily wage earners, people displaced by conflict, health workers and prisoners face huge risks in the face of this calamity.

The pandemic is poised to break into thousands of cases in South Asia as more governments across the region this week imposed strict lockdowns and curfews amid fears the virus will strike densely populated areas, overwhelming woefully inadequate healthcare facilities and devastating livelihoods across a region where more than 600 million people already live in poverty, Amnesty International said in a statement on Wednesday.

South Asia has one of the highest populations of refugees in the world, including more than a million Rohingya refugees in Bangladesh and three million registered and unregistered Afghan refugees in Pakistan.

In Cox’s Bazar, the first case of COVID-19 was reported this week. The failure to provide Rohingya refugees with accurate information about the virus has stirred alarming fears in the camps, according to Amnesty. The camps have been subject to an ongoing telecommunications blackout.

Social distancing is not possible in the Rohingya camps in Bangladesh, where tents are tightly squeezed together across the Kutupalong settlement. Refugees have to walk through the camps to access basic services. There are limited medical facilities at the camps and no emergency services available nearby.

“At this time, we should have hand sanitizers, soaps and masks to stay healthy and clean. However, we have not seen distribution of such materials since the outbreak,” Yassin Abdumonab, a young Rohingya man in Cox’s Bazar, told Amnesty International.

The Institute Epidemiology, Disease Control and Research reported another death due to the infection on Thursday, taking the total number of infected people to 44 in Bangladesh.

Pakistan reported 1,026 cases on March 25, with seven deaths so far, while India recorded the second highest with 606 cases and 10 deaths. The numbers are rising sharply on a daily basis and are estimated to be significantly higher than reported given the paucity of testing.

“States have a responsibility to provide information about COVID-19 that is accurate and evidence-based, that reaches people in languages they understand through mediums they can easily access. At the same time, there must be a concerted effort to counter misinformation about the virus that could harm people and to protect marginalized communities from stigmatization,” said Biraj Patnaik, South Asia director at Amnesty International.

“For people displaced by conflict, social distancing is not an option, health care is not easily available, and basic necessities are a daily struggle. States have an obligation to not just ensure they are included in the response to the COVID-19 crisis but to address their particular needs,” said Biraj Patnaik.

“No one should be forced to make the pernicious choice between starvation and infection. South Asia’s economies depend on the daily toil of workers who are forced to seek their living in insecure and often inadequate working conditions. States must protect their livelihoods as best as they can during this crisis. In the long term, international solidarity will be needed for a recovery. This is a global pandemic and it needs a global solution,” said Biraj Patnaik.

The vast majority of workers in South Asia earn their living in the informal economy, often depending on daily wages. According to the International Labour Organisation, the informal sector “accounts for 80 percent of total employment” in South Asia.

They include street vendors, sanitation workers, drivers, construction workers, cleaners, tea plantation workers, fisherfolk, porters, cooks, and domestic workers, many of whom are internal migrant workers and live far away from their families.

As lockdowns come into force, they will overwhelmingly be denied their means of earning a livelihood. In an economically low-income region with limited social security systems in place, they do not have an adequate – or, in many cases, any – social safety net to fall back on. In Sri Lanka last week, as a curfew was being imposed, queues formed outside pawn shops, highlighting the dire circumstances already hitting people.

The Amnesty also sheds light on the situation of health workers who are so crucial to the precaution and measures against the outbreak. Afghanistan, Bangladesh, India, Nepal and Pakistan are already raising concerns about the lack of personal protective equipment available to them as they treat patients infected with COVID-19.

In Bangladesh, ten physicians are already exhibiting symptoms and have been isolated. In Pakistan, a doctor from Gilgit-Baltistan died last week. “It is like suicide to treat patients without protection,” Dr Asfandyar Khan, President of the Pakistan Institute of Medical Sciences told a news conference in Islamabad, warning that doctors could strike unless they were given the protective equipment they need.

There are a lot of concerns over prison situation in Bangladesh as well. There are more than twice as many prisoners as there is capacity. More than 70 per cent of the country’s prison population is still awaiting trial.

Prisoners are also often subject to inhumane conditions, including poor ventilation and sanitation, that put their health at risk. Earlier this year, a Pakistani judicial inquiry commission highlighted the limited access to health care in prisons, reporting that 1,823 inmates are suffering from hepatitis, 425 from HIV, and 173 from tuberculosis – all contracted in prison.

In Sri Lanka, two prisoners were killed, and others injured, by prison guards last week when protests related to COVID-19 flared at Anuradhapura prison. Pakistan this week reported its first positive case of COVID-19 in a prison at Camp Jail Lahore, where there are nearly three times as many prisoners as capacity – the majority of them still awaiting trial.

Under international human rights law and standards, the authorities must ensure prisoners have prompt access to medical care and enjoy the same standards that are available in the community, including when it comes to testing, prevention and treatment of people infected with COVID-19.

Although, Bangladesh and Some other South Asian countries have taken welcome steps towards the release of some prisoners, including India, Pakistan, Nepal, Sri Lanka, these are yet to be implemented or applied consistently.

“South Asia’s prisons are a blight on the region’s conscience. They are notoriously overcrowded, violent, unsanitary and lacking health care, which place inmates at high risk of infection. Efforts should be made to urgently reduce overcrowding, including by considering release for older detainees and those who may qualify for early parole and who no longer pose a threat to public safety,” Patnaik said. 

“There should also be a presumption of release for people charged with a criminal offence who are awaiting trial. Those who will not be released must be given the same standards of medical care available to everyone else in the country, including transfers to medical facilities if they require specialised care.”