Humanitarian activists warn it may be impossible to stop the spread of the coronavirus in refugee camps, where sanitary precautions are difficult and social distancing impossible.
Inside Nabadoon camp on the outskirts of Mogadishu which hosts about 3,000 families, most recently displaced from Somalia’s Lower Shabelle region following an intensification of fighting and US airstrikes, few can afford soap and water is rare.
“This can get very bad. It will be hard,” said Patrick Youssef, deputy director for Africa at the International Committee of the Red Cross. “Our fear is that governments will seek to protect those they see as their own populations and people … in refugee camps will be left to fend for themselves.”
The spread of coronavirus in Africa has been much slower than in Europe and Asia, but the World Health Organization (WHO) is concerned about a steep rise in cases across the continent in recent days.
The WHO’s Africa region – sub-Saharan countries plus Algeria – had recorded 990 confirmed cases and 23 deaths as of Tuesday morning.
Tedros Adhanom Ghebreyesus, director general of the WHO, has warned that official numbers may underestimate the scale of infection on the continent. “Probably we have undetected cases or unreported cases,” he said. “In other countries we have seen how the virus actually accelerates after a certain tipping point, so the best advice for Africa is to prepare for the worst and prepare today.”
South Africa, Senegal and Rwanda are the most recent countries to impose stringent new restrictions on movement. President Cyril Ramaphosa said police and army would enforce a three week lockdown from Friday.
But little attention has yet been paid to the 6.5 million refugees in sub-Saharan Africa, many living in precarious conditions, often already weakened by malnutrition and disease.
Health officials across Africa know that hospitals can deal with only a fraction of those needing care if the virus spreads through overcrowded cities, remote villages and among vulnerable populations such as those suffering from HIV and other chronic conditions.
Authorities are already moving to protect some sites. In north-east Nigeria, visitors have been banned from camps housing tens of thousands of people displaced by the Boko Haram insurgency, in a bid to prevent the spread of coronavirus.
Nigeria, Africa’s most populous nation, on Monday reported its first death from Covid-19, as the country’s overall number of confirmed cases rose to 36.
Prisoners and other detainees, such as those in detention centres for migrants, are also a concern, said Youssef.
Uganda, which has nine confirmed cases, hosts more than 1.4 million refugees, with more arriving every day from South Sudan, the Democratic Republic of the Congo and, to a lesser extent, Rwanda and Burundi.
Professor Pauline Byakika, a specialist in infectious diseases at Uganda’s Makere University, said prevention and control were key to fighting the virus in the crowded conditions of most refugee camps.
“This is a highly infectious disease,” Byakika said. “They are crowded, they don’t have handwash facilities – they don’t even have hand sanitisers – [and]distance between one patient and the other is so close.”
Jane Ruth Aceng, Uganda’s minister of health, said that any case of COVID-19 in refugee camps would be treated like outbreaks elsewhere.
“We have tents that we have procured, and [which are]ready to be set up to manage people who may get infected wherever,” she said. “For those who are severely ill, they will be referred and managed in the regional referral hospitals whose capacities are being built to handle COVID-19.”
Many refugees and displaced people live in villages or cities, not in camps. These include some vulnerable communities. (Source: The Guardian)