COVID-19: Response In Africa
International Medical Corps has already been working closely with Burundi’s Ministry of Health (MoH) and other key stakeholders to protect the country from Ebola, and has leveraged these preparedness activities to support the country’s COVID-19 contingency plans. Our team activated 10 COVID-19 steering committees in 10 health districts and trained rapid response teams, establishing district-based coordination in the provinces of Muyinga, Ngozi, Kirundo and Kayanza, bordering Rwanda and Tanzania. With support from International Medical Corps staff from the DRC, the Burundi mission has provided training on COVID-19 for almost 600 healthcare providers and provided training of trainers for an additional 67 MoH personnel. Since the start of the pandemic, the country team also has helped the government conduct screening and follow-up at Bujumbura International Airport, examining incoming passengers from countries with confirmed cases of COVID-19, and it has provided training on COVID-19 risks communication to more than 1,000 health and non-health personnel at the airport and the hotels where suspected cases are quarantined. Today, our Burundi team continues to help the MoH expand COVID-19 response capacity at the provincial level, strengthening provincial training committees, setting up district rapid response teams and improving IPC and WASH conditions in health facilities, including five provincial hospitals, refugee camps and points of entry. We also began constructing COVID-19 triage units at the five provincial hospitals we serve. Through a local partner, International Medical Corps continues to conduct community outreach and education programs through engagement with religious and administrative leaders.
Although there has been a slight reduction of the number of new cases in recent weeks, limited testing capacity and non-adherence to precautionary measures such as social distancing remain key risks for the spread of the pandemic, particularly in insecure or hard-to-reach locations. The coming weeks will be critical, as the country resumes normal life and business in spite of ongoing community transmission, with nearly 7 million children set to resume school on October 5 after more than 31,850 schools were closed in March. International Medical Corps has been responding to COVID-19 by screening patients, training healthcare workers on prevention and treatment, raising awareness in refugee camps of COVID-19 and how to prevent it, and distributing PPE to frontline health staff. Since March 27, our team has been implementing a COVID-19 response and prevention project in the Minawao refugee camp in the Far North, which hosts more than 60,000 refugees, and where malnutrition is widespread. To date, health teams have trained 26 health workers and 165 outreach volunteers in COVID-19 prevention, screened 4,987 patients for COVID-19 and reached 121,548 people with COVID-19 prevention messaging. Our community health workers in the Far North have also distributed 28,149 items of hygiene and PPE. In Cameroon’s East region, we have trained 93 community health workers who have reached 60,041 people in vulnerable communities with COVID-19 prevention education. We also recently started a gender-based violence (GBV) program in the East region that seeks to improve access to GBV services in a COVID-19 context among 8,000 women and children.
Central African Republic
International Medical Corps was asked by the USAID Bureau for Humanitarian Assistance (BHA) to lead CAR’s Community Engagement Committee, a consortium that also includes Oxfam, the Danish Refugee Council and Concern Worldwide, to support the country’s COVID-19 response. Activities are now launching to help populations in Bangui and its major corridors that will target more than 373,500 community members. The program will strengthen response capacity for COVID-19 detection at the primary healthcare level, improve community hygiene activities and improve psychosocial support for infected patients and their communities. The program will also target a large number of children who live on the streets and represent a very large and vulnerable portion of CAR’s urban youth. So far, we have distributed almost 1,500 bars of soap. Additionally, International Medical Corps supported three treatment centers in hospital settings and reached almost 44,000 community members through COVID-19 awareness-raising activities, all through traditional, face-to-face methods.
The Chad country mission closed in June 2020. Before the closing, International Medical Corps completed a two-month project responding to COVID-19 at Chad’s UNION district hospital in Ndjamena. Our team trained 50 Ministry of Health staff on how to use PPE, how to detect COVID-19 symptoms and triage patients, and how to implement IPC measures. In addition, our team provided 10,060 non-sterile gloves, 600 gowns, 1,240 pieces of soap, 120 units of bleach, 650 face masks, 10 bottles of hand sanitizer gel and 20 pairs of protective scrubs to the hospital.
Democratic Republic of the Congo
International Medical Corps is supporting 92 facilities in the DRC with COVID-19 activities, including 90 primary healthcare facilities and two hospitals. So far, 83,750 people have been screened for COVID-19 at these facilities, with 680 suspected cases. To date, the DRC team has provided COVID-19 training for 803 healthcare personnel, including 487 community health workers and 117 Ministry of Health (MoH) medical staff. The DRC mission is training additional MoH staff at 82 health facilities on COVID-19 IPC measures through on-the-job training. Current national COVID-19 preparedness and response activities in the DRC are centered in the capital city of Kinshasa, but International Medical Corps’ network of screening and referral units (SRUs)—set up over the past 18 months to fight DRC’s Ebola epidemic—have the potential to conduct wide-scale COVID-19 screenings. International Medical Corps has set up 95 such facilities in 11 health zones along the border of eastern DRC. So far, 91 International Medical Corps staff members working in SRUs in and around Goma have undergone training on COVID-19 case management and IPC measures. International Medical Corps is in the process of setting up 20 soft triage units at supported health facilities in Fizi and Kalemie health zones, and has identified community-based organizations that will receive training on basic COVID-19 IPC as well as risk communication. Trained community health workers (CHWs) are raising awareness among their peers in small groups using MoH approved tools provided by International Medial Corps.
The country team continues to participate in national and local-level COVID-19 coordination meetings with different bodies, including government agencies and other implementing partners. Between mid-April, when we began the process and late June, our team screened 33,417 patients for the virus in facilities we support, referring 186 suspected COVID-19 cases for further observation and possible testing. The team trained 715 frontline staff and supported 63 health facilities. Training included staff from International Medical Corps, our partners, Ethiopia’s Administration for Refugee and Returnee Affairs (ARRA) and host-community health workers. Also, 8,957 community residents participated in COVID-19 awareness-raising activities. The team has indirectly reached 1.1 million beneficiaries through mass-media campaigns that include banners, posters, fliers and radio messages. Unsettled security conditions in recent weeks have hampered efforts to update these figures. Our training has focused on COVID-19 awareness, how to identify symptoms of the disease, the proper use and handling of personal protection equipment (PPE), case management and psychological first aid (PFA). Our team in the town of Dollo, in southeastern Ethiopia near the country’s border with Somalia, is screening refugee traffic at the Dollo Ado reception center for evidence of fever.
International Medical Corps in Libya mobilised quickly to address the threat posed by COVID-19, training rapid response teams working for the country’s National Center for Disease Control (NCDC) about the virus and its symptoms; its prevention, transmission and treatment; how to conduct contact tracing; and how to use PPE. International Medical Corps was the first international NGO operating in the country to support the NCDC by donating PPE for its rapid response teams. We are also training health staff in all of our supported facilities on how to respond to suspected cases of COVID-19, as well as providing supplies of necessary PPE. Starting in June, in response to needs identified in consultation with the Libyan government, we began supporting five hospitals with training and PPE, while strengthening their capacity to triage and isolate COVID-19 patients. Our efforts have focused on the cities of Sabha, Tripoli and Misrata, which are experiencing the highest numbers of COVID-19 cases. In the Tripoli area, we have trained community health workers from migrant communities to ensure that they receive correct information about the virus and are aware of appropriate services that are available to them. Our mental health counsellors continue to support our primary healthcare teams at three field locations while preparing culturally appropriate COVID-19 messages for an online awareness-raising campaign on a country-specific COVID-19 Facebook page. The counsellors, together with our MHPSS specialist, are training municipality emergency committees on psychological first aid, and on how to deal with the combined stress of COVID-19 and the ongoing conflict. Beginning this summer, we have transferred our GBV programs to a remote case-management system that ensures survivors can still access our services when restrictions on movement outside the home are in place. Our GBV/protection team is training social workers from the Libyan Ministry of Social Affairs about the heightened risks of GBV that can occur as tightening restrictions on movement and curfews force more survivors to spend prolonged periods inside their homes with their abusers. In July, the team started similar training for frontline healthcare workers as well, to give them a broader understanding of the impacts of COVID-19 on women and girls.
The COVID-19 pandemic is at a critical juncture in Mali following a military coup on August 18 that led to the dissolution of the current government. With no resolution yet reached on the transitional government, the future of COVID-19 response, prevention and testing efforts are now in jeopardy, with cases on the rise. International Medical Corps has been responding to the COVID-19 pandemic in places where we have active programming, including Timbuktu and Ségou, by training health staff, disinfecting key public places and health facilities, and distributing medicine and WASH supplies. We so far have reached 70 health facilities with COVID-19 activities and trained 136 frontline staff on COVID-19 treatment and prevention. As part of the national COVID-19 Task Force of the Health Cluster, International Medical Corps’ Mali team meets regularly with governmental counterparts in capital, Bamako, to determine needs and provide technical support, collaborating with such partners as ECHO, OFDA, WHO and UNICEF. The team also has worked with the MoH to fully disinfect 10 mosques, six community health centres, one referral health centre and one regional hospital in Timbuktu. Subsequently, we provided WASH kits to these 18 facilities, along with two women’s centres that provide gender-based violence (GBV) support. We also supported the organization of a mass COVID-19 awareness campaign in Timbuktu with the local youth council, reaching more than 5,000 people. In Ségou, our Mali team has distributed handwashing materials to 19 health clinics and 39 public sites and launched COVID-19 activities in 19 communities in the San health district, including prevention education and the distribution of hygiene supplies. In addition, we recently launched COVID-19 response activities in central Mali in Gourma Rharous, which includes training for health facility and mobile clinic staff, support for the isolation and management of suspected cases, community awareness-raising activities and efforts to improve infection prevention at health centres. International Medical Corps health volunteers have reached more than 10,780 people with COVID-19 information since March. To ensure the safety of volunteers and frontline health staff in Mali, International Medical Corps has provided more than 5,910 PPE and hygiene items.
In Nigeria, International Medical Corps has been responding to COVID-19 by training community volunteers on IPC and referral pathways for health services and serving on the national COVID-19 Task Force. To date, we have trained 1,873 community volunteers who are delivering health education in vulnerable communities and seven internally displaced person (IDP) camps. They have reached 87,162 people with COVID-19 messaging and delivered 1,514 sanitation supplies, including hand sanitizer, face masks and chlorine for water treatment. Our WASH team has collaborated with other humanitarian partners to distribute 444,940 bars of soap to households and has put in place an additional 107 handwashing stations in IDP camps. Our nutrition team continues to provide services through 15 outpatient therapeutic programs, providing COVID-19 prevention messages during nutrition screenings for 24,675 children. On July 1, the country team started a new COVID-19 program in Damboa that will support WASH activities at five IDP camps, provide supplies and capacity-building support for IPC to one health facility and ensure that protection and GBV prevention are integral to all activities. This project will target 166,000 beneficiaries, including 99,000 IDPs. Our food security and livelihoods team continues to provide cash-based transfers and commodities to 130,896 people while providing education on COVID-19. The team will soon expand to Kano, to provide cash-based transfers to 12,700 households and support general food distributions provided by the government to 63,500 beneficiaries. The team also provided a refresher training of volunteer community mobilizers on COVID-19 prevention, with 72 female participants.
In Somalia, International Medical Corps is coordinating its response to COVID-19 through the Ministry of Health at both the federal and regional government levels and is a member of the Inter-Agency Risk Communication and Community Engagement Taskforce. In Galkacyo South—about 500 miles northwest of Mogadishu—we completed a COVID-19 isolation centre within the Galkacyo South Hospital. Officials from the Galmudug Region’s Ministry of Health presided over a formal opening of the facility in mid-June. Elsewhere, we have donated PPE to humanitarian partners in Jowhar, including humanitarian-aid organization INTERSOS, the Federal Ministry of Health in Mogadishu and COVID-19 isolation centres. In addition, we have trained 604 staff on IPC measures, how to recognize COVID-19 symptoms, how the virus spreads and how to use PPE. Our GBV team has conducted focus group discussions with women and girls across our four operational areas, asking what they know about COVID-19, how they receive information and what their main concerns are about the virus. We have also conducted a baseline survey of COVID-19 knowledge, attitudes and practices in our areas of work, conducting the survey remotely to avoid the risk of transmission. We included phone-based household questionnaires and key informant interviews with several stakeholders, including Ministry of Health staff, traditional birth attendants, traditional healers, health centre committees and religious leaders. International Medical Corps-supported health facilities in four of Somalia’s 18 regions continue to screen beneficiaries for signs of the virus. We screened more than 11,000 people during the first two weeks of August across our operational areas. To help with messaging, we have posted materials in the Somali language about COVID-19 at all our offices and in health facility waiting areas. In addition, we are broadcasting radio messages about COVID-19 on popular FM stations to reach as many beneficiaries as possible.
International Medical Corps continues to help lead the pandemic response in South Sudan, serving as co-lead of the country’s COVID-19 Case Management and IPC Technical Working Group. We have been a major contributor in developing the national case management strategy, as well as developing and upgrading a clinical management guide based on current WHO and CDC protocols suited to the South Sudanese context. Our country director also has joined the South Sudan NGO Forum Steering Committee as an advisory member to assist the group with COVID-related advocacy, planning and preparedness. An infectious disease unit (IDU) that we co-manage in Juba is the sole medical facility in the capital as well as the biggest in the country capable of treating COVID-19 patients. This facility, which has a staff of more than 100, has admitted and managed 116 suspected and confirmed COVID-19 patients. In addition to inpatient medical care, our staff provides nutritional and psychosocial support and trains South Sudan healthcare workers on infection prevention and control (IPC) and clinical management of COVID-19 patients, training more than 320 healthcare workers since March. International Medical Corps is looking into building a Level III intensive-care unit at the Juba IDU, in response to a formal request from South Sudan’s Ministry of Health and the WHO. If completed as envisioned, the facility would be the first of its kind in the country that would be fully accessible to the public and capable of providing comprehensive critical care, including life-support systems. It would also allow for eventual teaching and researching components. In other areas, we are screening all entrants to protection-of-civilian (PoC) camps in Juba, Malakal and Wau. As of late August, we have screened more than 40,000 people in all three camps. In addition, we have put in place an adapted triaging system at the PoCs to pre-sort patients symptomatically to reduce transmission inside health facilities. Since April, we have provided on-the-job training and supportive supervision to more than 300 healthcare staff at the Juba IDU and the PoCs across a broad range of issues, including case management, standard precautions of IPC, COVID-19, nutrition and anthropometry, safe patient transportation and psychological first aid (PFA). As of late August, we had reached 54,443 people living in the PoCs with risk communication messages focusing on IPC and behavioral change. We also provide home care remotely for COVID-19 patients exhibiting mild and moderate disease symptoms in communities where we operate, and in the PoCs.
International Medical Corps continues to respond to COVID-19-related issues in West Darfur, South Darfur, Central Darfur—all states in Sudan’s Darfur region—plus South Kordofan and Blue Nile states, in southeastern Sudan. Our community health workers and volunteers reached 5,798 individuals between August 5 and 19 with COVID-19 awareness and sensitization messages at health facilities that we support. We also aired health awareness messages about COVID-19 on a local radio station in Central Darfur, and plan to air similar messages on another four radio stations. We have received samples of information, educational and communications materials developed by the Ministry of Health (MoH), and will translate them into local languages before printing and distributing them in areas of where we operate. We screen all patients for COVID-19-related symptoms who arrive at the health facilities we support and ensure that all health facilities are practising IPC guidelines in accordance with established protocols. In all five states, we continue to participate in the MoH-led coordination meetings and discussions, interacting with the other stakeholders. Our staff has presented plans for COVID-19 responses for the respective states. In Central Darfur, we have selected more than 120 volunteers to be trained in a community-based surveillance system. These will form a network that will engage in community education, reporting and referring to any suspected cases, providing communities with feedback on any issues and conducting contact tracing when required. International Medical Corps staff in other states are also selecting volunteers in preparation for their training and engagement. International Medical Corps received PPE that will be distributed to some of the health facilities in the coming weeks. Our clinic staff will be trained in the proper use of PPE, as well as in how to monitor and report on PPE use.
The COVID-19 situation in Zimbabwe continues to deteriorate rapidly. At first, the virus was spread by an influx of returning citizens from South Africa and Botswana, fleeing lockdown-induced economic hardships and job losses, but community transmission has been on the rise lately. Although the healthcare system was already overstretched before the pandemic, the situation has now worsened dramatically. For more than a month, 15,000 nurses have been on strike over their decreasing wages, affecting all healthcare services. International Medical Corps is implementing two COIVD-19 projects in Zimbabwe. In the first, we are providing WASH and community hygiene promotion activities for more than 31,000 people in Binga, one of the most impoverished, marginalised districts in Zimbabwe, which faces severe water scarcity due to years of drought. In the second, which we are implementing across three provinces, we are targeting 17 health facilities, aiming to rehabilitate WASH facilities within COVID-19 isolation areas. Through our recently completed Amalima Project, our team and their partners have collaborated with the Ministry of Health and Child Care to develop educational materials for communities about the COVID-19 pandemic. The program developed 100,000 fliers and 12,000 posters for communities in Bulilima, Mangwe, Gwanda and Tsholotsho on COVID-19 prevention. Those materials have been widely distributed in partnership with more than 300 community health workers who serve in vulnerable communities. We also helped provide 300 bicycles for these community health workers—enabling them to more easily reach remote areas with COVID-19 messaging—as well as 6,000 reusable masks. International Medical Corps has supported two treatment centres and 15 hospitals, training 117 frontline staff since late February and reaching more than 703,000 people. Since early July, we have distributed more than 12,450 PPE and IPC items, including masks for healthcare workers, soap, sanitiser and gloves.