Fragile Lives and Livelihoods: We Need to Prepare for the Worst

[Deeq A.]

By: Abdi Ali

The absence of many infections and deaths in Somalia does not mean Covid-19 is absent. Time is of the essence.

Reflect on this unsettling news story:

“The spread of Covid-19 in Somalia rapidly accelerated in the last few days. The latest unofficial death count stands at hundreds and there are no reliable figures for the numbers of those infected. The worst impact of the outbreak seems to be concentrated in major cities.  In Mogadishu alone, hundreds more cases are reported in every district. Road closures, erected in the past year as part of security measures, hampered efforts to bury the dead and bodies are being buried in makeshift graves within the communities, exacerbating the outbreaks. There is a major health emergency everywhere you look.

Panic buying at the Bakaara market – the largest in Somalia – led to stampede and sporadic looting ensued. There are reports of several deaths. Fear of looting meant all shops and restaurants are closed, impacting the food supply and there are shortages of basic necessities. Following significant outbreaks in the police stations and army camps, the vast majority of the army and security personnel left positions, creating a dangerous vacuum.

 All neighbouring countries have put a ban on flights from the country. Dual nationals, who make up most of the government officials, who are caught in this are appealing to their countries for urgent evacuation. With no one seemingly in charge, the people of Somalia are left to their fate….”

This isn’t of course a real story and God forbid things materialise as described. However, when a country’s social and economic fibres are crumbling, the consequences can be horrifying. We need to learn from what is already happening in countries that are in the grip of Covid-19.

We must wake up.

Lives and livelihoods intertwined

A brutal reality for millions of Somalis is that their next meal depends on their going out to earn daily wages in order to feed their families. The spread of Covid-19 could therefore wipe out earners whose dependents are either too fragile or sick to survive on their own. For most, if the virus does not kill them, starvation will.

This is why the idea of locking down towns and cities, without support measures being put in place, are likely to prove catastrophic, nor would the government ever be in a position to enforce it either. It is an invidious choice when, for many, the options are either dying from the virus or from hunger.

Incoherence and confusion will cost lives

The steps the government took to suspend flights and close schools were welcome. However, the “official” Covid-19 numbers are unexplainably low – just a handful in a country where there are no test, trace and isolate processes in place. There is a growing unease that all of this talk about few cases is providing a false sense of reassurance and making the people dangerously complacent. Rather than assuming that the low infection rate is an indicator that the country is largely unscathed, the government should instead be assuming the worst.

It also means the country may well be behind the curve and the next few weeks could be crucial. Rather than underplaying the impact of this, time is now of the essence and the government should be doing everything it can to get its act together.

We need decisive leadership

This is not the time to prevaricate, grandstand or indulge in political skirmishes. Millions of our people’s lives are at stake and the government’s sole focus should be on this virus. Clear guidelines must be issued which outline social distancing, use of alternatives to face masks and self-isolation. People need to understand that many of them will die and that they need to take all necessary precautions.

Lessons learned from other countries provide useful insights. These include:

Setting up a national taskforce

People need information that is unambiguous and reliable. A national taskforce led by someone who is well-respected will transcend political barriers. The taskforce needs to have the budget and authority to coordinate the public information campaign, gather information on where and how the virus is spreading; and (c) coordinate the economic and medical response. The taskforce needs to be supported by relevant experts and report directly to all relevant political leaders across the country.

“Is Badbaadi” Awareness Campaign

Misinformation and wrong beliefs about the virus should be countered effectively. People need to understand (through the media, mass text messaging; loudspeakers on cars / rickshaws on the streets, etc) that the virus does not discriminate. Warnings about the useless and dangerous cures must be amplified.

Recruitment of volunteers

The government should recruit, and pay, hundreds of volunteers to help with the mitigation plan.   These army of volunteers could provide critical intelligence and insights on the spread of the virus and the impact on the communities; support communities with information and advice and coordinate help on the ground. They will be the eyes and ears of the national taskforce, freeing up the police, doctors and nurses to deal with the emergency.

Emergency Economic Support  

The Minister of Finance should start setting aside contingency funding for fighting this outbreak. All non-critical funding needs to re-prioritised, perhaps through an emergency budget. Discussions need to be held with food importers and large market traders to understand their spare capacity for dealing with possible food and medical shortages in the event of panic-buying.

An emergency funding plan needs to be put in place to support food subsidies for people who are most at risk (those in refugee camps, orphans, families whose breadwinners have died from the virus, people in lockdown, etc). We need to understand what is happening outside of Mogadishu – in refugee camps and other towns across the country so that food and medical supplies can be prepositioned as needed.

The Central Bank of Somalia should consider opening COVID-19 Appeal Fund into which Somali diasporas and others can donate directly. These funds should be prioritised for the families impacted by Covid-19.

Political Stability

All relevant government ministries (e.g. internal security, home affairs, defence) need to think through the implications of infections within the police and armed forced. For instance, they need to develop contingency plans for potential outbreaks of violence, looting; how to secure key food and medical supplies; how to enforce potential lockdowns; mass troop desertions; terrorists taking advantage of this.

Government of National Unity

It is important for the government to include key opposition politicians into the discussions. The decisions made during the outbreak could have far reaching implications for the country and would require legitimacy and wider support.

Succession Planning: If both or either the president or prime minster are struck by the virus or incapacitated, who will stand in for whom? Having a clear plan for ensuring political stability will be critical.

Temporary tent hospitals

There are more “presidents” in Somalia than public hospitals. There are no dedicated facilities for treating people with the virus. A large proportion of the papulation is likely to have underlying health problems as a result of three decades of war, and may not even know it (malaria, diabetes, blood pressure and tuberculosis, to name a few). Millions of children and adults suffer from malnutrition and weakened immune systems, making them susceptible to this deadly virus.

This means the risk to the most vulnerable in the population is particularly elevated. When a large number of people get infected and become seriously ill, they will head for the few public hospitals they know, leaving a trail of infections. The burden on the hospitals will be overwhelming.

Designated Covid-19 Hospitals: The government should consider setting up Covid-19 tent hospitals in the areas outside of crowded districts, making use of football grounds as appropriate. These tent hospitals will provide food and basic hygiene services to help nurse victims back to health. Ringfencing patients this way will help contain the spread of the virus and make sure the limited number of other hospitals are free to deal with non-Covid-19 patients safely.

Designated Burial Sites:  Appropriate burial sites need to be identified early to prepare for the potentially large number of deaths. Body bags need to be ordered.   

Ambulances: Dedicated ambulance services need to be set up to collect victims from the community, and mortuary vehicles to collect the bodies.

Mogadishu’s Roads: Most of Mogadishu’s roads have been closed for almost a year and are inaccessible to ordinary people. There needs to be a way of making sure the bodies of Covid-19 victims can be transported quickly and securely. If bodies were to pile up in houses because people cannot access the roads, the spread of the virus and risks to the wider public health is potentially catastrophic. The government must come up with a plan for this.

Virus Hotline: The government and telecom companies should work together to set up free hotline for reporting infections and deaths. The hotline can be managed by volunteers to gather information on the virus and ensure victims’ bodies are collected.

Exit Strategy

The government should seek the help of relevant experts on how to contain the virus. Getting the country back to normality, whilst ensuring any second wave of infections are managed appropriately, should also be a top priority.

Let us be focused and united in our determination to save our people. We need to prepare for the worst and hope for the best.

“Shar ku tasho kheer wax kaama dhibee”.

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