By Osman Nur
This article will highlight 1) impact of Coronavirus, 2) Somalia’s capacity, 3) inadequate WASH services to combat the spreading deadly disease, 4) the challenges towards the theories aimed in preventing the spread of coronavirus in the Somali context, 5) Preparedness and Response 6) and provide some recommendation to communities, government and aid workers in Somalia. Coronavirus is an infectious disease caused by the COVID-19 virus. It is rapid spreading, and strained the health systems of the most powerful countries like China, America, Italy, Spain, and so forth. The question that the article examines is whether the Somalia “ can cope and flatten the curve of Coronavirus”. The answer to this question is difficult however the article will highlight the reality on the ground. The virus has now spread to 210 countries, and territories around the world and two international conveyances affecting 2,147,799 and killing 144,313 as of 16th April 2020 according to https://www.worldometers.info/coronavirus/.
Somalia has so far recorded eight cases and five deaths following testing against 222 cases. Of this, 70 were reported to be male while 10 are male of today, 16th April. The highest percentage of the infected cases’ age is in the range of 20 40- years old, followed by 16% are above 60 years old, and 4% is in between 0- 20 years old.
Majority of infected cases are in Mogadishu (73), 5 are in Hargeisa, while 2 cases are in Kismayo according to Ministry of Health of Somalia Government. If Somalia’s exponential rate of increase of COVID-19 continues to increase exponentially, then in four weeks from now on to 6 May, there will be approximately 1,000 cases.
Given the spread of the Virus, Somalia has instituted measures to contain the possible spread of COVID19 including closing schools, business centers, banning large gatherings and suspending international and domestic passenger flights and imposing curfews. Puntland imposed their curfew 1st of April, while the Federal Government imposed curfew as of 15 April. However, this did not happened as people were interacting and business were open as usual. It is yet to see how others will see this and adhere the measures. In Mogadishu there were demonstrations against curfew refusing to follow the governments’ attempt to lock down the city. The main reason of this is to limit the social transmission through social distancing without disrupting commerce. (some evidence suggest that curfews rather lockdowns are better suited to sub– Saharan Africa’s social and economic).
Preventing deaths and debilitating illness are the prime concerns, humanitarian partners are also concerned about the possible impact of the virus on the livelihoods of vulnerable populations in Somalia including internally displaced people, food insecure communities, and people living in locust infested or flood prone areas. The reliance on remittance by relatives in the diaspora is also likely to diminish as bread winners outside the country see their economic opportunities reduced.
Knowing the impact that Covid 19 has caused in the countries where the health system was advanced, what do you think the impact would be in Africa countries particularly Somalia where there is poor health system, no resources whilst the country is facing recurrent humanitarian crises, drought and conflict with the displacement of 2.6 million IDPs living over 2,000 highly congested settlements, two – thirds of whom are minors, there is exceptionally high risk for wider- spread community transmission of the virus. (UNCHR Somalia April 8 2020).
Before the rise of Coronavirus, Somalis and other communities across the globe have been suffering and struggling with the impact of Acute Watery Diarrhea (AWD) which is a killer and caused by poor hygiene, lack of hand washing and adequate sanitation facilities at the IDP settings in fragile countries. The prevention of AWD is good hygiene and hand washing similarly to Covid 19. It is my belief that AWD will decrease given the new rise of Coronavirus that requires frequent hand washing with soap. There is positive advantage that Coronavirus contributes in the prevention of AWD apart from the death/mortality it causes to the human being in the world if the theories are implemented by Somalis. A total of 6,709 cases of Acute Watery Diarrhea (AWD/cholera) were reported across Somalia in 2019, according to the Early Warning, Alert and Response Network (eWARN) system of WHO. Since January 2020, at least 1,505 AWD/cholera cases have been reported across Somalia. (Somalia situation report 5 April 2020 UNOCHA).
1. Impact of Coronavirus
Coronavirus is an infectious disease caused by the COVID-19 virus. The virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. (Source: WHO).
Disease outbreaks affect girls and boys, women and men differently. While children’s health appears less impacted by COVID-19 than older adults, children’s education is interrupted, protective structures disrupted and their families and communities placed under stress by health and economic burdens. Children are also at risk of psychological distress at times of crisis as well as increased risk of violence, abuse exploitation and neglect.
Education: Groups that are already disadvantaged, such as adolescent girls in IDP camps, experience the greatest risks and impacts when their education is interrupted.
Child protection: From child protection perspective, the essential ongoing support and case management for vulnerable and at-risk children may be blocked by social distancing measures.
Girls, especially those from marginalized communities and IDPs and with disabilities, may be particularly affected by the secondary impacts of the outbreak.
Gender based Violence (GBV): Economic stress on families due to the outbreak can put children, particularly girls in IDP, at greater risk of exploitation, child labour, prostitution and gender-based violence. Girls and young women facing severe economic shocks are more likely to take on high-risk work for their economic survival.
Livelihoods: – due to the requirement in regard to the precaution measures particularly social distancing, we ought to find ways to mitigate the economic shock that will bring the majority of the country into food insecurity in the months ahead given the speed of Coronavirus across the globe. From other countries like Bangladesh, Covid 19 is a humanitarian crisis and we have to admit that with different perspective dimension, health, protection, GBV and livelihoods. In Somalia there is an estimated 1.15 million people who are in Crisis (IPC Phase 3) or Emergency (IPC Phase 4). From February to September, the population in Crisis (IPC Phase 3) or Emergency (IPC Phase 4), who are in need of urgent humanitarian food assistance, is expected to rise by 40 percent to 1.61 million people. Meanwhile, more than 2.9 million people are expected to be Stressed (IPC Phase 2). (Somalia Food Security outlook FSNAU – Feb to September 2020). In Somalia, people are very poor who have to skip meals due to the poverty level. So it is hard to keep people stay at home, for the realization and safety of the people by forcing them to stay home, we should need to provide food and emergency cash transfers.
2. Capacity- health system
Somalia’s capacities to prevent, detect and respond to any global health security threat scored 6 out of 100 as measured by the Health Emergency Preparedness Index in 2016. The number of health workers in different parts of the country is 2 per 100,000 people compared to the global standard of 25 per 100,000 people. Less than 20 per cent of health facilities have the required equipment and supplies to manage epidemics. The risk of COVID-19 spreading remains high because of crowded living conditions in urban settings and and poor hygiene practices common in IDP settlements. According to WHO, countries in fragile, conflict and vulnerable settings like Somalia are especially at risk for wide-spread community transmission should an imported case go undetected among the general population.
Somalia has extremely limited capacity regarding the diagnosis, treatment, and prevention and respond to an outbreak of Covid 19.
3. WASH and other services
Hygiene practices remain insufficient, leading to a heightened risk of water-borne disease. Less than half of the FGD participants reported washing their hands regularly after defecation. 53% of the assessed displaced and non – displaced households in 53 districts out of the 73 districts in Somalia reported that they don’t have access to soap. While 1% of the households self-report that they never wash their hands, handwashing appears not to be a common practice at all key moments. For instance, 89% of households reportedly wash their hands before eating, but only 45% of the households reported doing so after defecation.
The report further revealed that 32% of the assessed households do not have access to sufficient drinking water. Over four million people were reportedly found to be without a sufficient quantity of water nationally. (REACH. 2019. Joint Multi-Cluster Needs Assessment (JMCNA). 34% of the respondents said that the main problem is the lack of availability or access to water in the communities that entails to be addressed collectively.
The point of bringing this to your attention is how the Somalis and particularly IDPs are vulnerable and won’t be able to cope with the Coronavirus despite the ongoing efforts in providing public awareness and provision of soaps in the prevention of the disease but many has to be done.
The access to health facilities at the IDP settlements is very poor and the few are less equipped with less and or poor services. The most vulnerable population includes over 2.6 million internally displaced persons (IDPs) living in overcrowded sites with poor hygiene. Due to their low economic status, the IDPs have limited access to health care service, if at all. Many also lack safe drinking water, clean latrines and hygiene kits including soap. Apart from IDPs, the elderly – approximately 2.7 per cent of the population – and the urban poor, are also considered vulnerable groups who could be heavily impacted should COVID-19 spread.
Given the above facts and figures, IDPs are amongst the most vulnerable people for Coronavirus that is killing the rich and poor, the Christian and the Muslim. Disease doesn’t know status or background. The only way you can prevent and protect your self, your community and society is to follow the health warning and adhere to the precaution measures.
Mr. Nur is humanitarian practitioner currently working with ADRA as WASH deputy manager, worked with Save the children, World Vision, COOPI and SOSDA, local NGO in Somalia. He holds master degree in Peacebuilding and has 14 years’ experience in humanitarian and development. He can reach him [email protected] or twitter @OsmanNurMohame3
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