The World Health Organisation has highlighted contact tracing as a key activity for reducing the transmission of COVID-19 in indigenous communities. Contact tracing is the process of identifying and assessing people who have been in contact with known and confirmed cases of COVID-19. Tracking infectious disease outbreaks can be challenging in particular circumstances, such as remote communities and informal settlements due to there being contacts without addresses, locations with no street names, incorrect contact names or the use of nicknames. Contact tracing for COVID-19 in parallel with other infectious disease outbreaks may also make the activity more difficult. Lessons from the Ebola outbreak in the Democratic Republic of the Congo show that even in challenging areas, contact tracing is possible. Contact tracing for COVID-19 has also been conducted successfully in indigenous communities in countries like Brazil, Australia and the United States. Factors that may facilitate successful contract tracing among indigenous communities include recruiting indigenous contact tracers and utilising technology to update results in real-time. To further reduce stigma and community resistance, smartphone apps can be utilised to aid local contact tracers in their work, and the data collected can be used to improve reporting and surveillance of outbreaks in real-time.
Whether the contact tracers use a mobile application or paper forms for data entry, it is necessary in most cases for the teams to walk from door-to-door to identify and isolate suspected/confirmed cases and their contacts to break the transmission of coronavirus. General guidance on how to conduct contact tracing is available from the World Health Organisation (WHO). Specific guidance is also available for the WHO Africa Region.
Collective isolation of indigenous communities
Collective isolation of communities has been implemented in some settings to protect indigenous people against COVID-19. In some cases, indigenous communities such as the Awajún and Wampis in Peru have implemented traditional practices of isolation and lockdown from disease, and it is important that these measures are supported and respected. In other areas, collaboration with local governments and organisations have helped facilitate isolation. In cases where “outsiders” need to enter the community, the entry should be agreed and accepted by the community and only staff that are appropriately trained should conduct work in the community during the pandemic.
In the Bolivian Amazon, local government, indigenous leaders and health professionals implemented a COVID-19 prevention and containment plan including contact tracing and isolation of the community. A case study and protocol on their response is available here.
Collective isolation due to COVID-19 is different from indigenous people living in voluntary isolation (without sustained contact with local or global communities). Indigenous groups living in voluntary isolation who have always chosen to be isolated are likely to have reduced immunity against common infectious diseases, and therefore, it is crucial that neighbouring communities allow these groups to remain isolated and safe during the pandemic. One such particular threat is illegal miners and loggers entering indigenous land.
Reduced travel into indigenous communities
Minimising or restricting movement by non-indigenous people in, out and through the villages and lands of indigenous people have been widely applied in order to prevent the entry of COVID-19 in their communities, including in Ecuador and Australia. Such restrictions may be led by the community itself and supported by responding organisations and governments.
Reducing travel and isolation of communities, however, may not be possible in all scenarios. For example, in Kenya, the indigenous Masai are not able to close borders to their territories as this would lead to increased food insecurity in the population. In these cases, working with communities and supporting their decisions, on what measures can be taken and who will implement them, is recommended.
Recommendations for promoting and supporting hygiene practices, ensuring access to affordable water, reducing the risk of transmission in public places (through mask use and physical distancing), reducing social gatherings while encouraging the use of community support systems and further considerations for responding to COVID-19 in rural areas are available here.
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Author: Astrid Hasund Thorseth
Last update: 28.10.20