Covid-19 and internally displaced people in Bangladesh: In search of policy solutions

The United Nations Division for Sustainable Development Goals (DSDG) has recognised the disproportionate impact of the Covid-19 pandemic on poor and densely populated urban areas, and particularly on informal settlements and slums. Bangladesh recorded its first case of Covid-19 on March 8, and the rate of infection has rapidly increased since then.

The government of Bangladesh has responded to the pandemic by raising a national-level alert and implementing a wide range of public health measures. However, when considering the high-density nature of informal settlements and slums, preventing the spread of the virus through social distancing and self-isolation measures becomes hugely difficult, if not impossible.

These issues arise in the context of intensifying rural to urban migration patterns due to displacement caused by climate change, which has increased the density of informal settlements and placed extreme pressure on urban infrastructure. Although Dhaka has been the destination of choice for many new climate migrants, most of these people pass through secondary cities and regional centres along the way.

These cities have the potential to become major population centres, however, pull factors such as employment opportunities make Dhaka the primary city of choice for many new climate change migrants. To reduce the strain placed on Dhaka and ensure that all citizens have access to the essential services they require, secondary cities will play an important role in adopting new climate change migrants by creating competing pull factors against Dhaka.

Following the government's "general holiday" declaration at the beginning of the Covid-19 transmission, many people left Dhaka, and it was reported that, "hundreds of thousands of people, who had come to Dhaka in hopes of leading a better future for themselves as well as for their children, are now being forced to leave the city of their dreams due to job cuts caused by the coronavirus."

According to a joint survey conducted by Brac, DataSense and Unnayan Shamannay, the pandemic has put over 102 million people at financial and economic risk. Among those surveyed, over 34 percent of families said that at least one family member had lost their job. Meanwhile, 74 percent of families witnessed a fall in their income and 1.4 million expatriate workers were found to be returning home after losing their livelihoods.

With Dhaka already reaching its limit in terms of carrying capacity and ability to cope with the impacts of the pandemic, secondary cities across Bangladesh are well placed to absorb climate change migrants and create new economic opportunities. The Covid-19 situation makes addressing displacement, particularly concerning resettlement, public health, and employment, more urgent than ever.

The response to the Covid-19 pandemic must be equitable, and the framing of law and policy to allow for the effective development of secondary cities to accommodate climate migrants will be an important means of achieving this. As part of this framing, awareness and understanding of the challenges and opportunities for the implementation of law and policy in secondary cities amid the global pandemic is necessary.

A healthy, productive workforce is the backbone of economic activity. The Covid-19 pandemic has demonstrated the interdependency between a healthy workforce, robust economic growth and a rise in living standards. Without access to basic medical services, supportive health infrastructure and nutrition, urban renewal or regional development is unsustainable.

Bangladesh has made remarkable strides in improving the health outcomes of its citizens and developing the capacity to perform public health initiatives. However, significant challenges remain. Health workers continue to be highly concentrated in urban secondary and tertiary hospitals, despite 70 percent of the Bangladeshi population living in rural communities.

Sound health policy must also be integrated with other policy disciplines to promote good health outcomes of emerging regional centres and a middle class. Sanitation, clean drinking water, healthy nutrition, basic health education and family planning are all necessary to improve the health outcomes of displaced and vulnerable communities.

Steps are already being undertaken to improve the health outcomes of Bangladeshis, however, further coordination is required to future-proof existing policy and programmes so that it can better address the rising issue of climate change displacement and migration, particularly in the light of Covid-19.

The public health measures put in place thus far largely failed to recognise the realities faced in informal settlements where adequate health care, water and sanitation facilities are often not readily available. There has been evidence of minimal adoption of such measures by the public at large and a lack of public awareness of the measures, and the virus more generally (Banik, R, et al, 'Covid-19 in Bangladesh: public awareness and insufficient health facilities remain key challenges' (2020) 183 Public Health 50, 50-1).

Without access to adequate health services, shelter, or social security to help them cope with the new measures, internally displaced persons are more vulnerable to risks of infection (World Bank Group, 'Covid-19 Crisis Through a Migration Lens'; Migration and Development Brief 32; April 2020).

Thus, in addition to increasing the effectiveness of awareness programmes, public health measures ought to be reflective of the realities faced by climate migrants and the need for adequate health care facilities to be made available to them. In this way, the Perspective Plan of Bangladesh 2010-2021 notes that "health care facilities will be taken at the doorstep of the people' by constructing thousands of new clinics at the grass-root level to provide primary health services to the rural community".

This position presents a clear iteration of developing the capacity for local and regional centres to provide healthcare services and reduce migration to Dhaka that already faces significant strain on its healthcare infrastructure. A stronger emphasis will need to be made towards the provision of services to regional centres so that these secondary cities can create pull factors for future migration.

The commitment to provide quality health services is continued in the government's 7th Five Year Plan which outlines health policies that have synergies with new city development for the relocation of displaced persons. The Plan calls for, among other things, improved service delivery, the decentralisation of the management of facilities and protecting the interests of the poor. All of these measures are to take into account 'deficiencies in governance and management of the health sector'.

The government will play an important role in facilitating and supporting an array of public policies which have an overarching objective of creating sustainable, secondary cities. Such policies ought to be at the forefront of the minds of policymakers and government officials alike, particularly within the present climate.

Focus on equipping secondary cities with the resources necessary to accommodate climate migrants will be a vital strategy, not only serving as a long-term solution to ensure that climate migrants have access to the resources and infrastructure they require, but also in responding to the challenges posed by the Covid-19 pandemic which has seen many climate migrants leave Dhaka to return to rural villages.

As has been observed, the realities of the way many citizens live make following current health guidelines very challenging. This is particularly acute concerning climate migrants who, as marginalised populations, require recognition of their lived experiences and the challenges they face, within the laws and policies that are designed to assist them.

Dr Shawkat Alam is a professor of law and director of Centre for Environmental Law at Macquarie University, Sydney, Australia. Email: Shawkat.alam@mq.edu.au. Web: https://researchers.mq.edu.au/en/persons/shawkat-alam