“Our awareness-raising activities are now mostly focused on preventive measures against the COVID-19 pandemic. Informing the local population about the disease will help to prevent transmission within communities,” said 37-year-old Adamou Abass, who is in charge of the health and nutrition programme for the international non-governmental organization (NGO) Action Against Hunger (ACF Spain) in the Tahoua region of Niger.
Nationwide, the pandemic has resulted in the disruption of infant and child feeding practices due to a slowdown in prevention nutrition awareness activities and a reduction of access to health and nutrition services by people who are not using medical facilities during this time. Abass is among many humanitarian workers in Niger who have integrated COVID-19-related activities into their response plan. He notes that to prevent an increase in malnutrition and infant mortality in the region, it is crucial for health and nutrition activities to continue amid the COVID-19 response.
According to the Government and its partners, due to the economic downturn and containment measures, 5.6 million people (23 per cent of the country’s population) are at risk of food insecurity during the lean season from June to September, compared with 1.9 million anticipated at the beginning of the year. Furthermore, the number of children suffering from severe acute malnutrition is expected to increase by 35 per cent.
When the first positive case of COVID-19 was reported on 19 March, the Government announced barrier measures to contain the spread of the virus, including the declaration of a state of health emergency, closing of borders, establishment of a curfew, movement restriction between regions, a ban on gatherings of more than 50 people, and closure of worship places, schools and entertainment facilities.
New ways of delivering emergency aid
In compliance with the newly introduced preventive initiatives, the humanitarian community has adopted preventive methods to protect implementing staff and beneficiaries during the provision of aid. These include physical distancing, installation of handwashing stations and distribution of hygiene promotion kits, risk communications and outreach, isolation of COVID-19 patients, education by radio and television, and temperature checks.
Humanitarian organizations are practicing physical distancing when providing relief. People receiving assistance are asked to stand at least 1.5 metres apart from one another. To avoid frequent interaction between people, the World Food Programme (WFP) in Niger now distributes two- or three-month food rations instead of one-month supplies in the Tillabéri and Diffa regions. In Diffa, 3,182 MT of food was distributed covering April to June, while cash assistance of about US$2.08 million for four months was also distributed.
Social distancing is also practiced in classrooms. As 8-year-old Chetou Oumar states, “I attend Awaridi primary school in Diffa with my brothers and sisters. We have recently returned to school after a two-month closure due to COVID-19 and we have noticed so many changes. A maximum of two pupils now share a bench in classrooms, instead of three, and we no longer play in groups like we did before,” she said.
With a consistent decrease in the number of COVID-19 positive cases from mid-April, the Government decided to lift bans with regard to the sanitary isolation of Niamey, the capital city, including the reopening of schools as of 1 June.
Relief organizations have also installed handwashing stations in various public sites, including government offices, sites for internally displaced persons (IDPs), refugee camps, transit centres and in host communities. The UN Children’s Fund (UNICEF) has set up 514 handwashing facilities and donated 560 boxes of soap to the COVID-19 regional committee in Diffa. Religious sites, schools and 38 local administrative buildings were also disinfected by UNICEF and its partners. They also set up 636 handwashing facilities and provided hygiene supplies, including soap and bleach, to these facilities. This assistance is being replicated countrywide.
With a COVID-19 case fatality rate of 6.47, robust awareness-raising campaigns are ongoing. Supported by humanitarian partners, the Government’s communication committee leads sensitization efforts on good hygiene practices and general health information on the pandemic. Messages are transmitted over the national radio station, 2 public television channels, 32 private radio stations and 138 community radios. Key messages focus on various aspects, including handwashing with soap and clean water, the use of masks, social distancing and COVID-19 symptoms.
Action Against Hunger (ACF) carried out awareness-raising sessions and trainings on good hygiene practices in the Madaoua and Bouza villages in the Tahoua region. With the support of UNICEF, 300 community-based relays have been trained and are now conducting door-to-door community outreach in Diffa.
Within the framework of its COVID-19 prevention and response strategy, UNICEF and its partner Search for Common Ground are broadcasting spots in seven languages (French, Haoussa, Kanuri, Fulfulde, Arab, Toubou and Boudouma) through community radios in Diffa, to raise awareness on COVID-19 preventive measures. They have provided the 12 municipalities in Diffa with 38 audio tools for continuous awareness-raising in public places.
To ensure that patients receive appropriate care and to prevent cross-infection, COVID-19 treatment centres have been set up nationwide. In Diffa, UNICEF supported the training of 112 agents in epidemiological surveillance and management of COVID-19 cases. In addition, 68 agents were trained in psychosocial support, while 15 rapid intervention teams were also set up.
Temperature checks are a fundamental activity in the fight against the pandemic. In the Sayam Forage refugee camp in Diffa, the United Nations High Commissioner for Refugees (UNHCR) and its implementing partner Agence pour le bien être (APBE), a local NGO, have set up a temperature check system with the use of laser thermometers. Medical precautionary initiatives are also applied in other regions.
“The application of COVID-19 preventive measures enables us to protect ourselves and patients. During this very challenging time, I remain fully committed to my job in respect of the Hippocratic Oath taken by medical personnel to save lives,” said 40-year-old Bouhari Issaka, Chief Medical Officer of APBE, who is working at the Intikane health centre in the Tahoua region.
Since the onset of the crisis, the humanitarian community continues to support government efforts in response to the pandemic. As of 2 August, the Ministry of Health has reported 1,136 cases of COVID-19 out of 10,809 tests carried out, with 1,028 recoveries, 39 people undergoing treatment and 69 deaths.
Challenges that impede the provision of timely assistance
While effective collaboration in the fight against the pandemic is ongoing, some challenges are hampering the response process. Niger, which mostly limits screening to symptomatic cases, has a capacity of 1.8 tests per 10,000 people, compared with, for instance, 5.5 tests in Namibia. The surveillance system needs to be strengthened nationwide, including cross-border collaboration, to ensure that public health measures are taken on both sides of the porous borders. The country has a total of 54 air and land entry points.
Prior to the outbreak, the implementation of humanitarian operations was already hampered by access constraints, including persisting insecurity, particularly in the West (Tillabéri and Tahoua), South and South-East (Maradi and Diffa) regions. The Government’s extension of the state of emergency declared on 17 March for another three months in Diffa, and some departments in the Tillabéri (10) and Tahoua (2) regions will impact the free movement of humanitarians and supplies. It will also disrupt adequate response to the growing food insecurity crisis.
Conflicts are causing more displacement and disrupting livelihoods. Between January and June, more than 350 protection incidents including killings, abductions, looting, threats, gender-based violence, rapes, extortions and the payment of illegal taxes were recorded in the Tillabéri and Tahoua regions, resulting in 1,000 victims. Meanwhile, 404 protection incidents were recorded in Diffa over the same period, affecting about 2,751 people and causing the displacement of more than 21,000 people.
Humanitarian access is further impeded by security incidents against humanitarians, such as killings, carjacking and robberies. Since January, 135 security incidents directly impacting humanitarians have been registered nationwide. Aid workers are constantly engaged in advocacy for the respect of humanitarian principles and international humanitarian law to gain access to the people in need.
Finally, the provision of timely assistance is hindered by insufficient funding. In the second half of the year, the revised joint 2020 Humanitarian Response Plan and COVID-19 response seeking US$516.1 million has received $103.6 million – only 20.1 per cent. Immediate funding is urgently needed to maintain the gains achieved so far and to provide timely and life-saving assistance to the most vulnerable people.Distributed by APO Group on behalf of Office for Coordination of Humanitarian Affairs (OCHA).
Adamou Abass teaches by example as he uses a handwashing station in front of his office in Tahoua, Niger, March 2020 – Credit: ACF