Impact on Community Based Organisations (CBOs)
From very early on (March 23-30) in the COVID-19 pandemic APCOM carried out a survey of 9 countries (Cambodia, India, Indonesia, Laos PDR, Mongolia, Nepal, Pakistan, Philippines and Sri Lanka) to better understand the impact of COVID-19 on communities with diverse SOGIESC, services and providers in the Asia Pacific Region. The survey results were released on April 3rd as the first reports in APCOMs newsletter series. From June to August 2020 APCOM surveyed a further seven countries and obtained additional data from India and Sri Lanka. The data from this second survey are discussed in this second newsletter series. This second report in the series discusses the impacts on the community-based organisations during the first six months of 2020, a year very unlike any other.
As governments moved to implement strict non-pharmaceutical measures limiting mobility and restricting face to face contact, the operations of community-based organisations were significantly impacted. All face to face events and many activities provided by CBOs were suspended. Initially staff often worked from often without the right technology. All meetings were moved to on-line events and organisations worked hard to identify alternative ways to deliver their programs and services.
CBOs’ primary concerns in the initial phase were to (i) ensure staff wellbeing both mentally and physically; (ii) enable staff to work from home i.e. ensure IT access, proper hardware and software and (iii) ensure staff were able to work safely from the office/clinic i.e. the appropriate access to transport, PPE and knowledge, if required, to provide in-person clinics.
Staff knowledge and engagement
Recognising that their staff did not always feel properly informed, CBOs initiated group chats via social media channels to deliver reliable and up to date information on COVID-19. Regular engagement with their own staff and also with other CBO’s led to staff feeling more empowered, increased collaborative working and encouraged sharing of innovation initiatives. Mutual support other during the more restrictive ‘lockdown’ period increased and, as measures gradually relaxed, strategies for what to do and how to better manage operations were further developed.
Following the directives of their governments, CBOs responded quickly to protect and safeguard their staff by trying to obtain personal protective equipment for both staff and clients wherever possible. Staff, volunteers and service users were also encouraged to look after their wellbeing and seek professional assistance if needed.
These two measures – the efforts to engage/inform and safeguard staff well-being – increased staff confidence to share that information within their rural and urban communities (Fiji islands).
Organisations found that switching to the ‘new normal’ required both extra resources (e.g. IT equipment, PPE, sanitisers) and manpower to cope with the physical and virtual delivery of services (e.g. increased home visits, organising home delivery of medicines and ST kits, shuttle buses for staff). This has created an extra strain on organisations due to limited funding and the transition to the ‘new normal’ is a gradual process that is still ongoing.
CBOs are concerned about both existing and new funding. With many fundraising events cancelled there has been a significant drop in income which could have been used to support these ‘new normal’ activities.
Many CBOs have increased their efforts to enhance co-operation with overseas HIV/AIDs organisations to support the provision of comprehensive services during the pandemic, while undertaking COVID-reprogramming to redirect funds appropriately. However, concerns remain about achieving program indicators set with funders prior to COVID-19. Much of the online outreach work, the team building and networking which have been identified as essential during the pandemic are not recognised as official indicators and as yet, by June 2020, no directives had been issued to grant implementers to review targets and indicators.
In an effort to raise funds at this difficult time CBOs have also approached both corporates and pharmaceuticals to obtain support.
Organisations initially moved to skeleton services and suspended outreach clinics, events, trainings, mobile testing etc. CSOs worked hard to initiate essential mitigation strategies in an effort to maintain services and programmes. This included moving to online working wherever feasible; securing PPE and applying social distancing policies; securing appropriate data packages, hardware and software for staff; promoting and supplying patients with multi-month supplies of ARV and condoms, and maintaining contact via phone calls and social media to prevent loss to follow up. This was easier for some countries than others where the technical hardware, software and critically IT skills were limited.
Where NPI measures gradually relaxed CBOs have slowly begun to reinstate services and events as far as possible alongside virtual services. However, in many countries where measures remain restrictive (e.g. Sri Lanka, Myanmar, India) there is a worry about the impact of the length of interruptions to services. It is often these same countries that are facing difficulties with access to virtual online platforms.
Supporting Communities with essentials
Communities themselves have been severely impacted with many individuals losing their source of income. Access to food, shelter and paying bills is often a greater concern for these individuals than their health. CBOs have voiced concern both for the health and social welfare of the communities they serve. Many have had to pivot and request to use monies from funders to support communities with food, water, shelter and sanitary needs.
Innovating in the face of adversity
Additional innovative initiatives were also introduced by CSOs as an indirect/direct consequence of COVID-19. In Hong Kong the HK Aids Foundation launched a variety of e-workshops to cover physical and mental health issues as well as leisure and lifestyle topics. Other CSOs have also recognised the need for such e-workshops. One indirect positive result of COVID-19 has been an accelerated roll out of some of the pilot projects. For example, HIV self-testing, use of virtual counselling, development of chatbots, home delivery services and allowing multi-month supplies of ARV.