The impossibility of social distancing among the urban poor: the case of an Indian slum in the times of COVID-19

ABSTRACT

As cases of COVID-19 were rising in India and the country’s political leadership instituted a nationwide lockdown, one of the authors of this article received a timely invitation from a friend – a government official – to make rounds with him and his team to various neighbourhoods within the metropolitan city of Bangalore. The team consisted of members working in healthcare, municipal corporation, and local police, and was tasked with ensuring that the government enacted measures of social distancing were being observed by local residents in public spaces. The author witnessed, in real time, the ways in which residents were engaging with the containment measures that were instituted as part of the political leadership’s attempt to flatten the curve of COVID-19. What was observed in an urban slum was particularly poignant and illuminating. The observations captured how, for residents of the urban slum, social distancing is more an aspiration than an attainable reality. Indeed, social distancing is impossible if such a protocol does not come with concomitant economic support targeted to the most socially vulnerable in society.

KEYWORDS:

• COVID-19
• India
• social distancing
• urban slums

In response to the proliferation of COVID-19 in India, the country’s Prime Minister Narender Modi, enacted a set of draconian measures with the ostensible intent to curb the spread of the virus. These measures include travel bans, stringent screening protocols at airports receiving international travellers, more resources for testing centres in government and private hospitals, providing regular news updates on the disease to citizens, and, as of 25 March, a nationwide lockdown that has effectively shuttered businesses, offices, schools, places of worships, shopping malls, and other public spaces where groups normally congregate. As COVID-19 is spread from droplets emitted through breathing, talking, coughing, and sneezing (World Health Organization 2020), such measures have been implemented with the express aim of establishing social distance – the physical separation between individuals (of approximately two metres). As such, having citizens avoid close contact with one another is believed to be the most effective path by which to contain, what could otherwise become, the most explosive spread of a deadly virus in recent history. However, the question remains: Just how realistic are measures of social distancing for society’s most vulnerable, such as those millions of people living in urban slums?

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Sita, a resident of a slum, sits outside her meagre home that measures no more than ten by ten feet, wondering what is social distancing? Her home is part of a slum consisting of a total of forty-two units, which share common toilets. These units have no foundation and have been cobbled together with basic structuring materials and tin roofs. The slum is located immediately under a busy overpass in Bangalore, India, and was provided as a temporary residence – for what was originally intended to last for no more than a year – to poor urban families who had been dislocated by the government when their homes were seized and destroyed to accommodate the widening of MS Ramaiya Road in 2010 (The New Indian Express 2011). It is a decade later and Sita and her neighbours continue living in this highly congested, dirty, and makeshift slum, surrounded by copious amounts of noxious waste, while waiting for their long-promised, permanent homes.

Sita’s bewilderment with social distancing is certainly not surprising given the conditions of the slum in which she lives. Whether it is the few dilapidated toilets that all residents of the slums share or the high-intensity electric cables traversing across the units or the incessant noise from the traffic on the overpass, the recently implemented mandate from the government to maintain social distance in response to COVID-19 seems to be more an aspiration than any attainable reality for Sita. As Sita’s neighbour Sajan described, they live in such intimate proximity to one other – with porous shared walls and small, communal spaces – it is virtually impossible to maintain even the veneer of social distance.

Lakshmi, also a neighbour of Sita’s, works as a cook and is concerned about feeding her children, who otherwise went to school and received lunch under the mid-day meals programme. Due to the national level lockdown caused by COVID-19, which includes the closure of public schools, she is not only left with no source of income, but she is now denied the reprieve she previously had of knowing that her children will receive nourishment for at least one meal during the day. Though local government as well as several non-governmental organizations (NGOs) are seeking to distribute food packets, she questions their timely availability. Indeed, COVID-19 has only worsened the long queues at the administrative sites where government agencies distribute food packets to those living below the poverty line. Lakshmi explained that delays in receiving food packets through India’s limited welfare programmes occurs during the best of circumstances; under the present conditions of a global pandemic, food packets – as well as the human capital necessary to deliver them – are very constrained. It is not uncommon for those entitled to a food packet to not receive it. Sighing she retorted: “I can go hungry but how can I ask my children to go hungry”.

Ritesh, too, is worried about his family in the times of COVID-19. With no money coming into the home, he is using the very little savings his family had accumulated to survive. He, like Lakshmi, ponders when government assistance, if any are to be made available, will materialise. As Ritesh lamented, “if the virus doesn’t kill us, hunger will”.

Not surprisingly, the poverty ubiquitous in the slum and its surroundings have led residents to make difficult decisions about whether to follow containment measures prescribed by government leaders or to continue on with daily work activities. Indeed, these residents of the slum are also daily wage earners, often working in the informal economy, which simply means that if they do not work, they do not eat. They are taxi and autorickshaw drivers, vegetable vendors, carpenters, scrap collectors, waste pickers, delivery boys, tea girls, waiters and waitresses, and domestic labourers. Praveen, for instance, continues to work as a waste picker as conforming to the practice of social distancing for him would mean his and his family’s starvation. Likewise, Rajen continues to go to work as a gatekeeper at a nearby apartment complex that houses middle- and upper-middle class families, for the complex’s residents expect him to be present at work and perform his duties as usual. Rajen is well aware of the consequences for not showing up for work even during the current global pandemic; it would not only mean the immediate loss of his family’s modest and only source of income but also dismissal from his long-term job. Thus, when presented with the dilemma of social distancing or working, Praveen and Rajen’s poverty compel them, understandably so, to the latter.

These experiences are certainly not idiosyncratic to the slum in which Sita and her neighbours live. Indeed, residents of slums throughout the country are wrestling with the tension between following instituted containment protocols extending from the global pandemic and navigating the unforgiving practicalities of daily life. For example, as reported in a recent article in The Indian Express, Urmila, who lives in a slum in Mumbai, opined that it is impossible to put into practice any of the containment measures against COVID-19 that have been issued by the World Health Organization (or the Indian Prime Minister). Perhaps nothing captures this perspective more aptly than her remark: “Sometimes I have to skip bathing to save water for cooking … [and yet] you want us to wash our hands frequently?” (Iyer 2020).

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As of 2018, there were some 600 slums in the city of Bangalore alone (Roy et al. 2018). Data from India’s national consensus has shown that one in six Indians living in urban communities reside in slums. These slums are marked by poverty, overcrowding, hazardous environmental and social conditions (George et al. 2019), and have been characterised to be “unfit for human habitation” (Rahman 2013). Today, these slums shelter many of the estimated 176 million living in extreme poverty in India (The World Bank 2019).

The precarious conditions of India’s urban slums have only been exacerbated by the global spread of COVID-19. As of 1 April 2020, India has reported 1,238 confirmed cases, 124 cured cases, and 35 deaths (Government of India 2020). The relatively modest number of confirmed cases in proportion to India’s large population is attributed to the very limited number of tests that have been conducted to date – COVID-19 tests have mainly been used on Indians returning from certain affected countries and not on members of the wider public displaying symptoms. Instead of responding to COVID-19 with mass testing, government leaders have orchestrated a nationwide lockdown predicated on the idea that such an action would prove most successful in establishing social distancing. Yet, largely remiss in the political leadership’s decision-making process that led to the institutionalisation of top-down social distancing measures was the need to consider how such a decision would be experienced by the significant portion of the country’s urban poor, particularly those living in slums.

Unfortunately, social distancing functions better in theory than it does in practice when it comes to India’s urban poor living in slums. The living conditions of urban slums – as was suggested at the start of this article by the description of the slum in which Sita’s cramped unit is located – are such that residents do not need to enter public places to expose themselves to the salient risk of contracting infection. Sadly, the tight quarters and the communal spaces of the slums are natural conduits for a virus that relies on physical closeness to spread. Moreover, as Praveen and Rajen explained, as daily wage earners with very limited access to social welfare, the consequence of not working in an effort to socially distance one’s self from others is grave – it would almost surely lead to their families’ starvation. So, whether dwellers of slums yield to the indeterminant risk of the virus or to the immediate risk of hunger, both options are shrouded in harm and the choices being proffered is, ultimately, between the bad and the worst.

Moreover, the population density in urban slums is relatively high, with 420 people living in each square kilometre (Altstedter 2020). If COVID-19 were to breakout in a slum, its sheer density alone will result in the mass and the expeditious proliferation of the virus. The magnitude of the spread can make its tracing, testing, and treating impractical, if not entirely impossible.

Myriad other factors render India’s urban slums to be particularly susceptible to an outbreak of a communicable disease like COVID-19. Namely, a lack of clean drinking water (Joshi et al. 2014), a dearth of sanitation facilities (McFarlane 2008), inadequate attention to personal hygiene (Pati, Kadam, and Chauhan 2014), poor living conditions (Waheed and Siddiqui 2018), food insecurity (Agarwal et al. 2009), and a lack of immunisation (Agarwal, Bhanot, and Goindi 2005) expose residents in urban slums to significant risk insofar as they establish the necessary environmental conditions, which foster the contraction and the transmission of the disease (World Health Organization 2005).

However, it would be wholly short-sighted to assume that an outbreak of COVID-19 in urban slums would be isolated to its own physical boundaries; that those individuals living outside of the slums will be somehow impervious from contagion. On the contrary, we contend that the dual realities of the slums – being densely populated and its dwellers being daily wage earners that must continue to work regardless of the social distancing measures introduced by the government – could quickly lead to an uncontrollable proliferation of the disease among the wider population.

The visit to the urban slum in Bangalore at which Sita and her neighbours relayed their ongoing concerns, revealed the central problem with the approach adopted by the Indian government in an effort to contain COVID-19. Namely, the social distancing measures introduced in India did not adequately account for the predicament under which the most socially and economically vulnerable individuals live (Fotaki and Prasad 2015; Segarra and Prasad 2020), including, in this case, those that make urban slums their residence. That is, the issuance of a country wide lockdown by the Indian government did not come with concomitant resources that would allow for the most vulnerable to follow the social distancing measures being prescribed. It is high time to thoroughly consider (and, where appropriate, accommodate) the implications that the practice of social distancing will have on this disenfranchised segment of the population.

It is perhaps too simple to describe urban slums as ideal petri dishes for the spread of COVID-19. It is as important, if not more so, to identify those initiatives that the government could introduce alongside social distancing measures, which would enhance the feasibility of maintaining physical separation between individuals living in urban slums. For the purposes of the present article, and based upon observations witnessed at the Bangalore slum, we identify three such initiatives that could be operationalised in India for the duration of the period the social distancing measures are in effect – or will be in the future. First, and perhaps most importantly, it is critical to provide direct cash transfers to the most socio-economically vulnerable who can no longer work and have no access to alternative resources for basic survival. Such cash transfers could be administered through the existing Public Distribution System (PDS) and Jhandhan bank accounts – established government schemes targeted for Indians living below the poverty line. Second, it is essential to offer accessible information about COVID-19 and the practical steps to follow given the limited resources at hand to avoid contracting infection. Where possible, this information should be delivered in local languages to maximise comprehension and follow through. Third, it is important to make free kits for hygiene maintenance (including soaps, sanitisers, tissue papers, and masks) available to those who do not normally invest the little money that they earn on such “luxuries”. For ease of delivery these kits could also be distributed through the existing PDS. While these options will not substitute for a cure for COVID-19, and they certainly will not be the solution to the broader societal crisis of extreme poverty, they will go a long way in creating the environment in which social distancing becomes a more viable option for the most vulnerable.

To be sure, accrued benefits that would yield from the operationalisation of such initiatives will not only be experienced by the residents of the slums. They will also have reverberating, constructive outcomes for the wider Indian communities within which the slums are located. For instance, if residents of slums have access to basic income, they will be far less likely to continue on with daily wage-earning activities during a global pandemic for hunger would no longer be what determines whether they choose to continue to go to work or not. Not going to work will, in turn, negate the potential for intra- and inter-community contagion.

In short, whatever social distancing measures are deemed necessary by government leaders to contain the proliferation of COVID-19, they will only be successful if sufficient economic support have been allocated to those who occupy the most vulnerable of spaces. As cases of COVID-19 among individuals living in slums in Mumbai and Harayana are confirmed (Barnagarwala 2020), it is ever important for meaningful and swift actions to be undertaken that would make social distancing achievable for this population as, to not do so, has the potential to pose unimaginable havoc to humanity.

Acknowledgements

Kishinchand Poornima Wasdani gratefully acknowledges research funding through an Accelerate Postdoctoral Fellowship, funded jointly by MITACS, Canada and RV Institute of Management, India. Ajnesh Prasad gratefully acknowledges research funding through an Insight Development Grant from the Social Sciences and Humanities Research Council and the Canada Research Chairs program.

Disclosure statement

No potential conflict of interest was reported by the author(s).