What is going to happen now?

The World Health Organisation said a few days ago that they feared the African continent is on the verge of a great surge in the number of Covid-19 cases.  They gave details of rises of up to 33% for three African countries where testing is relatively reliable.  Based on that, they said that the whole continent is very likely to be in the same state.  This announcement came at the same time as UNICEF advocated for the South Sudanese Government to reopen all schools.  There is a definite conflict of views between these agencies.

Local Covid-19 Facilities

Facemasks made locally drying after being washed.  We have
stopped doing this because too few people would buy them.

Here in South Sudan, there are only two testing facilities across the country, one in Juba and the other here in Nimule.  Juba is the capital city, so are a major priority.  Nimule was chosen because we have the main means of road access into the country, used by the majority of trucks bringing goods to all parts of the country from East Africa.  It is essential that all truck drivers are tested and refused entry if they are positive.  This has been happening under the auspices of WHO.  However, due to the low capacity of the testing machine and low staffing levels, it is only possible to do up to sixty tests each day.  For that reason, tests are only done on priority cases: truck drivers and health workers.  So far six health workers (including a doctor) have tested positive at Nimule Hospital.  As described in a previous blog post, there have been huge delays for truck drivers on both sides of the border while waiting for tests and test results.

There are no local quarantine facilities in Nimule, so those who test positive have to self-isolate if they are asymptomatic or with low-level symptoms.  This is problematic because of local resistance to Covid-19 measures.  The hospital has a small isolation unit for those with symptoms who are awaiting test results and those tested positive who are awaiting transfer to distant areas.  The unit is composed of two leaky tents (it is the rainy season right now).  The water pump has been broken since the beginning of the outbreak and was only fixed last week, so water has been carried from some distance away.  The majority of the hospital staff refuse to work in the isolation unit because of lack of protective gear and also lack of pay.  There are no arrangements for feeding those in the unit, so the NGO representatives regularly do a whip-round out of their own pockets.  Because of these difficulties, the hospital tries not to send people to the unit unless there is absolutely no alternative.

Attitudes in the Community

Most people claim that Coronavirus does not exist.  According to the majority view, it is all a plot by the rich nations working through the NGOs to spoil the lives of South Sudanese.  They point to the fact that the NGOs are paid for their work.  There is a huge resistance to all precautionary measures.  I think this reaction is due to fear, which is causing people to bury their heads in the sand, and also to concerns about survival.  The local community attitudes reflect attitudes across the country. 

Many churches have reopened in direct contravention of Covid-19 regulations.  These churches claim that the government advice comes from Satan and is a way to stop Christianity.  Very large numbers are attending with no social distancing or face masks.

There are many funerals, all attended by large numbers of people over several days, without the least regard for social distancing.  I suspect that Covid-19 plays its part in some of these deaths, but it is impossible to prove this one way or the other due to the low level of testing.  Yesterday I was told that a former teacher from Cece Primary School, quite a young man, has died.

It has been very difficult for areas impacted by closures, which has been a major cause of civil disobedience.  People still need to feed their families and live from hand to mouth, washing dishes for restaurants, fetching water to sell to locals etc.  On a positive note, large numbers of people who previously depended on handouts from the refugee camps in Uganda, start work to produce their own food.  Thankfully there has been plenty of rain. 

Churches, for example, rely on collections to provide for the living expenses of priests and pastors.  Goods are more expensive because previously local people crossed the border and bought their stock at the nearest Ugandan market and resold it in Nimule.  Now, they have to pay truck drivers to bring the goods.  The churches are now disobeying and most people are attending Sunday services.  Bars and hotels are open for business, with crowds of locals coming to watch international football matches on the television.

NGO Activity

Most of the NGOs who were initially involved in the fight against Covid-19 have reached the end of the end of their contracts.  Some may resume if their international headquarters agree, but others are completely finished. The latest and most devastating, is the end of the WHO contract.  From now on there will be no testing of truck drivers at the border.  Trucks can now pass freely. 

HUMAES has worked hard to make people aware of Covid-19 through radio talk shows and moving around the county.  They continue to distribute soap, buckets and locally made face masks, but when they return to check, they often find the buckets empty, the soap gone and everybody close together with no face masks in sight.  Increasingly, they face anger from those they talk to.

Government Agencies

The law enforcement agencies such as police, security and immigration who were initially working together with local government, are now refusing to cooperate and have stopped attending Health Department meetings.  The closure of the border has impacted on corrupt practices, because it has become such a slow process to enter the country, thereby cutting the number of opportunities for illegal demands for payment each day by immigration and customs officials.  Their lack of cooperation is almost certainly because of the lack of opportunities for enrichment.

At a meeting I attended earlier this week, the head of local government told the meeting that police and security are no longer enforcing the regulations.  Some of their chief officers can be seen playing cards, drinking and taking sheesha in all the places where they are supposed to be enforcing the regulations.

The Director of the County Health Department does not know which way to turn in his efforts to curb the virus.  Every day there is more bad news.  Government staff are rarely paid and there has been no money from the central government at all, let alone for Covid-19 activities.  That is in spite of the huge amounts poured into South Sudan.  Even without pay, he works seven days a week in his personal effort to galvanise everybody.  The same applies to the Education Director, who is hard at work on child protection strategies for out-of-school children.

At a meeting of Headteachers, the Acting Town Clerk (the equivalent to a Mayor) said that as nothing can be done from the top, we need to work from the bottom.  He is appealing to all local village chiefs to help in combating the pandemic at local level and join hands to change the situation.  A priority for the Town Clerk and also the Education Department is ensuring the personal well-being of school children who are being neglected and teenagers who are completely out of control, causing a large rise in teenage pregnancies and elopments.  This is starting to be addressed through the local chiefs’ advice to families.

Schools

There is a big debate on what to do about reopening schools.  UNICEF is advocating reopening immediately for the sake of the children’s education.  However, large class sizes, small numbers of classrooms, size of classrooms and inadequate numbers of teachers will make it impossible to socially distance. 

On the other hand, Kenya has led the way by declaring 2020 a ‘dead year’ and will not reopen until the next academic year, which starts in January 2021.  Children in Kenya will all repeat their current year.  This will enable those in the final examination years to have a full year of lessons instead of failing exams which are important for their future.  To me, the Kenyan model makes more sense in South Sudan, as long as we can address the social issues faced by our children in the meantime, which we are trying to do.

Opinions are very much divided on the right way forward.

Conclusion

What a mess.  Although the numbers reported in South Sudan are tiny compared to those in the US or Europe, they give a very inadequate picture because of the lack of testing.  As mentioned the large number of funerals tell a different story.

The economic situation is a huge pressure on people to ignore restrictions and deny the reality of Covid-19.  This in turn leads to further infections, which (if WHO is right) are escalating in any case.

The general atmosphere of lawlessness in South Sudan, which is ongoing, makes matters worse.  Other parts of South Sudan are in an even worse state because of inter-tribal conflict, which at least is not a feature here.

As my youngest daughter once said to me with great passion at the age of five, “Don’t give up!  You must never give up!”  At least the local government is committed, even if they struggle to find support and have no resources themselves.  Our own school partner HUMAES is also very committed.  HUMAES, being a local organization, is not leaving and is looking at other ways to help in the battle against Covid-19.

If you are a religious person, please pray for our very difficult situation.