The COVID-19 virus is holding the world in its grip. The complexity and consequences of the pandemic are even greater in the crisis-areas where ZOA works. Countries where hygiene is poor, with minimal health care and a very limited number of hospital beds. ZOA is also present in overcrowded refugee camps where keeping distance is not an option. Support is needed more than ever. We respond, even when restrictive measures make our work difficult. A short overview of the situation in the countries where we work.
Update: 27th of July 2020
Over the past decades, the Afghan people has had to deal with constant conflict, poverty and repeated natural disasters. The outbreak of COVID-19 only exacerbates these conditions. IDPs, vulnerable people and refugees are the most at risk and will be most affected by COVID-19 (OCHA, 2020). Due to the ongoing conflicts, Afghanistan’s health care system is underdeveloped and poorly available throughout the country. In Afghanistan, the number of infected people is rising rapidly.
Most of ZOA’s projects in Afghanistan can continue in a modified form. COVID-19 (related) activities have been added to several projects. Besides, the ZOA team in Afghanistan launched a COVID-19 awareness-raising campaign for women in self-help groups and other vulnerable women. The women in the project area are often not aware of the risks and dangers of the COVID-19 virus because they do not have access to the media. The campaign was started to educate poor families about the global pandemic. The campaign consists of distributing information using brochures and awareness-raising, disinfecting houses, and distributing COVID-19 kits (including soap for washing hands and laundry, sanitary towels and masks). The self-help group members also discuss COVID-19 issues with the assistance of an illustrated COVID-19 guide for children. The ZOA team is also distributing health kits via the self-help groups. The ZOA team in Afghanistan has also done an analysis on risk perception and level of knowledge regarding COVID-19.
The staff of ZOA Burundi are concerned about a possible outbreak of COVID-19 (and its impact) in Burundi. In the beginning of July, the Burundian government launched a mass-testing campaign. Until the 26th of July there were 345 confirmed COVID-19 cases. In total 1 death was reported. Even though it now becomes easier to get tested, the system is still based on self-reporting, and not so much on contact tracing. Asymptomatic people will not be tested. The reported numbers are probably still an under representation of the real amount of cases. The promotion of preventive measures is limited in Burundi and mass gathering do continue (churches, markets, schools etc.)
The implementation of the ZOA projects continues for the time being. Appropriate security measures are being taken. For example, activities with over five people together are being stopped. Everyone needs to take the 2 meter distance into account. Each activity with beneficiaries starts with awareness raising on COVID-19. ZOA staff needs to wear a mask by indoor meetings and in cars. Besides, the number of visitors at the office are limited.
Numerous cases have already been reported in Congo but it is assumed that many more people are infected. There is not enough testing capacity in the country to accurately reflect the data. Increasing infections will put enormous pressure on the already underdeveloped health care system. Meanwhile, the country faces outbreaks of ebola, cholera, measles and malaria. In some areas, adding to this, insecurity is limiting health care access. Vulnerable groups are the elderly, people with disabilities, displaced persons, refugees and people with low incomes, living in overpopulated areas (OCHA, 2020). The government has already taken several preventive measures. Schools, churches and restaurants are closed and meetings are only allowed to take place with a maximum of 20 people. In addition, it is compulsory to wear a mask.
The implementation of activities continues so far. Taking into account the fact that no meetings may take place with more than 20 people. Besides, within the current projects, actions are taken to explain COVID-19 and the necessary prevention measures. Fewer ZOA employees are working in the field at the same time and travelling to project areas is being limited. All the ZOA staff wear masks to limit the spread of the virus according to the measures set by the provincial government.
In Colombia there have been 233.541 confirmed cases of COVID-19 with 7.975 deaths. Health officials have warned of the impact that COVID-19 may have on the many vulnerable migrants from Venezuela currently in the country. Colombia is home to 1.8 million refugees and undocumented migrants. These people often do not have access to basic services such as health care, WASH and food. With the current COVID-19 pandemic, refugees and migrants have become even more vulnerable. Refugees risk the change of being accused of further spreading the virus (OCHA, 2020). Since the lockdown in Colombia many Venezuelan refugees have returned to Venezuela.
In Colombia, ZOA is working to respond to the great need created by the COVID-19 pandemic. Since 24 March, the whole country has been in compulsory isolation in the hope of preventing the spread of the virus as much as possible. All people need to wear a face mask outside their own house. The quarantine rules state that one person per household may go outside once a week to buy essentials. All non-essential businesses have been closed. In Uribia, Colombia’s northernmost municipality, 92.2% of people live in poverty and about 95% of households work in the informal sector. These households are forbidden by law to leave their homes and it is therefore not possible for them to work.
ZOA has started a multi-purpose voucher program from the beginning of May to provide food and other essential items for 5,125 people per month for the next 3 months. This enables 800 families to stay safely at home during the quarantine. National quarantine is expected to be extended. The multi-purpose voucher program is being complemented by the installation of 1500 household handwashing stations. These will be placed in a migrant settlement and distributed to the 800 families who receive monthly vouchers. In addition, 1500 food parcels were distributed at the end of May.
COVID-19 is likely to overwhelm the already fragile health system, reducing the capacity to handle existing diseases such as malaria, diarrhoea and cholera. The total number of infected people are rapidly increasing and reached 13.248 on the 27th of July. A total of 209 people died due to COVID-19 and 6.216 people recovered.
In Ethiopia there is a state of emergency. However, at the end of July COVID-19 related government-imposed restrictions were eased, allowing intra end inter regional movements. ZOA is now able to operate without restrictions, respecting the mandatory use of masks, hygienic measures, and social distancing in their activities.
All ZOA offices have a hand washing stations at the gate of the office and all vehicles are disinfected regularly throughout the day. Within each program area, the ZOA teams are in close contact with the local government officials and other (I)NGOs to share information and follow-up on the safety measures that have been put in place. As confirmed cases are increasing only a few team members are coming to the office. Other team members are working from home. When people come to the office, they respect the mandatory use of masks, hygienic measures, and social distancing in their activities in the office.
The teams in Ethiopia has done the following COVID-19 related activities since the pandemic: 49.115 individuals received information about the prevention of COVID-19, 6.920 individuals were supported with hygiene kits, 160 handwashing stations are constructed or repaired at public places, 8 health facilities are supported with COVID-19 required materials and/or trainings. 6756 individuals received food support and 2575 farmers received support to produce more and better crops.
The Iraqi health system is severely underfunded and unsuitable for dealing with a large-scale medical emergency. The Ministry of Health estimates that 20,000 doctors have left since the 1990s, leaving few qualified health personnel, even in normal times. In Iraq, airports are closed and there are restrictions on movement within the country, which means that you can only go outside with permission. Besides, schools and shops are closed and only supermarkets and pharmacies are still open. Iraq is an urbanised society where large families live together in one house. Preventing social interactions is difficult (OCHA, 2020).
Several ZOA projects are at a standstill because of the crisis. For example, community centres may not be opened and agricultural programmes are on hold, preventing farmers from cultivating their land. Fortunately, other activities can continue since some essential work may be carried out by relief organisations. ZOA has been distributing food parcels to families who currently no longer have an income. Besides, in camps, we help distribute hygiene boxes with soap and other useful products and we provide information on how to prevent contamination.
Liberia is still recovering from the 2014-2016 Ebola outbreak and its negative consequences at the economic, political and social level. The country is currently relatively stable but experiences lack of basic services, widespread poverty, low mutual trust, corruption and recent anti-government protests. Although Liberia and its population have defeated Ebola with many lessons learned from this outbreak, the country does not appear to be ready to fight COVID-19 with its limited health facilities, low capacity of the government to carry out tests and a growing number of cases.
On 8 April 2020, the President of Liberia declared a state of emergency for the entire country. Travelling between counties is no longer possible. In Montserrado, Margibi, Nimba and Grand Kru Counties, people have to stay at home and only one person per family is allowed outside for a maximum of one hour. Government offices, companies and other institutions are closed as much as possible and only essential services remain available. For many Liberians, especially in the cities, this means that they will no longer be able to go to work, have no income and therefore cannot provide for the basic needs of their family. Besides, dependence on rice imports, reduced tax revenues due to reduced exports and a lurking petrol shortage may worsen the situation.
In line with the measures taken by the government, ZOA Liberia has limited its activities. Only essential visits to project sites or activities where ZOA and partner organisations do not need to be physically present continues, to reduce the risk of the virus spreading from Monrovia to other counties. ZOA ensures that communities are provided with buckets so that everyone can wash their hands and that they have access to correct information. ZOA Liberia is strategically well-positioned to play a role in the COVID-19 response and foresees food security interventions in the future. The government is setting up coordination structures to ensure that ZOA and other partners coordinate interventions.
Access to health care in Myanmar is limited and doctors are seriously concerned about the availability of the necessary medical and protective equipment. It is estimated that only 200 respirators are available and that these machines are only available in the 3 largest cities of Myanmar. Currently 299 people are infected and 5924 people have been tested. Test facilities are being built in four major cities. Most of the infections in Myanmar are among those who have returned to Myanmar from Thailand, India, Malaysia and China. It is difficult to find out how the virus is spreading in Myanmar. Especially in remote areas people are facing food shortages due to travel restrictions and loss of income amid the COVID-19 pandemic.
Most people of the ZOA team work from home and in small numbers at the office. The ZOA team in Myanmar has a weekly online COVID-19 update meeting with the consortium and with the partners. There are also meetings with authorities to discuss approval for hygiene and food security activities as well as access to project areas.
Many of the ZOA projects in Myanmar can temporarily not continue because of COVID-19 restrictions. However, within current projects, a COVID-19 response is started, in close cooperation with the project partners. In the project in Kayin state, 1500 hygiene kits for 7500 people are distributed to prevent the spread of corona. 2267 vinyl posters and 2760 brochures with information about COVID-19 in the local language have been distributed. Besides, there are 6730 masks distributed to 1346 households in 32 villages. Also, two quarantine centers were supported with materials and training on how to prevent the spread of COVID-19.
In Nigeria, several factors are contributing to the spread of disease; high population density in urban areas, lack of access to safe water, inadequate sanitation, a poorly functioning health system, inadequate information and preventive measures and traditional practices. These factors especially play a role in conflict areas. COVID-19 is expected to exacerbate pressure on health systems and increase capacity shortages (OCHA, 2020). The government of Nigeria has introduced severe restrictions to slow down the spread as much as possible. The population of Nigeria is only allowed to go out on the streets twice a week to do their shopping.
Part of the ZOA team in Nigeria works from home. Permission has to be requested from the government to continue the work in the field. ZOA’s activities in Nigeria can continue to a certain extent. Due to various adjustments, most of the activities can continue for the time being. All staff members of ZOA are being informed about COVID-19 and how they can best implement the prevention measures. ZOA has a lot of experience in Nigeria with infectious diseases such as cholera and now uses this knowledge and expertise as effectively as possible to combat COVID-19. Click to read more about a recent Distribution of hygiene kits in Northeast Nigeria.
The main risks for the South Sudanese population concerning COVID-19 are related to population density in camps or urban environments, lack of awareness, poor health and nutritional status, inadequate sanitation and inadequate humanitarian aid (OCHA, 2020).
In South Sudan the test capacity is very low. Till the 25th of June 10,226 COVID-19 tests are conducted. The cumulative number of cases is 1942 with 221 recoveries and 36 deaths.
In South Sudan, the impact of COVID-19 on the ZOA team is noticeable. Airspace and land borders are closed, schools are closed and all shops (that do not sell food) are closed. Besides, there is a ban on gathering. The work of ZOA can continue because an exception is made for humanitarian work.
The team in South Sudan tries to carry out its work as much as possible including COVID-19 response. For example, during a distribution in Pibor, communication relating to COVID-19 was spread. In Yei, during training in small groups, also, awareness-raising was done. The team raises awareness on how to deal with people who get infected, and how to prevent stigmatization. Moreover, WHO information cards on COVID-19 are being distributed.
Sri Lanka was in full lockdown, including a curfew, for almost two months, starting March 20th. From mid-May onwards, the government relaxed several measures. The population can slowly resume their regular activities in compliance with safety guidelines. The full lockdown has been lifted in all districts. There is only a curfew from 10 o’clock in the evening until 4 o’clock in the morning. If there are (religious) holidays there is also a curfew during the day. Since Monday May 25th it is again possible to travel between the different districts. Schools are not yet open and group meetings are not yet allowed. The number of reported cases in Sri Lanka has increased due to the return of Sri Lankans from countries such as Nigeria and Kuwait.
Most ZOA employees can work in the office. Adequate protective measures are taken both in the office and in the field in order to continue the work in a safe manner. The regular program activities are slowly being restarted in Sri Lanka. The goal of the team is to implement all the COVID-19 response activities by the end of June. As a result of ZOAs work 1100 refugees have received a food ration package; more than 9000 seed packages have been distributed to promote home gardening; psychosocial support has been provided to women who are victims of domestic violence; hairdressers have received hygiene education; 600 hygiene kits have been distributed and information has been provided on COVID-19 prevention measures and government guidelines.
Numerous COVID-19 infections have already been confirmed in Sudan. Besides the COVID-19 virus, Sudan is vulnerable to other outbreaks of diseases such as cholera, malaria and measles. Sudan lacks the necessary medical personnel to deal with outbreaks. COVID-19 infections may cause hospitals closing to other patients. In Sudan, 2.1 million people are displaced. Many people live in camps. Also, 1.1 million refugees live in overpopulated areas, which increases the risk of spread (OCHA, 2020).
The ZOA team in Sudan is also affected by the COVID-19 virus. The team is still allowed to work in the office, but the number of people present is limited. The airport in Sudan is closed and the number of staff that can travel to the field is limited. Meetings with more than 10 people are prohibited and there is a curfew. Integration of corona prevention and awareness-raising measures within the projects will be started.
Syria is at high risk of a COVID-19 outbreak due to continued displacement, overcrowded camps and villages, and the high vulnerability of people in large parts of the country. IDP populations are particularly vulnerable. After nine years of crisis, Syria’s fragile health care system is severely disrupted and unable to respond adequately to a widespread COVID-19 outbreak. In July we see that the economy continues to suffer with rampant inflation affecting food prices in a country that has a 90% poverty level.
On the 27th of July there were 627 confirmed COVID-19 cases with 36 deaths. With very little testing, the numbers are likely much higher in the general population than has been reported.
The borders with Jordan an Iraq remain closed, and Lebanon has very limited access. Limited exceptions are made for humanitarian aid and trade. Commercial international passenger flights remain suspended. On the other hand, regional travel restrictions and social distancing measures have been largely eased.
In Syria, a number of projects have started that specifically focus on the COVID-19 response. In one of these projects households will be provided with hygiene kits and with information and tools for solid waste management. The team is also trying to slow down the spread of the virus through hygiene education and the distribution of hygiene materials. In addition, ZOA works to improve water supplies. These projects aim to reach 29.000 people.
In Uganda there have been 1.103 confirmed cases of COVID-19 and one person died due to COVID-19.
At the end of July COVID-19 restrictions are lifted a little bit but schools in Uganda remain closed till further notice. In this regards, ZOA Uganda has focused on home schooling a support to small group learning at home.
Besides, ZOA Uganda has done a three-month intervention focusing on hygiene and awareness raising.
In Yemen, 80% of the population needs humanitarian aid and only 50% of the health facilities are fully operational. This makes the population of Yemen very vulnerable to widespread disease. A health crisis is currently unfolding in Yemen. The health system is at a breaking point due to a lack of intensive care unit beds, lack of personal protective equipment and a lack of trained medical personnel. COVID-19 is spreading rapidly in Yemen. Due to the limited testing capacity, it is very difficult to estimate how many people are actually infected by the COVID-19 virus. In addition, COVID-19 is also masked by other common diseases such as pneumonia, respiratory infection and dengue. IDPs living in crowded informal camps are particularly vulnerable. There are currently 3.6 million IDPs living in Yemen. As a precaution, a partial lockdown is in place. Schools in Yemen have been closed, passenger flights have been postponed and land borders have been closed (OCHA, 2020).
Most people of the ZOA team work at home and when travelling to the field or coming to the office strict precautions are taken. In the current projects the activities continue as normal with adaptions to COVID-19. As for example social distancing during distributions, hygiene promotion through media/SMS communication and cars with speakerphones. Project activities in which many people have to come together are being postponed. Various of ZOA’s activities are being carried out in such a way that awareness of COVID-19 is being taken into account. There is also a COVID-19 response in Yemen. As for example, Personal Protection Materials are being purchased and distributed and awareness sessions and training sessions regarding COVID-19 are being organized for health workers.
Click here for a timeline of ZOA’s emergency response.