This essay examines how a small-scale non-governmental organization mobilizes community members in Montreal, Canada, to respond to the city’s shortage of personal protective equipment during COVID-19 by making more than 1600 scrub caps for local healthcare workers. As the CAP-MTL project has progressed, organizers have constantly adjusted how they run the project in order to meet evolving needs through three major phases: (1) centralizing resource allocation, (2) building a self-sufficient production team and (3) pairing volunteers with healthcare workers. This case study highlights how in crisis response projects, organizers must be flexible and adapt to fluid and dynamic situations.
The province of Quebec has reported the highest number of cases of COVID-19 in Canada, having more infections than the rest of the country combined. Since April, frontline healthcare workers in Montreal have faced severe shortages in personal protective equipment (PPE) (Bensadoun, 2020). In early May, the Canadian Institute of Social Inclusion for Immigrant Parents (CISIIP), a small Montreal-based non-governmental organization (NGO), established CAP-MTL: Sewing for Montreal Frontline Healthcare Workers, a project that brings together diverse individuals to make fabric scrub caps for healthcare workers. Fabric scrub caps are helpful in combating the spread of COVID-19 because they reduce the propensity for people to touch their hair and face. Compared to disposable plastic products, fabric scrub caps are more comfortable to wear. They are also washable, reusable and easy to make. By the end of June 2020, CAP-MTL had donated more than 1600 caps and 400 masks to 30 healthcare units in Montreal.
The vital role of NGOs in international disaster response and in emergency assistance has been well documented in scholarly work (Iizuka, 2018; Irrera, 2017; Mondal et al., 2000; Schmidt et al, 2016; Waldman et al., 2018). In situations where the demand overwhelms a government’s ability to respond, governments need to work closely with NGOs to mitigate negative impacts (Iizuka, 2018). NGOs can be more flexible than their government peers (Mondal et al., 2000) and more efficient in deploying a wide range of materials and logistics (Irrera, 2017). Those NGOs that have built trusting relationships with local communities can better mobilize and empower community groups in undertaking resilience-related tasks (Waldman et al., 2018). At times like the COVID-19 global pandemic, local responses such as NGOs and social workers became more important than ever to support medical and public health services (O’Leary and Tsui, 2020; Walter-McCabe, 2020). This article presents a case study of the CAP-MTL project. It shows the role a small NGO plays in responding to COVID-19, focusing on how community members were brought into a specific project based on their different skill sets in order to maximize its efficacy. This case study also shows how small NGOs possess the flexibility and adaptability to respond to evolving needs over the course of a crisis.
Since the launch of CAP-MTL at the beginning of May 2020, the author has worked as the project’s donation and social media manager. During this time, the author observed other team members and collected data through qualitative means, primarily anthropological participatory observation.
Case of CAP-MTL
When Shannon, the head of CISIIP, heard about the shortage of PPE in Montreal and the possibility of making fabric caps and masks for healthcare workers, she called me to ask for help to set up a community-aid project: CAP-MTL (Table 1). CAP-MTL is not alone: there are other scrub cap makers in Chinese communities based in Toronto and Vancouver, who are already donating caps to local healthcare institutions. Those groups provided us with sewing tutorials and shared their expertise and experiences.
Table 1. CAP-MTL team structure. Meanwhile, to ensure effectiveness and efficiency, CISIIP conducted a quick survey among healthcare workers in Montreal to better understand their PPE needs, especially regarding fabric masks and scrub caps. An online Google Form for scrub cap applications was created to accept orders from healthcare workers. A call for fabric donations was sent to many Montreal communities. A Facebook page (@CAPMtl) was set to provide a lieu to engage both healthcare workers and volunteers. Volunteers were actively recruited. By mid-May, CAP-MTL grew to 152 volunteers.
Discussion: The three main phases of CAP-MTL
Due to the nature of the project, the coordinators at CAP-MTL place priority on efficient production. As the CAP-MTL project has progressed, the organizers have constantly adjusted how they run the project according to the shifting needs of healthcare workers. The project so far has undergone three major phases.
First phase: Centralized allocation for efficiency
At the beginning of the project (early May), in order to quickly produce a large number of PPE items, decision-making and the coordination of production were highly centralized, with the project leader making all decisions about resource allocation and workflow. Volunteers who were proficient in sewing were given priority in accessing fabric and sewing materials. The organizers also planned the logistics concerning delivery itineraries. At this early stage of the project, production was slow (around 80 caps per week). Each delivery route was long and took an hour to complete since volunteers lived throughout the city.
Second phase: Decentralizing and self-sufficient production team
In mid-May, as more and more volunteers joined the project, many expressed their desire to contribute but were concerned about their lack of handicraft skills and/or lack of a sewing machine. Meanwhile, the CAP-MTL team identified four neighbourhoods with a high concentration of volunteers: Angrignon, South Shore, NDG and Downtown. In each of these neighbourhoods, around four volunteers could drive, cut or sew. To improve production efficiency, the tasks of fabric cutting and sewing were assigned to different volunteers, who would then partner with each other to become a small self-sufficient sub-production team. Like Adam Smith’s division of labour, volunteers were divided according to their type of expertise: donation team, delivery team, cutting team, sewing team and sewing assistant team. Accordingly, the CAP-MTL team provided fabrics to the same volunteers who would do the cutting each week, which helped reduce the pressure on delivery volunteers as delivery time would be reduced to 10–20 minutes per route. Furthermore, we were able to involve more people in the project who lacked a sewing machine or strong sewing skills. The production rate accelerated (around 300 caps per week), as volunteers who were proficient in sewing could now fully dedicate themselves to this task (Figure 1).
Figure 1. The process of scrub cap making in the second phase (Credit: Yi Yang). The figure shows how a scrub cap is made in the second phase. First, volunteer A donates fabrics. Next, volunteer B cuts the fabrics according to the standardized size. Then, those cuttings are sent to sewers (volunteer C). Another volunteer might join in to sew buttons and add the final touches. Finally, volunteer D collects and delivers the caps to their assigned destination.
Third phase: Pairing volunteers with healthcare workers
In mid-June, the CAP-MTL management team further decentralized the production process by pairing these now self-sufficient teams directly with healthcare workers: volunteers arranged times for scrub cap pickup with the frontline workers themselves or with the help of a delivery volunteer if needed. Some healthcare workers also donated fabrics to volunteers directly. By decentralizing, more time was devoted to producing items, rather than to logistics and management.
CAP-MTL has been a dynamic project that has evolved with the changing size and circumstances of its volunteer base and raw material. The advantage of being a flexible small NGO is a transferable lesson for future crisis management. The story of CAP-MTL provides important insights both for NGO management and for policy makers in times of crisis:
In a community-based project where time and efficiency are imperative, organizers must be flexible and constantly adapt to the current situation. CAP-MTL organizers developed a flexible management style by constantly modifying their strategies to meet resource supply and demand, in order to maximize production efficiency.
NGO leaders must make an effort to understand volunteers’ needs and abilities. The division of labour outlined in phase 2 provided opportunities to involve more volunteers who could not sew and/or did not own a sewing machine, further increasing the production rate.
Social media platforms are effective tools to engage both volunteers and healthcare workers in the project. We posted photos of caps and masks and feedback from healthcare workers wearing them on our Facebook page. Volunteers are motivated and feel rewarded to see PPE items they made liked by healthcare workers, while healthcare workers can also have a platform to express their gratitude to volunteers.
Policy makers should consider small funding to help small-scale NGOs set up projects to engage in real-time emergency response. If CISIIP had access to a small pool of funds at the outset of the COVID-19 crisis, organizers would have spent less time in fundraising for fabric donation and would have focused more on making scrub caps.
Governments should include small NGOs in their responses to crises. As CAP-MTL shows, they have the scale, flexibility and spirit to engage communities in providing aid efficiently and effectively.
The author thanks Professor Bernard Bernier, Dr Matthew Wyman-McCarthy, Shannon Xu, Jocelyn Wang and Chelsey Cao for their comments, and Yi Yang for the artwork in Figure 1. A special thanks to all volunteers of CAP-MTL project.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.Funding The author(s) received no financial support for the research, authorship and/or publication of this article.
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Qiuyu Jiang, PhD (anthropology, McGill), is a researcher at the Canadian Institute of Social Inclusion for Immigrant Parents. Her research interests are transnational migration and urban marginalized groups.