Hurting the Displaced: How COVID-19 is presenting new challenges for the Northeast
The COVID-19 pandemic continues to evolve rapidly and expand geographically across affected African countries. Out of the 47 countries in the WHO African Region, 46 have reported confirmed cases with local transmission now occurring in almost all the countries. Since the first index case was reported on April 18, 2020, the infection rate continues to increase in the Northeast states including Borno, Adamawa and Yobe.
With over 7.5 million people in need of humanitarian assistance due to the ongoing security crisis in the region, the threat of the COVID-19 pandemic looms, particularly for its 1.8 million Internally displaced persons (IDPs) in the three states, and even more for the 413,271 IDPs living in the 51 highly congested camps (28 in Maiduguri metropolitan area and 23 in deep field locations).
Current risk assessment
The stealth of the virus in the extremely congested living conditions and interacting with a population characterised by high prevalence of comorbidities, including high incidences of chronic malnutrition and malaria coupled with the current measles and expected cholera outbreaks can result in serious implications.
Help and funding are also needed urgently for millions of people in Nigeria who have been hit severely by the effects of the Coronavirus pandemic, including conflict-hit communities on life-support in the Northeast.
According to the World Food Programme, more than $182 million is needed to sustain life saving aid over the next 6 months. “We are concerned by conflict-affected communities in northeast Nigeria who already face extreme hunger and who are especially vulnerable. They are on life-support and need assistance to survive,” said Elisabeth Byrs, WFP senior spokesperson.
Many organisations – local and international – continue to show their commitment, to BeatingCorona.africa, to provide humanitarian assistance to the states, especially with adapted implementation modalities to ensure compliance with social distancing and other mitigation measures.
As at July 11, 2020, the fatality rate in Adamawa (9.7), Yobe (12.9), Borno (6.9), Gombe (4.0) is just averagely high compared to other Nigerian states. But efforts to flatten the curve are further worsened due to poor compliance in the use of face masks, social distancing, and good hygiene practices by the general public. Borno rose to become the eleventh worst affected state with 563 cases and 35 deaths, and 100 cases (7 deaths) have been recorded in Adamawa and 61 cases in Yobe (8 deaths).
Humanitarian partners are supporting Borno, Adamawa and Yobe Governments to establish and run additional isolation centres. But the health system is stretched and barely coping with detected and suspected cases; trade and commerce are just beginning to return, but there remains limited access to essential food and non-food items.
There is also a highly condensed displaced population in towns — especially in some IDP camps, and stigmatisation within the community is a big challenge. With low community awareness and education, stigmatisation of COVID-19 positive cases is indirectly discouraging case reporting.
Pathway to minimising COVID-19 impact through health solutions
With the rising number of cases in the Northeast, it is extremely important to scale-up surveillance at points-of-entry through robust screening strategies and quarantine all suspected cases.
With organisations such as UNDP, UNICEF, the UN and state governments involved in procuring and mobilising additional PPEs and IPC commodities, additional support still needs to be provided to advance social protection systems.
The rapid rise in transmission across high-risk IDP camps demand enhanced sample collection and testing, including an establishment of isolation centres in high priority LGAs. There needs to be improved contact tracing in all hotspot locations through enhanced community-based surveillance, and just like Kaduna, volunteers who understand the communities should be involved in public engagement to address the stigmatisation issue.
More importantly, the pandemic has revealed the crisis in the Nigerian health system.
Governments and institutions have to invest in capacity building for health partners staff working under different response pillars. Rather than adopting these solutions as a government-led prerogative, the training of health facility laboratory focal persons and the scale-up of WASH interventions in major health facilities and IDP camps has to be a partnership between private and public institutions. Otherwise, residents in the region will continue to suffer the pains of displacement and dissatisfaction that has persisted for more than 10 years.