As we have seen over recent weeks, the impact of Covid-19 has caused unprecedented disruption, deaths, and confusion in developed countries. The public health capacity of countries such as the United States and UK has been overwhelmed. 

For fragile countries, which are already experiencing existential issues such as severe conflict or natural disasters, the shock is going to be even more acute and the impact potentially devastating in terms of deaths and disruption.

In this article, we highlight two sub-Saharan African countries that are currently experiencing conflict, with a significant population extremely vulnerable and lacking adequate health care. In both contexts, the humanitarian needs are going to be acute. 

The novel coronavirus is circulating  at a time when humanitarian agencies are already overstretched with a record number of displaced persons and donors fatigued, following lengthy conflicts in Syria, Iraq, Yemen and parts of Africa. 

Preparation for Covid-19 needs to take place across the world, including fragile states, to ensure resources, staff, and partnerships are in place, so that they can distribute aid to the most needy.

Burkina Faso

In Burkina Faso, as of April 4, there are already 302 known cases and 15 deaths as a result of Covid-19. The country is in lockdown. 

But with the healthcare system already extremely weak and overwhelmed, and a spiraling displacement crisis, the situation is grave and will only become worse. In large parts of the country, terrorist and insurgent groups have taken root, forcing civilians from their homes. So far more than 760,000 people have been displaced and almost a million are in need. Many of these people have been displaced over the past three months, as the security situation has deteriorated rapidly. 

The growth of radical Islamist groups, alongside climate-related issues, has already exacerbated tensions between ethnic groups such as the Fulani, who are accused of being affiliated with radical Islamic groups. 

Without immediate international healthcare assistance and other humanitarian support, the situation is set to deteriorate rapidly, and Covid-19 is likely to take root and spread among the needy, who have neither water, nor information on the need for social distancing. In addition, as with other conflict areas, accessing many of those in need who live in areas controlled by armed groups will be extremely difficult.

Somalia

Somalia, one of the most fragile countries in the world, has experienced conflict for many years, notably a conflict between the government and Al-Shabaab, along with clan disputes, droughts, and climate change. Over recent months, the situation has once again deteriorated following more violence. As of April 4, seven cases of coronavirus have been reported in Somalia, but the number is likely to grow.

The humanitarian conditions are grim with more than 3 million people are displaced and more than 5 million people in need. Critically in terms of the country’s vulnerability to the new coronavirus, water, sanitation, and hygiene services are limited, while health care is extremely limited, and vulnerable groups such as refugees, and the elderly often are among those most likely to lack basic services.  

Vulnerable People  

These are just two examples of countries that are extremely likely to face a catastrophic impact from Covid-19. But the risks are likely to be equally significant for people in Syria, which has experienced a decade of conflict, and for people in large refugee camps around the world, not to mention asylum seekers who are waiting on the U.S.-Mexico border, or those deported from the United States to Guatemala, El Salvador, and Honduras. 

Risks

The global pandemic also poses significant risks to humanitarian agencies. Given that Covid-19 is currently concentrated in the United States and Europe, there are real risks that humanitarian staff could spread the disease, which is likely to lead to distrust among locals. If not managed correctly, humanitarian agencies could quickly be labelled as the enemy, which would have significant implications. If targeted, they could face security risks that could make it impossible for them to deliver life-saving services.

Donors and the United Nations, which has launched a $2 billion response, are making considerable funding available. Meanwhile, the International Monetary Fund and World Bank have both committed to provide loans to low- to middle-income countries for emergency aid. But for fragile countries such as Somalia and Burkina Faso, the last thing that the governments need is to be saddled with more conditions for their support. Various aid agencies are also launching their own appeals for significant sums of money.

But all of this requires humanitarian donors to give at a time when developed countries are facing their own extraordinary economic threats.

The Initial Humanitarian Response 

Along with the preparation, humanitarian agencies in collaboration with the World Health Organization need to ensure that those in fragile environments are tested in large numbers as quickly as possible. This will then ensure that those who test positive are isolated and treated. 

Given how difficult this model has proven to be in the United States, Italy, and elsewhere, there are significant challenges to implementing it in conflict zones. But a failure to do so will not only result in a large number of deaths of vulnerable people, but will—through migration whether legal or illegal—translate into further outbreaks in different countries across the world, which will cause yet more disruption, financial costs, and deaths. 

Rather than acting independently, humanitarian agencies should work together to ensure that needs are met in a coordinated fashion. This would likely include collaborating with local partners, where possible, such as other nongovernmental organizations and local government officials, who can help manage the response and provide oversight to ensure that healthcare facilities and other local infrastructure are as well-supplied as possible. Such a collaborative approach will help pool resources to ensure the most needy get help, build trust with the local population, and help save lives.