By Epiphania Ngowi and Emmanuel Sulle
As we continue to face huge impacts of this unprecedented COVID-19 pandemic, not only on our lifestyles but also our approaches, strategies, and policies to combat this pandemic must swiftly change as the need arises.
Globally, leaders keep revising their strategies as they grapple with the devastating impacts of COVID-19 on lives of the people and economy, and also on their own political life. Nevertheless, all policy and political decisions must be informed by science, local knowledge and skills. Ignoring scientific recommendations may have disastrous impact on human lives and future economic outcomes.
As scientists from all corners of the world seek to decode the virus and find medicines and therapies for this novel virus, they too have been changing their approaches such as the recent trials of placing people suffering from severe coronavirus on their stomachs help them increase the amount of oxygen getting into their lungs.
Yes, this is a novel virus. We are still trying to understand it, figuring out not only how to stop the outbreak but also how to treat the victims and cope with it and the new environment it brings:. Tanzania and many other African countries are no exception.
From no need for masks to masks for all?
Despite the initial guidelines that masks are only essential for frontline health workers, for those infected by the virus and or people taking care of those infected persons, we may have to wear masks in public all the time and in all the gatherings if we are to beat this Pandemic. The United States Centre for Disease Control recommends that people wear simple cloth made masks to prevent spreading the virus most because there are those individuals who might be infected but remain asymptomatic.
In Tanzania, key hospitals like the Muhimbili Orthopaedic Institute (MOI) in Dar Es Salaam and Kilimanjaro Christian Medical Centre (KCMC) in Kilimanjaro have also issued guidelines requiring a mandatory wearing of masks for anyone entering these hospitals regardless of one being a patient or regular visitors.
Implement lockdown or what alternative?
While all hard hit countries in Europe and East Asia and even our own neighbours in East Africa, Uganda, Kenya and Rwanda have all implemented lockdown, the Tanzania government has not implemented such drastic measure despite numerous calls to put it in place. Instead, the government started with awareness raising campaigns, closed all schools and universities, stopped all mass gatherings including political and public gatherings. It allowed short churches and mosques services to be conducted in less congested facilities, and left other services including bars to operate. It has now banned all international flights. We believe, given the continuing outbreak, further actions including strategic lockdown are unavoidable.
Lockdown in informal settlements?
Some analysts and bureaucrats in Africa and Tanzania as well have raised some genuine reasons why lockdown may not work in Africa. Indeed, it is important to note that on the African continent and in each country coronavirus will have differentiated impacts among the populace.
While lockdown is the best known option, it is difficult to implement social/physical distancing for people living in slums/shacks and or highly congested suburbs/informal settlement and they then may be at higher risk of catching the virus. It is also hard for these people to stay indoors without government intervening to provide sufficient access to food and basic income.
Food during lockdown?
In many African countries the lack of daily access to basic needs especially in slums, informal settlements and some suburbs is the key challenge. It is definitely a big issue in rural villages to implement a lockdown where people depend on their farms and livestock to derive their basic household food stuffs. Therefore, it is essential that government looks at ways to limit inter-personal contact, while also providing or allowing access to food.
The South African government which quickly implemented the lockdown received praise and criticism. In the South African case, however, those who opposed blanket lock down floated clear proposals for example, academics and social movements demanded changes in some of the government’s restrictions to allow street vendors and spaza shops to operate to allow people to access food and gain some basic income. The government amended several restrictions to ensure essential services are restored in the country. However, food remains an ongoing problem with some shops being looted in order for poor South Africans to access food. Elsewhere in Sri Lanka the army is being pressed to deliver food to people in neighbourhoods to buy.
A call for changing lifestyles and behaviours?
Around 6pm, 15 April 2020 we were driving home back from a quick grocery shop. A radio presenter stated, ‘it is time for people to stop sharing a bowl of food because by doing so you are not keeping enough social distancing and increasing the possibility of touching other peoples’ hands and therefore a possibility of spreading coronavirus.’
Earlier in the day the government of Tanzania announced that there were 26 new cases of COVID-19 in Tanzania taking the total confirmed cases to 88 and 4 deaths. As we write, however, the cases of coronavirus in Tanzania, have reached 147 cases and deaths remain at 4 people. As we finalise this piece, on the 17th April, globally, the World Health Organisation reported 2,078,605 confirmed cases of COVID-19 including 139,515 deaths. These statistics keep getting worse. The African continent remains the least affected one with 12,360 confirmed cases but the curve is sharply rising.
With these statistics in mind, surely we have to make difficult choices during this pandemic to prevent its further spread and protect humans from future outbreaks.
For example, if the pandemic persists in informal settlements in African countries, isn’t it time to improve planning? Planning done by people themselves, well-informed of their own needs and the need to avoid dangers of unplanned areas. It is also necessary to address the underlying reasons these informal settlements come about in the first place.
Already, Harvard University Health Experts have warned that we may have to continue practicing social distancing until 2022. In addition a renowned infectious disease expert Dr Anthony Fauci is urging people to stop hand shaking forever. Impacts that dirty hands causes in our lives are huge, since diseases spread to children from parents and visitors’ dirty hands, with people touching each other whenever they meet.
Coronavirus is a wakeup call for improved personal hygiene, enforced where necessary, such as a complete ban on spitting in public spaces and observing coughing etiquette. Even if COVID-19 is contained, the vigilance and care taken over travel hygiene should never disappear and travel will never be the same – for the better health for all.
Missing Indigenous or traditional skills and knowledge
Our response to the virus is also missing indigenous peoples’ skills and knowledge not only on how to deal with a Pandemic but also on curbing the spread through physical distancing. Those African leaders who claim this is impossible might have forgotten that some communities practice social distancing. For example, Katherine Snyder has shown among Iraqw communities of Tanzania, that they used to manage the threat of illness and disease by imposing their own quarantines until it was determined that danger of contagion was no longer a threat. Current policy makers must remember what treasures our communities had and/or continue to have that we can employ to mitigate the current crisis.
What’s next then?
If we are to combat the COVID-19 spread now, African countries like Tanzania need to take on board peoples’ views, learn and adopt workable strategies from other countries including African states to implement strategic lockdowns of hotspot areas to curtail the outbreak. This may include limiting peoples’ movement in and out of hotspot areas while ensuring that people in those areas have access to basic foods and income during the lockdown.
Along with all these measures, experts’ warnings, guidelines especially those by the government, World Health Organisations including mass testing, awareness raising must be prioritised. Since we are all in this unprecedented pandemic, let transparency reign from household level to community level and from national government to international communities as a means to curb the spread and damage caused by COVID-19. Let us all be guided by compassion, love and hope. In solidarity, unity and trust in our science and indigenous knowledge, we can all get through this pandemic and rise again.
Epiphania Ngowi is a Master’s student at the School of Public Health, University of Cape Town and Emmanuel Sulle is a Research Associate at the Institute for Poverty, Land and Agrarian Studies, University of the Western Cape, South Africa.