The Case of Pakistan

The Impact of COVID-19 on the Perceived Well-Being of Displaced Households

in The International Journal of Social Quality
Author:
Fariya HashmatResearch Associate, Graduate Institute of Development Studies (GIDS), Lahore School of Economics, Pakistan fariyahashmat01@gmail.com

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Ahmad NawazAssociate Professor, Graduate Institute of Development Studies (GIDS), Lahore School of Economics, Pakistan anawaz@gwdg.de

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Tony BradleyCentre Director, Social and Economic Action Research Centre at Hope (SEARCH) and Senior Lecturer, Business Sustainability, Innovation, and Social Economy, Liverpool Hope University Business School, UK bradlet@hope.ac.uk

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Asad GhalibSenior Lecturer, Liverpool Hope University Business School, UK ghaliba@hope.ac.uk

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Abstract

This article represents a qualitative investigation of the vulnerabilities of displaced households in Pakistan caused by the COVID-19 pandemic. The analyses are conducted through the lens of social quality theory and the social quality approach according to four societal dimensions that condition household life chances. Our findings reveal that these households reflect a reversal of the sustainable development cycle. They are at risk of being economically unstable, being unable to gain new skills, falling into absolute poverty, increased morbidity rates, and disrupted education. The most severe form of deprivation is the disruption of their networks of social cohesion, leading to greater isolation and marginalization; this is especially true for women and children. The Pakistani government must take immediate and substantive action to improve the situations of these most vulnerable of households.

The entire world is experiencing a new potent challenge in the shape of the COVID-19 pandemic. Since the start of the disease in December 2019, in the Hubei Province of China, it has become a public health emergency. This is having a profound effect on the everyday life experiences of people in the socioeconomic and financial, sociopolitical and legal, sociocultural and welfare, and socioenvironmental and ecological dimensions. In turn, this is having a disproportionate impact on the social quality of the most vulnerable groups, particularly within so-called “less-developed” and “medium-developed” countries (LDCs and MDCs) (Consilium 2021). Furthermore, the pandemic is having an even greater bearing on the lives and well-being of displaced persons, such as those reported on in this article.

Within MDCs such as Pakistan, the economic fallout of COVID-19 is visible, as the economy—already experiencing low growth due to macroeconomic imbalances and subsequent stabilization programs—had been severely impacted during the last quarter of 2019–2020. Economic growth declined by an unprecedented 0.4 percent (Planning Commission 2020–2021). Equally, the vaccine rollout, compared to those of rich nations, has been poor, with vaccines hardly making it out (if at all) to marginalized and displaced communities.

Human displacement has become a ubiquitous issue in all territories. In the migration discourse, surging numbers of people are forcibly displaced due to conflict, violence, and disasters (Hedman 2009; Lam et al. 2016; Sánchez-Céspedes 2016). Displacement, induced by infrastructure projects, particularly in Asian countries, is increasing due to a rise in urbanization. Each year, 10 million people are forcibly displaced by construction projects, including for infrastructure facilities such as dams and reservoirs, urban renewal schemes, energy and mining projects, oil exploration and extraction, transportation networks, and roads, railways, and highways (Aboda et al. 2019; De Wet 2005). Displaced people find themselves enmeshed in situations of prolonged dislocation or are permanently dispossessed in respect of their economic assets and societal networks. Consequentially, forced displacement gives rise to major ethical concerns. It reflects an inequitable distribution of development benefits and losses (Cernea 2004).

In addition to this issue, COVID-19 is multiplying the risk factors faced by displaced persons. They are frequently relocated in densely populated settlements, overcrowded camps, and unsuitable environments. In such deprived situations, they are only able to gain marginal access to already overstretched local health systems. Communicable diseases spread rapidly. Evidentially, the various COVID-19 variants causing the pandemic can affect anyone. But, it is the displaced who are at the greatest risk of contracting the disease, as they already have difficulty accessing the basic necessities of life. These comprise gaining access to healthcare, shelter, decent livelihoods, and personal security—particularly in respect of protecting women from violence—alongside access to children's education, inter alia.

These involuntary displacements, caused by such infringements on social quality, also create major impositions on specific demographic groups and communities. Because dispossessed groups are almost invisible to state authorities, they possess significantly restricted rights. This can lead to statutory interventions being imposed in ways whereby the affected populations’ life chances deteriorate. This raises major issues of social justice and equity, reflecting normative dimensions of social quality (Cernea 2004). Social quality may be understood as a series of measures connecting socioeconomic, sociocultural and psychological, sociopolitical, and socioecological aspects of societal change.

Against this backdrop, and developing from earlier research (Hashmat 2020), this article focuses on the sociopsychological and cultural aspects of the quality of circumstances of daily life pertaining to displaced persons in urban Pakistan. The state at the federal and provincial levels is relatively weak. The ability of governmental services to address the pandemic and to improve the social quality dynamics for this population has been negligible. As such, this article explores the lives of the most vulnerable groups and displaced households in Pakistan, who are experiencing the harsh realities of this pandemic. The specific community investigated comprises families who were forcibly displaced because of the construction of a 27.12 km railway line (25.40 km elevated and 1.72 km underground). It is a long mass transit project, the Orange Line Metro Train (OLMT), and it is located in the most densely populated areas of Lahore, Pakistan.1

Additionally, the theoretical basis of this study draws on social quality theory (SQT) (IASQ 2019; Van der Maesen and Walker 2012) and the impoverishment risks and reconstruction (IRR) model (Cernea 1995, 1997, 1998, 1999). Societal support may protect people from stress factors through resilience and may increase one's access to psychological and material resources, acting as a cushion against stress. However, in pandemic times, where people's integration is minimal due to lockdowns, the disruption of societal networks and of the cohesion of displaced households may exacerbate their members’ mental health.

Previous research (Hashmat 2020) was conducted among these households in order to assess the impact of displacement on their life chances. More recently, in 2021, we revisited some of these displaced households to capture the impact of COVID-19 on their lives. Originally, the qualitative assessment comprised thirty displaced households; we returned to fifteen of them to conduct in-depth interviews. Through these interviews, we aim to answer how the respondents’ sociopsychological well-being has been impacted by the pandemic, keeping in view the dimensions of social quality indicated above. Further, this article aims to explore the efficacy of the role of the state and various societal networks in mitigating the impact of this pandemic.

The following, second, section highlights the epidemiological summary of COVID-19 in Pakistan from 1 March 2020 till 2021 via graphical illustrations and the measures imposed by the government. The third section sheds light on the theoretical framework, combining the SQT and IRR frameworks, which act as foundations for our study. The fourth section provides an insight into the “societal context,” discussing Pakistan's sociopolitical, socioeconomic, and sociocultural patterns that are directly related to the vulnerable conditions of the disadvantaged families and that shed light on the preexisting “land politics” that led to disadvantaged living conditions for the displaced. The fifth section comprises our methodology, which is followed by a thematic analysis and a discussion of our findings. Finally, we conclude our article by linking the findings and analysis with the characteristics of preexisting government policies and by subsequently discussing the role of federal, provincial, and local authorities in managing the effects that the COVID-19 crisis has had on displaced families.

Pressing Conditions: the Epidemiological Context

The first COVID-19 case surfaced in Pakistan in February 2020. It was, arguably, initiated by an influx of an increasing number of international travelers. Pakistan shares borders with China and Iran. The former was the epicenter of this virus, and the latter experienced a rapid increase in the number of cases during February 2020. Hence, within a few days a national emergency was declared as the pandemic rapidly spread across the entire country.

The cumulative numbers of confirmed and active COVID-19 cases, along with deaths, recoveries, total COVID-19 tests conducted, and critical cases in Pakistan, are presented in Table 1 below. These pertain to the period of one year—March 2020 till December 2021. And Table 2 illustrates the breakdown of COVID-19 province- and region-wide cases.

Table 1.

COVID-19 Statistics of Pakistan (Last updated: 5 December 2021)

Confirmed Cases Deaths Recovered Total Tests Critical Cases
1,286,825 28,767 1,245,606 22,211,141 854

Source: Government of Pakistan (https://covid.gov.pk/stats/pakistan)

Table 2.

COVID-19: Cases by Province (Last updated: 5 December2021)

Sindh Punjab KPK Islamabad Baluchistan AJK/GB
476,674 443,453 180,316 107,887 33,506 34,576/10,413

Source: Government of Pakistan (https://covid.gov.pk/stats/pakistan)

The general guidelines that the government issued for the disease's prevention comprised the following:

  • Washing hands often with soap and water for at least twenty seconds;

  • Using a surgical mask in all public places;

  • Covering mouth and nose with a tissue or sleeve (not hands) when coughing or sneezing;

  • Avoiding crowded places; and

  • Avoiding physical contact with sick people.

As the pandemic arrived relatively late in Pakistan compared to China, the United States, and Italy, the government had some time to prepare and develop a plan to manage the public health crisis. However, because COVID-19 was a new disease, the government had to face a plethora of challenges in devising specific prevention policies amid great uncertainty. The first step taken by governments across the globe were strict economic lockdowns forcing many people in many sectors to “work from home” (Shahid 2020). But for developing countries like Pakistan, curbing the disease by imposing lockdowns in certain sectors jeopardized people's welfare. The Labour Force Survey for 2017–2018 states that the informal sector in Pakistan accounts for 71.7 percent of employment outside the agriculture sector, where the workforce is dependent on daily wages and hence lacks social security (PBS 2019). The government was faced with a tough choice: it could impose economic lockdowns to reduce the disease burden associated with COVID-19, or keep the economy open to avoid “death by poverty” and risk exacerbating the problems for an already strained health sector. Consequently, Pakistani decision-makers faced an overly complex and interconnected web of economic welfare policy challenges. Figure 1 shows the number of weekly confirmed COVID-19 cases, which peaked during June 2020.

Figure 1.
Figure 1.

Weekly confirmed COVID-19 deaths. (Source: https://ourworldindata.org/explorers/coronavirus-data-explorer)

Citation: The International Journal of Social Quality 11, 1-2; 10.3167/IJSQ.2021.11010213

By early July 2020, the COVID-19 curve began to decline. Doctors paid attention to how the disease was managed in countries where the pandemic hit first, hence administrators imposed “smart” lockdowns in neighborhoods marked as infection hotspots, and effective (although somewhat delayed) center–provincial coordination helped in implementing informed policies based on localized data (Shahid 2020). In addition, the government imposed an international traveling ban, and it ensured the closure of all educational institutions.

The second wave, which started in November 2020 and peaked during December 2020, further propelled the government to continue with lockdown policies and standard operating procedures (SOPs) in combating this pandemic. However, with the advent of this third wave in April 2021, the state started a step-by-step vaccination program against COVID-19, which led to a gradual lifting of the lockdown measures. Though it gave people a bit of economic relief, this decision resulted in a surge in COVID-positive cases, which necessitated an increase in speed and intensity of the vaccination program.

More recently, the month of August 2021 has seen a new Delta variant of COVID-19, which has led to yet another increase in COVID-positive cases, despite the ongoing process of vaccination. Therefore government has again enforced “smart” lockdown policies. Figure 2 illustrates the cumulative fatality rate due to COVID-19 in Pakistan from March 2020 till December 2021.

Figure 2.
Figure 2.

COVID-19 fatality rate. (Source: https://ourworldindata.org/explorers/coronavirus-data-explorer)

Citation: The International Journal of Social Quality 11, 1-2; 10.3167/IJSQ.2021.11010213

Hence, the health system is now buckling under the pressure created by COVID patients, and vaccination has become imperative. Figure 3 illustrates the share of people who got fully vaccinated against COVID-19 versus those who only got partially vaccinated between March 2021 and December 2021.

Figure 3.
Figure 3.

Share of people vaccinated against COVID-19. (Source: https://ourworldindata.org/explorers/coronavirus-data-explorer)

Citation: The International Journal of Social Quality 11, 1-2; 10.3167/IJSQ.2021.11010213

After vaccinating health workers and senior citizens, Pakistan gradually opened vaccination to people over 18. The government is prioritizing densely populated urban centers and “hotspot” areas, where the coronavirus spreads more easily than in scattered rural communities (Weibel 2021). So far, 23% percent of population has been fully vaccinated in Pakistan. This is because vaccination encounters a myriad of context-specific challenges in the socioeconomic, cultural, and political domains, which in turn, is substantially affecting its uptake (Ali et al. 2021). Irrespective of the geographical spread, several myths pertaining to the COVID-19 vaccine have arisen, ultimately limiting the national administration and rollout of vaccines (Qamar et al. 2021).

The majority of people are not against vaccination per se, but are hesitant because of what they have heard about the side effects. In this regard, social media is playing a significant role in promoting myths and fake rumors. However, the vaccine is suspected by some to be a “Western plot.” Such perceptions and practices can be seen against the backdrop of economic, sociocultural, and (geo-) political forces, which are encoded in “societal memory.” Not only is there a need to reverse the significant impacts of COVID-19 on routine vaccination by arranging supplementary immunization activities (SIAs), but there is also a need for the government to deal with other pressing issues that are affecting the vaccination programs in the country.

Table 3 shows the vaccine statistics in Pakistan till December 2021.

Table 3.

Vaccine Statistics (Last updated: 5 December 2021)

First Dose Second Dose Total Doses Administered
81,076,341 51,163,073 124,760,553

Source: Government of Pakistan (https://covid.gov.pk/stats/pakistan)

Marginalization of the Displaced: The Societal Context

In any society, human rights embody key values comprising fairness, solidarity, dignity, equality, and respect (see also the normative factors of social quality in IASQ 2019). These rights significantly give power and enable marginalized people to speak up and challenge their poor treatment by public authorities. Development projects do benefit people and are considered as one of the key factors in determining the economic growth of a country (Palei 2015), thereby having a considerable effect on human security (Caspary 2007) and human development (Stewart 2019). In this context, though acquisition of land and property may be considered as a prerequisite for the execution of development projects, they generally occur in a manner that violates displaced people's human rights by depriving them of their economic assets and societal networks (Bugalski and Pred 2013).

Compulsory acquisition is inherently disruptive in nature. Even when compensation is generous and procedures are generally fair and efficient, the displacement of people from established homes, businesses, and communities will still entail significant human costs. Where the process is designed or implemented poorly, the socioeconomic, sociopolitical, and sociocultural costs may be enormous. It may separate families, interfere with livelihoods, deprive communities of important religious or cultural sites, and destroy networks of societal relations. If compulsory acquisition is done poorly, it may leave people homeless and landless, with no way of earning a livelihood, without access to necessary resources or community support, and with the feeling that they have suffered a grave injustice.

The Land Acquisition Act of 1894 is the constitutional framework of Pakistan regarding compulsory acquisition. The law entrusts the Pakistani state with the power of eminent domain to appropriate land for “any public purpose,” upon provision of “just” compensation. However, this law is a relic of colonial times, when landowners were marginalized and their land was forcibly acquired for “public purposes” against their will. In contemporary times, compulsory acquisition has become a delicate issue in the context of rapid growth and changes in land use and land politics. As there is no clause in this act pertinent to the resettlement and rehabilitation of displaced people in an adequate manner, particularly in terms of the reconciliation of their disrupted societal connections and networks, to date resettlement plans are carried out on an ad hoc basis. Apart from this, the payment of financial compensation presents further challenges. It is difficult to financially quantify noneconomic losses. Therefore, the price assessment needs to account for the subjective effect of well-being because human suffering is difficult to quantify. Therefore, the human element, as well as the inflationary factors, needs to be accounted for as far as price assessment and the payment of compensation is concerned.

In view of these factors, there is no doubt that the situation of displaced families has further been aggravated with the advent of COVID-19, which is having a profound impact on their everyday life experiences and well-being.

Theoretical Framework

This study seeks to contribute to the literature relating to social quality theory (SQT) (IASQ 2019), as it informs an understanding of the life chances and circumstances of displaced people within an MDC. SQT enables an analysis of the interactions between a range of societal complexities in urban contexts, together with the consequences for ecosystems and vice versa. It comprises four societal dimensions: the socioeconomic and financial, the sociopolitical and legal, the sociocultural and welfare, and the socioenvironmental and ecological dimensions (IASQ 2019).

In the context of the displaced households, this article is based on the above-mentioned IRR model (Cernea 1995, 1997, 1998, 1999), which is linked with SQT through its implications for the four societal dimensions. In fact, the IRR model directly relates to involuntary resettlement and brings into perspective the intrinsic risks, or risk factors, which lead to impoverishment during the process of displacement and relocation. In turn, these have an effect on the behavioral patterns of displaced households and thereby affect the quality of their daily circumstances. In this context, the sustainability of displaced communities rests on SQT's five normative factors: social justice, solidarity, equal value, human dignity, and eco-equilibrium (IASQ 2019).

Displaced people or forced evictees are subject to varying socioeconomic and financial risks, which are landlessness, joblessness, homelessness, marginalization, food insecurity, increased morbidity and mortality, loss of access to common property and services, and society-caused disarticulation. These risks are inextricably bound up with the conditional factors of SQT, which have been exacerbated during the pandemic, leading to an increase in the suffering of displaced people. The conditional factors as aspects of the analytical framework of SQT pertain to the daily lives of the displaced communities. They are: (1) the socioeconomic security people live with; (2) social cohesion as experienced in their communities; (3) social inclusion as realized in their civil rights; (4) the extent of their social empowerment, namely enabling them to play responsible roles in society and in the processes of societal change; and (4) their access to a safe and secure environment. All conditional factors are divided into various domains (Van der Maesen and Walker 2012). The instruments for research into the changes in these domains are known as “social quality indicators” (Ali and Lin 2019).

This study also relates to a previous study of the city of Peshawar in Pakistan about the perceived maps of social quality drawn from survey respondents based on their income, education, age, and gender (Ali and Lin 2019). The present study about the societal impact of the COVID-19 on displaced households may be regarded as a specification of analyses of the diversity of the perceived maps of social quality in reference to the interests of these specific population groups. It is a new contribution from Pakistan seen through the lens of SQT and the SQA.

However, the IRR model is not solely restricted to these risks, but can be adapted to include other risks as well. For example, Ted Downing and Carmen Garcia-Downing (2009) identify other risks that may be experienced by displaced persons, for example loss of access to public services, disruption of formal educational activities, violation of human rights, changes of climate conditions, and sense of belongingness.

In our study, we will be focusing on five key risk factors: (1) loss of income and livelihoods (joblessness); (2) health insecurity (increased morbidity); (3) poor housing conditions (homelessness); (4) disruption in education; and (5) loss of social cohesion and networks (societal disarticulation). The first four factors concern domains of the socioeconomic security conditional factor, and the fifth factor concerns all domains of the social cohesion conditional factor.

The objective of this study is to deploy the sustainability cycle as a core concept. “Sustainability” here refers to the cyclical development of the sociocultural and welfare, sociopolitical and legal, socioenvironmental and ecological, and socioeconomic and financial societal dimensions. “Sustainability” is frequently viewed as solely concerning issues of environmental and ecological considerations. But more recent understandings of full-spectrum sustainability (Barrett 2010; Foley et al. 2020) discuss quadruple bottom-line accountability (Sawaf and Gabrielle 2014; Waite 2013) and the development of a business sustainability cycle (Bradley forthcoming(a)), and they recognize that sustainable business and general societal practices need to embrace people, purpose, and profit alongside planetary issues. This is akin to the perspective adopted within the United Nation sustainable development goals (SDGs). Indeed, in Bradley's (forthcoming(a)) business sustainability cycle, from an integral perspective, the addition of purpose (often conceived as governance reporting or progress; see Cambridge Leadership Development 2013) to the triple bottom line transforms the measurement of sustainable practice from three lines of accountability to a cycle of increasing continuous sustainability improvement. In the study put out by the so-called “Dutch Social Quality Think Tank” on the challenge of overall sustainability, a study presented at the Rio conference on sustainability (i.e., the 2012 United Nations Conference on Sustainable Development), the above-mentioned four-dimensional approximation of overall sustainability was discussed (IASQ 2012). This may underpin the people, purpose, and profit approach, mentioned above, through the lens of SQT and the SQA. The herewith-related problematic is of crucial significance for displaced persons, as their experience of sustainable living is impaired at each pole of the fourfold cycle, and indicates a cycle that operates with the opposite effect, namely, toward reducing continuous sustainability deprivation. The COVID-19 pandemic (including the implicit societal crisis) from this perspective can be conceived as a major disruptor of this cycle of development. The disruption is felt not at the level of the conditional factors of social quality (the objective layer) but it is also felt at the level of the constitutional factors of social quality (the subjective layer). This distinction has already been explained in the study about the city of Peshawar (Ali and Lin 2019). Governance approaches can be interpreted from their direct effect on the crisis, as well as their long-term significance for “full-spectrum sustainability.”

Broad relationships between the conditional factors of social quality and the IRR factors are associated in Figure 4. While these are not perfectly matched, they can be seen as highly connected. As health inequalities and morbidities increase, so social cohesion decreases. Societal disarticulation leads to reduced levels of social inclusion. Joblessness is a key factor affecting socioeconomic security. Educational deprivation impacts the capacity for social empowerment. Finally, homelessness reflects an inability to have control over one's environment and, hence, ecological and climate change mitigation.

Figure 4.
Figure 4.

Matrix of Relational Associations between the SQ Dimensions and IRR Factors

Citation: The International Journal of Social Quality 11, 1-2; 10.3167/IJSQ.2021.11010213

Methodology

Research Design

We have used a qualitative methodological approach for this study, with the goal of exploring the complexities experienced by displaced families, particularly on psychosocial well-being, during the pandemic, that is, from March 2020 to December 2021. The data collection method comprised in-depth interviews with a purposive sample of displaced households. The aim was to investigate the instrumental role of social networks in mitigating the impact of the pandemic. In this context, thematic analysis was used for coding.

Data and Sample

Based on the original study conducted by Hashmat (2020), we revisited the displaced households to capture the impact of COVID-19 on their lives. From the original study dataset of 180 households, which comprised 90 displaced (treatment) and 90 nondisplaced families (control)—we returned to fifteen displaced households to conduct in-depth interviews regarding how their psychosocial well-being, as a partial measure of social quality, has been impacted by the pandemic. Our sampling frame comprised the areas of Anarkali and Central stations, within the OLMT, as depicted by the red circle in the middle of Figure 5.

Figure 5.
Figure 5.

Map of the Orange Line Metro Train (Source: Lahore Development Authority [LDA] and National Engineering Services Pakistan (Pvt) Limited [NESPAK]).

Citation: The International Journal of Social Quality 11, 1-2; 10.3167/IJSQ.2021.11010213

Maximum displacement occurred in areas that were situated close to these two stations, particularly in Jain Mandir. This area was densely populated, hence cut-and-cover technology was employed in the construction of underground stations, due to which buildings and properties on the ground were demolished and families were forcibly displaced therefrom.

Data Collection Procedure

For this research study, interviews were conducted with the households at their residence on Sundays to ensure the presence of all family members. However, during our data collection, COVID cases were surging exponentially. For their containment, the Government of Pakistan had to impose a lockdown and therefore out of a total of fifteen in-depth interviews, nine of them were conducted face-to-face and the remaining six were conducted over the telephone. The necessary telephone numbers were acquired from the database that was built last year from the list provided by the executing agency, the Lahore Development Authority (LDA). All the interviews were recorded and transcribed verbatim from the audio file.

Findings and Interpretations

The patterns that surfaced during the in-depth interviews point toward the overall decline in the well-being of the displaced families during COVID-19. As shown in Figure 6 below, the well-being of displaced persons before COVID-19 follows a multi-step decline2 trajectory, which transforms into a declining smooth3 curve during this pandemic, reflecting a sharp decrease in well-being as depicted by the steeper curve after the arrival of the disease.

Figure 6.
Figure 6.

The Trajectory of Displacement and COVID-19

Citation: The International Journal of Social Quality 11, 1-2; 10.3167/IJSQ.2021.11010213

Displaced families were trapped in these formidable pandemic circumstances for more than a year. We revisited them and conducted fifteen in-depth interviews, from which five core themes emerged: (1) loss of livelihood and income; (2) health insecurity; (3) poor housing conditions; (4) disruption of education; and (5) disintegration of social cohesion. In the following section, we seek to illustrate and interpret each of these SQ dimensions, in turn, using quotations. These themes draw their theoretical underpinnings from the IRR model, and, furthermore, they connect to a part of the conditional factors of SQT, namely the domain of socioeconomic security and some aspects of social cohesion.

Loss of Livelihood and Income

One of the most pronounced feelings that seemed to resonate in the responses we obtained relates to the loss of livelihood and income. According to the World Bank (2020), lockdown measures and the economic crisis—which have accompanied the spread of COVID-19 throughout the world—are affecting the financial resources of the most vulnerable. It is likely that they will continue to have long-term repercussions on local, national, and global economies for multiple decades. For the displaced, who are more often dependent on insecure and informal employment than nondisplaced people, concerns are even higher (Hochrainer-Stigler et al. 2019). This is particularly true in low- and middle-income countries such as Pakistan.

This sentiment was echoed a number of times in the interviews with the displaced families. For instance, an informal worker stated: “I was working as a street hawker but now due to the lockdown, I have lost a significant proportion of my customers, which has led to the decrease in my livelihood.” According to the International Labour Organization (ILO), COVID-19 is having a profound impact on the world of work. It is not only jeopardizing public health, but it is also causing economic and general societal disruption, which in turn is threatening the long-term livelihoods and well-being of millions (United Nations 2020).

However, in addition to the anathema of COVID-19, exogenous factors such as inflation further jeopardized the livelihoods of the displaced. A housewife shared her concern in this regard: “Due to the rising price levels of food items, it is nearly impossible to run the kitchen expenditure. And reaching to the pre-COVID level of nutrition is simply out of reach now.”

A study conducted by Marshall Reinsdorf (2020) reports that COVID-19 is adversely affecting global currency markets, resulting in currency devaluations and inflationary pressures. This has the effect of pricing basic items beyond the reach of already struggling families, particularly those who are marginalized displaced families.

In addition to the rise in price levels, some of the displaced families also reported loss of remittances from relatives abroad, who were, equally, unable to work because of lockdown measures. This further aggravated the vulnerability of displaced persons, as remittances represent a vital source of income for them (Bisong et al. 2020). During an interview with a seasonal worker from Gulf region, we found out that, due to COVID-19 and subsequent travel restrictions, he had been staying at home for one-and-a-half years, which has resulted in a decrease in his family's well-being.

It is important to note here that COVID-19 has aggravated the well-being of already displaced families, in terms of the loss of their livelihoods and income as depicted by our findings. This suggests that fourteen out of fifteen displaced households reported a loss of income and the closure of businesses during the pandemic, as evidenced by their comments.

Health Insecurity

Health insecurity is next in line to the loss of livelihood and income. The displaced respondents spoke out regarding the grave challenges they were already facing in the form of poor nutrition and untreated health conditions. One of our respondents shared the following with us:

We all used to have a full protein diet comprising meat, but now we are consuming a less calorific diet. Apart from physical health, it is also having a psychological impact resulting in constant fatigue and stress. (Razia, 53 years old)

The literature (Cao et al. 2012; Terminski 2013) reports that displaced communities, contrary to nondisplaced communities, have a greater risk of being exposed to illnesses due to lack of food and an unbalanced diet. However, the process of forced displacement and consequential relocation has also taken its toll on their psychological health in the form of post-traumatic stress disorder (PTSD) and depression. According to Stuart Turner and colleagues (2003), four of the most common psychological reactions found in displaced people groups have included PTSD (as a reaction to violence or torture), depression (for example, as a reaction to loss), somatization, and existential dilemmas (where belief patterns have been challenged).

Against this backdrop, in the wake of COVID-19, all this has appeared to heighten the risk of contracting the pandemic, since displaced families are already quite vulnerable. Our findings suggest that a lack of financial resources is preventing displaced families from seeking healthcare and buying protective equipment, such as masks and sanitizers. Due to the information asymmetries regarding the unawareness of the public sector provision of COVID-19-related testing facilities, most of the respondents thought that treatment was very expensive and that they simply could not afford it. Therefore, it is more of a lack of effective communication—about the preventative measures against COVID-19 (sanitizers, masks, and social distancing)—that has stymied these communities, as indicated by the following comment from a respondent:

In March 2021, my husband got detected with COVID-19. Due to financial strain, we took him to the nearest government hospital but it was already working at optimal level in treating COVID patients; hence we were forced to bring him home. Fortunately, a charitable organization helped us in buying the antivirus injections and medications. Although he has recovered, symptoms of weakness and lower capacity still linger on. (Amna, 35 years old)

Our findings, which are in line with the study made by Christelle Cazabat (2020), indicate that anxiety and human isolation resulting from lockdown measures during COVID-19 has further affected the displaced households’ psychological health. In this regard, research has shown that displaced people are at higher risk of anxiety, depression, and other forms of distress, which could be exacerbated by the psychological impact of quarantine (Brooks et al. 2020). Lack of space and privacy can also aggravate the psychological impact of the pandemic, thereby leading toward higher levels of anxiety.

It is worth mentioning that the displaced families, with a history of gender-based violence, partly because of stress and the financial strain of displacement, have particularly seen a surge in violence during the pandemic times. There has been an increase in the frequency and severity of domestic violence as families are forced to spend more time at home. One of our respondents stated: “Due to lockdown and the closure of logistic transport, my husband, who is a driver, lost his contractual job. Because of staying at home, he was psychologically disturbed, which frequently led to the violence towards me.” Spousal abuse and domestic violence has increased in Pakistan like they have in other countries, due to COVID-19 lockdowns, lost jobs, a meltdown in the economy, and husbands working from home.

To sum up, it is important to note that displaced families have experienced serious health insecurity as a consequence of sociopsychological disruption, which has significantly undermined their overall well-being during the pandemic times.

Poor Housing Conditions

Our findings further suggest that the displaced families, who were already living in poor housing conditions and sharing limited space, have now become more likely to contract COVID-19 (Banbury et al. 2020). Evidently, poor housing conditions indicate that the displaced may not be able to self-isolate, implement physical distancing, or even access water and sanitation as depicted by one of our respondents, who stated: “During the COVID times, because of bad sanitation condition in the house, my children have often fallen sick; we couldn't improve the sanitation condition due to lockdown.” Similarly, another respondent stated that the incidence of COVID-19 and subsequent lockdown measures have considerably affected the renovation of his house:

Since we got relocated to a new house, the facilities were at the minimum. We wanted to improve the housing condition. But due to smart lockdown, the chances to improve the housing condition were almost minimum and further during the lockdown, the rise in price levels, we simply couldn't afford to improve the housing condition. (Aslam, 47 years old)

Moreover, they are less able to follow instructions from health authorities because they have less space per person and would not be able to isolate an ill family member like members of nondisplaced households could (Mackworth-Young et al. 2021).

Due to loss of income, the displaced are at a heightened risk of eviction in these pandemic times because of their inability to pay the monthly rent (Hochrainer-Stigler et al. 2019). Our findings also show that many displaced families were already struggling to keep up their rent payments before the pandemic and that, during the pandemic, because of less income-earning opportunities, the majority of them have simply failed to pay rent. Because of the lesser enforcement of measures to mitigate the risk of the nonpayment of rents in COVID times in Pakistan, these families are facing the risk of being displaced once again.

Disruption in Education

Disruption in educational activities was one of the core themes of our findings and it is linked with involuntary displacement (Mathur and Marsden 2000). This is because when families get displaced, under severe circumstances, some children quit school and often start working to earn a living. However, school closures, due to COVID-19, are likely to create more challenges for students, many of whom were already behind or facing difficulties in learning pre-pandemic (Rhoades 2010), particularly displaced students. During our interviews, one of the respondents shared:

Our children are facing stress and trauma associated with displacement. COVID-19 is further impacting their well-being. Their focus, confidence, and performance have been greatly affected. (Rizwan, 41 years old)

There are certain challenges and problems associated with taking online classes in a developing country like Pakistan during COVID-19. For instance, most of our respondents told us that their children have minimal access to internet facilities and that, in addition to this, the anathema of frequent load-shedding makes it difficult and challenging to attain education online. This results in low participation or proxy attendance in online classes. Behavioral issues among students were also found to be higher during lockdown (Noor et al. 2020). All these challenges are intensified for displaced children. First of all, the learning environment is further reduced by the current closure of schools. Second, out-of-school children are at higher risk of abuse in the home. Equally, the disruption of their education undermines their sociopsychological well-being and potentially harms their long-term employment prospects.

In a nutshell, it is important to note that displacement, to some extent, had already separated children from their familiar school environment, and that recently the incidence of COVID-19 is further playing a significant role in the disruption of educational activities mainly because of the state-imposed lockdown policies and subsequent closure of schools.

Loss of Social Cohesion and Networks

One of our most significant findings is the disintegration of societal networks, particularly during the pandemic, which has crippled the sociopsychological well-being of displaced families. During the process of displacement and relocation, leaving their homes, neighbors, friends and relatives significantly reduced their overall well-being. Even if they managed to resettle in new localities, adjusting to the norms of their host environment wound up worsening their sociopsychological well-being. But, in the wake of COVID-19 and consequential lockdown measure, our findings suggest that the pandemic has taken a fundamental toll on the displaced communities’ societal connections comprising relatives and friends, as evidenced by the comments below:

Already it took a long time to resettle into a new environment after displacement, and then came COVID-19, out of the blue, and disrupted our newly built social networks (Shakeel, 53 years old).

Due to COVID-19, the government imposed smart lockdown policies, which further minimized the possibilities of any social cohesion and networks at a community level. (Abdullah, 52 years old)

COVID-19 created a sense of fear in the neighborhood and, coupled with governments’ social distancing and lockdown policies, it left a possibility of any social interaction to almost zero. (Amna, 35 years old)

When asked about the frequency of interaction with their relatives and friends, it was revealed that social connections have been most significantly affected because of physical distancing and lockdowns. For some, staying away from their loved ones also resulted in health problems. Debra Umberson and colleagues (2010) say that relationships are a fundamental source of societal connection and that such connection has a big influence on individuals throughout their lives and has a profound impact on their well-being.

Forced displacement tears apart the existing social fabric. It disperses and fragments communities, dismantles patterns of social organization, and breaks interpersonal ties. Kinship groups become scattered. Life-sustaining informal networks of reciprocal help, local voluntary associations, and self-organized mutual service are disrupted. This results in a serious loss of valuable personal, interpersonal, and societal characteristics of communities, influencing or determining the immaterial and material circumstances of daily circumstances (Bradley forthcoming (b)). This disruption of the social quality of daily life of displaced people and related societal disarticulation, are, typically, unperceived and uncompensated by the programs causing them. This real loss has long-term consequences.

Conclusion

This article explores the lives of some of the most vulnerable displaced families in Pakistan, families that were forcibly uprooted due to the construction of a 27.12 km railway line, a mass transit project, the Orange Line Metro Train (OLMT), in the most densely populated areas of Lahore, Pakistan. These displaced families are now experiencing the harsh realities of COVID-19. We have investigated how the sociopsychological well-being of these households has been affected by the pandemic. All forms of support may protect people from stress factors through resilience and may increase one's access to psychological and material resources, acting as a cushion against stress. However, in pandemic times, due to their minimal integration, the imposition of lockdowns, and the disruption of societal networks, as well as the damage to social cohesion, displaced families experience a significant deterioration in the nature of the social quality of their daily lives.

In the wake of COVID-19, some of the major themes that emerged out of the analysis of our narrative evidence were, as mentioned above, loss of livelihood and income, health insecurity, poor housing conditions, disruption of education, and disintegration of social cohesion. It has been observed that displaced communities have become more vulnerable during the pandemic, because they are already situated on the lowest rung of the socioeconomic ladder and are, subsequently, trapped in a cycle of deprivation—the reverse of a cycle of sustainability. Given that the world is enmeshed in a global pandemic, the lack of precise data on the displaced, particularly in Pakistan, has hampered assessments of how displaced people are being influenced by the coronavirus, and how their circumstances are comparable with those of nondisplaced people. Furthermore, limited testing capacity, in many areas, has significantly reduced the well-being of those communities.

In order to draw conclusions from this study, we link the above findings of our qualitative investigation with the characteristics of preexisting government policies. Subsequently, we discuss the role of federal, provincial, and local authorities in managing the COVID-19 crisis and its impact on displaced families in particular.

As mentioned in the thematic analysis above, the economic activity of displaced people has been hit hard during the pandemic. Marginalization occurs when families lose economic power and spiral on a path of “downward mobility.” Small shopkeepers and artisans downsize and slip below poverty thresholds. Many individuals cannot use their earlier acquired skills in their new locations; human potential and capacities are lost or rendered inactive or obsolete. Economic marginalization is often accompanied by sociopsychological marginalization, which is reflected by deterioration in societal status (Cernea 2004), which we identify as a reversal of the sustainable development cycle.

In response to the evolving COVID-19 situation, a holistic National Action Plan (NAP) for 2020–2021 has been drafted by the Government of Pakistan, which, in the context of our study of displaced families, has implications for the emerging social quality dimensions of their lives. We now discuss some of the ways this new plan/policy aims to ameliorate social quality and how our respondents have fared so far.

Policy Aims

Increase in Social Quality through Sustaining Livelihoods and Income

In our survey, most of the respondents were informal workers who lost their jobs or businesses. The risk of losing wage employment is very high in urban areas for those employed in the informal sector. Yet, creating new jobs is difficult and requires substantial investment. Unemployment or underemployment among resettlers often endures long after physical relocation has been completed (Cernea 2004).

The Government of Pakistan has taken certain emergency measures to mitigate the negative impact of the containment measures, especially for daily wage earners and street vendors. These programs include the Prime Minister's Emergency Relief Package for the poor, provincial relief packages, and the State Bank of Pakistan's (SBP) Refinancing (Employment) Scheme, among others. The plan envisages measures to protect existing jobs and generate more domestic and overseas employment opportunities. The plan further focuses on Public Sector Development Projects (PSDPs) committed toward labor-intensive sectors, small sector projects engaging the local community, and the facilitation of self-employment schemes and entrepreneurship through the Prime Minister's Kamyab Jawan Program (Youth Employment Scheme [YES]). Skill development is also being prioritized to ensure youth employment through various federal and provincial initiatives such as the Prime Minister's “Skills for All” Hunarmand Pakistan Program. During our survey, a couple of families were hopeful that the aforementioned government initiatives would be beneficial for them in the long run.

Increase in Social Quality through Sustaining Health Security

COVID-19 has seriously undermined the quality of the lives of the displaced families by making them more vulnerable to poverty. During our survey, all the respondents unequivocally informed us that COVID-19 had posed severe health problems, which had significantly marginalized their well-being. Further, they said that the government had not done enough to mitigate the adverse outcomes of these idiosyncratic problems caused by COVID-19. Very few displaced families have benefited from the state-level Poverty Alleviation and Social Safety (PASS) program, which has aimed to provide a relief package of PKR144 billion for the poor and the vulnerable. However, there is a further need to take some long-term actions to provide income and employment security to the impoverished. This requires coordination between all state agencies and federating units.

One of the most significant findings of our survey is that the morbidity rates of displaced households have further increased. This is because the displacement-induced stress and psychological trauma has been coupled with COVID-related illnesses. And according to our survey, the children and the elderly have been the main victims. At the state level, the government has started providing Universal Health Coverage (UHC) in the wake of this pandemic and envisaged an essential package of health services. However, the respondents have shown their disapproval of the UHC's effectiveness, and they resoundingly wanted the Punjab provincial government to provide UHC the way the provincial government of Khyber Pakhtunkhwa (KP) has carried out in their province.

The respondents further said that their food security has been compromised due to the pandemic, and that the disruption of agricultural supply chains has resulted in an increase in food prices. The federal government has announced a package of PKR100 billion for the agriculture sector to control the food price hikes during the pandemic. However, the respondents were of the view that there has been a lack of enforceability on the part of the provincial government to control food prices, which has resulted in food insecurity.

Increase Social Quality through Sustaining Education (Basic, College, and Higher Education)

In our survey, some families reported a disruption in educational activities due to displacement, and the severity of this disruption has been magnified due to the pandemic. Almost all the displaced families had their children in public schools, which were closed during the lockdowns. Unlike private schools, the public schools lack the logistical capacity to carry out online classes, which has further intensified the disruptions in educational activities. Based on the interviews, we have found that there has been an increase in existing inequalities, not only when it comes to accessing basic education, but when it comes to accessing technology (e.g., laptops, smartphones, and other electronic devices). Against this backdrop, the government must address these shortcomings in order to sustain the quality of education in public institutions.

Increase in Social Quality through Social Cohesion

During the interviews, an important finding related to the disruption of societal networks of the displaced families, which have been exacerbated during COVID-19 and have ultimately led to the decline in the quality of their daily circumstances. Displaced families in pandemic times tend to have minimal participation in societal relationships, and COVID-19 is no exception. This has not only reduced their well-being but also significantly undermined their capabilities and functioning. And therefore, their true potential has not been allowed to come to fruition: their ability to survive and improve their life circumstances will depend on the state playing a proactive role in providing them with sufficient conditions through societal integration, which will allow them to deal with the adversity they have experienced during these pandemic times.

The Problem of Land Use

The aforementioned policy goals fundamentally focus on ameliorating the challenges and difficulties faced and experienced by marginalized displaced families during COVID-19 via relief packages and funds; however, the roots of the misery that families have been experiencing clearly can be traced back to current state and city land policies (developed as part of their urban space planning initiatives). These policies are apparently disrespecting the rights and reducing the social quality of the lives of these disadvantaged and vulnerable families.

Against this backdrop, the Land Acquisition Act of 1894 needs to be revamped in accordance with the contemporary challenges being encountered during land acquisition. Most significantly, it should have a rehabilitation and resettlement section because currently it is not catering to the grievances of the displaced. The act should also incorporate the requirement that governments take responsibility for displaced people on psychological grounds by extending counseling sessions to those whose mental health has been negatively affected by their displacement. They should have a counseling network to help people in this regard: governments at all levels can collaborate with private counseling networks through public–private partnerships. Second, the law should contain clauses on the resettlement of displaced families in such a way as to ensure or at least aid in the reestablishment of their social cohesion and social networks. The disruption of social ties is a key mechanism by which development-induced displacement may negatively impact the psychological health of displaced families. This is because social capital may be linked to poverty indicators such as income, livelihood, employment, health, education, and food security, and its disruption may take its toll on psychological well-being. Hence, the government should be responsible for providing an appropriate resettlement environment for displaced families, where they can resettle in an adequate manner with minimum disruption to their social networks.

Summary

All levels of government—the federal, provincial, and local—must play a prudent role in addressing the concerns of displaced families in a synergized manner by providing them with all the help they need during these pandemic times. This will, to some extent, result in restoring their social cohesion and thereby motivate them to cope with serious adversity in a sustainable manner and subsequently put a halt to further deterioration in their well-being. They will thereby be able to see an end to the reduction in the social quality of their daily lives.

We have analyzed the problematic situation of displaced families by picturing the quality of the conditional factors of daily life mainly in its sociocultural and welfare, socioeconomic and financial, and sociopolitical and legal dimensions as used in the SQA. “Displacement” though refers here to spatial conditions and traditions of environmental policies and planning, in other words to the socioenvironmental and ecological dimension. Our argument therefore needs to be connected with Pakistan's politics regarding environmental and ecological problems and challenges. Syed Shahbaz Hussain and Pirzada Sami Ullah Sabri in their study on environmental conditions in Pakistan concluded: “Like most developing countries, Pakistan faces critical challenges in the conservation of existing natural resources and their further enhancement to meet the demands of an ever-increasing population. Pakistan needs to create policies that are more effective, environmentally friendly and useful for sustainable economic development” (Hussain and Sabri 2014).

The COVID-19 pandemic clearly has accentuated preexisting contradictions, problems, and disparities in Pakistan. Displaced people are undoubtedly paying an unbearable price. The frictions experienced are woven into the relationships between the four dimensions. The challenge both for scientific research to come and for Pakistani politics is to develop comprehensive and inclusive policies in order to enhance the social quality of daily life for all Pakistani people, including displaced families.

Acknowledgement

We appreciate the cooperation of Lahore Development Authority (LDA) for sharing with us the information about the displaced households. We are also grateful to two anonymous referees for their insightful comments. Finally, we thank Lahore School of Economics for their support during the course of this study.

Notes

1

The executing agency, Lahore Development Authority (LDA), stated that maximum displacements occurred in areas that were situated in close proximity to these stations such Jain Mandir, Purani Anarkali Ahata Baba Wazir, Edward Road, Kacha Lake Road, Parachute Colony, Potsal Colony, and Railway Colony. Since these were densely populated localities, cut-and-cover technology had to be employed in the construction of underground stations due to which buildings and properties above ground had to be completely demolished.

2

It occurs when a small number of serious crises take place but with little improvement and recovery in between.

3

Most cases of steep decline relate to the persistent loss of income due to a series of adverse circumstances throughout the period of displacement. Furthermore, the intensity of decline is aggravated when any family member experiences a chronic illness.

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Contributor Notes

Fariya Hashmat has completed her MPhil in development studies from Graduate Institute of Development Studies (GIDS), Lahore School of Economics, where she is working as a Research Associate. Her research interests include poverty and deprivation caused by human displacement and migration. Email: fariyahashmat01@gmail.com

Ahmad Nawaz is an Associate Professor at Graduate Institute of Development Studies (GIDS), Lahore School of Economics. His research interests include poverty and equity, gender, and institutions. Email: anawaz@gwdg.de

Tony Bradley is Centre Director of SEARCH (Social and Economic Action Research Centre at Hope) and Lecturer in Business Sustainability, Innovation, and Social Economy at Liverpool Hope University Business School, where he co-leads the Greening Markets Research Group. He is a sociologist and political economist specializing in interpreting the impact of the green civic movement on localities, businesses, and the wider economy. Email: bradlet@hope.ac.uk

Asad Ghalib is a Senior Lecturer at the Liverpool Hope University Business School. His research interests lie in designing, conducting, and analyzing household surveys to capture a range of socioeconomic characteristics. He has also been engaged in developing models to capture and gauge social impact in households and across communities. Email: ghaliba@hope.ac.uk

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