The global COVID-19 crisis from the perspective of communities in Africa: Policy Briefs

Policy Brief

BOTSWANA

This policy brief presents the findings of the Sustainable Futures research project (Botswana Hub), which documented the experiences of vulnerable communities in Old Naledi and Damochujenaa during the Covid 19 pandemic. Lockdowns and restrictions exacerbated vulnerabilities among these communities increasing food insecurity and hunger. Public health measures need to be balanced against other risks such as insecure incomes, weak social protection systems and limited access to basic services. Crisis responses must be based on local needs and capacities and promote strong community engagement.

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Policy Brief

UGANDA

The COVID-19 pandemic changed societies across the world. In Uganda, COVID exacerbated preexisting vulnerabilities in  communities in both rural and urban areas exposing the weaknesses of health and social assistance systems. What can be done to improve responses to emergencies the future? This policy brief outlines recommendations and priorities for action. It is based of the findings of the research project Whose crisis? Which captured the impact of the pandemic on communities in sub-Saharan Africa.

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Policy Brief

NIGERIA

Covid 19 restrictions and lockdowns worsened already precarious livelihoods and endemic poverty in across Nigeria. The impacts of the pandemic on vulnerable communities have exposed the weaknesses of crisis responses at the local, state and federal levels. Socioeconomic recovery requires policies to promote resilient and sustainable livelihoods and protect households against future shocks. This in turn calls for close collaboration between governments, civil society, and private sector.

This brief provides policy recommendations for effective emergency responses that support local economies and provide social safety nets. Recommendations are based on in-depth interviews and discussions with a wide range of stakeholders including academic experts, traditional and political leaders, entrepreneurs, policymakers and communities. The goal was to encourage debate on long-term, sustainable and indigenous socioeconomic progress. This initiative was part of the research project “Whose Crisis? The global COVID-19 pandemic from the perspectives of communities in Africa,” which aimed to explore the lived experiences of communities in Uganda, Nigeria, Eswatini, Malawi and Botswana.

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Policy Brief

ESWATINI

This policy brief presents the findings of the Whose Crisis? research project which aimed to document the lived experiences of vulnerable communities during the Covid 19 pandemic in sub–Saharan Africa. The brief focuses on the impact of pandemic restrictions on communities in Eswatini drawing key messages from the research to inform future emergency responses. Research findings demonstrate that Covid 19 restrictions had severe impacts on lives and livelihoods, ultimately leading to feelings of resentment, neglect, hopelessness, and anger. Crises interventions must be adapted to local capacities and context.

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Policy Brief

MALAWI

This policy brief summarises the findings of the Whose Crisis? research project which aimed to understand lived experiences of communities in the wake of the Covid 19 pandemic in Malawi. The brief outlines key messages to help stakeholders improve future emergency responses. More coordination among sectors and strong engagement with vulnerable communities can lead to more effective interventions.

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Storytelling Sustainability - Festival of Social Sciences 2022

On November 1st, we launched the Scottish Hub of the Sustainable Futures network at the University of Glasgow.

To celebrate and showcase our own work, we encouraged visitors and attendees to engage in a little bit of their own creative storytelling exploration. Below, you can see the results of these explorations. The displayed zines and postcards give a glimpse of what their creators have to contribute to the sustainability debate.


In the Claws of COVID-19 Stigma: The Case of Paul Odida’s Family in Alebtong District, Uganda

Under the auspices of the ‘Whose crisis? The global COVID-19 Crisis from the Perspective of Communities in Africa’ project, a team of  researchers from Uganda, Malawi, Eswatini, Nigeria, Botswana and Glasgow; Scotland, aimed at exposing unseen aspects of living with COVID-19 by co-curating representations and understandings of the social and cultural crisis generated by the pandemic in Africa. The project was funded by the African Humanities Research Council (AHRC, UK) through the University of Glasgow.

The Ugandan researchers carried out a study in Apala and Abia counties in Alebtong District in Northern Uganda and Banda, Nakawa Division, Kampala District.

However, in this particular article, I particularly focus on the issue of COVID-19 related stigma as experienced Mr. Paul Odida and his family. Mr Odida is from Abia County, Alebtongo district. Before we had an extensive interaction with him, we had earlier on heard in our pre-fieldwork visit that Mr. Odida’s family had faced unprecedented COVID-19 related community isolation and stigma in the region. The research in Alebtong took four intense days from 11th to 14th May 2021. And the extensive interaction we had with Odida, took place on 13th May 2021.

When Covid-19 started in China in late 2019, the ambitious Mr. Paul Odida who wanted to retire with a degree was at his graduation at Kampala University (one of the private universities in Kampala, Uganda) after completing his Bachelor’s degree in education. At that time, he was only hearing about the Corona Virus and its related COVID-19 on radio and television and word was passing around that the virus was intensifying in China.

By then, the 63 year old retired teacher who currently engages in commercial agriculture and religious work, did not know that the pandemic would find its way to Uganda and finally hit him hard in unprecedented ways in his rural enclave in Abia County, Alebtong district. Abia is about 260 Kilometers from Kampala; Uganda’s capital city.

It was around May, 2020 when his son’s wife who works in Southern Sudan came to live with the family that the whirlwind of unexpected events started to unfold. At first the family was afraid of her, but later, they calmed down and she started doing the house and farm chores and to go to church with other members of the family.

Mr. Paul Odida, his wife and granddaughter on the day of our interaction on 13th May 2021 in the compound at his home. Photo taken by Phionah Alonyo

Paul’s daughter-in-law had stayed with the family for about 27 days when one evening, while the family was about to have supper, she informed her father in-law that she was not well. She was feeling dizzy, had a headache and was also sneezing. Paul advised his daughter in-law to go to the health center early the following morning to get medical attention. And that is what she exactly did at day break.

Even though by the time we had our interaction with Odida, his daughter in-law had already left the home, he narrated to us how the events unfolded as follows.

While Odida’s daughter in-law was in an out-patient queue at Apala Health Centre, she sneezed and then one Health Assistant came around and inquired about who had sneezed. At that moment someone within ear and eye shot of the unfolding events shouted ‘Corona’ and all people around ran away for their dear lives! She, and a weak old lady were the only ones left standing in queue. People who were peeping at the developing story from a safe distance then shouted at the old lady that she was standing with a corona victim and the old lady fainted!

At that moment, all the ill equipped medical personnel at the rural Apala Health Centre who had never handled a COVID victim were scared of her. Luckily enough for her, there was one Health Committee member of Apala Health Centre who knew her and her family who came to her rescue and she was taken to an isolation room.

However, all along, people from the nearby Apala Trading Centre were peeping at the Health Centre asking about a person who had brought them the Corona virus. Meanwhile, while at the Health Centre’s Isolation Room her blood and other samples were taken, she was given some medicine, masks and gloves and told to go and isolate herself from home as they waited for the results of her tests.

Since the rural Apala Health Center had no ambulance, she had to walk home. But as she was leaving the health facility, one lady passed word around Apala Trading Centre that the corona virus victim was coming out of the Health Centre and that they should not allow her to pass by and spread the virus around town. At that particular time, the community’s belief was that a corona virus victim could contaminate all his/her surrounding environment with the virus! The young lady was shouted at, and people were calling her a prostitute and all sorts of derogatory names, while others wanted to lynch her. She had no option other than passing through thickets and bushes until she arrived home in the evening; very tired and exhausted. The family took all precautionary measures and isolated her in her own hut. Her mother in-law was given part of the protective gear of masks and gloves, and it was only her who took food and tea to her hut. During this time, we were told that she was remorseful and apologetic all the time; begging the family to forgive her because she did not intend to kill them all with the corona virus.

Mr. Paul Odida, far right, his wife in the middle and granddaughter on your right, and the research team members on the left at the time of our interaction. In the background on your left is the hut in which his daughter in-law was isolated. Photo taken by Phionah Alonyo.

Meanwhile, the entire village was wary of Odida’s family. His home was declared a no-go zone! No family member dared to leave the home least he or she was lynched by the angry villagers who thought that his family had brought the virus to finish off the entire village!

For three consecutive days the daughter in-law was isolated in her own hut and a nurse who had kept her number at Apala Health Centre usually called her to ask about her condition. On the fourth day, her results came out indicating that she had no corona virus! However, by this time, the declaration of her negative results could not change the community’s perception about her and her family for an inch. Their family’s community isolation and stigmatization continued.

Due to the communal isolation and stigma, Odida’s family was almost running out of basic necessities like salt, sugar and soap and at one time Paul telephoned and requested his own son to buy him a kilo of sugar and deliver it home but the son refused fearing to catch the virus! The situation was worsened because during the first wave of the corona virus (as I earlier on hinted),   in Uganda, the belief in the village was that since it is airborne, one victim could contaminate the air of the entire neighbourhood. Therefore no one dared come near Odida’s home! However, when his son in Southern Sudan heard about the family’s predicament, he sent him some money over the phone and one other daring young man who called him uncle bought all the supplies and brought them home declaring that if he were to die, he would die with his uncle other than seeing him and his family starve to death at home. Therefore, it was the supply of a sack of rice, sugar, ginger,  cooking oil, paraffin and other basic necessities plus his chicken and vegetables that pushed the family through the months within which the entire neighbourhood  was stigmatizing them. And throughout this time, Odida’s family was conducting church service at home.

It was around this time when the Alebtong District Health Officer and the Local Council 5 Chairman came to follow up with the case and along the way the community members stopped them saying that Odida’s home was a no-go-zone. The officials then called and invited the young woman to go to them but along the way people were running away saying ‘corona victim’. The Local Council Chairman and the District Health Officer had an impromptu meeting with the converging community members and informed them that the young woman did not have the corona virus and that they should stop mistreating her and Odida’s family unless they had personal vendetta against them. But even after this, they continued stigmatizing her and she couldn’t go to the communal bore hole to fetch water.

In total, Odida’s family was isolated by his community for three months. However, even though one can say that this communal behavior towards Odida’s family showed the community’s anti-corona virus vigilance; an approach that shielded them from the spreading of the virus, on the other hand it shows how the virus’ multifaceted claws tore apart the African communal fabric.  For people in an African setting where communality is part of the social menu, Odida’s family communal isolation and stigmatization was too much and unprecedented in his living memory – it was a socio-cultural crisis! And it was not only that, but also a medical one because it was during this very time that he also developed depression and hypertension. He was also worried that his daughter in-law will never set foot again at his home because of the gross stigmatization and stress that she faced while there.

However, when he critically looked back at his experience, humble and religious Paul said ‘it is only God who saved me and my family’. And when he was asked about the major lessons he picked from this predicament, he told us that:we should look after our health I am now more conscious than before and I cannot go to a public place without a mask… follow what the health officials tell you and it is good to go for medical checkup’.

For the Ugandan government which distributed face masks to Alebtong District communities almost a year after the first 2020 corona virus wave in Uganda he had this to say: ‘Government should always act immediately. It should not wait for a year to distribute masks’.

Commenting about his post-stigmatization relationship with the community Odida said:

We are on talking terms. Some seem ashamed but no one has ever asked for forgiveness … but I do not blame them much for treating me and my family the way they did because when I look back, I think if I had corona I would have killed so many people because a week before my daughter’s sickness, our catholic Bishop was around this place and we moved in four zones with him and other believers.

Even though at the time of our fieldwork in May 2021 Alebtong district had not had a corona virus victim, the above scenario shows the far reaching socio-cultural and psycho-social consequences of the pandemic even in areas where it did not physically set foot. The above story also shows that the advent of the corona virus came with a new phobia – Corona or COVID Phobia; a form of hatred directed towards both suspected and real corona victims. We have also heard and read about stories around the world where kinds of generalized attacks and hatred are directed towards people from countries where particular variants say COVID-19, Indian Delta and Omicron are suspected to have come from. This means that as governments and other institutions are focusing on telling people to wear masks and get immunized to hold this virus in its tracks, they should also find a way of offering psycho-social support to victims of gross COVID-Phobia or even sensitize the public about the effects of stigmatizing victims of the still unfolding corona pandemic.

By Dr. Richard Kagolobya


Research paper: Whose Crisis? COVID-19 Explored through Arts and Cultural Practices of African Communities

Research Report and Data Access

We are excited to have been published in the Journal of Open Humanities Data in their special collection of Humanities Data in the time of COVID-19. The article is openly accessible to all.

Read the article now

Abstract

The “Whose Crisis?” project is in response to a continually evolving global health pandemic, COVID-19. In this context, the dominant discourses have been generated in the Global North, overwhelmingly by a minority of wealthy and powerful authors, reflecting narrowly on a crisis that, while impacting the whole world, is experienced in vastly different ways. This article frames and contextualises data from this project through an introduction to the background, contexts, and methods of a project designed to reflect the lived experiences of, perspectives on, and responses to COVID-19 in vulnerable communities across sub-Saharan Africa. The project has been carried out by a large team of collaborators who prioritise the lived experiences, customs, and needs of the communities engaged through a culturally responsive and arts-based research approach. The article points to the methodological implications of arts-based research to explore plural perspectives in participatory ways, and the socio-political possibilities of amplifying the voices of under-represented and under-served communities in Africa, in terms of global health in a pandemic context.

How to Cite: Perry, M., Armstrong, D.M., Chinkonda, B.E., Kagolobya, R., Lekoko, R.N. and Ajibade, G.O., 2021. Whose Crisis? COVID-19 Explored through Arts and Cultural Practices of African Communities. Journal of Open Humanities Data, 7, p.29. DOI: http://doi.org/10.5334/johd.52

"The pandemic has brought into focus the complexity and interrelatedness of physical and mental well-being with cultural and societal structures. It has highlighted the need for responses that can bridge this complexity, that reflect on the global diversity of human experience, and provide a more balanced understanding of the COVID-19 pandemic."

Research Report and Data Access

We are excited to have been published in the Journal of Open Humanities Data in their special collection of Humanities Data in the time of COVID-19. The article is openly accessible to all.

Read the article now

Abstract

The “Whose Crisis?” project is in response to a continually evolving global health pandemic, COVID-19. In this context, the dominant discourses have been generated in the Global North, overwhelmingly by a minority of wealthy and powerful authors, reflecting narrowly on a crisis that, while impacting the whole world, is experienced in vastly different ways. This article frames and contextualises data from this project through an introduction to the background, contexts, and methods of a project designed to reflect the lived experiences of, perspectives on, and responses to COVID-19 in vulnerable communities across sub-Saharan Africa. The project has been carried out by a large team of collaborators who prioritise the lived experiences, customs, and needs of the communities engaged through a culturally responsive and arts-based research approach. The article points to the methodological implications of arts-based research to explore plural perspectives in participatory ways, and the socio-political possibilities of amplifying the voices of under-represented and under-served communities in Africa, in terms of global health in a pandemic context.

How to Cite: Perry, M., Armstrong, D.M., Chinkonda, B.E., Kagolobya, R., Lekoko, R.N. and Ajibade, G.O., 2021. Whose Crisis? COVID-19 Explored through Arts and Cultural Practices of African Communities. Journal of Open Humanities Data, 7, p.29. DOI: http://doi.org/10.5334/johd.52

"The pandemic has brought into focus the complexity and interrelatedness of physical and mental well-being with cultural and societal structures. It has highlighted the need for responses that can bridge this complexity, that reflect on the global diversity of human experience, and provide a more balanced understanding of the COVID-19 pandemic."


Corona

By Tom Ketlogetswe, Thapong Visual Arts Centre, Botswana

 

Your strength is not in doubt
You are stronger than many imagined

Nations are perishing
Locals are hiding in fear

Your strength knows no boundaries
Your sweeping powers are unimaginable

Leaders across the globe shiver
Heroes are neither spared

The poor have no place to hide
The rich are contemplating hiding in cosy closets

You have unleashed your strength
Indeed you have surpassed your immediate predecessors

Copyright: Tom Ketlogetswe 2020


A drive to remember: ECOaction at work in the Covid-19 lockdown

By Reagan Kandole, Mia Perry, Vanessa Duclos, Raihana Ferdous and Deepa Pullanikkatil

The Covid 19 pandemic continues to expose the most vulnerable people in Uganda’s communities. As the country transitioned towards a total lockdown, banning public transport, strict regulations on the labor force and only essential services — monitored by the health and security sector — the progress and gains made by community initiatives like ECOaction have been threatened. ECOaction is a non profit organisation that creates income and livelihood opportunities for the most marginalised urban youth and women through innovations in waste management. ECOaction is located in Banda, an unplanned settlement of Kampala City, Uganda. The organisation works with the most vulnerable groups of plastic collectors, mainly elderly women and young adults, and provides them with alternative markets for recycled products. ECOaction also builds the capacity of its beneficiaries around waste management and environmental conservation. One of the main challenges in our community right now is that they are not able to sell any of the plastics they collect to the recycling companies during the lockdown, which means they have no money to pay for food to feed their families.

For most of the women we support, the main source of income is collecting plastics and if they cannot move around to collect and sell these bottles, then they are not able to feed their families. Even with the government’s attempts to distribute food to the most vulnerable, not everyone will be able to access that support and there is an urgent need for more basic supplies to be distributed. Otherwise, there is a risk that many people will die of starvation, malaria, stress and many other diseases”. Reagan Kandole, Executive Director of ECOaction.

The photo story below depicts the journey that ECOaction’s team took, despite public transport bans and distancing policies, to reach out to this community


No one is safe until everyone is safe

By Dalton Otim, Research Administrator of the Ugandan hub

 

It’s approximate 5 months now, almost all the countries in the world have focused their attention on the fight against Covid-19 disease caused by Coronavirus. In Africa, particularly in Uganda, its now approximately 3 months since the socio political and economic situation started to be destabilized and affected due to a series of lockdown instituted in phases.

Immediately the first positive patient with Covid-19 was tested, the government swung into action by curtailing personal movements and social gatherings. This was supplemented by a nationwide curfew where people were ordered not to make any movement past 2:00 pm during the lockdown. It is this that made life hard for majority of Ugandans especially those that live in urban areas.

Economically, all businesses not dealing in food stuffs and medicines were ordered to close with immediate effect. All private vehicles were not allowed on the road save for those from institutions which had to be cleared by the minister of transport. It was only big trucks carrying goods from and too neighbouring countries of Kenya, Tanzania, Rwanda, South Sudan and the Democratic Republic of Congo that were allowed to move freely.  Actually, the truck drivers have turned out to be the big challenge that the country has come to struggle with as they are the ones that are testing positive in most testing centres.

Campaigns on encouraging citizens to keep social distance, thorough hand washing and use of face coverings were run everywhere on radios and televisions. The security forces were deployed everywhere to effect the lockdown and indeed many people who tried to do the contrary were beaten, arrested and jailed.

Lessons learnt by the Ugandan hub members from the lockdown

  1. The government measures put in place to limit the spread of the virus have been largely effective as the country has got no any fatality as of 15th May 2020.
  2. Decentralization of policies can work if given support from the centre. In every district, a task force was created, facilitated and given full authority to make sure that all the new people that come in are tested. This has increased community vigilance. How we wish this is extended to other social challenges facing the communities and households.
  3. Many urban dwellers are not food secure not because there is no food supplies but due to lack of purchasing power to access the food. This is a big crisis that all concerned individuals need to interest themselves in. As someone said “No one is safe until everyone is safe”. So as researchers  and community practitioners we need to initiate and engage in projects that will improve people’s ability to withstand such calamities in the area of food security.
  4. Uganda having gone through previous epidemics such as Ebola and others, it prepared it to quickly respond to Covid-19 as well. Click here for details.

Dr Alex Okot, is in Lira during the lockdown and shares some issues this situation brought for the communities the hub works with in Alebtong district.


COVID-19: Impact on Women in Rural Communities

By Kyauta Giwa and Grace Awosanmi, Nigeria Hub

 

Ever since the outbreak of the COVID-19 pandemic around the globe and in Nigeria in February 2020, the effect of the different measures has taken its toll on the survival and livelihood of the rural population. Farming and small-scale businesses, which is largely dominated by women in agrarian and rural communities, have not been exempted from its effects. A large percentage of these women are not educated, and they earn their living through homestead farming/gardening or petty trading. Many of these women who survive on daily sales were shut out of business for weeks. The restriction of movement caused an increase in the cost of living and the prices of goods and essential services, thereby affecting household incomes. Moreover, the women who engage in daily subsistence businesses have found the situation especially difficult. Considering they cannot carry out their business activity as usual, they face a serious threat and a huge economic challenge to their survival and that of their families.

 

The women that are involved in small scale farming produce food for immediate consumption and sell the remainder to help meet their families’ other needs. Rural women are known for transporting goods and farm produce on trucks and pick-up vans when accompanying their goods to the various local markets. The closure of the interstate borders and the stay at home directives issued in the country affected the movement of farm produce from one part of the country to another, leading to an increase in the prices of staple food items. Most people have complained that their food produce is getting spoilt. Despite the lockdown, these women have still found ways of getting their goods to different neighbouring markets. They usually transport their farm produce to the market in groups by hiring vehicles and each person must accompany her produce, which does not permit adherence to physical distancing and thereby exposes them to the pandemic. Sales at the market during at this period were stated to be general low.

 

For rural children, the means of getting an education during this period has been impossible. Most rural women are household heads, and most of them do not own internet enabled phones and therefore cannot afford data for internet connectivity to engage their children on online educational programs. Some of the children run errands or hawk petty wares, wander around or are at the mercy of the neighbours or elders within the communities during the lockdown. Information on the spread of the disease by the Centre for Disease Control was not relayed in local languages, thereby making it difficult for these women to access credible information. Most women lack access to basic information about preventive measures to ensure personal hygiene, thereby exposing them to infection. Poor responses have been seen in most rural areas where people do not believe in the outbreak of the disease and act ignorantly.

 

The low cost of living in rural communities makes it difficult for people to be able to afford hand sanitizer. Most people have never used hand sanitizer before, so many have resorted to producing homemade hand sanitizers using chemical products within their reach. These homemade sanitizers might be unsafe to use, or inefficient. The government should empower and protect the rural women and children in this time of coronavirus by ensuring that they are included in targeted information concerning COVID-19. They should also ensure the inclusion of the agricultural produce by the women in the palliative package as good source of income.


Reflections on COVID-19 - who can be reached?

By Olúwafúnmiládé Eunice Ṣóbọ̀wálé, Ọláwálé Micheal Adébọ̀wálé, Grace Ìdòwú Awósanmí, ADÉYẸMỌ E.O and Samir Halliru

COVID-19 pandemic is a great peril, daunting and daring humanity by bringing extreme contrasts in relationships and communications in our present world. The patterns of communication engaged in the Global South are crucial to the social changes experienced by the population. The use of correct modes and methods of communication enhances participatory and mass communication, bringing about positive and unexpected outcomes. In the Global South, interpersonal relationships and social ties play a vital role in the cultural and traditional communities while embracing changes and developments. These age-old customs of cultural ties have revealed the sensitivity of the communities to spontaneous changes and developments. Perhaps this explains the poor compliance with the measures laid down to lessen the spread of the virus. Most of the traditional communities in Nigeria have found it difficult adapting to:

  1. The lockdown protocol or the restrictive movement order, which suggests everyone should stay home and only go out when necessary.
  2. Avoidance of social distancing or gatherings of large groups at burials and weddings, and also in market and worship places.
  3. No shaking of hands.

For people in the Global South, the importance of complying with these measures has been questioned as a result of their disposition to their culture and traditions. This contrasts with those in the Global North, where the pattern of social interaction is more private. Assenting to the new rules stated above has introduced serious hurdles in stopping the spread, especially in Africa. This is connected to the fact that a large percentage of the population get their means of livelihood daily, which means following the stay-at-home order results hardship. Further conversations with some of the individuals on why they are not obeying the order exposed some pertinent factors that make staying at home problematic. Some of the typical responses are ‘What are we going to eat? and ‘Staying home does not feed my large family’. What is provided is not sufficient for all those in need when compared to the supplies available. Our government’s efforts should be geared towards providing information on the danger of breaking the lockdown.

Whenever the lockdown is relaxed, overcrowding occurs at marketplaces due to the influx of many people coming for supplies within the allotted time. The mingling by the people and the ineffective crowd control at such places raises alarms about the poor adherence to individual safety measures. These situations could be prevented with adequate education and public awareness to ensure the safety of everyone.

No shaking of hands is another measure used to curtail the spread of the virus. Handshaking is an age-old part of the culture of most communities in the Global South; it is used as an expression of gratitude, respect or agreement. The new rule of avoiding handshaking is causing individuals that obey or enforce the rule to face stigmatization and be looked at by members of the community with disdain. In the Global South, addressing this issue will require creative and sensitive local-based education strategies to ensure that everyone adopts this measure.

The communications on COVID-19 by the National Centre for Disease Control (NCDC) in Nigeria are broadcast in the English language, meaning only the rich and educated receive the information and suggesting that that is the only demographic at risk. The crucial information needs to be translated into all the local languages and must be transmitted through local radio programs to educate the masses about taking the appropriate safety measures and how to contain the spread in local markets and places of worship. Also, engaging the use of different social media platforms such as Facebook, Twitter, and discussion groups (zauren hira) will help with compliance. The above strategies will increase public awareness and compliance with the guidelines and bring about a positive connection in moulding the lives of individuals or groups, thereby encouraging the adoption of the COVID-19 measures issued by the government.

In addition, recruitment of local ambassadors within the local communities is essential. Such recruitment will actively involve religious leaders who have influential bonds with their followers. This is important because many local people appreciate a closer link to their local perspectives rather than adhering to concepts that originate at a central.


By Titi Tade, Medical Social Worker, Lagos, Nigeria

 

The COVID-19 Pandemic plunged the world into an unprecedented crisis. Globally, most gaps within the different health sectors in Africa were exposed due to the contagion.

In Nigeria, the initial high of identifying and isolating our index case and his close contacts by the National Centre for Disease Control (NCDC) gradually gave way to the reality of community transmission that has been aggravated by the economic fall out of the lockdown, fear of seeking COVID-19 treatment from government facilities and a general distrust of the government led COVID-19 fight as a scam. Nigeria, as at 5th June 2020, had 11,844 confirmed cases during which Lagos State maintained epicenter status with 4,694 cases.

As a Health/Social Care worker in Lagos State, I am both a member of the public who is worried about the growing rates of community transmission and a member of the “frontline” who has to provide services to the general public within a health system that is in the beginning stages of  being overwhelmed. Prior to COVID-19, the health system had always faced the challenges of gross under-funding, inadequate staffing, brain drain and competition from traditional healers.

On a day to day basis our challenges mirror those of healthcare workers around the world. We worry about getting infected at work and taking the infection home to our loved ones, we worry about insufficient supply of Personal Protective Equipment (PPE) and how to safely reuse them.  Due to the shutdown of commercial transportation during the lockdown, if you did not own a vehicle, you worried about how you would get to work. As the lockdown eases and people resume their daily activities, you worry about community transmission in commercial vehicles as you make your way to work.

Normally in government hospitals, the number of patients that come in on a daily basis number are in the thousands, it is not unusual for a clinic to be run by 3 nurses with 150 patients waiting to see 10 doctors.  During the lockdown, most cases seen in the hospital were COVID-19 cases, emergency cases and a handful of other illnesses but nothing as overwhelming as pre COVID-19 numbers. Unfortunately, as the lockdown is being gradually eased open, the number of infections is rising, and the hospitals are opening to patients who have not been able to see their healthcare professionals in about 2 months for their regular appointments, this combination means that the number of people accessing healthcare services will outstrip the pre COVID-19 numbers. Hospitals and healthcare workers are bracing for the surge in patients with trepidation as we watch how the healthcare systems of ‘developed nations’ are being overwhelmed by treating and responding to the Coronavirus.

As the saying goes, behind every dark cloud is a silver lining. Our silver lining is the fact that since colleagues have been fighting the virus globally for over 6 months now, there are a lot of lessons to be learned from them. The digital age has made it possible for new information about how best to fight the pandemic become available in literally seconds from when the initial author posts the information on the internet. In Nigeria, we have used numerous virtual platforms such as Zoom to conduct trainings on experience learning and best practices for healthcare workers. We have also used the platforms to reach healthcare workers in locations of the country that are only just recording their first infection of the virus. The NCDC is working with affected State Governments e.g. the Lagos State Government, the Federal Ministry of Health as well as State Ministries of Health to ensure a coordinated approach to our Isolation and Treatment Centres and to shorten the timeline between testing of people to hospitalization of COVID-19 positive people. This doesn’t mean that everything works perfectly just yet, but we are learning, adapting, documenting and sharing the new information as we go along.

Everyone has been talking about the “new normal”, but what that is for us in healthcare in Nigeria is still being shaped. Everything from the way patients are booked to visit the hospital, to how healthcare professionals attend to patients will most likely change. These routine processes would now have to respect infection prevention and control measures, physical distancing and, rather harshly, be implemented with the assumption that everyone has the coronavirus until proved otherwise. It will take some adapting to the “new normal” for both healthcare providers and service users but it is a change we must embrace

So…

In Nigeria, we are adapting to these evolving rules for socializing and engaging others. We are adapting to wearing face masks anytime we are outdoors. We are adapting to the ‘new normal’. Being the resilient people that we are, we begun a trend, the fashionable re-usable face masks, which I think will stay, long after the end of the COVID-19 Pandemic.

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