La résilience
CST member Sumia (right) speaking to Moriom. ©FAO/Asif Jilani

UN community-based initiative helps slow spread of COVID-19 in Bangladesh


“When my family found out that I was going to work with COVID-19 patients, they were not supportive at all,” said Sumia Akter Sumia. “I stopped sharing much about my role with my family because I was determined to not let their fears stop me from helping people in my community during this difficult period.”

Sumia works as a Community Support Team (CST) volunteer. She first received a three-day training from the Emergency Centre for Transboundary Animal Diseases (ECTAD) programme of the Food and Agriculture Organization of the United Nations (FAO). Sumia was then teamed up with Jubayer Al Nobel. Together, they cover a poor area of Dhaka, the capital of Bangladesh. The pair are one of 1 432 CSTs trained to cover the city.  

 “At the beginning, we were faced with a lot of challenges. It was clear from the first day how much the disease had spread and I was scared for my own health. The families we visited were clearly scared too. On only the second day, one family whom we visited slammed the door on us. I was ready to give up but instead I became more empathetic to the fear everyone was feeling because of this pandemic and I knew that I had to be patient.”

With funding from the World Bank Pandemic Emergency Financing Facility, the United States Agency for International Development (USAID), the Bill & Melinda Gates Foundation, and the United Kingdom’s Foreign, Commonwealth & Development Office (FCDO), the CST platform is a multi-sectoral, collaborative initiative led by the Directorate-General of Health Services (DGHS) in partnership with several organizations of the United Nations (FAO, United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), World Food Programme (WFP), non-governmental organization BRAC and volunteer organizations (Platform, Himu and Young Bangla) to promote mask-wearing, identify people with symptomatic COVID-19, and ensure home quarantine to limit further transmission. Additional technical support is provided by national institutions Aspire to Innovate (a2i), the Institute of Epidemiology Disease Control And Research (IEDCR) and icddr,b. 

Leveraging extensive experience in community-based approaches to mitigating epidemics in animals through the ECTAD programme, FAO has played an instrumental role in designing the CST intervention and provides ongoing technical support for monitoring CST implementation and evaluating its epidemiological impact. Since being piloted and launched in June last year, FAO has trained 1 432 CSTs like Sumia and Nobel in 129 wards across Dhaka North City Corporation (DNCC) and Dhaka South City Corporation (DSCC). Between June 2020 and January 2021, CSTs visited 1 825 424 households across both corporation, screening 207 663 suspected cases, of which 54 508 were identified as having signs and symptoms consistent with COVID-19.

A comprehensive information management system with a dedicated CST smartphone app has been developed to support the CST’s work. It provides real-time monitoring and sharing of the data with all the partners. This has enabled a dynamic feedback mechanism, which allows the programme to quickly identify issues or challenges and adapt itself as required. 

A dedicated mobile app was developed to support household screening and vulnerability assessment by the CSTs. A CST-dedicated telemedicine system was also set up under coordination of DGHS with technical support from FAO and UNFPA, providing toll-free numbers and a hotline to support symptomatic individuals and a separate hotline to support women of reproductive age for any sexual and reproductive health or gender-based violence issues. Dedicated doctors and midwives are connected to symptomatic individuals, pregnant women or vulnerable individuals by the CSTs and receive comprehensive counselling, consultation and referrals to appropriate health facilities.

“Community members now welcome us and rely on us for support”, said Sumia. Vulnerable members of the community have been particularly appreciative. One mother, Moriom, was concerned when her son with disabilities showed symptoms. “They share their home with four other families. People like her cannot afford to go to the hospital. They rely on us to connect them with doctors and to be prescribed treatment. Since the national vaccination drive has begun, they are looking to us to support them with registration for the vaccination. Now my own family fully supports my work because they can appreciate how much I have been able to help my community.”