Words from friends on COVID-19
East Africa COVID-19 situation, challenges, and response
By Frank Dimmock (Africa Mission Specialist – The Outreach Foundation)
As I write this, on April 9th, 51 of the 54 African countries have reported cases of the Coronavirus or COVID-19. South Sudan became the 51st country on Sunday, April 5, to identify a case. Many of the initial African cases were ‘imported’ by visitors from Europe and the Middle East to South Africa, Nigeria, and Rwanda.
Steps have been taken by Governments to close land and air borders to people, allowing only freight shipments.
Social Distancing and hygiene measures, based on Public Health guidance, have been implemented, non-essential services have been closed and curfews initiated.
The health systems in most Sub-Saharan African countries are not equipped to handle this pandemic. For example, Kenya has 14 general hospital beds per 10,000 population and Ethiopia has 3.
Many people in East Africa are living in informal settlements (slums), such as: in Nairobi, Ethiopia, Uganda, and DRC. These informal settlements are characterized by poor quality and dense housing and limited basic services – utilities, water, and sanitation. In these cases, social distancing, isolation of cases and contact tracing are almost impossible. There are other populations in the most vulnerable category to the virus: the homeless, migrants, refugees, displaced, and those with physical or mental challenges.
South Sudan, with 11 million people, currently has 4 functioning ventilators. The President has imposed a curfew from 8 PM to 6 AM until mid-May. Outreach partners in the Presbyterian Church of South Sudan (PCoSS) have postponed their long-overdue General Assembly until November. Many PCoSS members are living in the camps for internally displaced and in refugee camps in neighboring countries. Thousands of refugees have also migrated to urban areas (e.g. Addis and Nairobi) in search of employment or trade where they also live in crowded settings, risk discrimination, and are no longer are under UN protection. Faith leaders are critical partners in camps and in urban areas where they can network congregants, disseminate messages and direct the sick to appropriate care.
Throughout East Africa, there are also critical food shortages. Just prior to the virus outbreak there was an infestation of locusts that destroyed many fields and stored crops. This has led to a 30% reduction in food rations for refugees and widespread hunger throughout the region. Food prices have risen exponentially.
It is in the nature of South Sudanese to greet each other warmly and enthusiastically by shaking hands and other physical contact. Under normal circumstances, avoiding a greeting may be considered a social offense. It might signal, for example, that one person has a problem or dispute with another. If the public health rationale for refusing to shake someone’s hand is not understood by both individuals, this may lead to negative reactions and social pressures that run counter to public health advice. While some South Sudanese, especially those working for public and private institutions, have been quicker to adapt, the uptake has been slower across the wider South Sudanese society, leading to some confusion as to the ‘correct’ way to respond, which could create or exacerbate tensions amongst individuals or groups.
South Sudanese are deeply religious people who often turn to their religious institutions in times of crisis. Similar social pressures and contradictory practices may arise when it comes to religious gatherings. The Government of South Sudan has declared a total ban on public gatherings, closing schools, markets, mosques, and churches. On 23 March, the Catholic, Episcopal, and Presbyterian Churches in South Sudan announced the suspension of church services and the closure of institutions (including schools and theological colleges) under their jurisdiction for one month. Congregations were advised to worship from home until the government advises that it is safe to engage in public and group worship. The South Sudan Council of Churches, uniting its member churches in South Sudan, including Presbyterian partners, issued a pastoral letter reiterating a joint commitment to these measures.
However, as in other countries facing the pandemic, some Christian groups outside of the mainstream churches, have issued contradictory messaging, arguing that church gatherings are exempted from the ban because they allegedly ‘act as a counter to the pandemic’. These contradictory messages have created tensions, not only between the Government and some Church groups’ leaders but also between their followers and other South Sudanese who are following the guidance from the Government and mainstream churches.
One important lesson learned from the Ebola epidemics has been that the traditional importance of funeral rites and ceremonies cannot be ignored. Attendance at funerals is a cultural obligation and religious leaders are expected to lead a service. Individuals and religious leaders who refuse to participate in funerals can be condemned as disrespectful.
South Sudanese are also culturally obliged to visit and care for sick relatives who have been hospitalized. Women are especially responsible for being caretakers in those situations. Restricting hospital visitation has already created tension in some areas.
The common, cultural practice of tea drinking is another important social event for South Sudanese. Prohibiting gatherings where men socialize, and women serve, will be impactful on both social health and economic livelihoods. Research has also shown that when there are ‘stay-at-home’ conditions, there is often an increase in domestic violence and child abuse.
So… Faith leaders, including Outreach’s Presbyterian partners in South Sudan, Kenya, and Ethiopia, are engaged in information campaigns to extend appropriate messages to the public on the prevention and treatment of those infected.
Handwashing facilities with soap have been opened in many camps and PPE (where available) is being distributed to front-line health workers.
All countries in the region have introduced secure movement restrictions, including border closures and curfews. Some of these restrictions, often enforced by police and military personnel, have resulted in violent public reactions. In some instances, undocumented migrants and refugees are anxious about being tested or going to a hospital in fear of detainment, separation from their families, or deportation.
Please prayerfully consider supporting the COVID-19 appeal launched last week by The Outreach Foundation. This is a general appeal to assist Outreach partners globally. Together, we can accompany our partners and churches in East Africa in preventing the spread and responding to the COVID-19 crisis.
We at the Outreach Foundation are praying for U.S. congregations to stand together with Christian brothers and sisters and share the love and hope of Christ, especially during this critical time.
Romans 8:38-39
For I am certain that nothing can separate us from his love: neither death nor life, neither angels nor other heavenly rulers or powers, neither the world above nor the world below – there is nothing in all creation that will ever be able to separate us from the love of God which is ours through Christ Jesus our Lord.