With the clear limitations of many public health measures, particularly in settings where health systems are weak, relying on community capacities to respond to pandemic shocks and ‘build back better’ (another familiar buzzword) is seen as the way to go. This does not mean that standard public health and technical measures are abandoned, but they must go hand-in-hand with community resilience-building.
For some, this is at last a recognition that local efforts count, and that centralised health systems are not the only solutions. A more plural, rooted alternative is needed. For others, this is a typical neoliberal sleight of hand, downplaying the role of state support in times and relying on community voluntarism.
Whatever the underlying motivations, the big question is what happens on the ground and how can this help both with pandemic preparedness and response? This was the focus of our research in Zimbabwe, conducted in real-time over two years from March 2020. As the earlier blog that introduced our new book highlighted, we had an open-ended approach to research. No prior questions or hypotheses and an approach that lent itself to finding out what was happening as events unfolded in real-time.
We therefore did not start out with any prior ideas about ‘community resilience’; indeed, we did not use the term (and I am not sure we could translate it into Shona or Ndebele anyway). Instead, we explored the reactions to the pandemic in different sites through deep immersion, inductively understanding the dynamics.
Resilience building in a plural health system
Our new open access paper in the British Medical Journal (Global Health) journal presents the findings and explores whether what we found was ‘community resilience’. Around two themes – adaptable livelihoods and learning and innovation – we certainly found a core set of practices, centred on making use of local, contextual knowledge, learning and sharing ideas across networks and social and technical innovation, not least around COVID-19 treatments (including local herbs and tree products, such as Zumbani, see lead photo). All contributed to a process of building resilience, the ability to resist and transform shocks and stresses.
However, these practices were all highly differentiated – across sites and amongst people – and so a simple form of ‘local’, ‘community’ resilience could be questioned. Indeed, while autonomy and independence was hailed, in practice it was the interaction between formal and informal health systems – a plural health system – that was important. In the same way a standard version of ‘resilience’ was also challenged, as the responses were not ‘bouncing back’ to a prior state, but often resulted in transformations in livelihoods, social relations and politics, sometimes with empowering effects on certain people, but more often than not a sense of resigned coping in the face of on-going hardship compounded by the pandemic.
The paper is open access, so you can read the full piece, but meanwhile here’s the abstract:
Based on real-time recording and reflection of responses to the COVID-19 pandemic, this article identifies the features of ‘community resilience’ across sites in rural Zimbabwe. The findings confirm the importance of local knowledge, social networks and communication, as highlighted in the literature. In addition, a number of other aspects are emphasised, including the importance of adaptable livelihoods, innovation and collective learning. Flexible adaptation was especially important for responding to lockdowns, as livelihoods had to be re-configured in response to public health measures. Meanwhile, innovation and shared learning was vital for generating local treatment responses to the disease. In the Zimbabwe context, these adaptation and innovation capabilities emerge from a particular historical experience where resilience in the face of harsh economic conditions and in the absence of state support has been generated over years. This is often a more resigned coping than a positive, empowering, transformational form of resilience. While adaptation, innovation and shared learning capabilities proved useful during the pandemic, they are not evenly spread, and there is no singular ‘community’ around which resilience emerges. The article therefore argues against seeing ‘community resilience’ as the magic bullet for disaster preparedness and response in the context of pandemics. Instead, the highly differentiated local practices of adaptation, innovation and shared learning – across gender, age, wealth differences – should be seen as an important complement to public, state-led support in health emergencies, and so part of a wider, plural health system.
And here is an extract from the conclusion:
Pandemics are an opportunity to rethink the way health systems operate. However, the popular idea of ‘community resilience’ must always be seen as part of a wider suite of responses and not as a magic-bullet solution. In the Zimbabwe case, responses to COVID-19 occurred in the context of a weak health service, an economy in a dire state and when trust in the state – or more precisely politicians – was extremely low. Here a resigned resilience – or coping – centred on autonomous local capabilities, although differentiated within a ‘community’ and also stretching beyond a locality, was clearly important in the COVID-19 response in rural Zimbabwe.
Generating such resilience, we saw the importance of plural health systems, involving many actors – formal and informal. This was not just ‘the community’, but a wider mix of players, all connecting around a complex pandemic response. Of course, such a plural system had long existed, but it came into its own during the pandemic. While the moniker ‘community’ is problematic and ‘resilience’ of course is an extremely difficult concept to pin down, certainly elements of what is referred to as ‘community resilience’ were present in our study areas during the pandemic.
See: Bwerinofa, I.J.; Mahenehene, J.; Manaka, M.; Mulotshwa, B.; Murimbarimba, F.; Mutoko, M.; Sarayi, V. and Scoones, I. (2022) What is ‘community resilience’? Responding to COVID-19 in rural Zimbabwe, BMJ Global Health
The 20 blogs that provide a real-time overview of the pandemic are now available as a low-cost book: You can buy the 160-page (full colour illustrated) book on Amazon (£12.72 for a paper copy, £1.25 for a Kindle version) or download it in high- or low-resolution versions here and here).
The research team are Iyleen Judy Bwerinofa, Jacob Mahenehene, Makiwa Manaka, Bulisiwe Mulotshwa, Felix Murimbarimba, Moses Mutoko, Vincent Sarayi and Ian Scoones.
This blog was written by Ian Scoones and first appeared on Zimbabweland
Post published in: Agriculture