How COVID adds complexity to relief work

July 2, 2020
Written by Mark Harper

COVID-19 has arrived in the Republic of the Sudan at a time when the country is already the dealing with fallout from a year of civil unrest and political change.

A turbulent time

In July of 2019, Sudan began the process of transitioning back to democracy for the first time in 30 years. Triggered by several months of protests and civil unrest, the change in government sparked hope of economic transformation and a brighter future.

Although the Darfur region has infamously been plagued by conflict since 2003, recent years had given cause for optimism. That was until 29 December 2019, when a dispute between rival tribesmen erupted in displacement camps in West Darfur and spread outwards. It’s estimated that 45,000 people were forced to flee, with some 5,000 people crossing the border into Chad.

A new challenge

Concern’s team in West Darfur began responding to the needs of the displaced , providing kits for families to rebuild their shelters, and constructing washing and toilet facilities after large areas of existing camps had been set ablaze.  Area Coordinator Kenneth Oyik, who has vast experience with complex emergencies in several African countries, admits that COVID-19 brings a new layer of complexity, one which he has not been experienced before.

“At first, few people took notice, thinking that the disease would stay out of Sudan or maybe just be confined to the capital city Khartoum, but recently cases have reached West Darfur.”

COVID information session in Sudan

Concern staff discuss programming in the era of COVID-19.

Sadly, there have already been several deaths, including healthcare workers.

Despite this, Kenneth reports that communities themselves are struggling to take the threat of COVID-19 seriously. People in the area are simply confronted with so many challenges that COVID-19 is not regarded as the biggest risk to their lives. “Few people have stopped shaking hands or started wearing face masks.”

Complicating matters, West Darfur borders with Chad and many communities straddle the two countries. “Officially the border is closed, to limit the spread of COVID-19, but there are hundreds of crossing points,” according to Kenneth. “Many families pass daily into the neighboring country to fetch water or do shopping.”

Concern’s response

The Concern team has made awareness and information sharing a priority, including the mass distribution of information leaflets and posters. Community volunteers who usually help to screen for malnutrition have become COVID-19 awareness champions – taking information on how to protect against the virus to their villages using megaphones and drama. Volunteers now immediately refer any suspected cases of malnutrition to the local health facility, while mass screenings have been suspended.

Nutrition staff in West Darfur have been trained in measures to reduce the spread of Covid-19.

This is just one of many adaptations Kenneth and the rest of the team have made to ensure the vital nutrition programming they have been doing can continue.  Other adaptations include increasing the supply of the therapeutic food used to treat malnutrition to monthly, instead of weekly stocks, thereby reducing the need for people to attend the facility.

West Darfur is classified as suffering from crisis levels of food insecurity, with 21% of people not having access to enough food. Program Director for Concern Sudan, Eva Sztacho, explains the team’s approache.

“About one quarter of the town of El Geneina live in camps. But the way we work is that we work with everyone. Both the host population and the displaced populations. We try not to differentiate between them and to build our community as a whole.”

System strengthening

Another important aspect of the team’s work in West Darfur is helping to strengthen health systems in the region. This project, funded by the European Union, involves  improving staff capacity, structural improvements to health facilities, and better access to medicines. Monitoring of disease levels and epidemics in the region is also a key component of the work

Now it has been adapted to include a response to COVID-19, by helping to maintain safe and sterile environments for normal health services to continue, and by increasing capacity to treat cases of the new virus. Concern is providing extra handwashing stations to all the health facilities and and ensuring that any training sessions that take place with health staff or community members observe strict social distancing protocols. And the team has assisted in the setup of two COVID-19 isolation centers, supplying 20 beds, disinfectant and extra PPE.

Social distancing at a clinic in Sudan

Awareness training on infant and young child feeding to prevent malnutrition now includes information on preventing the spread of COVID-19. Photo: Maad Mohammed Salih / Concern Worldwide

As has been the case here in Ireland and beyond, PPE is a huge worry. Supplies are insufficient and already some health staff fear contracting the virus. However, the challenges for Sudan in containing this crisis go beyond anything we have experienced here. Their health system simply does not have the capacity to adequately test, trace, and treat those who contract the disease. As of June 22, confirmed cases in the country are at 9,500 and confirmed deaths have reached over 600. However, even with improved testing capacity, these figures are likely to be much higher in reality.

By taking adaptive measures, our teams in West Darfur and across Sudan have managed to continuin with their life-saving work. You can support them by donating to our COVID-19 appeal today.