As governments, businesses, and individuals scramble to respond to the threat of a coronavirus pandemic, those of us who work at nonprofits and foundations rightly ask what we can do to make a difference. This is even more challenging when the constant media and social-media barrage provides so little useful information that anyone can act on but instead is contributing to unhelpful anxiety and worry.
While I now advise foundations and other organizations as the co-CEO of a nonprofit consulting firm, I have a perspective on what makes a difference gleaned from a career as a pediatrician and as medical director of the Massachusetts Department of Public Health during the 2009 outbreak of the H1N1 virus. I learned from experience that responses during a time of crisis are only as good as the strength of preparedness, support systems, and relationships that existed before the crisis.
Perhaps even more important, my medical career hammered home a crucial lesson for philanthropy: Any natural disaster or public-health emergency always takes an increased toll on those groups who were marginalized or excluded before the emergency. These groups often have been denied the material resources to buffer them from threats such as an infectious-disease outbreak or a devastating storm.
For example, given that most low-wage workers do not have paid sick leave, if they miss work due to their or a family member’s illness, they lose crucial income that could be the difference between being able to pay their rent or not. They also run the risk of being let go if they miss their shifts. If workers also lack adequate health insurance, they face the threat of crippling medical bills. Now what started as a simple illness has snowballed into a family financial disaster.
Promoting Resilience
Those pressures are why it is a struggle for so many people to heed the sound public-health advice to “stay home when you are sick” that we are hearing about coronavirus. So, in addition to a health problem, we face an equity problem. As the New York Times points out: “Unequal access to precautionary measures cuts along the same lines that divide the United States in other ways: income, education, and race.”
Yet grant makers and nonprofits can actively promote resiliency in their communities — the ability to use resources to respond to, withstand, and recover from adverse situations. Ideally, this work begins before disaster strikes, but there is a lot we can do now even if our preparedness was lacking. Now is a good time to remind ourselves of what the Greater Houston Community Foundation suggested foundations can do in the wake of a natural disaster. Its recommendations are equally relevant for a public-health crisis, such as a pandemic. Moreover, the recent piece by Antony Bugg-Levine in the Chronicle contributes important insights about maintaining the vitality of nonprofits in light of the current outbreak.
What’s also important to think about are the systems and structures that need to change — and that fail to protect the most vulnerable. Many foundations have stepped up their work to improve education, housing, economic empowerment, health care, and other systems that are critical to the health and well-being of individuals and communities. But the coronavirus outbreak and its impact on our economy and health make it ever more critical to double down on actions to strengthen the social fabric that communities need to thrive. In particular, it is crucial to pay specific attention to communities that are likely to suffer disproportionately during the pandemic because of historic, systemic barriers that have left them vulnerable.
Here are ways we can all work together to mount an effective response:
Reach out to people likely to be hardest hit, including people of color and other historically marginalized groups. Grassroots leaders and others know what would be helpful, but they may not have the resources or influence to get it. Use networks of grantees and other groups to gather information about what types of support would be helpful and to share resources. This is especially true when some groups of people are experiencing specific risks, such as the exclusion and bigotry some Asian Americans are facing during the coronavirus outbreak. Fund organizations that already have established and trusted relationships with the people you want to help so they can ramp up their outreach and education efforts. These can be local nonprofits or national ones such as the NAACP or UnidosUS, which have networks that reach people who are too often excluded. Many of the groups have already done great thinking about how to meet the needs of the people they serve.
Provide resources to communities to increase their resiliency. For example, if schools close for an extended period, foundations can provide funds for laptops or tablets for students who need to stay connected to their teachers and schools. Local grant makers often have more credibility and are more trusted than government agencies and other players and have an important role to play in times of crisis. In Seattle, local grant makers and corporations have come together to launch a $2 million campaign to support people disproportionately harmed by the coronavirus, including gig workers, people who lack access to insurance or sick leave, communities of color, and residents with limited English proficiency.
Recognize that some people are less connected to health care and public-health systems so we need to design special ways to catch their attention. Many people of color, immigrants, low-income Americans, and others have developed skepticism or even suspicion of health-care systems based on their prior experiences of exclusion, bias, or poor care. Support efforts that seek to build trust in public-health organizations and that work to engage even the most wary so they will more quickly adopt recommended approaches to protecting their health. Ensure that trusted messengers and organizations have accurate and timely information they can spread to their constituents and communities. Support efforts to spread educational messages in languages that will reach people who have historically been excluded, and make sure that these messages appear in the places where people typically get information.
Support actions that will reduce additional burden on strained health-care systems. Given that the capacity of our health-care system is already limited, foundations can emphasize efforts that keep people out of hospitals and emergency rooms and allow providers to focus on the surge of people who need acute medical care. This includes promoting vaccines for conditions like the flu and shingles, as well as smoking-cessation and other campaigns focused on reducing the burden of chronic illnesses that put people at risk for complications with coronavirus and other viruses.
Work with local, state, and national public-health leaders to bolster our public-health infrastructure. Public-health organizations often face unchallenged cuts to their budgets because the public and lawmakers do not fully appreciate the essential functions they play in our communities. Foundations can use their influence to advocate for sustaining these systems. This can’t be something we think about only during a crisis; the systems that advance public health need support all the time.
Support factual, timely, and measured public communication. Help credible sources counter the current media frenzy with accurate information. We need to make sure lay people get information in ways they understand. For example, the number of identified cases will certainly increase as more people, including those with mild or no symptoms, are tested. This does not necessarily mean there is actually more virus circulating but instead that it is being detected more. Help people understand how this risk compares with others, manage understandable anxiety, and keep people from falling prey to the dramatic nature of “breaking news updates.”
Use all of the philanthropic tools available, beyond grant making, and share what you are learning. Foundations can use their power to bring together key community players, business leaders, and government officials to collaborate to ensure a coordinated and comprehensive response. Grant makers can raise their voices and help raise the voices of their grantees and the people they serve, especially to let our elected officials know what is and is not working. This could include starting coalitions to promote paid sick leave. Advocating for paid sick leave and time-off benefits not only for individuals who are most at risk but for whole communities by allowing sick people to stay home without risking their families’ financial security.
Outside the United States
As a U.S. health expert, my lessons are drawn from a U.S. context. Beyond the United States, the best way philanthropies can help will vary widely, depending on the local government and public-health and health-care infrastructure. However, my colleagues and I have found that these two rules apply to almost any effort that is funded by international dollars:
Tap into existing and local structures. Most governments have processes and structures set up for emergencies. Circumventing them can create additional confusion and stress in a highly tense situation.
Consent is key. Whatever you do, get consent from the local government and people who live in a region where you want to help. Involve them in the decision making and processes. For example, in a humanitarian crisis, groups like Save the Children and International Rescue Committee are not allowed to enter certain countries to provide support until the national government has invited them or accepted their offer.
The time to act as coronavirus spreads is now, but to make a real difference we need to make sure our work has staying power and truly ensures those who have the least access to services they need will not only survive but thrive. Our communities are counting on us not to retreat or retrench in the face of this crisis but to show through our words and actions that we are prepared to take thoughtful, informed, and prompt responses to support them now and into the future.
