アジアの巨大スラムを襲う新型コロナの脅威

【マニラＡＦＰ＝時事】メアリー・グレイス・アベスさん（23）は、新型コロナウイルス感染症の大流行におびえている。だが、家族を守る最高の武器である「隔離」と「衛生」は、アベスさんが住むフィリピンの首都マニラのスラム街では手が届かないぜいたく品だ。（写真はフィリピン・マニラのスラム街）
　同じような危険が、アジア各国の巨大スラム街に押し寄せている。スラム街で清潔を保つことはほぼ不可能で、人々は生き延びるために毎日外出しなければならない状況だ。
　マニラのトンド地区にあるアベスさんの自宅は洋服ダンスほどの大きさで、「道で誰かに出くわしたら、どうしても触れてしまう」と語った。
　アジアでは新型コロナウイルス拡大防止のための対策が強化されており、マニラも封鎖されている。
　新型コロナウイルスへの感染はせきやくしゃみの飛沫（ひまつ）を通じて起きることが多く、世界の保健当局は最も効果的な予防策は外出を控え、手を清潔に保つことだとしている。
　「しかし、もしそのどちらもできないとしたら？」と英開発学研究所のアニー・ウィルキンソン氏は意見記事で書いている。「都市部の貧困層への影響は、他の地域に比べかなり大きくなるという現実的な危険がある」
　世界銀行の２０１７年の調査によると、東アジア・太平洋地域では２億５０００万人がスラム街に暮らしており、その多くは中国、インドネシア、フィリピンにいるという。
　スラム街では料理、洗濯、個人の衛生管理、娯楽が、人がたくさんいる共有スペースで行われる。
　アベスさんの住居には、マスクも消毒液も洗面所もない。トイレはバケツで、中身はエステロ・デ・ビータ川の黒く濁った水に直接捨てられる。
　スラム街は感染症が拡大するのに必要な条件がすべてそろっているといえる。

■生と死を分けるもの
　現在世界の新型コロナウイルス感染者は３３万人近くに達しており、うち１万４３９６人が亡くなっている。
　流行は加速しているが、アジアの最貧層の人たちは自らを守るすべがない。
　インドネシアもインドも、スラム街における感染予防に向けた特別な措置は講じていない。
　また、パキスタンのイムラン・カーン首相は、経済的被害が多すぎるため、大規模な都市部封鎖は行わないと表明した。「人々は既に難しい状況に直面しており、都市部を閉鎖した場合、最終的に新型コロナウイルスからは守られるかもしれないが、飢えで死ぬだろう」
　トンドの住民は、政府がマニラを封鎖して以来、仕事がないと話す。お金が底をついたら、仕事を探しに外に出なければならないと語る。
　スラム街の住民は重症化しても費用を懸念して治療をためらうとみられている。
　公衆衛生専門家のギデオン・ラスコ氏は、「質の高い医療へ迅速にアクセスできるかどうかが、生と死を分ける可能性がある」と指摘している。【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2020/03/24-13:09）

Mary Grace Aves is terrified of the deadly coronavirus pandemic, but the best weapons to protect her family -- isolation and sanitation -- are unreachable luxuries in the Manila shantytown they call home.
The same particularly dangerous set of threats loom over hundreds of millions packed into Asia's massive slums, where staying clean is nearly impossible and people have to leave their homes daily to survive.
It may be possible (to isolate) in other areas because they are rich. They have big spaces, said Aves, a mother of four. Here we are crammed.
If you run into somebody on the way out of the house you will touch, the 23-year-old said from her closet-sized home in Manila's Tondo district.
Asian nations have imposed increasingly heavy measures to fight the contagion, with the Philippines ordering around half of its 110 million people to stay home.
That quarantine includes Manila, but there was no sign of authorities enforcing it in slum areas on Wednesday. The order was being flouted in many parts of the sprawling metropolis.
Because the virus spreads through droplets that can be picked up with one touch or inhaled from a sick person's sneeze, global health authorities say the best protection is staying home and keeping hands clean.
But what if you cannot do either of those things?, asked Annie Wilkinson, a fellow at research group Institute of Development Studies, in an opinion piece.
There is a real risk that the impacts on the urban poor will be considerably higher than elsewhere, she wrote.
East Asia and the Pacific are home to 250 million slum-dwellers, many of them in China, Indonesia and the Philippines, a 2017 World Bank study said.
Homes in these slums are tightly-packed, tiny spaces that are only big enough for sleeping and lack running water.
Cooking, laundry, personal hygiene and leisure are done in common spaces filled with people, which means residents have to be in public in order to survive.
In Aves's settlement, there are no surgical masks, hand sanitizer or sinks, and toilets are buckets emptied directly into the black water of the Estero de Vita river.
The narrow, muddy passages between the homes are only wide enough for one person, so locals touch frequently as they slide past one another.
An infection there would have everything it needs to spread.
- 'Life and death difference' -
More than 218,000 cases of the COVID-19 infection have now been detected globally, with nearly 9,000 deaths.
Asia's poorest have been largely left to protect themselves as the outbreak accelerates.
Neither Indonesia nor India have imposed lockdowns, and have not taken significant steps specifically directed at preventing outbreaks in shantytowns.
In Pakistan, Prime Minister Imran Khan said the government would not impose a large-scale urban lockdown against the virus because it would extract too great an economic toll.
If we shut down the cities -- people are already facing difficult circumstances -- we will save them from corona at one end, but they will die from hunger on other side, Khan said.
Tondo residents said they had been out of work since the Philippines' quarantine kicked in but would be forced to go out to find other employment once their money ran out in a matter of days.
Unlike wealthier communities that can restrict access to outsiders with entrance gates or security guards, slum areas are wide open.
There's a possibility we'll get infected because we can't control who comes here, said 48-year-old Fely Tumbaga, who runs a small store in Tondo.
We don't know if outsiders have the virus, she added, noting that locals were increasingly wary of anyone they didn't know.
For slum dwellers who develop severe cases, reluctance to seek care due to the cost involved could prove a deadly decision.
The strength of a nation's healthcare system has been a key factor in death rates, but so is the severity of infection when people seek treatment.
Public health expert Gideon Lasco said the ability to pay but also to reach the hospital as lockdowns tighten will be decisive.
Immediate access to quality care can mean the difference between life and death, he said.