Governments have acted quickly to put travel bans, self-quarantine, and other preventative measures in place. These are critical steps taken towards curbing the spread of COVID-19, but an outbreak in areas grappling with congestion, lack of access to clean water, and weakened health care systems will likely face a new humanitarian crisis.

The tens of millions of people around Africa who are living in overcrowded displacement camps and informal settlements, often with poor access to health care, clean water and sanitation, are particularly vulnerable to COVID-19. They cannot practice social distancing. At the same time, if the virus spreads into places with active conflict, cases will be harder to trace.

The fear now is that unless urgent action is taken to curb the spread of the COVID-19, the virus could take hold in some of the world's most vulnerable communities, with devastating consequences. The ICRC's work to serve people affected by armed conflict and violence in Africa will not grind to a halt because of COVID-19. More than 40% of ICRC's operations are in Africa. Many of these programs are life-saving and in places where few other organizations have access.

A coordinated response

All delegations in Africa are reorienting their plans to face the challenges ahead, both in terms of adapting existing programs to respond to the shifting needs COVID-19 creates and developing new programs to tackle COVID-19 head-on.

Across the continent, the ICRC is working with Red Cross and Red Crescent volunteers to share accurate information on COVID-19 and how people can protect themselves and their families from the disease. This includes radio spots, small group sessions, flyers, posters, tv spots, and targeted information campaigns inside places of detention.

Burkina Faso

In Burkina Faso, some 1.5 million people have seen their access to health care cut or seriously reduced since 2019 due to the escalation of violence. As of February 2020, some 109 health centres were closed and 140 were operating at minimum.

The ICRC is running radio spots to share information on how people can protect themselves from COVID-19. In areas where people have been displaced from their homes by violence, the ICRC is continuing to improve access to clean water and soap. The ICRC will also distribute soap and hand sanitizer in places of detention and train guards in infection prevention and control.

Mali

Access to health care in Mali is limited as conflict and underinvestment has forced some health care facilities to shut down. Nearly 20% of health care facilities across Mali have been partially or completely destroyed and 93% of facilities in the north have been completely destroyed. Those that remain are totally overwhelmed with injuries from conflict and general health needs of IDPs.

Right now, the ICRC is setting up an infection prevention control in all the primary health clinics that the organization supports, including quarantine capacity at two facilities. The ICRC is also prepared to set up transit sites for suspected COVID-19 patients before they are transported to treatment centres. Chlorine, chlorine sprayers, and other disinfectant equipment will also be provided to health care facilities.

South Sudan

People in South Sudan must often walk for hours, and even days, to reach the nearest health care facility. The WHO estimates there is only one physician for every 65,000 people, while less than half of the health care facilities in the country are functional.

In addition to adapting how the ICRC treats gunshot and other life-threatening injuries, the organization is supporting the National Prison Services of South Sudan to run information sessions on COVID-19 to prevent the disease from entering places of detention. The ICRC is also installing handwashing facilities in the most populated prisons and distributing hygiene items to detainees.

Somalia

Less than 50% of people living in Somalia's urban areas have access to medical care. In rural areas, it drops to only 15%. The country suffers from outbreaks of measles and other diseases and one million children are estimated to be malnourished.

The ICRC has provided tents for isolation to the Mogadishu hospital that it supports, which can be used if there is a surge of cases of COVID-19. Health education sessions are being conducted in addition to providing soap to communities, clinics and hospitals, together with the Somali Red Crescent.

The ICRC is also implementing a surveillance system (EWARN) and contact tracing at the clinics' level in collaboration with Somali Red Crescent to collect information and monitor suspected cases. Hygiene items are being provided in places of detention. The ICRC is also providing soap, chlorine tabs and hygiene information on COVID-19 to more than 120,000 households with the help of Somali Red Crescent volunteers.

The Democratic Republic of the Congo

The Democratic Republic of the Congo is still reeling from an outbreak of Ebola. It also suffers from chronic outbreaks of disease like cholera and measles. These outbreaks put a further strain on local health services, which are now also facing COVID-19. There have also been indiscriminate attacks on the delivery of health care services and humanitarian aid.

In response to the threat of COVID-19, the ICRC is supporting the Ministry of Health in setting up quarantine and isolation measures in two provincial hospitals in Bukavu and Goma. The organization is also training staff in eight referral hospitals in suspected case isolation and helping all supported clinics and hospitals in infection prevention control measures.

The ICRC will continue its health care visits, training staff on the symptoms and case management, and putting in place infection control measures to reduce the risk of the virus from entering places of detention in the first place. With family visits no longer allowed in places of detention, the ICRC is looking into scaling up food and other assistance to detainees.

Cameroon

In the Anglophone region of Cameroon, The ICRC's teams are delivering soap and other household goods to 650 families. However, going forward, there are planning to distribute 22 tons of soap and 44,000 jerry cans in prisons and communities in different parts of the country. The ICRC also plans to provide bleach and cleaning products to detention centres.

Ethiopia

The ICRC is providing soap to detainees and setting up handwashing stations in 20 places of detention in Ethiopia, reaching 40,000 detainees. These initial places of detention were selected based on their sizes in relation to the number of detainees they have, and their proximity to cities and towns.

In addition, the distribution of flyers in places of detention with information on COVID-19 prevention, symptoms, and actions to be taken if someone is sick is ongoing. The ICRC is also sharing guidance and recommendations with authorities to limit the risk of outbreaks of COVID-19 in places of detention. Together with the Ethiopia Red Cross, the organization is sharing information with communities on prevention measures such as handwashing and physical distancing.

Kenya

The ICRC is working together with the Kenya Red Cross to support the Kenya Prison Services on infection prevention control, helping to develop protocols, providing hygiene training to prison staff, supporting the installation of screening, quarantine and isolation facilities, and guiding authorities on humane management of the restrictive measures imposed on the daily life of the inmates.

Djibouti

In Djibouti, the ICRC is working in coordination with the Ministry of Justice to conduct an awareness session for the staff and management of Gabode prison and shared protocols on infection prevention and control. Hygiene items, personal protective equipment and materials to set up the screening station at the gate have been provided to the prison management.

Southern Africa

From the ICRC regional delegation in Pretoria that covers southern Africa, the ICRC is appealing to governments to suspend all arrest and forced deportation of migrants to prevent the spread of COVID-19 in holding facilities and in the region. Countries of return are mostly countries with compromised health care systems due to conflict and armed violence.

The vulnerability of migrants, notably those in irregular situations or living in precarious conditions, should be factored in any national plan to respond to COVID-19, to ensure their adequate access to information, their inclusion in the prevention response and their access to health care should they fall sick.

Sudan

In Sudan, the ICRC is accelerating efforts to get communities access to water by repairing dozens of handpumps in Al Geneina, West Darfur, which was the scene of clashes earlier this year and home to tens of thousands of displaced people. There are also plans to provide soap and COVID-19 health education.

The ICRC is speeding up an urban water project together with local authorities in Damazine, Blue Nile State, where the town's existing water supply is under severe strain due to the growing presence of displaced people around its periphery over the years.

Additionally, the ICRC is helping federal and state Ministries of Health to build up contingency stocks of gloves, gowns, disinfectant and personal protective material. It plans to offer support to detention authorities for hygiene promotion with water stations, soap, awareness messages and posters in prisons. At the same time, the ICRC is supporting the Sudanese Red Crescent Society in their health activities, and their COVID-19 awareness campaigns, especially where the ICRC is working in Darfur, Blue Nile and South Kordofan.