Delores Robinson’s days are usually busy. She heads GROOTS Trinidad and Tobago, a civil society organization that provides psychosocial care for people living with HIV. It also manages a transition house that provides shelter and services for displaced members of key populations.

But since the first COVID-19 case in the country was confirmed, on 12 March, Ms Robinson’s workdays have become a whirlwind. The government’s containment measures—a stay-at-home order and a shutdown of all non-essential business—have thrust the most vulnerable people further into the margins.

GROOTS Trinidad and Tobago is an example of how civil society organizations can move quickly to identify and respond to the needs of the voiceless. Ms Robinson, a Jamaican, has lived in Trinidad and Tobago for the past 34 years. During conversation she alternates between wide, open smiles and a furrowed brow. These days there’s lots to worry about.

Every day she prepares meals for 30 families. She then personally delivers them. There is no structured funding for this effort—just money and other contributions from HIV response stakeholders.

There’s a unique story at each drop-off point. Today she manoeuvres through the narrow roads of Sea Lots, a low-income community in the shadow of the capital city, Port of Spain. The men on the block recognize her car. One offers to deliver her parcel. She laughs. Ms Robinson has come to visit the seven children of a single mother living with HIV who is currently hospitalized.

The Government of Trinidad and Tobago has provided a range of COVID-19 relief options. These include salary relief, rental assistance grants and nutrition support. Sometimes, Ms Robinson’s role is to help clients navigate government systems. For example, one illiterate mother living with HIV lost her food card and needs help getting it replaced.

“The forms are complicated for many people, plus they don’t have an Internet service,” Ms Robinson explained. “Now that we are all being encouraged to conduct business online, many have no access.”

Since the stay-at-home orders went into effect, she’s been asked by the police to accommodate women and children at the transitional home. The combination of income loss and constant contact has exacerbated abusive situations, leading to a spike in reports of domestic violence.

Ms Robinson reports that her clients living with HIV have so far had no problem accessing their treatment. Before COVID-19, it was standard practice for Trinidad and Tobago clinics to dispense two- to three-month supplies of HIV medicines at a time. HIV treatment facilities and sexually transmitted infection clinics remain open, although they have altered hours.

“They have their meds,” she said. “What they need most now is nutritional support to be able to stay healthy and take their treatment.” And they need masks.

UNAIDS Caribbean is advocating for governments in the region to ensure that community organizations like GROOTS are included in decision-making and planning around meeting the needs of vulnerable populations during the COVID-19 crisis. They are an essential service, ensuring that people’s most basic needs are met. These organizations should be included in contingency plans for connecting people living with HIV to services. And they should be resourced.

“We think we’re all in this together, but there are many people who don’t have the things we take for granted—a safe home, healthy food and the ability to speak out. It’s tiring work but it’s needed now more than ever,” Ms Robinson said.