Relief goods are handed out to residents during a government-imposed nationwide lockdown in India, as reports surface of coronavirus 'heroes' being assaulted. Photo: AFP / Government of West Bengal

Covid-19 has created unparalleled uncertainty for aid and development agencies globally. But as with Ebola and severe acute respiratory syndrome (SARS), one thing that is certain is that the poorest countries and the most vulnerable people will suffer the most during this crisis.

While several lessons were learned from the 2014-15 Ebola virus outbreak in West Africa, Covid-19 is an entirely new challenge for the international development community. The response to the new coronavirus is putting huge pressure on public finances, and publicly funded development agencies are not immune.

Nevertheless, it is in everyone’s interest that all vital work related to development agencies continues throughout the crisis. In this context, Quentin Durand, chief executive officer of Karuna-Shechen, an international non-profit organization headquartered in Paris, spoke to Asia Times recently on various aspects of Covid-19 and its impact on aid agencies and development work. Excerpts of that interview appear below.

As the CEO of Karuna-Shechen, Durand is responsible for getting international teams collaborate to approve and carry out actions in accordance with his organization’s priorities and vision.

Karuna-Shechen was founded in 2000 by Matthieu Ricard to help empower under-served communities in India, Nepal and Tibet to reach their full potential and create a better future. It provides medical aid, health care, education and health awareness to more than 140,000 people each year through three outpatient departments OPDs, seven mobile clinics, and a disease-prevention strategy through targeted awareness campaigns and training.

The organization’s OPDs in India and Nepal provide general consultations, family planning services, a pharmacy, a pathology lab, and a tuberculosis center, and in Nepal a dental clinic and gynecology service.

Durand believes that in the international development sector, all decisions should be associated with a bottom-up approach rather than top-down decisions.

Sachi Satapathy: What are the major challenges before international aid agencies due to the Covid-19 outbreak?

Quentin Durand: The coronavirus pandemic is a global health emergency. A third of the global population is currently on lockdown. This situation is unprecedented for everyone: actors of public health, governments and citizens.

We all have a crucial role to play and must get mobilized quickly and efficiently. Following the WHO [World Health Organization] recommendations, the absolute priority around the world is to halt the spread of the virus. Another important challenge is to make populations worldwide understand that they play the pivotal role in this crisis.

Many media around the world, such as the BBC, started “stay home” campaigns to sensitize their citizens to the importance of confinement in order to halt the spread of the virus. The WHO did the same thing in collaboration with FIFA and world-class footballers to draw attention.

SS: What should the right strategy be for international aid agencies to help countries, particularly poor and middle-income countries, affected by the Covid-19 outbreak?

QD: Except for the international aid agencies which provide essential services and goods, the safest strategy right now is to help reduce the spread of the virus. We should respect confinement where it is needed and communicate on the safety and hygiene guidelines provided by the WHO. If international aid agencies have the means to provide detection tests to populations, this would be a great thing to do, as testing and isolating the infected people is a priority.

South Korea has shown the world that its “trace, test and treat” strategy was very efficient to stop the spread of the virus, with almost 20,000 people tested per day once the virus outbreak happened, for up to 300,000 South Koreans tested. This led them to have one of the lowest coronavirus fatality rates in the world, around 0.7%, in mid-March. At the same time, many countries in Asia require trained staff, the right equipment and materials and many administrative authorizations before new production of test kits can start.

We think that all NGOs and aid agencies should, as it was recommended by the WHO, communicate relevant and valid information to as many people as they can. Mostly, we should communicate vital information to the populations we work with: firstly, regarding how to protect themselves from the virus and what are the hygiene practices to adopt.

Secondly, we should insist on the crucial importance of respecting the confinement where it is appropriate. That is why it is crucial to capitalize on the knowledge and networks of local NGOs in poor and middle-income countries. They are in a very good position to spread awareness concerning the virus in remote areas.

Building resilience is also very important to address such a crisis, and this means giving local actors the strength to overcome a crisis by themselves rather than being there only when the damage is already done. That means collaboration with local actors is indispensable, in order to give beneficiaries the means and the independence to help themselves when we cannot be there. This localization of aid is absolutely necessary in case of a crisis [such] as the one we face right now, with important reduction of our staff’s travels.

SS: Many aid and development agencies are limiting staff travel to curb the spread of the novel coronavirus. Do you think this is the right strategy for aid agencies to curb staff movement in this critical period?

QD: We do think that all aid actors should follow the recommendations of the WHO in order to stop the spread of the virus. That means respecting confinement measures and putting a stop to our staff’s travels.

We have a principle of doing no harm. Today, the virus is more concentrated in urban areas, where most of our staff is located. Therefore sending our staff to remote villages would be too risky.

What is rather preoccupying, however, is the progressive return of many urban people to their home villages, since they lost their jobs in the cities. During such a crisis, people who live in remote villages, and who can sustain themselves with the production of their home-grown vegetables, are actually better off. But this progressive migration from the cities to rural areas constitutes a great risk of spreading the virus in remote areas where people will not be equipped to fight this virus. 

SS: How will Covid-19 affect your development work in India and Nepal? What is your plan to address this?

QD: We have had to take the difficult decision to put a hold on our programs and temporarily close our clinics (primary healthcare OPD and mobile clinics in some remote villages). That is because the quick transmission of Covid-19 within health-care settings has been confirmed by the WHO after the crisis in Wuhan. Therefore, health-care facilities [like] ours, that are not equipped to welcome or treat coronavirus patients, should not remain active. The virus is especially harmful for people in precarious health. By keeping our activities going, we risk producing more harm than good.

However, it does not mean that we cannot do nothing. On the contrary, information is a very strategic and powerful weapon in the current war against the coronavirus. We think that all NGOs and aid agencies should communicate relevant and valid information to as many people as they can.

As of today, 950 Covid-19 cases have been reported in India. The Indian government has reacted firmly by implementing a nationwide lockdown. But if the virus spreads around the country, it could be devastating. Thinking long-term, as of when we will be able to regain our field activities, building on local strengths will remain our main priority. Programs that can sustain themselves in full autonomy, without our staff having to be present every single day – such as water and sanitation projects – remain crucial in preventing such crisis.

SS: The UN body says good hand and respiratory hygiene, as well as social distancing, can prevent the coronavirus from spreading through airborne droplets or infected surfaces. How should development aid agencies play a strategic role in these areas?

QD: The United Nations communicated about prevention practices, which have been relayed by most governments in order to limit the spread of the virus. Similarly, we communicated these practices to our beneficiaries through communication devices in their local language.

A big challenge for local populations remains their capacity to actually apply these recommendations to their daily life with the means that they do have. Sanitary measures, for instance, remain a challenge for who live in remote places and have limited access to clean water. We hope that the governments will do their best to remedy this situation promptly and will manage to provide tests and care for as many of their citizens as it is possible.

We keep a close watch on the recommendations given to local NGOs in order to participate as much as possible to the efforts to stop the propagation of the virus. I have the hope that, as soon as possible, we will be able to set up programs that will advance towards this goal.  

This crisis at least shows the interdependence challenge between public health authorities, governments, non-governmental organizations and citizens on a global scale. In the face of the challenges that await us in the [future], I am convinced that close collaborations between those actors at the international, national and local level will be necessary and play a key role.

Sachi Satapathy

Sachi Satapathy is an international development practitioner who has worked on large-scale projects. His interests are in public policy, poverty alleviation and public-private partnerships for development in middle-income and developing countries.