Poor communities take virus fight into own hands

Poor communities take virus fight into own hands

Communities in Klong Toey slum build makeshift isolation centre as cases soar

A health official explains the registration procedure for a Covid-19 test in Klong Toey district of Bangkok on Monday. Infectins are surging across many communities in the district. (Photo by Wichan Charoenkiatpakul)
A health official explains the registration procedure for a Covid-19 test in Klong Toey district of Bangkok on Monday. Infectins are surging across many communities in the district. (Photo by Wichan Charoenkiatpakul)

The air is thick with fear of contagion in the slum of Klong Toey, where many people live eave-to-eave in its densely populated neighbourhoods.

One sub-community has taken matter into its own hands by opening an improvised isolation centre, where residents infected with Covid-19 can stay until authorities arrive to securely transfer them to a medical facility for treatment.

Mariam Pomdee, the head of Patthana Mai -- one of several sub-communities which make up Klong Toey, the capital city's largest slum -- said 20,000 families call Klong Toey home. While the average household in the slum consists of five individuals, up to 13 people can reside in one home, she said.

Most of the homes in Klong Toey were built on tiny plots, many of which consists of nothing more than four walls and a door. With no partitions, all members of the household -- often from grandparents to grandchildren -- sleep in one room, right next to each other. The only other room in house is usually the shared toilet and bathroom. They also share a single toilet and bathroom.

The majority of Klong Toey residents live a hand-to-mouth existence, often doing odd jobs in the informal sector. As most commute to work in other parts of Bangkok and return to the slum in the evening, authorities are concerned that infected individuals may spread the Covid-19 virus to other parts of the city, as well as their family members and others around them.

Ms Mariam said Covid-19 cases in the community began rising after the Songkran holiday in the middle of last month. Transmission occurs especially fast within households, she said.

Patthana Mai, she said, has around 1,400 residents. About 450 houses in the sub-community are registered with the local district office, but the rest are unregistered dwellings.

The rising number of infections left Patthana Mai's administrative panel with no choice but to turn a communal activity ground into a temporary isolation centre, where residents who have tested positive for Covid-19 can safely wait to be picked up by health authorities, while receiving basic medical attention, Ms Mariam said.

"The idea was to keep the sick in one place to prevent the disease from spreading further," she added.

The isolation centre, which opened on April 24, is covered with large plastic sheets to create a restricted zone.

"The centre may look basic, but it at least can reduce the risk of transmission among family members," she said.

A similar isolation centre was also set up in Klong Wat Saphan, another sub-community, on April 19.

Furthermore, she said, the community has trained volunteers to educate people about ways to stay safe from the coronavirus and de-stress at a time of high emotional tension, as some people are consumed by "Covid paranoia".

"The growing anxiety, if allowed to go unchecked, looks certain to cause conflicts in the communities," Ms Mariam added.

In the meantime, health volunteers are carrying out Covid-19 tests on high-risk individuals who came into close contact with those infected, she said, before adding, "To live free of Covid is the bottom line for everyone."

Penwadee Saengchan, manager of the Duang Prateep Foundation, said the lack of space in Klong Toey means social distancing is often just a pipedream. She recalled a case of a man who found it impossible to self-isolate after his friend tested positive for Covid-19, and ended up passing the infection to two other family members.

Communities in Klong Toey have set up a dedicated Covid-19 hotline to answer residents' queries and coordinate assistance, such as alcohol gel, face masks, as well as household item deliveries for families who have gone into Covid isolation.

Ms Penwadee said community isolation centres are a must in a pandemic, as they form the the first line of defence against local transmission.

The concept of community isolation centres was first launched by the National Health Commission Office, the Bangkok Metropolitan Administration, along with health and social advocacy networks.

Ms Penwadee said those at high risk of infection can get tested at the royally donated mobile lab stationed in Klong Toey. People who tested positive for Covid-19 will then be referred to either hospitals or field hospitals, depending on the severity of their condition.

Klong Toey has recorded 304 Covid-19 cases since the start of Thailand's third wave of Covid-19 infections. Of these cases, 193 individuals live in overcrowded conditions.

The Kloey Toey slum comprises 12 sub-communities (see graphic), the hardest-hit of which is Patthana Mai, with 78 infections, or 5.3% of the population.

Ms Penwadee said authorities and local communities are racing against time to bring the infections under control, as if not, more than 1,000 people may fall ill.

"We don't want the Klong Toey community to be known as a super spreader hub," she said, adding the government should offer financial remedies for those who have lost their income.

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