As we in the global North brace ourselves for the coronavirus pandemic we are being told to wash our hands (for 20 seconds!) and self-isolate if sick. But what if you cannot do either of those things? One billion people live in slums or informal settlements where water for basic needs is in short supply – let alone 20 seconds worth – and where space is constrained and rooms are often shared. Yet discussion about vulnerability in these contexts has been startlingly absent.

A recent IIED blog raised the issue of poor infrastructure in ‘slums’ and informal settlements and rightly concluded that an overhaul of urban planning and development is needed to bring about improved infrastructure and public health. But in the meantime, we need to consider how COVID-19 could impact people living in densely populated and unsanitary environments, and what could mitigate the worst of these impacts. This is challenging as the health and social needs of these populations are often invisible.

So what are the health experiences, challenges and priorities of people in informal settlements? How do residents organise to address existing health threats? And how does this provide a basis for a COVID-19 response? These are the questions IDS and SLURC have been exploring as part of an ESRC research project on post-Ebola urban health in Sierra Leone, and also in a new GCRF funded hub on Accountability for Informal Urban Equity – ARISE.

Some of the insights from this research and some potential lessons for COVID-19.