cecilia [dot] von_arnold [at] lucsus [dot] lu [dot] se (Cecilia von Arnold)
- published 10 June 2020
For many countries in sub-Saharan Africa, the health care system was strained already before the coronavirus crisis. Lack of intensive care units and respirators and the difficult economic situation in most African countries limit the resources to combat the pandemic.
LUCSUS researcher Karin Steen, who returned from a teaching sabbatical in Zimbabwe when the corona pandemic broke out, share her reflections on the challenges, impacts and responses to the corona pandemic in Zimbabwe in particular, and Africa in general.
What main challenges are Africa facing when dealing with the coronavirus?
For many countries in sub-Saharan Africa, the health care system was strained already before the coronavirus crisis. In most countries on the continent there will not be enough intensive care units and respirators for all who need it. The difficult economic situation in most African countries limits the resources that governments can use to combat the pandemic. A few countries support their citizens, for example with distributing free food and tax exemptions, but generally African governments do not have the funds to sustain such measures without international aid. In Zimbabwe, the doctors and nurses have been on strike protesting the lack of medical equipment and low salaries for several months since the beginning of last year. They only came back to work after a private donor offered to pay part of their salaries.
Covid-19 is particularly dangerous to the many millions of people with TBC or whose immune systems are weakened by AIDS. In Zimbabwe – and other countries on the continent – people already have poor health as a major part of the population is food insecure, may depend on food aid, and/or is already starving.
Covid-19 could also disrupt ongoing peacebuilding efforts and worsen and generate new conflict situations in several countries. Nevertheless, a positive consequence of the coronavirus is that enemies has agreed on ceasefire during the epidemic such as in Cameroon, the Central African Republic, Libya, South Sudan and Sudan.
How has the virus impacted Zimbabwe and other parts of Africa?
The biological transmission mechanisms of the corona virus are of course the same everywhere, but the pattern and speed of spread varies. In a densely populated township or a refugee camp the virus may spread easier than compared to a village or among nomadic pastoralists.
In Zimbabwe the number of confirmed cases of covid-19 are only 222 and the number of causalities are 4. But only 38.000 tests have been carried out in Zimbabwe so the estimated number of unknown cases can be expected to be much higher. In the beginning of June, there were more than 162,000 confirmed cases, above 4,600 deaths, and 70,000 recoveries of Covid-19 in Africa. These figures are low compared to most other parts of the world. Most African countries still have low official numbers of infected patients, due to their later phase in the pandemic, as not many people can afford to travel abroad, and the lack of testing. Nevertheless, South Africa, which shares boarder with Zimbabwe, has a much higher number of confirmed cases as well as deaths. The connections between the countries are lively and many Zimbabweans live and work in South Africa. Thus the spread of the virus in Zimbabwe is probably much higher than the confirmed cases. However, there are characteristics that may make the pandemic less severe in Africa than in for example Europe. Less than 2% of Africa's population is over 65. and old age is found to be a factor making a Covid-19 infection more severe. In addition, many Africans live in rural areas with limited connection to many other persons.
The Zimbabwean health care staff work with substandard safety equipment using the same equipment the whole day. Many are of course very scared. There are cases where the medical staff has refused to even accept patients onto their premises for fear of being infected.
Many Zimbabweans would not consider to seek medical care if they get sick as they cannot afford it, for fear of being infected at the clinic, and as they know the clinic has no medical material. Much of this approach comes from decades of deteriorating health care facilities in the country.
The first person who died from diagnosed Covid-19 was a 30 year old well known broadcaster who belongs to a wealthy family. There was no respirator available in Harare when he needed one. This came as a chock to many well off citizens who suddenly felt more mortal, realising it does not help to afford good health care as there is not sufficient medical equipment available in the country. The health care system has been bankrupt for years and the elite travels abroad to get health care treatment. Following years of lack of health care supplies, the vast majority, probably, do not expect to get any health care if they get infected.
Consequences of the Lock down
Increased food insecurity and poverty As many countries world-wide decided on lock downs African governments followed suit, but not many countries have the resources to administer a centralised strategy. In general lockdowns may be simply unworkable in the continent.
In order to stop the virus from spreading, the Zimbabwean government decided on a month lockdown mid-March which is now extended until further notice. The problem is that most Zimbabweans live from day to day and have to be out earning money every day in order to be able to put supper on the table every night for their children. Remittances sent to them from relatives abroad has also decreased, putting further stress on people. Relatives act as a security net and a lockdown cuts these social ties. Above 95% of the population work in the informal economy, characterised by low wages, poor working conditions, and little or no social security. Even if the virus is successfully contained, the lockdown will lead to more poverty and starvation. People joke by saying “is it better to die from starving than from corona?” For many Zimbabweans, a week of lockdown is the difference between poverty and starvation. Those who disobey the curfew risk being beaten up by the police and/or the military who are making sure people stay inside during the lockdown.
Most Zimbabweans cannot afford to buy food in the supermarkets which are open some hours each day during the lockdown. The street vendors have to disobey the lockdown to survive, thus the informal markets operate in secrecy, moving into backyards. Some of the vendors will also have economic challenges going back to normal business after the pandemic. The government took the opportunity to tear down informal structures at the major market Mbare in Harare with bulldozers last week motivating it as an act to limit the spread of viruses also after the pandemic. The government has for decades destroyed street vendors stalls as they do not want vendors to be a part of the Harare street view. They have also used bulldozers to tear down property in communities were political opposition reside.
If we look at the neighboring South Africa again, the police and military violence following the actions taken to combat Covid-19 has been accused to have caused more deaths than the virus.
Impacts on households, women and gender inquality
Global evidence shows that when social stress increases, so do cases of violence against women. As repeatedly demonstrated, home is not the safest place for women. The institutional framework addressing the coronavirus crisis often neglect other areas of women’s rights. As an example, sexual and reproductive health services are being down-prioritised even more during this emergency. Again, warnings are raised that gender based violence globally – caused by lockdowns – may demand more victims than Covid-19.
During lockdown of schools, many African girls face increased household chores. Therefore they cannot keep up with studying at home. In Zimbabwe, there are warnings thatt child marriages are on the increase now. Also noticed globally is that the coronavirus is making the centrality of care visible and thus important unpaid and underpaid work is most often carried out by women. With the closure of services and schools, women’s time poverty will increase, with paid work and unpaid work adding up to extremely long days. Thus, there is a risk that the many gender equality gains made by emancipation will have a long lasting backlash after the pandemic.
Africa has a long history of dealing with epidemics like HIV and Ebola. Will these experiences help in dealing with corona?
African nations have learned much from tackling epidemics such as HIV and Ebola. It is argued that one important lesson that should be put to good use as they face the impact of Covid-19 is that communities must be at the forefront of responding. Disease outbreaks unfold differently in different communities and local people know the social conditions best. Another lesson learned is that measures imposed must be supported by the people affected in order to be effective. In this way it can be useful to not consider Covid-19 as one global outbreak, but as uncountable local epidemics happening at one time and with similar but different circumstances.
You were working in Zimbabwe when the virus started spreading in China, what were the reactions in Zimbabwe?
When the first news about the virus reached Zimbabwe the reactions were mild. As in other parts of the world people did not comprehend the enormous force the virus had. The next reaction was to avoid Chinese people. China is active with aid and infrastructural developments in Africa and there is a community of Chinese in Zimbabwe’s capital Harare. Their restaurants had less customers, for example. Then came the rumors. Maybe because many citizens do not trust their government and because of lack of education rumors spread easily for example about the origin of the virus. Is it a US strategy in the trade war with China? Is it caused by G5 technology, as it is spreading fast in Europe but slower in Africa? Or is it God’s punishment?
What do you think this crisis will mean for your future research in Africa?
I guess it will take years until I can conduct research again in the way I did before the pandemic. When travel regulations has been lifted, the virus may still be around and the socio-economic affects will be prevalent for a long time in this already economically challenged country. For example, the vendors have used their intangible capital for food and will not have the money to buy goods to resell. Thus food and fuel supply chains has been closed.
I am convinced the coronavirus crisis will be a crisis people will refer to in my research in the way they refer to the prevailing AIDS situation. For most Zimbabweans, the political limbo and economic crisis with a cleptocratic state decides they stay in poverty. The corona crisis will be yet another stressor with long-term economic effect put on their burden to endure.
Karin Steen is a researcher at Lund University Centre for Sustainability Science (LUCSUS). She has a Bachelor in Economic History from Lund University and a PhD in Sustainability Science from Lund University. Her research background covers for example gendered aspects of small scale farming in Zimbabwe, including analysis of piecemeal institutional change, land and labour rights, and life stories.