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IUHPE is pleased to announce the launch of its project on “COVID-19 Response for the African Region,” with the support of Vital Strategies.

IUHPE will be working with our members in the African region in developing a range of risk communication and community engagement strategies, based on health promotion principles, that will empower local communities in stopping the spread of the virus, while protecting people’s basic needs and promoting their physical and mental health.

Learn more about this project! 


Message from Dr. Mary Amuyunzu-Nyamongo, Regional Vice President, on the COVID-19 Pandemic

Africa has recorded 69,707 cases with 24,141 recoveries and 2,399 fatalities while Kenya is now at 737 cases, 231 recoveries and 40 fatalities. Compared to the rest of the world, the number of people directly affected by the virus in Africa is low. However, the main concern I have with the spread of Covid-19 is on the vast expanse of informal settlements in the region, more so in large cities and urban centers. It is estimated that 55% of urban dwellers in Kenya live in informal settlements. These settlements are characterized by poor environments, poor and crowded housing, lack of access to water and sanitation, and general poverty. The fact that over 80% of the informal settlement dwellers work in the informal sector, which has been adversely affected by the pandemic, adds to my fear for the country and the region generally.

The four social and health promotion actions promoted globally for containing the virus are:  (i) stay-in-doors; (ii) physical (social) distancing; (iii) wash hands and sanitize; and (iv) wear masks. Although there is credence in observing these guidelines, it is not practical for people who have lost their only source of income and who are currently jobless. A woman in an informal settlement in Nairobi asked me: "how can I distance when I live with my 5 children and one grandchild in a small room? Some of these measures are meant for people in big houses, they are not for us.”

The guidance of stay-at-home is also problematic for people who have no food and whose children are hungry. I met a group of women who normally wash clothes and/or houses for people on a daily wage waiting at a roadside in Nairobi. Most were initially hired as domestic workers but soon after the announcement of the first COVID-19 case, their services were terminated. When I asked them what they were doing on the roadside, one of them said: “the donations that come to the settlements never reach us, we are usually excluded and told that the support is for widows, or for one group or other that are on the list of the chief, or on the list of the government. Some of us have given our names to many groups to be considered for social support but we have never received that help. Sitting along this road is better because people can see us here.” In a nutshell, COVID-19 has effectively created a new cadre of poor people who originally were in employment.

For one to wash hands, he/she needs water, yet water is a scarce commodity in informal settlements, and even nationally. In Kenya only 34% of the population has access to water. Sanitizers are also expensive especially for families struggling to buy food and pay rent among other utility costs. Wearing a mask means tapping into resources that are not available. A young man interviewed on media asked: "for me to buy a mask I need Kes. 200 (US2.00), how can I spend this money on a mask when I do not have food?" 

A national curfew was put in place in April and a lockdown in specific places considered hotspots was effected around the same period. These two measures have not only limited movement of people, they have interrupted the flow of food into the urban centers. This could potentially make the cost of food too expensive, especially for the urban poor who are barely surviving. It is clear that the pandemic is exposing our social cleavages with the poor suffering the brunt of the impacts of the disease.

The COVID-19 health promotion activities are being coordinated by the Ministry of Health, however, it is clear that this being a global pandemic, decision-making has been elevated to the level of government ministers and the presidency. However, some of the decisions taken do not take into consideration the individuals and their communities. Consultations with community leaders and opinion leaders are at most ad hoc while the use of the community health structures is still limited. As COVID-19 morphs into community transmission (as opposed to travelers), there is an urgent need to identify and work with community structures. There is a need to empower the communities to put and implement measures to protect themselves. The Government should be at the forefront of providing relief to the poor and vulnerable and ensuring that accurate information is developed, updated and synthesized for use by the different communities. This pandemic will be won through active participation of the communities that are well informed and sufficiently facilitated through resource support by the Government.

 

We invite you to read all COVID-19 messages from the IUHPE President and Regional Vice Presidents.