COVID-19 – A turning point for SNEHA to work with urban informal settlements of Mumbai, India

-  Nikhat Shaikh (Research Consultant, SNEHA), Anuja Jayaraman (Director,  Research, SNEHA) and Rama Shyam (Programme Director, Empowerment, Health & Sexuality of Adolescents, SNEHA)

SNEHA (Society for Nutrition, Education and Health Action) an NGO, works to improve the health and safety of women, adolescents and children living in and around the most vulnerable informal settlements of Mumbai. SNEHA continues to respond to the COVID-19 emergency with full momentum, reaching close to 20000 members of the community it serves in the first few weeks of the lockdown which was imposed in India on 25th March 2020. As an NGO committed to health and wellbeing of women and children living in vulnerable settlements, working through a pandemic poses additional burden on the teams to deliver routine services which led SNEHA to explore alternate ways of working with people while still following government directive. It has bound SNEHA to enter an unexplored territory of working remotely, with opportunity to initiate different ways of thinking and engaging the community.

Pathways enabling remote COVID-19 response

Deliberation and quick decision: SNEHA was among the first NGOs to take an informed decision of prioritising the safety and well-being of its employees during the pandemic. The senior management brainstormed early on to develop a new plan to execute programme activities remotely following government directives. At the organization level, all major events, community campaigns and outstation travel were indefinitely postponed. Action was taken to get phone numbers of community members from official records, community volunteers and other credible connections in the community. Attempts were made to validate numbers, and in cases where valid numbers were not available, messages were sent through community volunteers.

Moving Online: The Information Management team worked out technological solutions to facilitate remote access to official files/folders/servers. They circulated presentations giving details of video conferencing tools such as Zoom and Google Hangouts in order to facilitate communications across the organization. Employees accessed their files and folders through Virtual Private Network. The fact that most of SNEHA’s data are stored on the Cloud helped in the smooth transition to working from home. With a strong IT system and the availability of information of our target group, teams were able to reach community members using phones.

Shift in work outlook: Although, initiating work remotely was not easy given the uncertainties and challenges faced while working in urban informal settlements, yet there was a positive energy among the employees to learn new ways of working. Initially, being systematic, structured and organized was difficult, but many of the essential field activities were completed before the lockdown. For example, Iron & Folic Acid (IFA) tablets were distributed to those in need in the community. After the lockdown, care was taken to equip the staff to deal with the new situation by connecting with the teams daily, sharing self-care tips, coping strategies and offering counselling services.

Coordinating with the government system for service delivery:

Efforts were undertaken to apprise government partners including the Integrated Child Development Scheme (ICDS), public health facilities, police and the District Legal Service Authority (DLSA) about our work plan. We proactively approached them to identify their needs and worked with them to achieve their targets. We helped in procurement and delivering of masks and sanitizers to be used by the government frontline workers. Counselling services were offered to police personnel. SNEHA has been asked by the Department of Women & Child Development to extend its counselling services to migrant workers in government shelters to help them during this stressful time. We collated information about the needs of the community to systematically share it with the government. For example, information on functionality of ration shops to ensure better monitoring of the Public Distribution System (PDS). Apart from SNEHA staff, trainings on COVID-19 were conducted for the government frontline workers by the organization. SNEHA worked closely with government functionaries at the city and state level to ensure continuity of health services for high risk cases.

Working with the community: During the lockdown, SNEHA continued some of its services like counselling for survivors of violence/sexual abuse, those needing crisis interventions and mental health and palliative care services. Timely provision of correct and authentic information on COVID-19 to the community continues to be a priority. Teams collaborated with community-based volunteers for COVID-19 prevention work by providing them with Behaviour Change Communication (BCC) & Information Education Communication (IEC) material developed by the Ministry of Health and Family Welfare (MoHFW). Currently, we are working with over 8,000 field volunteers to spread the messages across communities and to dispel myths, misconceptions and stigma attached to the illness. All home visits, counselling sessions, survey and group meetings are conducted using telephones. Additionally, we worked with community influencers like religious leaders for COVID-19 messaging and Corporators (representatives of local governing body) for provision of ration for vulnerable families. High risk maternal health cases and low birth weight babies are directed to the appropriate health facilities /health worker.

Communications strategy: SNEHA teams educated communities through direct phone calls and messaging on COVID-19 preventive measure like hand hygiene, personal hygiene, symptoms of COVID-19 and the steps to be taken, use of home-made masks, social distancing and other such precautions to prevent the spread of the virus. Easy to understand IEC materials were developed for the same. Our communication material is constantly being updated to respond to questions from the community. Care has been taken to use credible information based on guidelines issued by the Indian government, WHO, CDC and UNICEF; community members have been cautioned against believing messages from unverified sources.

Donor update: Communication from SNEHA to all donors to apprise them on the current work plan and of immediate steps taken to protect the staff and communities was undertaken. Online fundraising for COVID-19 through a video appeal was created to reach out to all the networks.

Learning: The whole experience has pushed us to innovate and use technology to connect and coordinate. Care was taken to support all staff in conducting regular activities remotely. It has emboldened us to use technology to carry out our interventions. We found a new way of functioning, the sustainability of which is yet to be ascertained , however it seems to be working for now and has helped in streamlining our processes.

In addition to all this, it is being reported that public toilets are being cleaned more often and the government authorities are sanitizing the informal settlements. Also, community members are washing their hands more often with soap. The public distribution system is distributing subsidized food. At SNEHA, our own work may expect to pivot from behaviour change relating to health to addressing food scarcity, more emphasis on WASH, advocacy for toilets etc.

Finally, adherence to washing hands, quarantine measures and social distancing remain a big challenge for people living in urban informal settlements, where water for basic needs is in short supply and where space is a constraint with houses being small with joint families or extended families living together. Yet the community-based groups are responding actively at their front and are being supported by our teams in all such endeavours. Experience of work points out that remaining connected and caring is important. We have turned this crisis into an opportunity to push our boundaries to learn and unlearn, and to be responsive. We are helping people cope with this crisis even as we support the government systems with relevant information they need to function effectively. The message is simple and clear; we can work together in times of crisis! We just need to care for each other, check-in about how we are doing beyond work and get on with renewed hope!