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Opinion: The virus may rapidly spread to countries that lack even the most basic resources to fight it

Were coronavirus to spread across the entire African continent, countries will have to rely only on their own scarce resources, writes Trócaire CEO Caoimhe de Barra.

Bidi Bidi in Uganda - the largest refugee settlement in the world.
Bidi Bidi in Uganda - the largest refugee settlement in the world.
Image: Andrew Roberts/TheJournal.ie

WE ARE LIVING through an unprecedented crisis. The entire world – from Los Angeles to Dublin to Manila – is facing a pandemic the scale of which has not been seen in a century.

The two key battlegrounds against the Coronavirus – China and Europe – are well-resourced but even they have been stretched to their limits dealing with its devastating consequences.

As the virus crosses borders, there are real concerns that it may rapidly spread to countries who lack even the most basic resources to fight this crisis.

Covid-19 is now present in over 40 countries in Africa, including some – Somalia, Democratic Republic of Congo – that are amongst the poorest places on Earth. The big fear is that the virus is being under-reported. Places like South Sudan, for example, have no reported cases, but that may be because they have no ability to test.

Poor countries are vulnerable at multiple levels – there may not be a functioning state to warn people how to protect themselves; many do not have the systems to detect the virus; most do not have a functioning health service to respond to a mass outbreak of illness.

Poverty also makes individuals more vulnerable. If you are living through a drought in somewhere like Malawi or Kenya, you may only be eating once a day. You may have HIV or be malnourished. Your immune system is going to be compromised.

We are told how hand washing is one of the best protections against Covid-19, but three quarters of sub-Saharan Africa’s 645 million people don’t have the facilities at home to wash their hands with soap and water. People have said they are being advised to wash their hands and they ask – ‘with what?’

The other key protection is social distancing. In conflict-affected countries, people are often living together in very crowded camps where the virus could take hold very easily.

A staggering 84% of refugees are living in developing countries. How do you stop a virus taking hold in a refugee camp? It’s the same principles as anywhere else: you isolate it, you design daily life so as people can avoid close contact, you provide plenty of soap and water, you encourage people to wash their hands.

That is, of course, easier said than done. The reality is that refugees are often living in overcrowded camps, that are starved of resources. So even accessing enough detergent and clean water to keep people healthy in normal times is a huge challenge. If an infectious disease arises, it can sweep through a camp in days, taking the most vulnerable people with it.

There are currently Coronavirus cases in 15 of the countries where Trócaire support people. Trying to contain the spread of the virus in these countries is going to be a mammoth task for our teams in the weeks and months ahead.

Our most affected region so far is the Middle East. Elsewhere, in Central America, Guatemala and Honduras are in lockdown. In Africa, cases have been reported in Kenya, Ethiopia, Somalia, Rwanda, DR Congo and Sudan, where Trócaire has ongoing programmes.  

Trócaire has experience combatting disease outbreaks and we can help to tackle this pandemic.

During the Ebola outbreak in west Africa in 2014-15, our teams in Sierra Leone delivered vital services to affected communities, helping to save thousands of lives. Today, we continue to counter the spread of Ebola in DR Congo, where over 2,200 people have died from the disease in the last 18 months. DRC had its last new case of Ebola a month ago. We are winning the fight against Ebola and we can win this new fight against COVID-19.

A lot of what we do to counter these outbreaks is similar to what we’re now seeing in Ireland – it is about providing hygiene and encouraging a change in social norms. In DR Congo, that means helping people to understand what the virus is and how to prevent its spread. We mobilise communities to carry out hygiene promotion activities and to support families forced into quarantine.

What makes Covid-19 different from other response work is that it is not isolated to one region or country. When Ebola struck West Africa, the world could mobilise in response. Were Coronavirus to spread across the entire African continent – and at a time when Europe and America are struggling to contain their own crises – African countries will have to rely only on their own scarce resources.

Agencies such as Trócaire will respond to the Coronavirus crisis while also trying to maintain other life-saving programmes. Trócaire runs the only healthcare facilities in Gedo District in south-central Somalia – a country that has been in conflict for almost three decades and where there is only one doctor for every 25,000 people. Ireland has one doctor for every 370 people.

Everyday scores of babies are safely delivered in Trócaire’s maternity units while people are treated for a wide range of illnesses. This work will have to continue, but our doctors and nurses may also have to cope with an influx of patients affected by the Coronavirus.

The virus also presents challenges to our work in Ireland. Organisations around Ireland are trying to deal with this risk in a sensible and appropriate way. Trócaire is no different.

We have cancelled all staff travel. Ireland has higher rates of infection than most of the countries we work in and we don’t want to risk spreading the virus.

Last week we also cancelled all face-to-face events planned around our annual Lenten campaign. Our school talks, mass talks and exhibitions will not go ahead. This will impact our crucial fundraising, but the most important thing today is stopping the spread of this virus and protecting each other. 

This crisis has highlighted how interconnected our world and our lives are. The global community is rallying together. The people who are least able to fight the virus are going to be the hardest hit. In the weeks and months ahead, we must be prepared to stand with people who are largely defenceless against the threat they face.

Caoimhe de Barra is CEO of Trócaire. You can support Trócaire’s work at trocaire.org.

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