African countries are finding difficult keeping track of covid-19

South africa had a plan for slowing the spread of covid-19. As outlined by Salim Abdool Karim, chair of the medical committee advising President Cyril Ramaphosa, on April 13th, the country would draw on its earlier experience using community health workers to deal with hiv and tuberculosis. It would screen millions of people in poorer areas. Those with symptoms would be tested and then treated and quarantined if necessary.

Yet a sound strategy has been undermined by, among other things, testing failures. State-run laboratories suggested they could do 36,000 tests per day by the end of April. Since April 5th they have managed to do just one-fifth of that. Results have also taken too long. As of June 6th the average turnaround time was 12 days.

Such delays mean the hiv-inspired strategy is “totally futile”, argues Marc Mendelson, an infectious-disease specialist at Groote Schuur Hospital in Cape Town. Waiting 12 days for an hiv test is agonising, but the patient will probably not infect anyone during that time. In the case of covid-19, by the time a result arrives, a patient may have infected scores of others.

Delays put more pressure on hospitals. In the wider Western Cape province, which has 0.5% of Africa’s population and 17% of its known coronavirus cases, intensive-care units are filling up. Others in South Africa may soon follow suit. The country had the 11th highest five-day moving average of confirmed new cases as of June 16th—and the rate of growth is accelerating.

If South Africa—which with Ghana accounts for about half of all tests in sub-Saharan Africa—is not testing enough, then nor are most other countries in the region. At the start of June African countries had tested, on average, fewer than 1,700 people per 1m, a fraction of the number in rich countries (America had done 26 times more per million people). “Testing is our Achilles heel,” says John Nkengasong of Africa cdc, a pan-African health institution. It is also symbolic of broader weaknesses in African health systems that mean the continent is less able to cope with mass outbreaks than rich parts of the world.

The challenge of testing has long been recognised. In February the World Health Organisation (who) overhauled African labs. Today 43 of the 47 countries in its Africa region can do molecular testing for covid-19, up from just two at the start of the year. Nevertheless, most countries still lack resources. Nigeria has the capacity to do at least 10,000 tests per day, but has averaged fewer than 900 since announcing its first case on February 27th. Some countries have had to wait more than two months for orders of test kits to be delivered.

The problem is that African countries are competing in the market for testing materials with rich countries, many of which are regular customers of the manufacturers and often buy in bulk. Some small African countries have placed orders for fewer than 10,000 kits, as many as Germany uses in a few hours.

Philanthropy has helped. In most African countries most of the testing kits used are those donated by the charitable foundation of Jack Ma, Alibaba’s founder. He has given at least 20,000 kits to every country in Africa. Yet this is far short of what is required. On June 3rd Dr Nkengasong said Africa needed at least 20m new test kits within 100 days.

To try to meet that goal, countries are pooling their resources and placing large joint orders. Africa cdc has agreed with manufacturers that 90m kits will be bought over the next six months. A bulk purchase establishes trust, argues Fatoumata Ba, a Senegalese venture capitalist and one of several African executives lending their expertise to the Partnership to Accelerate Covid-19 Testing (pact) scheme.

pact is a step forward, but problems remain. The first kits bought under the agreement are due to arrive only by the end of the month. And having kits does not obviate the need for technicians; South Africa laboured to keep pace even when it had enough materials.

The struggle to increase testing augurs ill for the broader response. The number of confirmed cases in Africa has been rising by about 30% a week over the past month. But that glosses over trouble spots, such as South Africa or Guinea-Bissau, where almost one-tenth of health workers have been infected. And it means that the absolute number of cases is mounting: it took 98 days for Africa to go from 1 to 100,000 cases, but only 18 days to reach 200,000.

The overall numbers matter, because African health systems will tend to be overwhelmed at an earlier point than those in Asia or Europe. Such weaknesses are the main reason why a study published by the Centre for Global Development, a think-tank, projected that death rates in Africa could be many times higher than predicted by other models that do not account for scant staff and cash-strapped hospitals. Already countries such as Kenya and Nigeria are planning ways to care for people in their homes rather than in hospitals.

Others are trying new ways of gauging the disease’s progress. Just four African countries keep high-quality records showing causes of deaths, according to the un. In many places most deaths are not recorded, let alone their cause. That makes it hard to calculate whether death rates are higher than average, a useful measure of the disease’s effects. In the absence of excess-mortality data, countries such as Rwanda and Senegal are doing “verbal autopsies”, where next of kin are interviewed.

South Africa does have mortality data going back years. In the three weeks to June 9th deaths from natural causes were unusually high in Cape Town, and on the rise elsewhere, too. At this point more testing would help, says Dr Mendelson, but the focus must be on reducing deaths. With that in mind the Western Cape is rationing public testing to those over the age of 55 and opening field hospitals. “We cannot test our way out of the crisis,” he says. ■

Editor’s note: Some of our covid-19 coverage is free for readers of The Bloomgist, our daily newsletter. For more stories and our pandemic tracker, see our coronavirus page

This article appeared in the Middle East & Africa section of The Economist under the headline “African countries are struggling to keep track of covid-19

Undertakers carry a coffin during the funeral proceedings for a COVID-19 victim at a Mosque in Cape Town, on June 16, 2020. Most of South Africa's infections -- around two-thirds -- are found in the Western Cape province, a popular tourist destination. CREDIT: MARCO LONGARI/AFP

Coronavirus infections pick up speed across Africa

Undertakers carry a coffin during the funeral proceedings for a COVID-19 victim at a Mosque in Cape Town, on June 16, 2020. Most of South Africa's infections -- around two-thirds -- are found in the Western Cape province, a popular tourist destination.  CREDIT: MARCO LONGARI/AFP
Undertakers carry a coffin during the funeral proceedings for a COVID-19 victim at a Mosque in Cape Town, on June 16, 2020. Most of South Africa’s infections — around two-thirds — are found in the Western Cape province, a popular tourist destination. CREDIT: MARCO LONGARI/AFP

After months of slow burn, recorded coronavirus cases are beginning to rise sharply in Africa. 

On Sunday night, Africa passed the 300,000 case mark with an overall death toll of around 8,000, according to researchers at Johns Hopkins University. 

While these cases amount to just three per cent of the world’s total, experts have warned that the pandemic is now accelerating in many parts of Africa, where poor health services make the virus an acute threat. 

It took almost 100 days for Africa to record its first 100,000 coronavirus cases. It took another 18 days for Africa to reach 200,000 cases and a further 11 days to hit 300,000. 

 John N. Nkengasong, the director of the Africa Centre for Disease Control and Prevention, has warned that the continent could be the next ‘epicentre’ of the pandemic as cases begin to overwhelm fragile health systems. 

Covid-19 has spread more slowly across Africa than many thought it would. This is mainly because most African governments took quick and robust steps to limit the spread of the virus early on, while officials in the UK and US dithered.

As early as January 2, Ivory Coast started screening passengers who had visited China recently. Many other countries followed suit soon after. 

When the pandemic began to take Spain and Italy by storm in March, Africa sealed itself off from international travel.  Some form of lockdown was implemented in almost every country on the continent when there were still relatively few cases. Many African governments doubled down on preventing these cases from spreading with contact tracing teams. 

But after months of slow-burn in different pockets, community transmission is well established in many countries and cash-strapped governments are being forced to ease lockdown measures. 

Experts at the World Health Organization say that Africa’s real caseload is probably far higher than the official tally. Many African countries have struggled to do more than a few hundred tests a day, as wealthier countries buy up kits and lab materials en masse. 

Earlier this month, the WHO warned that coronavirus was spreading out of cities and towns into rural areas, where healthcare services are limited. 

One medical worker in Eastern Congo told The Telegraph that they feared a ‘wave was about to hit’ the troubled region and that the official figures did not show what was happening on the ground. 

According to official statistics, South Africa is the continent’s coronavirus epicentre. Since Africa’s most industrialised economy relaxed its draconian lockdown several weeks ago, recorded cases have soared to about 100,000 — one third of Africa’s total case load. 

However, South Africa may be disproportionately represented in Africa’s Covid statistics due to it effective testing. South Africa has conducted more than 1.3m tests for a population of about 58m, this is ten times what Nigeria, with its giant population of more than 200m, has managed. 

Dr Mike Ryan, executive director of the WHO emergencies programme, said that the picture was mixed across the African continent. 

“We’ve seen increases of the disease in some countries in excess of 50 per cent in the last week, and we’ve seen other countries with very very stable numbers.”

But while numbers are on the rise in general – with substantial jumps in places like South Africa, Benin, Eritrea, Ethiopia and Burundi – the continent is yet to report a large rise in the number of deaths, he said. 

Dr Ryan added that there are caveats to these numbers – while hospitals do not appear to be overwhelmed, “testing is not as frequent in Africa so there could be under reporting of cases”. 

He warned that there is “no room for complacency on the African continent.”

“Will Africa be the next epicentre for this? I certainly hope not,” Dr Ryansaid. “The health systems in Africa is, in general, weaker than elsewhere in the world. 

“While they have the benefit of an age profile that’s much older, there are still many elderly people and many with underlying health issues.”

A Chinese language teacher speaks with students at the Confucius Institute at the University of Lagos. PIUS UTOMI EKPEI/AFP via Getty Images

We wanted to know if Chinese migrants in Africa self-segregate. What we found

A Chinese language teacher speaks with students at the Confucius Institute at the University of Lagos. PIUS UTOMI EKPEI/AFP via Getty Images

By YAN Hairong, Hong Kong Polytechnic University

Over the past 20 years there’s been remarkable growth in China-Africa links because of increased trade and investment. As a result there’s also been a great deal of movement of people between China and African countries. It’s estimated that there are now about 500,000 Africans in China, while the the number of Chinese in the 54 African countries ranges between one and two million.

Though Chinese people can now be found in most African countries, there’s a claim that some commentators and media outlets make: that they hold themselves apart from their host societies.

For instance, a US commentator writes that:

(They) have no experience in the world outside of China; no curiosity about these strange African lands and their people and a morbid indifference to Africa’s long-term future. (Most) are poorly educated and ill-equipped to live in different cultures.

To some, the claim of Chinese self-isolation might resonate due to the physical evidence of Chinatowns, such as those in the US, Canada and South Africa. However, the reverse is true.

Chinatowns in these countries are not products of Chinese voluntary self-isolation, but of forced exclusion policies of white settler societies and governments. For instance, the Chinese Exclusion Act in the US and the Chinese Exclusion Act in South Africa.

These exclusionary measures were driven by the fear of Chinese as the “Yellow Peril”: a racial construct used extensively in Western countries against Asians who were viewed as a threat to Western civilisation, with images of expansion, takeover and appropriation. Today depictions of African weakness, Western trusteeship and Chinese ruthlessness are continuations of these stereotypes. I believe that these myths persist because of bias in the media and because Chinese relations and people are sometimes used as political pawns.

My colleagues and I set out to examine the claims of Chinese self-segregation in various African countries. Based on surveys, interviews, and academic literature we examined the varied lives of Chinese people over the past 10 years. Our primary research site was Zambia, although we conducted research in many African countries including Kenya, Tanzania, South Africa and Sudan.

Our research examined where Chinese migrants lived, their knowledge of local languages and socialisation patterns. We found that – like all migrants – factors affecting Chinese integration include local political environment, recentness of migration, language barriers, and corporate policies to mitigate crime and conflict. In addition Chinese are also affected by host bias – such as anti-Chinese campaigns.

These have all made Chinese integration varied processes and supports previous research my colleagues and I have done.

The accusations of Chinese self-isolation in Africa does not mesh with the reality: the lives of Chinese people in Africa are varied and cannot be reduced to a single category. The accusations are also damaging as they are racist, undermine African-Chinese relations, misrepresent the global Chinese presence, and fosters suspicion of Chinese migrants as perpetual “others”.

Contract employees

One group of Chinese migrants are contract employees. They usually work with large Chinese companies as expatriate engineers, managers, and skilled workers. From our research we found that contract employees usually stay for one or two contracts (with one contract lasting between one and three years), but a small number may work as long as a decade.

Of all contract employees, contract employees working on infrastructure projects often had the most interaction with locals. This is because they lived and sometimes ate with their local colleagues.

For instance, we interviewed teams of Chinese and local drillers from a Chinese water well firm in Sudan. One Sudanese interviewee said:

Chinese live like locals. If the locals have brick houses, they’ll stay in them, but if not, they’ll stay in grass huts or tents.

In China it’s not uncommon for construction and mining workers to live collectively in compounds. They now do the same in Africa. This helps to save the company time and money, but it’s also a precaution to reduce their exposure to crime.

Company policies can also affect how much workers interact socially. For instance, our field research in Zambia found that the Chinese mine construction firm TLZD had policies whereby Chinese employees were not allowed out at night for their safety, but also because – due to language barriers – misunderstandings can lead to fights. Most Chinese in Africa, like first-generation migrants everywhere, are hampered by a language barrier.

Some company policies encourage integration because they make learning a language a requirement for the job. For instance, one Kenyan journalist based in Beijing observed that some large firms only hire Chinese “with a solid understanding of local African languages.”

Wall Street Journal correspondent Te-Ping Chen also observed that “Chinese immigrants that have come to Africa tend to live side by side with Africans (and) tend to speak local dialects.” By contrast, we found that white people have lived in South Africa for more than three centuries and Indian people for 150 years. But unless brought up on a farm, few white people speak an African language, while most young Indians speak only English or are bilingual in English and Afrikaans.

Migrant entrepreneurs

For the Chinese people that aren’t contract workers, they typically work in small and medium businesses as either owners, employees, or family dependants. Some will bring their nuclear family to Africa while others straddle two continents.

They tend to live in small groups all over cities, depending on their economic status. For instance in Luanda, Angola, less affluent Chinese groups have sprung up in informal settlements.

Scholars find that how much they mix and integrate depends on the nature of their business. For instance, Chinese retailers have much more engagement, with a variety of people such as local employees, customers, or partners.

As expected, the longer they stay the more localised they become – for instance their children go to local schools allowing them to integrate more. As many Chinese are traders, they are also active in learning local African languages.

Our research shows that even though there’s plenty of evidence that Chinese don’t self-segregate, it’s a myth that has been hard to confront because some people have examples of Chinese non-interaction and may be politically invested in generalising that tale.

YAN Hairong, Associate Professor, Hong Kong Polytechnic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

African governments and the looming debt repayment crisis after Covid-19

It is almost a law of nature. Just as the female praying mantis eats her mate after copulation, so too can borrowers and lenders fall swiftly out of love. One minute they are sweetly wooing each other to consummate a deal. Then, the moment it is done, they are at each other’s throats.

So it is odd that African governments and their creditors have not yet fallen out. They have plenty to quarrel about. Africa’s debt crisis has been simmering for some time. Two years ago the imf was already anxious about a growing number of African countries in “debt distress” or at high risk of it. This crisis was brought to the boil by covid-19, which has caused economies to shrink and tax revenues to plunge. Governments have ramped up spending to fight the virus. Investors are scared. In recent weeks the bonds of nine countries have traded at prices indicating that they might not be repaid.

The imf and World Bank have lent emergency cash, but a financing gap of at least $44bn remains. Various bigwigs have called for debt relief, including Abiy Ahmed, Ethiopia’s prime minister, and Larry Summers, a former American treasury secretary. Yet neither borrowers nor lenders seem enthusiastic.

The g20 club of countries has agreed to suspend bilateral debt-service payments for the rest of this year for the world’s 73 poorest countries, if they ask. Yet uptake has been low. In seven weeks fewer than half of eligible countries have requested assistance. Only seven have been given it.

Struggling governments are not asking for help because they fear being seen as deadbeats. “We need to make sure we are protecting our hard-earned access to international capital markets,” says Amadou Hott, Senegal’s minister of economy. “The best way to do it is, at any cost, to protect our commitments with private creditors.” This, he adds, is the view of all the African finance ministers to whom he has spoken.

Most of the 21 African countries that have sold bonds abroad have done so for the first time only in the past decade. Long-term borrowing is even more recent, but in 2018 eight African countries successfully issued 30-year bonds. This borrowing is expensive. Interest rates on foreign-currency government bonds sold by African countries are roughly seven percentage points higher than those sold by rich countries, because investors see them as riskier.

Asking for help could confirm that view. Romuald Wadagni, Benin’s finance minister, writes that taking advantage of the g20 offer could be treated as a default by private creditors, even though they are not directly involved. Moody’s, a credit-rating agency, says it may downgrade its assessment of Cameroon, Pakistan and Ethiopia because they went for it. To avoid this fate, Senegal plans to shun the offer. Kenya says it will do likewise, because the small print would restrict its ability to borrow commercially.

Even if African countries were to take up the offer of help from bilateral creditors (these are usually governments or their export-finance arms), including the biggest of them all, China, they would still have other worries. Roughly a third of sub-Saharan Africa’s government debt is owed to private investors. Bondholders alone are owed $115bn. The mere act of asking private creditors for leniency would probably lead to a credit downgrade. And actually renegotiating repayment terms would probably be classed as a default, say rating agencies.

For the most troubled countries, such as Zambia, the point is moot. In 2012 it was able to borrow more cheaply than Spain. Now it is priced right out of the market and has hired Lazard, a financial advisory firm, to help it restructure its debt. Angola, which needs to hand over $500m to private bondholders this year and almost certainly more to China, has also begun talks.

But for countries such as Ivory Coast, Ghana and Senegal, which owe private creditors as well as g20 governments, the judgments are tougher. Stopping payments for a while would free up funds to fight the coronavirus. But after the crisis they will need cash from investors.

Under pressure from the g20 to offer debt relief, private creditors have come up with a grudging proposal. The Institute of International Finance, an industry group, has proposed allowing struggling governments to take a payment holiday. Afterwards, they would have to pay back everything they owe, including extra interest. This resolves little, since it would simply store up trouble, leaving weary countries with an even bigger mountain of debt to climb. And even in the short run it locks African governments into a catch-22. To have even a slim chance of avoiding being deemed in default, they will have to agree to new repayment terms that leave creditors no worse off than now. But if they ask, they risk a downgrade with no guarantee that private creditors will agree.

Vera Songwe of the un Economic Commission for Africa hopes to find another solution. She favours creating a new body that would borrow cheaply and then lend money to governments. However, it would need backers with deep pockets willing to guarantee that private lenders would not take a loss. It has found few volunteers.

There is not much time to act. African bond issuers face a wall of payments starting in 2022 (see chart). Many hope they are just experiencing a short-term cash crunch. But unless their economies rebound quickly—or they get more help from the rich world—a wave of defaults seems inevitable. If so, it may be better to take the hit and restructure debt now, while hoping that credit markets have short memories. Ken Ofori-Atta, Ghana’s finance minister, pointed out in a webinar hosted by Harvard University that rich countries were taking extraordinary measures to protect their economies, while telling Africans to stick to the rules. “You really feel like shouting: ‘I can’t breathe,’” he said. ■

This article appeared in the Middle East & Africa section of the print edition under the headline “Thanks, but no”

Workers disinfecting a street in downtown Cairo last week.Credit...Fadl AbuZaid/Picture Alliance, via Getty Images

Coronavirus rips into regions previously spared

Workers disinfecting a street in downtown Cairo last week.Credit…Fadl AbuZaid/Picture Alliance, via Getty Images

By Declan Walsh

For months, one enduring mystery of the coronavirus was why some of the world’s most populous countries, with rickety health systems and crowded slums, had managed to avoid the brunt of an outbreak that was burning through relatively affluent societies in Europe and the United States.

Now some of those countries are tumbling into the maw of the pandemic, and they are grappling with the likelihood that their troubles are only beginning.

Globally, known cases of the virus are growing faster than ever with more than 100,000 new ones a day. The surge is concentrated in densely populated, low- and middle-income countries across the Middle East, Latin America, Africa and South Asia.

Not only has it filled hospitals and cemeteries there, it has frustrated the hopes of leaders who thought they were doing everything right, or who believed they might somehow escape the pandemic’s worst ravages.

“We haven’t seen any evidence that certain populations will be spared,” said Natalie Dean, an assistant professor of biostatistics at the University of Florida. For those not yet affected, she said, “it’s a matter of when, not if.”

Grave diggers burying a coronavirus victim at the Vila Formosa cemetery in São Paulo last week.
Grave diggers burying a coronavirus victim at the Vila Formosa cemetery in São Paulo last week.

Several of the newly hit countries are led by strongmen and populists now facing a foe that cannot be neutralized with arrests or swaggering speeches. In Egypt, where the rate of new confirmed infections doubled last week, the pandemic has created friction between President Abdel Fattah el-Sisi and doctors who have revolted over a lack of protective equipment and training.

In Brazil, the total death toll surpassed 32,000 on Thursday, with 1,349 deaths in a single day, dealing a further blow to the populist president, Jair Bolsonaro, who has continued to minimize the threat.

“We are sorry for all the dead, but that’s everyone’s destiny,” he said Tuesday.

In Bangladesh, natural disaster helped spread the disease. Cyclone Amphan, a deadly storm that tore through communities under lockdown there last month, helped drive cases up to 55,000.

This week Bangladeshi authorities reported the first death from Covid-19 in a refugee camp, a 71-year-old Rohingya man from Myanmar — an ominous sign for wider worries about the plight of vulnerable people huddled in hundreds of such camps in the world’s most fragile countries.

The upswing marks a new stage in the trajectory of the virus, away from Western countries that have settled into a grinding battle against an increasingly familiar adversary, toward corners of the globe where many hoped that hot weather, youthful populations or some unknown epidemiological factor might shield them from a scourge that has infected 6.5 million people and killed almost 400,000, over a quarter of them in the United States.

The Sadarghat ferry terminal in Dhaka, Bangladesh, last week. Cases surged in the country after a deadly cyclone tore through the country.
The Sadarghat ferry terminal in Dhaka, Bangladesh, last week. Cases surged in the country after a deadly cyclone tore through the country.Credit…Rehman Asad/NurPhoto via Getty Images

Some countries now being overrun by the virus seemed to be doing the right thing. In Peru, where President Martín Vizcarra ordered one of the first national lockdowns in South America, over 170,000 cases have been confirmed and 14,000 more deaths than average were recorded in May, suggesting there were many more virus fatalities than the official count of about 5,000.

South Africa, Africa’s economic powerhouse, banned sales of tobacco and alcohol as part of a strict lockdown in March, yet now has 35,000 confirmed infections, the highest on the continent. Even so, President Cyril Ramaphosa eased the restrictions last week, citing economic concerns.

The pandemic’s new direction is bad news for the strongmen and populist leaders in some of those countries who, in its early stage, reaped political points by vaunting low infection rates as evidence of the virtues of iron-fisted rule.

President Vladimir V. Putin of Russia, whose delivery of a planeload of medical aid to the United States in March was seen as a cocky snub, is grappling with the world’s third-largest outbreak, with 440,000 cases that have enraged the public and depressed his approval ratings to their lowest in two decades.

For Mr. el-Sisi of Egypt, the outbreak has posed a rare challenge to his preferred narrative of absolute control.

Although Egypt’s 30,000 cases are far fewer than those of several other Arab countries — Saudi Arabia has three times as many — it has by far the highest death toll in the region and its infection rate is soaring.

Last Sunday the government recorded 1,500 new cases, up from about 700 just six days earlier. The next day the minister for higher education and scientific research warned that Egypt’s true number of cases could be over 117,000.

Egypt has counted 30,000 coronavirus cases, but experts believe the actual number is much higher.
Egypt has counted 30,000 coronavirus cases, but experts believe the actual number is much higher.Credit…Mohamed Hossam/EPA, via Shutterstock

Some hospitals are overflowing and doctors are up in arms over shortages of protective equipment that, they say, has resulted in the deaths of at least 30 doctors. Outrage crystallized last week around the death of Dr. Walid Yehia, 32, who had been denied emergency treatment at the overwhelmed Monira general hospital where he worked.

Fellow doctors at the hospital went on strike for a week to protest his death. The main doctors union issued a statement accusing the government of “criminal misconduct” and warning that Egypt was veering toward “catastrophe” — strong words in a country where Mr. el-Sisi has jailed tens of thousands of opponents.

Last week, Mr. el-Sisi railed on Twitter against unspecified “enemies of the state” who attacked government efforts to combat the virus. Earlier, Egypt’s public prosecutor warned that anyone spreading “false news” about the coronavirus faced up to five years imprisonment.

Doctors at several hospitals said they had been threatened by Mr. el-Sisi’s feared security apparatus for daring to complain. The doctors interviewed for this article spoke on condition of anonymity out of fear of reprisal or arrest.

When doctors at the Mansheyat el Bakry hospital threatened to strike last month to protest the lack of training and protective equipment, they received a warning from a hospital senior manager: Anyone who failed to turn up for work the following day would be reported to the National Security Agency, which human rights groups have accused of torture and other abuses.

Reached by phone, the manager, Dr. Hanan el-Banna said the message was part of “normal disciplinary measures.” Then she denied that she had sent it.

A spokesman for Egypt’s Health Ministry did not respond to questions about the message, or other complaints from doctors.

Medical workers disinfecting surgical instruments at the 6th of October Central Hospital, in Giza, Egypt, which has been transformed into an isolation hospital for coronavirus patients.
Medical workers disinfecting surgical instruments at the 6th of October Central Hospital, in Giza, Egypt, which has been transformed into an isolation hospital for coronavirus patients.Credit…Menna Hossam/Picture Alliance via Getty Images

The power of the virus was brought home to Mr. el-Sisi in the early stages of the pandemic, when two senior generals died from Covid-19. Yet his government has frequently seemed determined to put a Panglossian spin on how well it is being handled.

The Coronavirus Outbreak

  • Frequently Asked Questions and AdviceUpdated June 5, 2020
    • How does blood type influence coronavirus?A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
    • How many people have lost their jobs due to coronavirus in the U.S.?The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
    • Will protests set off a second viral wave of coronavirus?Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
    • How do we start exercising again without hurting ourselves after months of lockdown?Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
    • My state is reopening. Is it safe to go out?States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
    • What’s the risk of catching coronavirus from a surface?Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
    • What are the symptoms of coronavirus?Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
    • How can I protect myself while flying?If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
    • How do I take my temperature?Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
    • Should I wear a mask?The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
    • What should I do if I feel sick?If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
    • How do I get tested?If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

Last week the Health Ministry published a promotional video that showed coronavirus patients in a hospital praising their care and hailing Mr. el-Sisi. “I can’t believe this, President Abdel Fattah el-Sisi,” says one masked patient. “I can’t believe what he’s doing for our sake.”

A very different picture emerges on Facebook, where desperate patients or their relatives have posted videos pleading for help.

In one widely circulated recording, a weeping woman says that her ailing father was refused treatment at several hospitals. In another, a man with coronavirus symptoms remonstrates with hospital security guards who turn him away. “Take your complaint to the police,” they tell him.

Even if Egypt’s doctors were not muzzled by their government, Western-style social distancing would be nearly impossible in a chaotic, densely populated city of 20 million people like Cairo where many families survive on day jobs. Mosques, churches and airports remained closed, but the decision to relax a night curfew during the holy month of Ramadan — ostensibly to allow people to break their daily fast together — may have accelerated the spread of the virus, experts say.

Many low- and middle-income countries, now grappling with surging cases, are also struggling to balance public health against the realities of poverty-stricken societies, said Ashish Jha, professor of global health at the Harvard T.H. Chan School of Public Health.

“At some point the lockdown becomes intolerable,” he said. “The human cost to day laborers, many of whom are already barely surviving, is enormous.”

The hopes of some countries that they could somehow avoid the pandemic are likely to be dashed, he added.

“In the early days, people were seeing patterns that were not really there,” he said. “They were saying that Africa would be spared. But this is a highly idiosyncratic virus, and over time the idiosyncrasy goes away. There is no natural immunity. We are all, humanity-wise, equally susceptible to the virus.”

Food donations in South Africa on Thurday. The country enacted strict lockdown measures to contain the virus, but now has the highest case load in Africa.
Food donations in South Africa on Thurday. The country enacted strict lockdown measures to contain the virus, but now has the highest case load in Africa.Credit…Kim Ludbrook/EPA, via Shutterstock

Experts say that Mr. el-Sisi’s obsession with showing that he is beating the pandemic may have encouraged some Egyptians to drop their guard — a phenomenon similar to that in the United States, where some Americans have taken comfort in President Trump’s breezy reassurances.

Unfortunately, such heedlessness can have dire consequences.

In March, Mohammed Nady, 30, an employee at the Sheraton hotel in central Cairo, posted a video to Facebook dismissing the virus as an American-engineered conspiracy to humiliate China.

A few weeks later, he posted a second video from the hospital announcing that he had contracted the coronavirus.

A third clip showed him in bed, struggling to breath. “I am dying,” he said. “I am dying.”

He died in April, three days before his father also died from the disease.

Reporting was contributed by Nada Rashwan in Cairo, Michael Cooper in New York, Manuela Andreoni in Rio de Janeiro, and Mitra Taj in Lima, Peru.

Declan Walsh is the Cairo bureau chief, covering Egypt and the Middle East. He joined The Times in 2011 as Pakistan bureau chief, and previously worked at The Guardian. @declanwalsh

Africa’s dependency on commodity exports, including oil, makes it more vulnerable to the impact of COVID-19. Getty Images

How a post-COVID-19 revival could kickstart Africa’s free trade area

Africa’s dependency on commodity exports, including oil, makes it more vulnerable to the impact of COVID-19.
Getty Images

By Faizel Ismail, University of Cape Town

The African Continental Free Trade Area was launched two years ago at an African Union (AU) summit in Kigali. It was scheduled to be implemented from 1 July 2020. But this has been pushed out until 2021 because of the impact of COVID-19 and the need for leaders to focus on saving lives.

Studies by the International Monetary Fund (IMF), the United Nations Economic Commission for Africa and others state that the free trade area has the potential to increase growth, raise welfare and stimulate industrial development on the continent. But there are concerns. Some countries, particularly smaller and more vulnerable states, could be hurt. For example, they could suffer revenue losses and other negative effects from premature liberalisation.

The impact of COVID-19 will only worsen these structural weaknesses. The Economic Commission for Africa has reported that between 300,000 and 3.3 million people could lose their lives if appropriate measures are not taken. There are several reasons for this level of high risk. These include the fact that 56% of urban dwellings are in overcrowded slums, 71% of Africa’s workforce is informally employed and cannot work from home and 40% of children on the continent are undernourished.

Africa is also more vulnerable to the impact of COVID-19 because it is highly dependent on imports for its medicinal and pharmaceutical products and on commodity exports. The latter include oil, which has suffered a severe collapse in price.

Other contributing factors are high public debt due to higher interest rate payments than Organisation for Economic Co-operation and Development (OECD) countries, a weak fiscal tax base, and the negative impact on Africa’s currencies due to huge stimulus measures taken by OECD countries.

The COVID-19 crisis has brought these weaknesses into sharp relief. But it also provides an opportunity for African countries to address them. For example, they could accelerate intra-regional trade by focusing on the products of greatest need during the health crisis. Countries could also start building regional value chains to advance industrialisation, improve infrastructure and strengthen good governance and ethical leadership.

These are all vital to guiding African countries through the current crisis.

These goals can be achieved if African states adopt a “developmental regionalism” approach to trade integration. This would include fair trade, building regional value chains, cross-border investment in infrastructure and strengthening democratic governance.

Fair trade

A number of conditions need to be met for a free trade area to succeed.

Firstly, African states vary widely in size and economic development. As a result some may warrant special attention and specific treatment. In particular, among Africa’s 55 states 34 are classified by the United Nations as least developed countries. These are low income countries that have severe structural problems impeding their development.

Building trade agreements in favour of small and less developed economies will contribute to fairer outcomes of the free trade deal.

Secondly, African governments should include their stakeholders – businesses (both big and small), trade unions and civil society organisations – in the national consultation process. This will require effective institutions that enable the fullest participation.

Additional steps countries should take to cope with the fallout from COVID-19:

  • Reduce tariffs on vital pharmaceutical products (such as ventilators), personal protective equipment and food products;
  • Stimulate intra-regional trade by prioritising these products for an immediate or early phase down in the free trade area.

Building regional value chains

African countries are increasingly connected to the global economy, but tend to operate at the lowest rung of the ladder. They are mainly supplying raw materials and other low-value manufactured outputs.

Cooperation is needed between Africa’s emerging entrepreneurs and industries to improve their competitiveness in global markets. This would have a number of positive outcomes including:

  • triggering industrialisation, which will transform economies
  • helping African countries obtain a fairer share of the value derived from African commodities and labour, and
  • improving the lives of people on the continent.

The current crisis creates an opportunity for African countries to build value chains on medical equipment, pharmaceuticals and personal protective equipment.

The clothing and textile sector could also be restructured to meet the needs of the health sector while taking advantage of the breakdown in supply chains from China and Europe.

As more countries lock down their economies and apply movement controls, agricultural and processed food supply chains are disrupted. This creates opportunities to build regional supply chains and partner with retailers.

There are also opportunities to build infrastructure to support the health response: hospitals, water and sanitation, schools, low-cost housing and alternative energy.

African countries can also benefit from the growing interest in environmental tourism.

Cross-border infrastructure investment

Since most African countries are less developed, and many are small, intra-regional trade will require them to cooperate to improve their infrastructure. This includes physical ports, roads and railways as well as customs procedures, port efficiency and reduction of roadblocks.

Progress is already being made. Examples include the Mombasa-Nairobi Corridor; the Addis to Djibouti road, rail and port connection; and the Abidjan-Lagos Corridor, which handles more than two-thirds of West African trade.

Increased investment in these types of cross-border infrastructure projects will benefit regional integration.

Democracy and governance

Most African states have started accepting multi-party systems of governance. Many have also embraced a culture of constitutionalism, rule of law and human rights.

Democratic governance supported by active citizenship will create an environment of transparency and predictability that encourages domestic and foreign investment. Both are vital for growth and industrialisation. The process is also essential for the sustainability of regional economic integration and democracy in Africa.

Countries are becoming better at fulfilling their democratic obligations. For example, 40 African countries, including the Seychelles and Zimbabwe, voluntarily joined the African Peer Review Mechanism. The mechanism is a remarkable achievement that the free trade area agreement must build on.

The way forward

The free trade area could become a landmark in Africa’s journey towards peace, prosperity and integration. The COVID-19 pandemic, notwithstanding its devastating impact on the health and economies of Africa, could be an opportunity to advance the free trade area in a more developmental, inclusive and mutually beneficial way for African countries.

Faizel Ismail, Director of the Nelson Mandela School of Public Governance, University of Cape Town

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Volunteers wearing face shields distribute food in Lagos, Nigeria, where improving the level of testing has been difficult. Photograph: Akintunde Akinleye/EPA

Africa lack enough COVID-19 test kits

Volunteers wearing face shields distribute food in Lagos, Nigeria, where improving the level of testing has been difficult. Photograph: Akintunde Akinleye/EPA
Volunteers wearing face shields distribute food in Lagos, Nigeria, where improving the level of testing has been difficult. Photograph: Akintunde Akinleye/EPA

Public health experts have warned about the risks of low supplies of coronavirus test kits as lockdowns in African countries begin to ease and urban populations become more mobile.

Different countries on the continent have adopted a range of testing strategies, but international competition for test kits and a lack of global coordination of resources have meant many African countries are testing with significantly limited reach.

More than half of African countries are experiencing community transmission as lockdown measures relax.

Kate Dooley, the director for West Africa at the Tony Blair Institute, said: “Most governments are currently rationing their use of test kits given limited supplies. We are aware of some cases where African governments who placed orders in early March are still yet to receive the supply, six to eight weeks later.”

Testing capacity, logistics and staffing challenges posed structural constraints to the ability of many countries to increase testing even when supplies became available, she said. Some countries, such as Nigeria, had been waiting months for deliveries of test kits.

There are 112,000 confirmed cases of Covid-19 in Africa, and 3,000 people are confirmed to have died from the virus.

Total infections are lower than in most other continents, owing in part to the effectiveness of lockdown and control measures, adopted early by several countries when cases were in their low dozens.

According to the World Health Organization, 1.5m Covid-19 tests have been conducted in Africaover the last 6 weeks. South Africa and Ghana account for half of the tests, and just eight African countries have administered more than 3,000 tests per million people.

The Africa Centre for Disease Control and Prevention has set up a digital purchasing platform, being piloted this week, to let African governments bulk order test supplies and protective equipment. It is hoped the platform will improve the continent’s negotiating position when bidding for supplies.

The ACDC director, Dr John Nkengasong, said last month that “a collapse of global cooperation and a failure of international solidarity have shoved Africa out of the diagnostics market”.

“African countries have funds to pay for reagents but cannot buy them,” he added.

According to Dr Iruka Okeke, the editor of the African Journal of Laboratory Medicine, gains made by African countries in the early stages of the outbreak could be at risk from a lack of test supplies.

“Unless we can vastly ramp up testing we risk entering a stage where it spreads through communities where there isn’t the capability to test them,” she said.

The prevalence of virus response measures and detection systems in countries that have already experienced deadly viruses has been vital, according to Okeke.

“Responses to Ebola, HIV and Lassa fever have improved the level of molecular biology in Africa, which countries have leveraged well.

“The problem is countries were preparing for an epidemic not a pandemic, so now African countries are competing for the same consumable resources as the other countries.”

Parts of Ghana’s virus response have emerged as a model in the region. With a population of 29 million, the country has tested almost 200,000 people, one of the highest rates in Africa. The country has registered 6,800 infections with over 2,000 recoveries, while 32 people have died.

Ghana has just five laboratories that can test for Covid-19 but has innovated to improve test levels, running laboratories for 24 hours, using drones to deliver samples from rural areas, and testing multiple samples at the same time.

Improving the level of testing in Africa’s most populous country has been difficult. Nigeria has 7,800 confirmed infections, with a third recovered and 226 deaths.

But according to Dr Casmir Ifeanyi, the president of the Association of Medical and Laboratory Scientists of Nigeria, a medical union, confirmed cases were “an underestimation of Covid-19 mobility.

“We have conducted fewer than 40,000 tests. For a country of 200 million where we have community transmission across the country, that is not the sample size to make any deduction about the spread of the virus.” Mass deaths in Kano have put pressure on authorities to increase testing.

There are now 25 laboratories that can test for Covid-19, up from five before the first confirmed case in February. But despite a capacity for 2,500 tests a day, Nigeria often administers less than half, hampered by personnel and logistical constraints, particularly in rural and insecure areas.

“We’re in a very severe situation especially now the government is talking about further easing the lockdown,” Ifeanyi said. “Without testing this will create problems.”

Africa didn’t dither but faces long coronavirus fight

It was an unsettling experience.

Every minute or so, the police would stop their van, jump out and – as people around them began to shout and run away – start to chase citizens more or less at random, it seemed to me, before shoving one or two of them into the back of their vehicle.

One woman wasn’t wearing a mask, an officer explained.

Another might have been selling contraband cigarettes.

Several people had, perhaps, been standing too close together, although it was hard to tell in the dark. And so on.

Lack of trust in the state

The whole process felt arbitrary and alarming – a clear abuse of authority.

Andrew goes on patrol with South Africa’s police

But in the days since then I’ve begun to think of that night in Alexandra in a different way; to consider not the police’s behaviour, but rather the hard-learned reactions of the citizens of the township.

To run. And then, if caught, to submit meekly.

It was, I think, a very clear expression of vulnerability – the behaviour of people who feel, instinctively, powerless to challenge the might of the state.

I’ve seen it often, both here in South Africa and – to a far greater extent – in other parts of the continent.

South African soldiers patrolling in Alexandra township during the coronavirus lockdown
Image captionSouth Africa’s army has been called in to implement strict lockdown restrictions

Something similar applies to hospitals too.

I’ve heard – first and second hand – too many anecdotes about people whose relatives were admitted to underfunded public hospital with “a stomach ache” or “just a cold” and who were abruptly pronounced dead within days.

In other words, many people have learned to look towards the police and the medical profession not for salvation, but for something more nuanced.

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It strikes me that an acute sense of vulnerability – not unique to Africa, of course – has characterised this continent’s response to the pandemic too.

Yes, there was some bluster in the early days about Africa perhaps being spared – and we still hear populists like Tanzania’s President John Magufuli trying to play down the threat.

But most people I’ve spoken to, particularly in poorer neighbourhoods, have shown an increasingly intense and proactive determination to do all they can to protect themselves and their families, and – importantly – not to expect, or rely on, the state to do it for them.

In a sense, that same vulnerable mindset applies to most African governments too.

Africa acted fast and decisively

After all, this is a continent where tuberculosis (TB), HIV, malaria and dysentery still kill – despite impressive recent improvements in public health – millions of people each year.

Six main causes of death in Africa

  • 1) Lower respiratory infections (10.4% of deaths):916,851
  • 2) HIV/Aids (8.1%):718,800
  • 3) Diarrhoeal diseases (7.4%):652,791
  • 4) Ischaemic heart disease (5.8%):511,916
  • 5) Malaria (4.6%)408,125
  • 6) TB (4.6%):405,496

Source: WHO – figures from 2016

And so, governments across the continent are already hard-wired to respond to new public health challenges like Ebola or Covid-19.

That is why they didn’t dither in the early stages of the outbreak.

As other countries dabbled with herd immunity, kept their airports wide open, or merely encouraged their citizens to avoid the pub, African states were busy implementing strict lockdowns and re-training their vast standing armies of community health workers.

Delayed but not contained?

But the question now – for South Africa and for the rest of the continent – is whether that sense of vulnerability can help to sustain a much longer and effective fight against the virus because the evidence – from Nigeria to South Sudan and beyond – now appears to show that Africa’s early successes may simply (and usefully) have delayed, rather than contained, Covid-19.

Students at this Kenyan university are voluntarily making critical medical kits.

The latest expert projections from a team here in Johannesburg indicate that the virus will – despite an impressively lowered infection curve – still kill more than 40,000 South Africans and is likely to peak only at some point in the second half of July.

At the same time, the severe economic damage caused by the early lockdowns is beginning to test the patience and the coping mechanisms of communities and governments which lack the deep pockets of Western nations.

Some excruciatingly difficult choices and battles lie ahead.

This is not to “catastrophise” Africa.

The continent’s early response – fuelled by a well-honed sense of vulnerability – has been world-class”

Andrew Harding
Africa correspondent, BBC News

The outside world sometimes seems to have flip-flopped – when it has even taken the time to notice – between seeing this continent as a slow-motion disaster that will eclipse all others with its coronavirus horrors, or a place where humidity, sunshine, a young population, widespread TB vaccines, or other less benign tropes, will somehow produce a miracle.

The truth is surely more mundane.

Africa is busy adapting to yet another deadly disease.

Muslim worshippers outside a mosque in Dakar, Senegal - Friday 15 May 2021
Image captionAfrica is adapting to coronavirus – like these Muslim worshippers in Senegal

Like other parts of the world, it will struggle, and it will eventually prevail, or at least find some sustainable long-term accommodation with the virus.

The continent’s early response – fuelled by a well-honed sense of vulnerability – has been world-class.

But its healthcare systems have been weakened, many would argue, not just by poverty and corruption, but by the systematic luring of African medical staff to Western nations over decades, by the short-termism at the heart of much international aid, and by the power-imbalances at the heart of the global economy and its key institutions.

Africa’s education crisis: millions of children locked out of school

Girls throughout Africa are missing out on schooling CREDIT: Issouf Sanogo/AFP

Sierra Leone’s minister for education, David Moinina Sengeh, is not in the mood to downplay the challenge the world is currently facing.   

“It’s a disaster,” he tells the Telegraph on a web call from Freetown. And while he is aware the initial focus in the pandemic has to be saving lives, he is not talking about health. 

“The education crisis is happening now, in parallel with the health crisis,” he says. 

“And it’s bigger in my opinion: 1.6 billion kids out of school, that’s a problem; 810 million kids not in school in low and middle income countries, that is a disaster.”  

For much of the world, it is a new disaster. But countries in West Africa that experienced Ebola in 2014-16, like Sierra Leone, have some experience of this kind of disaster, and its long-term impact. 

In Sierra Leone, almost 4,000 people died of Ebola. The economy was severely disrupted, and many children orphaned. 

Schools were closed for nine months to stop the spread of infection. During this period, with children out of school and vulnerable to exploitation, teenage pregnancies shot up by over 60 per cent; 11,000 girls who were previously in school got pregnant. More died from childbirth complications than Ebola itself, and many of those who did survive never returned to education. 

That is a huge loss. Study after study has shown that the benefits of educating girls span society, from reducing child mortality to boosting GDP. 

Mr Sengeh – who recently went viral after tweeting a picture of himself carrying his baby on his back in a sling, a rare thing for a man to do in his country – is adamant it won’t happen again. 

“School is the safest place for many children, and we lost out on learning, and the safety of children,” he says.  “[This time] we have been able to tackle this very directly to correct it.” 

Schools in Sierra Leone closed at the end of March, part of a series of measures aimed at stamping out the virus before it took hold in the African country of 7.6 million people.   

And while the picture is not totally clear and cases have recently jumped, it appears to be working: Sierra Leone has seen 570 cases and 34 deaths. 

But schools remain closed for the foreseeable future. As such, Mr Sengeh and his team have implemented a package of measures to ensure that children – and in particular girls – do not get left behind again.

These include radio educational broadcasts to reach people with no internet access or television. The government is also working to deliver physical education materials – paper, pens and pencils – to children without putting them at risk.  

It is also building mobile phone solutions using SMS and USSD technology – the tech on phones that allows mobile banking or top-up payments to work – which has about 80 per cent penetration in Sierra Leone.  

“Even with the simplest technology there are people left out, but we are trying to make sure that [group] is smaller and smaller,” he says, adding that the government is evaluating how many children are being reached. 

Save The Children said the efforts so far were positive. 

“The children say the programmes are good, but that is for those in supportive family environments, who are able to sit with their parents, play them back, do the exercises together. That’s not the case for all children,” says Ramatu Jalloh, director of advocacy for STC in Sierra Leone.

However, she says there are signs the government has learned its lessons from Ebola, particularly around protecting the most vulnerable. For example, it has been providing food to about 6,000 children who would normally eat their main – or only – meal at school. 

For poorer countries financial challenges like this are huge, from the household level up, according to Alice Albright, chief executive of the Global Partnership for Education. It has made $250 million available to countries like Sierra Leone to work on coronavirus response.

“One of the key risks is we slip back and lose the gains we have made since the beginning of this century,” she says. “We are very concerned that the ability to get the necessary resources for education is crowded out.” 

In Sierra Leone, most of the population lives on less than $2 a day, and only around half its children completed secondary school even pre-pandemic. 

“We cannot do things the way as we did before coronavirus,” says Mr Sengeh. “We cannot. We have to change and reimagine.”

Just before coronavirus hit, Mr Sengeh’s government overturned a ban on pregnant schoolgirls that had been put in place after Ebola. It also made education free for all in 2018 in a bid to keep more children in school.   

But Mr Sengeh also means new approaches, like the idea about to be discussed by cabinet, for a ‘girl’s empowerment fund’ which pays an as-yet-undecided amount of money into a girl’s bank account for every year of school completed. 

She can use it for university, or to start a business; or access the resources during her education, for hygiene kits or sanitary pads. 

“For the economy, for child survival, for immunisations – it’s an investment to ensure that girls complete secondary school,” says Mr Sengeh. 

“This is an idea we are actively working on to launch when schools reopen. We are building schemes for girls to encourage them to come back.” 

Why covid-19 seems to spread more slowly in Africa

It was not what fishermen usually mean by a good catch. Last month a worker at a fish factory in Tema, a port city in Ghana, infected 533 people with the virus behind covid-19. President Nana Akufo-Addo linked the “super-spreader” to about 10% of the country’s 5,408 cases.

That Ghana could identify the person is a tribute to its response. It has tested more than 155,000 people, the fourth-highest per-person rate in Africa, according to data from cdc Africa, a public-health body. Elsewhere a lack of testing makes it harder to assess the true course of the disease. But what data there are, and new analysis by the World Health Organisation (who), suggest the virus is spreading more slowly in Africa than elsewhere—and that its path will vary across the continent.

Africa, which contains about 17% of the world’s population, has less than 2% of its confirmed cases of covid-19. By May 13th cdc Africa had counted 69,947 cases and 2,410 deaths. Over the past month reported cases have doubled roughly every two weeks. Until recently American cases were doubling about every three days.

This may partly reflect insufficient testing. Africa has checked just over 1m people—a day’s work for officials in Wuhan. South Africa and Ghana account for nearly half. The Partnership for Evidence-Based Response to Covid-19, a public-health consortium, notes that “the true number of infections is likely to be much greater than currently known.” Its rough estimate suggests a tally eight times higher.

Another sign of undercounting is the share of covid-19 tests coming back positive. The “test-positivity-rate” is an imperfect guide. But assuming those being tested have covid-like symptoms, a rate above 5-10% suggests there are many uncounted cases, says Jason Andrews of Stanford University. At least 22 African countries have rates above 10%, including Algeria (91%), Sudan (87%) and Tanzania (78%).

John Magufuli, Tanzania’s president, does not believe his country’s results. “We only see them releasing positive, positive, positive results,” he said. He claims that the national laboratory was sent papaya, goat and sheep samples that tested positive. (The lab denies this.) No new official data have been released since April 29th.

Opposition activists and ngos say that there have been dozens of burials of covid-19 victims in Dar es Salaam, Tanzania’s largest city. On May 12th the American embassy said that hospitals there were “overwhelmed”. “It is a cover-up,” says Zitto Kabwe, an opposition leader.

There are similar reports of undocumented surges in other countries. In Kano, in northern Nigeria, hundreds of unexplained deaths have been alleged by gravediggers. In Mogadishu, the capital of Somalia, medics claim that the deaths they are seeing do not chime with official totals.

Nevertheless there are few signs that these “ghost hotspots” are ubiquitous. Some countries, including Mauritius, Namibia and the Seychelles, have not reported a new case for two weeks. Ethiopia, Rwanda and Uganda have fewer than 700 cases between them and positive-test rates below 1%. Nor are there reports of surges. “In a society like ours there’s simply no way this could be kept secret,” says Berhanu Nega, an Ethiopian opposition leader.

Crucial in slowing the early spread of covid-19 was the swift introduction of containment measures. Most African countries implemented lockdowns far earlier than rich countries did. By the end of April at least 42 African countries had done so; 38 of these were in place for at least 21 days.

So despite undercounting, official data are still a rough reflection of reality in many countries, say those leading the response. “While covid-19 likely won’t spread as exponentially in Africa as it has elsewhere in the world, it likely will smoulder in transmission hotspots,” says Matshidiso Moeti, the director for the who in Africa.

Her view of a slower, longer pandemic is explained in a paper by who colleagues, published by bmj Global Health on May 14th. Unlike other models, which tend to apply patterns seen elsewhere in the world to Africa, theirs claims to make assumptions based on the continent’s “unique socio-ecological context”. For example, it takes into account the fact that Africans travel less, thanks to sparse road networks.

The authors reckon that without containment measures 16-26% of those in the who Africa region would be infected in the first year, with higher shares in well-connected countries like South Africa. About 29m-44m people would be symptomatic. This is a lower estimate than other models yield. The who also calculates that there would be 83,000–190,000 deaths without mitigating steps—implying a lower rate of infected people dying than in rich countries, mostly because Africans are younger. However, Africa does not have rich countries’ hospitals. Surges in cases would overwhelm health systems.

Because the model assumes no mitigating measures such as lockdowns, the actual tallies should be lower. Yet many African governments are in the midst of loosening restrictions, as they try to balance the harm of covid-19 with that to their economies and public health more broadly. Researchers at Imperial College London reckon that in some countries the knock-on effects on treatment for hivtb and malaria could be of the same order of magnitude, in terms of years of life lost, as that of covid-19.

Many rich countries are easing lockdowns after reaching, in theory, peaks in new cases. African countries may be doing so while case-rates accelerate. Africa seems to be suffering a slower pandemic, but the risks are still immense. ■

Snipers, stylists and Staff Benda Bilili: Andy Hall’s Africa – in pictures

For decades, photographer Andy Hall has documented major events and daily life throughout Africa – from the Cuban withdrawal from Angola and the last days of apartheid to music, the obsession with football and the effects of climate change

All photographs Andy Hall

Days of coronavirus may be ending – but the worst may hit developing countries

A girls washes her hands in Burkina Faso as the number of cases climb in the country CREDIT: Shutterstock

As Europe’s nations start to emerge from lockdown into spring sunshine, hoping infection peaks are behind them, epidemiologists are increasingly worried about poorer parts of the world.

While the worst of the early pandemic may be over or slowing down in China, Europe and the United States, the coronavirus is on the march elsewhere.

Developing and middle-income countries in Africa, Asia and Latin America which might have thought they had escaped the worst could instead be months off their peaks, health officials now fear.

The United Nations this week tripled the sum it says is needed to avert a Covid-19 catastrophe in the world’s poorest nations. It put out an appeal for a further $4.7bn for medical and food aid, on top of another $2bn requested in March.

A lack of reliable data in much of the world means case numbers and deaths are unclear and so far likely to be vastly underestimated. But the signs are alarming in several countries and the disease may continue to spread in developing countries for another three to six months, the UN said.

‘Rise in conflict hunger and poverty’

Meanwhile, the economic toll of lockdown is already leading to poverty and unemployment for millions.

“The most devastating and destabilising effects” of the pandemic “will be felt in the world’s poorest countries”, UN Under-Secretary-General for Humanitarian Affairs Mark Lowcock said. “Unless we take action now, we should be prepared for a significant rise in conflict, hunger and poverty. The spectre of multiple famines looms.”

Several leaders in the developing world have speculated that their countries may be spared the worst because of their relatively youthful populations. Younger citizens could result in a slower spread and a “slow burn” outbreak in some countries, epidemiologists have suggested.

A temporary hand-washing station in Kenya as cases climb in the country CREDIT: Patrick Meinhardt/Bloomberg

But scientists also warn that any benefit from youth could be counterbalanced by poor healthcare and the unknown effects of Covid-19 on those who are malnourished and carry diseases such as malariatuberculosis or HIV. Parts of Africa are already causing concern.

Charlotte Watts, chief scientific adviser for the Department of International Development and a member of the Government’s Scientific Advisory Group for Emergencies (Sage), said: “It’s really hard to say where will be hit worst – it’s a disease that knows no borders and spreads quite easily around the world.

“But we are concerned now about the likely wave that’s going to spread across sub-Saharan Africa, and we’re starting to see numbers increase rapidly.”

Low testing in Africa

Africa has so far recorded 35,000 cases of coronavirus and over 1,500 deaths. This number is soaring every week, but experts say low testing means these figures only show a shadow of the crisis.

In Nigeria, Africa’s most populous nation, fears are mounting that the pandemic has spread far more than anyone anticipated. Over the last few weeks, there has been a spate of at least 640 mysterious deaths in the country’s populous northern Kano state.

Solid information on the situation in Kano is scarce. However, reports suggest that both doctors and gravediggers are being overwhelmed. Aminu Kano Teaching Hospital, a major hospital in Kano city, has reportedly been inundated with patients showing coronavirus symptoms.

In Tanzania, the situation looks equally grim. The country’s strongman leader, John Magufuli, is continuing to downplay the pandemic. His government has promoted church-going and steam inhalation as ways of combating the ‘satanic’ virus. As he refuses to put harsh measures in place, a stream of unconfirmed videos shows dead bodies lying on the street and men clad in protective equipment burying bodies under cover of darkness.

The figures on Africa’s medical preparedness are stark. On average sub-Saharan Africa has about one doctor for every 5,000 people, compared with 14 in the UK, according to the WHO. There are only an estimated 2,000 live-saving ventilators in the entire continent, compared with around 170,000 in the US. At least, 10 African countries have none at all.

Adam Kucharski, an epidemiologist at the London School of Hygiene and Tropical Medicine, predicts that the virus is spreading undetected in low and middle-income nations, with the impact to be seen in a month or two.

He told the Telegraph: “Our working theory is that although, for example in Africa, these are younger populations, I think because of comorbidities and other health conditions, you’d still expect potentially quite serious impact.”

Women in Bangladesh wait for relief supplies provided during the coronavirus outbreak CREDIT: Mohammad Ponir Hossain/Reuters

Estimates of the human toll of that impact among African countries vary widely.

The World Health Organization said this week that 190,000 people in Africa could die of Covid-19 and 29 million to 44 million could get infected in the first year of the pandemic if containment measures fail. The body’s modelling sees the disease spreading more slowly than elsewhere, but “smouldering” for several years in transmission hotspots.

The United Nations Economic Commission for Africa (UNECA) has warned of an even more apocalyptic scenario: even with intense social distancing, the continent of 1.3 billion could see nearly 123 million cases this year. And some 300,000 people could die.

Deaths in rural India

India is also seeing a worrying rise in cases and it has long been suspected the official numbers are greatly underestimated.

Earlier this week, the Indian Minister of Health was still proclaiming that there has been no community transmission, even as the country that day recorded 195 deaths.

Despite spending 40 days in lockdown, cases are continuing to surge and show no signs of letting up – there has been a 14 per cent increase to 52,952 over the last 48 hours.

Again patchy data is likely to be clouding the real picture. Most deaths occur in rural areas, doctors say, and medical certificates stating the cause can be rare. Public health officials are left trying to check anecdotal indications of increased deaths.

An auto rickshaw driver is threatened for breaking lockdown rules CREDIT: Reuters/Francis Mascarenhas

In the city of Malegaon in Maharashtra, the state which has recorded India’s largest number of coronavirus infections, 580 deaths were recorded in April, double the figure for last year. Authorities are currently testing family members as they suspect the dead were coronavirus victims, unaccounted for due to the lack of testing.

India’s peak may still be two months away, said Dr Randeep Guleria, the Director of All India Institute of Medical Sciences.

Across India’s north western border, Pakistan has also seen deaths tick up ominously, even as ministers have tried to argue the disease is somehow less virulent in South Asia. Deaths have doubled to nearly 600 in 10 days and here too, the peak is not expected until possibly July.

In both countries the economic toll of the lockdown looks set to be 

Pakistan could lose 18 million jobs and see a million small businesses go bust, Asad Umar, the planning minister said earlier this week. One in four Pakistanis have cut their food intake as a result of straitened circumstances and some 20 to 70 million may fall below the poverty lines as a result of the precautions.

Such an economic cost has forced both nations to relax their safety restrictions even as cases are still growing.

A worker sprays disinfectant on a relative of a coronavirus victim during a funeral in Jakarta, Indonesia CREDIT: Willy Kurniawan/Reuters

Indonesia is well on its way to becoming a new southeast Asian hotspot two months after the health minister,  Terawan Agus Putranto, was citing an absence of cases as a “blessing from the Almighty”.

The death toll in the world’s fourth most populous nation currently stands at around 930, with many suspecting the figures are still unreported.

Mortuary workers have spoken of their exhaustion as they struggle to bury dozens of bodies piling up daily at cemeteries.

Cases doubling in Latin America every few days

And early hopes that the tropical climates of the Caribbean and Central and South America might act as some kind of defence against the coronavirus have also been dashed.

Brazil is now the epicentre of the disease in Latin America, with the number of cases at more than 100,000 and rising. Daily death tolls this week have been around 600.

Brazil’s far-right leader, Jair Bolsonaro, has consistently downplayed the severity of the virus, describing it as a flu or the sniffles. When he was asked about the day’s death toll of 474 at a press briefing last month, he replied “So what?”

Rio de Janeiro’s Christ the Redeemer statue is illuminated wearing a facemask CREDIT: Mauro Pimentel/AFP

Official death tolls again probably obscure the scale of what is happening. In the city of Manaus, just 532 deaths are attributed to Covid-19. Yet city data shows 2,435 people were buried in April alone, compared with 871 in April last year.

In Brazil, as well as Ecuador, Peru, Chile and Mexico, the number of cases is doubling every few days.

In the Caribbean, Haiti is at risk from a “perfect storm approaching”, said Dr Carissa Etienne, director of the Pan American Health Organization.

Although the country has reported only 100 cases, around 17,000 Haitians have returned from neighbouring Dominican Republic, where the disease is spreading widely, and this number is expected to reach 55,000 in the next few weeks.

Haiti’s health system is poor and the country has struggled to recover from a devastating earthquake which took place in 2010.

With months if not years of the epidemic left to run, the final distribution of cases could look very different by the end. Countries or regions of the world who at first thought they had escaped should be cautious, said Dr Josie Golding, epidemics lead at Wellcome.

“We have no idea how this will turn out and countries should prepare for the worst,” she said. 

Sexual and gender-based violence during COVID-19: lessons from Ebola

Victims of sexual and gender-based violence suffer trauma that lasts long beyond medical crises.
Corbis News via GettyImages

Monica Adhiambo Onyango, Boston University

The COVID-19 pandemic is a disaster that has severely disrupted the normal functioning of populations around the world and continues to proliferate indiscriminately.

Disease outbreaks like COVID-19 threaten the health of all. But women and girls are disproportionately affected. During epidemics, the very measures taken to protect populations and keep health systems afloat leave women and girls especially vulnerable to violence.

Sexual and gender-based violence is a hidden consequence of the COVID-19 pandemic. As communities around the world are forced to stay at home, women and girls are at a heightened risk of domestic violence, intimate partner violence, child abuse, and other forms of sexual and gender-based violence.

Because disasters exacerbate pre-existing gender inequities and power hierarchies, violence in the home may worsen as prolonged quarantine and economic stressors increase tension in the household. Women and girls are isolated from the people and resources that can help them, and they have few opportunities to distance themselves from their abusers.

During epidemics, it’s harder for sexual and reproductive health workers to appropriately screen for sexual and gender-based violence. And referral pathways to care are disrupted.

Our research shows that an increase in sexual and gender-based violence was observed during the 2013-2015 Ebola outbreak in West Africa. During that outbreak, response efforts focused on containing the disease.

This focus was important, but protocols were never established to protect girls and women from violence during the outbreak. Quarantines and school closures were put in place to contain the spread of disease. This left women and adolescent girls vulnerable to coercion, exploitation and sexual abuse.

There is already concern that COVID-19 is leading to an increase of sexual and gender-based violence.

Rising levels of violence

Sexual and gender-based violence does not begin with disasters like COVID-19. But the chaos and instability they cause leave women and girls more vulnerable.

The United Nations secretary-general, António Guterres, has sounded an alarm on a “horrifying global surge” of domestic violence.

In Kenya, cases of sexual, gender-based and domestic violence have increased significantly since the country began its response to the virus. In China, domestic violence reports nearly doubled after cities were put under lockdown, with 90% related to the epidemic.

Helpline calls have increased in Malaysia, Lebanon, France, Argentina, Cyprus and Singapore. A sharp drop in calls in Italy suggests that the lockdown also prevented many women from seeking help.

According to the World Health Organisation, 35% of women around the world have already experienced some form of sexual and gender-based violence in their lifetime. In some crisis settings, this number skyrocketed to more than 70%.

Ebola experience

Increases in sexual and gender-based violence were observed during the 2013-2015 Ebola outbreak in West Africa. Estimates concerning the scope are difficult to obtain and vastly under-reported. Survivors of violence were ignored as health workers counted the number of Ebola cases.

According to some reports, Guinea reported a 4.5% increase in sexual and gender-based violence and twice as many rapes. More often than not, this violence was evident only by its devastating consequences for women and girls.

In the aftermath of Ebola, both Sierra Leone and Liberia saw an upswing in teenage pregnancy rates.

The parallels between the response to Ebola and COVID-19 are striking. Public health infrastructure during Ebola came to a grinding halt. In a desperate attempt to control the virus, governments employed many of the current social distancing strategies. These included school closures, curfews, and quarantines.

As Ebola spread throughout West Africa, heavily burdened relief efforts failed to account for particularly vulnerable populations. The needs of women and girls, especially concerning sexual and gender-based violence, were largely ignored in response and recovery planning.

Many organisations waited until Ebola was under control before addressing these needs. By then it was too late.

Lessons learned

One of the key lessons learned from the Ebola outbreak was that epidemics leave women and girls especially vulnerable to violence. Mistakes made during the Ebola epidemic are valuable lessons in the COVID-19 response.

Governments must ensure the protection of women and girls right from the beginning of an epidemic. However, a top-down approach is not enough. Prevention and mitigation initiatives need to be integrated across sectors.

Research has found independent women’s groups to be the single most important factor in addressing violence against women and girls. In light of this, women and girls should be involved in the development and delivery of services during COVID-19. And comprehensive data on the gendered impact of COVID-19 should be collected.

All protective services for women and girls must be classified as “essential” during any disaster. Domestic violence hotlines, safe spaces, sexual and reproductive health services, referral pathways, and justice mechanisms are necessary in pre-pandemic times, and even more important in crisis.

Governments should identify organisations already focused on sexual and gender-based violence and give them the tools and resources to continue supporting women and girls during the pandemic. Since social distancing limits screening opportunities, these organisations should explore alternate entry ways for women to access care, especially in places like supermarkets and pharmacies.

As hospitals and clinics deal with infected patients, the health sector should collaborate with gender-violence organisations to deliver services creatively and strengthen referral pathways in accordance with virus mitigation measures.

High-quality clinical care for survivors should be accessible at all times. Community gatekeepers including religious, traditional, women, and youth leaders should play a key role in both virus and violence mitigation initiatives. They can also serve as early warning and alert groups within the community.

Frontline workers should be trained to recognise and safely refer cases of sexual and gender-based violence. And women should be aware of the increased risk during times of crisis, and where to access help.

The consequences of sexual and gender-based violence do not end when medical crises are contained. The impact of COVID-19 will be wide scale, longstanding, and likely generational. Response and recovery planning must ensure that those most impacted by COVID-19 are not forgotten.

Additional research was done by Alexandra Regan, a Master of Public Health candidate at Boston University School of Public Health

Monica Adhiambo Onyango, Clinical Associate Professor, Global Health, Boston University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus: “190,000 could die in Africa in one year”

Treating and isolation are key, says WHO’s Africa boss

As many as 190,000 people across Africa could die in the first year of the coronavirus pandemic if crucial containment measures fail, the World Health Organization (WHO) warns.

The new research also predicts a prolonged outbreak over a few years.

“It likely will smoulder in transmission hot spots,” says WHO Africa head Matshidiso Moeti.

This patchier and slower pattern of transmission sets Africa apart from other regions, WHO experts say.

Other factors taken into account are the region’s younger populations who have “benefitted from the control of communicable diseases such as HIV and tuberculosis”, as well as lower mortality rates.

The WHO’s warning comes as Africa’s most populous nation, Nigeria, plus others including South Africa and Ivory Coast, have begun relaxing some of their lockdown measures.

What does the study say?

The study finds that between 29 million and 44 million people in the WHO African region could get infected in the first year of the pandemic. Between 83,000 and 190,000 could die in the same period, it warns.

The estimates are based on prediction modelling, and focus on 47 countries in the WHO African region with a combined population of one billion – Egypt, Libya, Tunisia, Morocco, Eritrea, Sudan, Somalia and Djibouti are not included.

Across the whole of the African continent more than 2,000 coronavirus deaths have been recorded by Africa’s Centre for Disease Control. By comparison, 140,000 have died in Western Europe, where the virus took hold several weeks earlier.

Cases have been recorded in every African nation except Lesotho.

South Africa has the highest number of confirmed cases – more than 8,200 and 160 deaths – while Algeria has the most deaths – 483.

“Covd-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region,” Dr Moeti says in a WHO statement.

“We need to test, trace, isolate and treat.”

Pentecostals and the spiritual war against coronavirus in Africa

Stefan Heunis/AFP/Getty Images

By Benjamin Kirby, University of Leeds; Josiah Taru, Great Zimbabwe University, and Tinashe Chimbidzikai, Max Planck Institute for the Study of Religious and Ethnic Diversity

Since the emergence of COVID-19, a number of media commentators and academics have reflected on the “spiritualisation” of the pandemic among responses in different African settings.

There’s been particular interest in the influence of prominent Pentecostal pastors on public health messaging. Some have expressed concern about the possible consequences of their invocations of spiritual warfare.

We’ve examined how idioms of (spiritual) warfare have been deployed in response to the coronavirus pandemic and wish to bring a broader perspective to recent debates about these dynamics. We consider examples from Tanzania and Zimbabwe, drawing on our ongoing research in these settings.

Many Pentecostal Christians, in Africa as well as other continents, portray the coronavirus as a “spiritual force of evil” rather than as a biomedical disease.

Through this lens, the world is presented as a battleground between God and the agents of Satan. For those who enlist to “fight for Jesus”, the most effective weapon is prayer.

Spiritual warfare provides a framework for explaining and responding to both mundane and extraordinary events – from a cancelled flight to a global pandemic. But despite their close association with Pentecostals, these militarised idioms may also resonate with other groups.

The prophet

In Zimbabwe, Prophet Emmanuel Makandiwa has been criticised for reassuring his congregants that they will be “spared” from the virus. This will happen through prayer and the divine protection he mediates. “You will not die, because the Son is involved in what we are doing,” he says, calling it

the freedom that no medication can offer.

This declaration epitomises a sense of Pentecostal “exceptionalism”, embodied in the claim to be “in this world but not of this world”. It clearly risks instilling a level of complacency among his followers about the threat of the virus. It amplifies the possibility of noncompliance with government safety measures.

Advert for online service led by Prophet Makandiwa.
Christ TV Channel/Twitter

Prophet Makandiwa has also been accused of perpetuating conspiracy theories. Drawing Biblical allusions to the “mark of the beast”, he has warned followers about “microchip” implants. These, he predicts, will accompany future vaccination campaigns. This claim has also been made by pastors elsewhere in the African continent.

In Uganda, steps have already been taken to prosecute pastors spreading misinformation.

The president

Efforts to “spiritualise” the virus have also been pursued by some African leaders. For example, Tanzanian President John Pombe Magufuli described COVID-19 as a demon (shetani). Through it Satan seeks to “destroy” Tanzanian citizens.

Despite the government promoting physical distancing, he declared that churches or mosques would not be closed because this is where God and “true healing” (uponyaji wa kweli) are found.

Invoking the idiom of spiritual warfare, Magufuli explained that COVID-19

cannot survive in the Body of Jesus (and) will be burned away.

Commentators have observed that Magufuli is himself a Roman Catholic (albeit with Pentecostal ties). Yet few have acknowledged his implication that God can also be “found” in mosques, nor his recommendation that Tanzanians also embrace indigenous medicinal practices for protection.

In a country where Christians don’t constitute a clear religious majority, Magufuli invokes the rhetoric of spiritual warfare to articulate a sense of national religious identity.

A woman walks past an election billboard featuring now president of Tanzania, John Magufuli in Dar es Salaam.
Daniel Hayduk/AFP/Getty Images

These invocations mostly adopt a rhetorical style reminiscent of Pentecostal pastors but maintain a broad, inclusive focus on God (Mungu).

Tanzanians responded enthusiastically to Magufuli’s call for citizens “of every faith” to participate in three days of national prayer. Many took to social media to circulate photos and videos featuring the Tanzanian flag and words of prayer.

Some perspective

Yet a growing number of commentators have criticised Magufuli. As with Makandiwa, they argue that his use of spiritual warfare rhetoric generates a dangerous expectation of viral immunity.

Some commentators have taken Magufuli’s emphasis on prayer to be emblematic of the government’s perceived failure to adequately address the pandemic.

The government, say critics, has fallen prey to “superstitious” thinking. Some draw allusions to the use of water-based medicine in the Maji Maji rebellion against German colonial rule.

As others have observed, the act of giving spiritual agency to the virus as a “personal demon” can also serve to downplay structural failures which have contributed to its spread. It divests responsibility to both COVID-19 as a sentient “enemy” and citizens.

There is a risk, however, that exaggerating the “idiosyncrasy” of the Tanzanian government’s response to COVID-19 – and indeed that of Prophet Makandiwa – may perpetuate another myth of “exceptionalism”. One which echoes colonial depictions of African populations as singularly “superstitious” and “incurably religious”.

A billboard in Lagos, Nigeria.
Markus Matzel/ullstein bild/Getty Images

In truth, spiritual warfare idioms have been diversely invoked – and unevenly received – across the continent. They have prompted lively “religion and science” debates.

Moreover, the plausibility of spiritual warfare idioms should not be exclusively attributed to people’s religious sensibilities. After all, “warfare” is the signature trope with which global political figures, health experts, and media commentators have framed COVID-19.

Like Magufuli, world leaders like the UK’s Boris Johnson, France’s Emmanuel Macron and the US’s Donald Trump have all invoked warfare motifs against the single, identifiable “enemy”.

European governments have also been accused of using this framing to shift responsibility onto citizens as “combatants”, whether for failing to adhere to physical distancing or for their biomedical frailty. Narratives of individuals heroically “winning their war” against a decidedly personal demon are no less persuasive to some in Europe than to some in Africa.

None of this is intended to take away from the ambivalent and sometimes plainly harmful effects of attempts to spiritualise the pandemic. Nor is it to imply that religiously informed strategies of communication and implementation are incompatible with more “temporal” methods.

Religious groups like Pentecostal congregations may indeed constitute an important “public health resource” when it comes to delivering services and messaging. And they can cultivate a sense of hope and mutual care in the face of uncertainty.

Rather, we suggest as anthropologists and scholars of religion, this warfaring rhetoric might stem from a shared discomfort among Africans and Europeans alike at the prospect of an adversary without discernible self-will or conscience. An impersonal demon.

As literary critic Anders Engberg-Pederson
articulates it:

We declare war on the virus, because we want it to be something that it is not.

Benjamin Kirby, British Academy Postdoctoral Research Fellow, University of Leeds; Josiah Taru, Lecturer, Great Zimbabwe University, and Tinashe Chimbidzikai, Doctoral Research Fellow, Max Planck Institute for the Study of Religious and Ethnic Diversity

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The eight must-read African novels to get you through lockdown

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Isabel Hofmeyr, University of the Witwatersrand; Aretha Phiri, Rhodes University; Grace Musila, University of the Witwatersrand; Manosa Nthunya, University of the Witwatersrand; Nedine Moonsamy, University of Pretoria; Sam Naidu, Rhodes University; Sarah Nuttall, University of the Witwatersrand; Susan Kiguli, Makerere University, and Tom Odhiambo, University of Nairobi

For those looking from the global North, African literature is often marketed in a narrow way, comprising worthy stories of resistance, written in an uplifting and sober realist mode. Seen from the continent itself, this view has long been brushed aside by the effervescence and animation of ongoing literary experimentation and creativity. I approached literary academic colleagues from South Africa, Kenya and Uganda to choose – and share their thoughts on – one of their favourite books of African fiction. The resulting finger-on-the-pulse list offers a bookshelf that speaks to the vibrancy of both contemporary and older African literature. – Isabel Hofmeyr


Waiting by Goretti Kyomuhendo

Susan Kiguli, Makerere University

The 2007 novel is set in the time of the war to get rid of the dictator Idi Amin. The main character, the adolescent Alinda, and her family have to hide from fleeing soldiers. It is an atmosphere of great angst and fear tinged with hope for the arrival of the liberators, who are a merged force of Ugandan exiles and Tanzanian soldiers. This short novel ingeniously handles the matter of the Lendu woman, the Indians and the Tanzanian soldiers with a blend of suspicion and optimism for the unknown and mystique suggested by foreigners.


The Feminist Press at CUNY

The narrative thinks through the gaps and anxiety created by war, where ordinary citizens do not know what to expect. It describes the violence, victims and loss that come with lying in the path of fleeing soldiers and pursuing liberators. The setting is a village near Lake Albert at the border of the Democratic Republic of Congo.

This is a novel depicting a situation of post-independence internal and cross-border conflict. It is a worthy read particularly because it resonates with this time when the world is tense under the weight of a marauding pandemic.

I used to think war meant violent clashes between human beings, but since the arrival of the coronavirus I think it includes human beings confronting disease.

The Wormwood Trilogy by Tade Thompson

Nedine Moonsamy, University of Pretoria

Tade Thompson’s The Wormwood Trilogy (Rosewater, The Rosewater Insurrection, The Rosewater Redemption) has been widely acclaimed. It was recently nominated for the 2020 Hugo Award for Best Series. For African readers, it is a watershed moment, marking the arrival of an African science fiction trilogy that we so needed and deserve. Set in the near future, these novels capture the interaction between an invading alien population, the Homians, and the citizens of Nigeria.

All three books hit the sweet spot between exploring what science fiction means to us – who, as the characters often point out, have been historically subjected to alien invasions – and the pleasure of simply imbibing well-written and pacy genre fiction.


Orbit

Teeming with alien life, Wormwood is an extra-terrestrial biodome that embeds itself in Nigerian soil. Its sprawling tentacles provide organic power and, contrary to what one might imagine, people flock to the surrounding community of Rosewood because Wormwood also performs ritualistic acts of healing on sick human bodies.

In contrast to greater Nigeria, where power outages are still frequent and homosexuality illegal, Rosewood has all the makings of an African techno-utopia. Yet at the heart of the trilogy is the niggling question about whether it is ever possible for humans and aliens to co-exist with symbiotic ease.

The novels make use of sharp-witted, hard-boiled detectives to probe further into alien motives; Thompson’s female characters, in particular, are a testament to his talent as they bristle with an unsentimental brand of Nigerian humour. Getting to know these characters makes reading the trilogy rewarding in itself, but Thompson’s world building is a force to be reckoned with. The interweaving of chaotic Nigerian streets, alongside organic extra-terrestrialism and imagined human technologies, is handled skilfully, allowing readers to delve into a seamless African biopunk universe that makes us marvel at the potential of what is to come.

A General Theory of Oblivion by Jose Eduardo Agualusa

Grace A Musila, University of the Witwatersrand

On the eve of Angola’s independence in 1975, Portuguese expatriate Ludovica Fernandes Mano goes into isolation in her penthouse apartment in the city of Luanda, out of fear of the post-independence future. She seals off her apartment with bricks, withdrawing into a new life with her dog and her garden on the terrace, which keeps her fed. Her only connection to the outside world – which soon descends to a 27-year civil war – is her radio.

Angolan novelist Jose Eduardo Agualusa’s A General Theory of Oblivion is a riveting tapestry of history, detective fiction and poetic interludes, interwoven with poignant turns of phrase and absurdities delivered with a straight-faced candour. It is a perfect lockdown read, not because it is about isolation, but because Ludo’s self-isolation is filled with hilariously narrated encounters and adventures, including a trained messenger pigeon that keeps two young lovers in contact. Ludo uses small pieces of diamond to trap pigeons for food; but when her trap delivers a messenger pigeon with a note attached to its leg, Ludo decides to set it free so the lovers might receive their message – and with it, her swallowed diamonds.

Ludo spends her time writing out her reflections initially in notebooks, and later the walls of her apartment, using charcoal. We get to read excerpts of her poetic reflections; from whose philosophical musings the novel draws its title.


Harvill Secker

Her encounter with the messenger pigeon draws an intricate network of the world she has withdrawn from, into her sanctuary, eventually ending her 30-year isolation when a young burglar accidentally discovers her and forms a bond with the now elderly lady.

The novel is a patchwork of short, interconnected stories. They weave a web of connected lives which lend it an expansive and colourful range, through short, pacy, thriller-style chapters, interspersed with Ludo’s poetic reflections. This is a book you read when you want to be surprised, and to have your imagination stretched by startling turns of phrase, odd logic and lyrical philosophical observations about life.

Warm, occasionally absurd, humour renders the inevitable tropes of war-time – torture, executions and profiteering – bearable. Part of the novel’s charm lies in its eccentric characters, like the self-fashioned “collector of disappearances” who tracks disappearances of planes off air spaces, as well as more ordinary disappearances, such as the journalist who apparently vanished right before people’s eyes.

This 2015 novel is a stunning canvas of the historical devastation of the Angolan civil war and richly imagined textures of ordinary people’s everyday worlds told with great warmth and inventiveness.

Freshwater by Akwaeke Emezi

Sam Naidu, Rhodes University

At a time when the world is experiencing unprecedented restrictions to mobility, Freshwater offers a searing and illuminating narrative about various kinds of border-crossing and about being multiply-located. In this unusual, at times shocking, bildungsroman, Emezi’s protagonist, Ada, is the child of a Nigerian father and a Malaysian mother. From early childhood, and then increasingly as she approaches adulthood, it is clear that Ada exists in a liminal zone: between spirit and human worlds; between cultures and nations; and between sexualities and genders. In retrospect, the novel’s dedication, to

… those of us with one foot on the other side,

that is, to those who do not claim one single affiliation, but both or many, is economically apposite. This liminality is portrayed with astonishing vividness and through varying perspectives, often drawing on traditional Igbo mythology and cosmology to create imagery which is unsettling and challenging.


Faber and Faber

As an “African” novel, 2018’s Freshwater is innovative and irreverent in the way it marries African religious and cultural beliefs with “Western” geography, religious iconography and cultural symbols, ultimately defying literary categorisation, just as its protagonist repudiates predetermined categories of identity. (The novel is set in Nigeria and the US, and it deliberately presents Ada as a hybrid, transnational character.)

It also contains a rare combination of sensuous, brute physicality with the spiritual. By the end, it is clear that Ada cannot be claimed by her homeland or her diasporic home as she transcends even the human-spirit border to become something which is indefinable, “as liminal as is possible – spirit and human, both and neither”. This bold, contemporary novel captures the porousness of borders, which may prove disquieting for the reader, but also very liberating. In these times of lockdown, Freshwater transports the reader boldly to unexplored, uncanny territory.

The Old Drift by Namwali Serpell

Sarah Nuttall, University of the Witwatersrand

I recommend Namwali Serpell’s 2019 Zambian tour de force The Old Drift. This is a long book – all 563 pages of it – by a writer whose prose and outsize imagination will hold you spellbound throughout. It’s a postcolonial family saga across three families and three generations. It is also the story of the great Zambezi river, and its capaciousness, capriciousness and capacity for revenge in the face of human-centred attempts to control it.


Penguin Books

Serpell unfolds her canvas along two trace-lines of Zambian modernity: the building of the Kariba Dam, the biggest man-made dam in the world at the time of its construction; and Edward Nkoloso’s Zambian National Academy of Science, Space Research and Philosophy and his attempts to send the first Afronauts to the moon. The novel is grounded in precisely rendered historical events but also has a partially speculative sweep. Its final scenes take place in 2023, with a smart techno-twist. The story is narrated not just from a human perspective but from that of a mosquito swarm, a “bare ruinous choir, a chorus of gossipy mites”.

This is a book that asks for your time – and now you’ve got it. Read. And be riotously rewarded.

Hunger Eats a Man by Nkosinathi Sithole

Manosa Nthunya, University of Pretoria

It may as well be the case that at this very trying historical time, it may be difficult to appreciate the offerings of fiction. After all, on a daily basis, we are being asked to read and reread the world, asking ourselves if the catastrophe that has befallen us will pass. What comfort, then, can fiction offer when the very future is at stake? But read on we must – and we do – because it remains an activity that allows us to see how large the world is, despite seeming very small at the moment.


Penguin Random House

A book that could be worthy of consideration is Nkosinathi Sithole’s Hunger Eats a Man (2014), a novel that examines the devastating effects of poverty in the rural areas of South Africa.

Much of the literature that is being produced in contemporary South Africa has a bias towards the city, with often very little reflection on the experiences of people who live in rural communities.

In this award-winning novel, Sithole opens a world that is marked by deep adversities, exploitation and an increasing disillusionment with a nation still learning how to crawl. It is a book worth reading, and reflecting upon, as we start counting down the inevitable costs of this catastrophic moment.

Broken Glass, by Alain Mabanckou

Tom Odhiambo, University of Nairobi

Alain Mabanckou’s fiction may not be known in much of Anglophone Africa but translation is making it easily available. Mabanckou’s 2005 Broken Glass, set in a bar, Credit Gone West, is a good read for times likes these – easy enough for someone interested in light reading; deep enough for someone looking for a nuanced depiction of African modernity. For those who can no longer access their beloved pub, it will remind you of the sounds, smells, sights, that only a bar can produce, from the beginning to the end.


Serpent’s Tail

The tragic life of Broken Glass, the narrator, who appears “self-quarantined” in the bar, mirrors those of the different characters in the society, whose stories we hear in the many anecdotes he tells. The dark humour, satirical tone, endless allusions, and lack of conventional punctuation (sometimes making it tedious to follow the tale), all build up to a dystopic story. But, in the end, the bizarre story in Broken Glass should surely lead you to search for more of Mabanckou’s novels.

Life and Times of Michael K by JM Coetzee

Aretha Phiri, Rhodes University

The oldie on the list, from 1983. An award-winning novel by JM Coetzee, Life and Times of Michael K evokes a desperately depressing sense of subjective fragility and existential nothingness – concerns for which the author is well known.


Ravan Press

Set during a period analogous to civil war, it’s a story about a seemingly insipid and largely enigmatic character whose journeys across and encounters with inhospitable landscapes and unwelcoming communities from the Western Cape province to the Karoo see him, at the novel’s end, gathering water from a well with “a teaspoon and a long roll of string”.

And yet Michael K’s vacuous itinerancy also suggests something pathetically hopeful about the existential journey and signals something ironically prescient about the will to endure. Michael K is a sobering read for these testing times.

Isabel Hofmeyr, Professor of African Literature, University of the Witwatersrand; Aretha Phiri, Senior lecturer, Department of Literary Studies in English, Rhodes University; Grace Musila, Associate Professor in the Department of African Literature, University of the Witwatersrand; Manosa Nthunya, PhD candidate in Literature, University of the Witwatersrand; Nedine Moonsamy, Senior Lecturer, University of Pretoria; Sam Naidu, Professor, Department of Literary Studies in English, Rhodes University; Sarah Nuttall, , University of the Witwatersrand; Susan Kiguli, Associate Professor of literature, Makerere University, and Tom Odhiambo, Senior Lecturer in Literature, University of Nairobi

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why is used clothing popular across Africa?

People shop for used clothing at the busy Gikomba market in Nairobi, Kenya. SIMON MAINA/AFP via Getty Images

By Dan Banik, University of Oslo

The sale of used clothing is a billion-dollar global industry. According to some estimates, almost 70% of garments that are donated globally end up on the African continent.

This happens through a complex global supply chain, where donated items that cannot be sold in thrift shops in high-income countries are resold in bulk to commercial textile recyclers. The garments are then sent to sorting centres, often located in the Middle East or Eastern Europe. These are then graded and sorted into bales. The bales are in turn resold to wholesalers on the African continent.

East Africa alone imports over $150 million worth of used clothes and shoes, largely from the US and Europe. In 2017, USAID estimated that the industry employed 355,000 people and generated $230 million in government revenue. It also supported the livelihoods of an additional 1.4 million in the East Africa Community bloc.

But scholars have also highlighted the complexities of this billion-dollar industry and how these commodity chains perpetuate poverty. This has led to a pushback. In 2016, the leaders of Rwanda, Uganda, Tanzania and Burundi issued a communiqué outlining a major tariff increase on imported used clothing. The plan was to ban all imports of used clothing by 2019. But the international trade disputes that followed led most countries to back out from implementing the ban.

The pushback rested on two broad sets of arguments. First, there is a widespread belief that the popularity of used clothing contributed to the collapse of the domestic textile industry in many parts of Africa in the 1980s and 1990s. Second, the continued use of used clothing is portrayed as undignified and eroding African pride.

Nevertheless, used clothing continues to enjoy unrivalled popularity in many countries. We sought to establish why by studying the phenomenon in Malawi, where used clothes are known as “kaunjika” (meaning “clothes sold in a heap”). It is a popular and resilient business.

We found that there were important economic and social pull factors behind the popularity of used clothing. We also found little support for the viewpoint that wearing used clothing is an attack on the dignity of African citizens.

The pull factors

Between March 2018 and February 2020, we visited local markets and shopping malls and interacted extensively with street vendors, shop keepers, wholesalers and consumers in Blantyre, Limbe, Zomba and Lilongwe.

Our goal was to better understand the widespread popularity of used clothing in Malawi. We were able to identify a number of common factors.

Quality: Used clothes and shoes sourced from high-income countries were considered to be of far better quality than brand new items available in local markets. Customers were often willing to pay a higher price for used merchandise than comparable new items.

Clothing labels indicating where items were produced were viewed as less important than the source of the donation. For example, kaunjika sourced from China was popular with vendors and customers because of sizes and styles that were more compatible with local preferences. Many vendors also claimed that when compared to clothing produced in China for African markets, clothing that had been produced for the Chinese themselves or for Western markets was of better quality.

Affordability: Many Malawians cannot afford even the cheapest new garments sold in local stores. Used clothing can be sold at higher prices than new items, mostly to middle income consumers in urban areas. But items that are not considered to be of good quality or style continue to trickle down the supply chain. These items are then sold by vendors operating in more rural areas where consumers with lower purchasing power have even fewer alternatives.

Fashion trends: Malawian consumers cited fashion trends and the “uniqueness” of imported used clothing as important factors for buying kaunjika. This was particularly the case for the younger generation who had been exposed to international trends and popular culture through social media. People crave “the latest fashion” often not available in the local retail stores.

Low start-up costs: The buy-in costs for local vendors of used clothing were very low. This created economic opportunities in the informal economy for groups with limited resources to access start-up capital. Several vendors told us that despite starting their businesses with limited funds, they had gradually been able to expand their operations and create employment opportunities.

And although the informal sector is characterised by numerous challenges – poor working conditions, lack of social protection, child labour and loss of tax revenue, to name a few – kaunjika appeared to offer a much needed way for many to earn a living.

Used clothing and sustainability

A recent report predicts that the global second-hand clothing market is set to double to $51 billion in the next five years, exceeding fast fashion within a decade.

It is still too early to tell how changing consumption patterns in high-income countries will affect used clothing markets around the world. But what appears certain is that the Malawian consumer, like many on the African continent, will continue to demand access to the same quality, styles and brands as the rest of the world, even if it means buying used clothes “sold in a heap”.

Dan Banik, Professor of political science and Director of the Oslo SDG Initiative, University of Oslo

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What African countries are doing to help people to eat amid the lockdowns

Stuck at home because of the lockdown, 25-year-old Ugandan Richard Kabanda is worried about feeding his family.

The motorbike taxi driver, who used to earn about $2 (£1.60) a day, has had no work since the government banned public transport last month as part of measures to slow the spread of coronavirus.

“We are going to die because there is nothing we can do,” he told the BBC from his house, which is in a slum, close to the swamps by Lake Victoria.

“We are going to die inside our homes because we will run out of food yet we’ve been told not to leave our homes.”

How to balance lives with livelihoods

Once his savings had run out, he had hoped to benefit from a food distribution programme that the government promised to 1.5 million of those most in need.

His experience was typical of the more than four out of five African workers who survive day-to-day in the informal sector and have no access to state assistance.

African governments, including Uganda’s, are now facing a policy conundrum.

A trader sleeps next to items to be sold at a market following a directive from Ugandan President Yoweri Museveni that all vendors should sleep in markets for 14 days to curb the spread of the COVID-19 coronavirus at Nakasero market in Kampala, Uganda, on April 7, 2020.
Image captionStall holders in Uganda’s capital, Kampala, were asked to sleep with their produce during the lockdown to prevent them moving around

Many acted swiftly with lockdowns or restrictions on movement as the spectre of coronavirus approached the continent. But the authorities are also aware of the toll these measures are taking on their citizens.

They are now grappling with how to move into the next phase of how to contain the virus and restart the economy.

“Getting the balance right between people’s lives and livelihoods is the big trick for poorer countries,” said Ronak Gopaldas, director of the South Africa-based risk management company, Signal Risk.

“If people don’t work, they don’t eat. Ongoing lockdowns are unsustainable in their current forms.”

Woman selling chicken
Image captionPeople in the informal sector make up more the 80% of the workforce across the continent

Few African countries have social safety nets to catch people if they lose their jobs.

The precarious existence for those workers in the informal sector, and the large numbers of relatives who rely on them, means that the halting of economic activity could spell disaster.

So what are African governments doing to cushion their citizens from the impact of unemployment?

Looking at sub-Saharan Africa as a whole, the World Bank has predicted that the region could fall into a recession in 2020 for the first time in 25 years as a consequence of the coronavirus outbreak.

Nigeria, South Africa and Angola are likely to be hit hardest, but all countries will see a slow down.

Impact of coronavirus on GDP

Source: Standard Chartered Bank

Governments and central banks have come up with a series of macro-economic measures, including tax relief and interest rate reductions, to try to avoid the worst effects.

While those may mean that some keep jobs that would otherwise have been lost, it is the help that governments can give directly to the people that may be more significant in the short-term.

Is South Africa’s big plan working?

South Africa, with the continent’s most industrialised economy, has announced the biggest action plan so far.

Last week, President Cyril Ramaphosa outlined a comprehensive $26bn (£21bn) economic package, amounting to 10% of the country’s GDP, to help boost the economy.

Economic mitigation

Some of the measures governments have introduced

  • Nigeria$1.4bn fiscal stimulus, extend cash transfers for poorest
  • Kenyatax relief and reductions, new cash-transfer scheme
  • UgandaBoosted lending capacity of development bank, food handouts
  • South Africa$26bn economic package, new cash-transfer scheme

Source: IMF

He said that this would be “equal to the scale of the disruption [coronavirus] is causing”.

Jane Barrett, who works in South Africa for Wiego, an organisation that supports women in informal employment, says that things are currently “pretty dire on the ground”.

People are relying on food parcels that are being distributed by charities and civil society organisations but “we are hearing heart-breaking stories all the time of people not being reached in rural areas and whole informal settlements where food distribution has hardly touched”, she adds.

A township resident carries a food package handed out by a non governmental organisation during a 21-day nationwide lockdown aimed at limiting the spread of the coronavirus disease
Image captionIn South Africa, charities have been distributing food to those most in need

About $2.6bn of the money the government is spending will be given in the form of cash transfers to those most in need.

People who are already receiving child benefit, currently $23 per child per month, will get an extra $16 per child next month and potentially more money after that.

This should help 18 million South Africans – just under a third of the population.

State pensions will also be boosted and those who are not receiving either of these benefits, or unemployment insurance, could qualify for a new payment of $18 a month for the next six months.

This is not an insignificant amount, Ms Barrett says, “but I’m not sure that it’s going to be sufficient to alleviate the terrible hunger that we are seeing”.


Weekend briefing

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Some of the money to pay for the whole economic package will not come from loans or new taxation but will be the result of a reorganisation of spending priorities and drawing on a surplus in the unemployment fund.

But South Africa will still need to borrow more to pay for these commitments.

Other countries on the continent may find this harder as they could be reluctant to incur more debt repayment costs, says Razia Khan, chief economist for Africa at Standard Chartered Bank.

While donors have announced a freeze on repayments for now, this will not last forever.

“Given the greater formalisation of South Africa’s economy it is able to come up with its package,” she adds.

“But this is the difficulty for many countries – it is incredibly hard for governments across the region to reach out to those who operate in the informal sector. This is a key hurdle.”

Kenya’s ‘pro-poor’ approach

Kenya’s government has used an existing cash transfer programme, Inua Jamii, to boost payments to more than one million vulnerable people, who are either elderly, disabled or orphaned.

A man pulls a handcart with jerrycans along the street before a curfew, as the spread of the coronavirus disease (COVID-19) continues
Image captionSome people are able to carry on working despite measures to prevent the spread of the virus

But there will still be many others among Kenya’s 51 million people who will need help.

In announcing a new scheme, known as the Covid-19 Support Stipend, President Uhuru Kenyatta said his government was adopting a “pro-poor approach… knowing that they are disproportionately affected” by the pandemic.

It has earmarked $93m for the fund that will target squatters, street hawkers, food vendors, motorbike taxi drivers and other labourers who have lost their jobs with weekly payments.

But how many, and exactly who, will qualify is not yet clear as the authorities need to establish the infrastructure to identify those most in need.

And $93m does not sound much compared to the $2.6bn in South Africa.

‘The hunger makes us forget the coronavirus’

A policeman stands by traders waiting the opening of Rood Wokos great market in Ouagadougou CREDIT: AFP

Normally Dassasgo market in eastern Ouagadougou, Burkina Faso’s capital, bustles with a thousand stalls selling all manner of food, trinkets and goods. 

But when the pandemic came, everything started to fall apart. Last month, officials closed the market down to stop the infection, turning hundreds of traders onto the street. 

Now Aminata Yanogo, a seasoned vegetable seller, has to dodge police beatings along Ouagadougou’s dusty roads to make ends meet.

Before the lockdown, Mrs Yanogo was making about 9,000 CFA (£12) a day selling bags of chillies and peppers. Now she is lucky to make a tenth of that. “If we don’t sell anything, our children will starve. If we stay at home, my children will have to go outside to beg,” she says. “We are suffering.”

The coronavirus pandemic has killed more than 200,000 people worldwide but far worse could be in store for the likes of Aminata. Catastrophic food shortages and mass starvation are threatening greater devastation than the virus itself. 

According to a report released by the UN last week, the number of people in acute food insecurity – the point where people are facing famine – is expected to double from 135 million to 265 million by the end of 2020, unless dramatic steps are taken.

The world is facing “multiple famines of biblical proportions” in “about three dozen countries” killing up to 300,000 people a day, warned David Beasley the Executive Director of the World Food Programme (WFP)

A trader carrying goods on her head in Ouagadougou after the market was closed as a preventive measure against the spread of the Covid-19

A perfect storm

Experts say a multitude of factors are coming together to in a ‘perfect storm’ for many developing countries especially in sub-Saharan Africa and South Asia, as well as in countries already facing crises, like Yemen, Venezuela and Congo.

All the things that were driving global hunger before the coronavirus – wars, climate change, refugee crises, a dearth of sanitation, locust swarms in east Africa and devastating water shortages in southern Africa and Pakistan – are still here.  

But now the pandemic and accompanying national lockdowns are throwing tens of millions who lived on the edge into poverty and battering delicately balanced food supply chains. 

Lockdowns and government mishandling of the crisis are dramatically reducing people’s ability to buy basic goods and limiting farmers’ access to seeds, pesticides and labour. 

At the same time, any fiscal headroom poor countries had before the crisis is rapidly closing as swathes of the international economy goes into free fall. Plummeting oil prices is laying waste to the national budgets of states already facing major malnutrition and security problems like South Sudan, Chad and Nigeria. 

Locust swarms in east Africa had already been driving food shortages CREDIT: AP

On top of this, international tourism has ground to a complete stop and overseas remittances are drying up fast as family members in the developed world, cease to make money. Some European money transfer companies have reportedly seen a decline of between 80 and 90 per cent in payments made to Africa.

“In wealthier countries, there is at least the potential for the government to step in as the wage provider of last resort but poorer countries lack the fiscal space to do this,” says Dr Amrit Amirapu, Lecturer in Economics, University of Kent.

“Even if [poorer] governments were able to pay workers, most workers in these countries are informal so the government has no record of them and the process of getting them funds is more challenging.”

“The world is not running out of food,” Elwyn Grainger-Jones, Executive Director, CGIAR, a global partnership of groups researching food insecurity, told The Telegraph.

Global food prices have been coming down for several years and we’ve had good harvests over the last few years. The main problem is access.”

People wearing protective masks line up at a vegetable street market in Caracas. Venezuela is particularly vulnerable to food shortages CREDIT: Reuters

Access to food

Nowhere is the problem of access seen more clearly than in India. 

When Prime Minister Modi announced a sudden nationwide lockdown for his nation’s 1.3 billion people on March 24, with only four hours notice, tens of millions of informal labourerswho had migrated to cities became unemployed almost instantly.

Without financial savings or sick pay, almost one-quarter of the Indian workforce and their families suddenly had no form of income or means to purchase food or medicines. India does not lack food. The government is sitting on 87 million metric tonnes of grain stock, enough to provide one sack of 100kg rice or wheat for every single family member who has a ration card.

However, with Indian state borders closed and supply chains coming to a standstill, the government is struggling to reach almost all of those in need. A poll of over 11,000 migrant labourers in India by the Stranded Workers Action Network found 96 per cent had not received any government food rations.

The International Labour Organisation says food aid is already critical for roughly 380 million Indians working in the informal economy, such as rickshaw drivers or street vendors. 

The situation will probably get far worse for many Indians. Dipa Sinha, an economist who teaches at Ambedkar University in Delhi, has said if the lockdown continues up to 70 per cent of the city’s population could require food aid by mid-May.

The story is also grim in Afghanistan. In the western city of Herat, Saleh Mohammad has lost his job because of Covid-19. After fleeing fighting in his home in Kunduz province, he settled in a camp on the outskirts of the city and took daily labouring jobs. These have now ended with the city’s lockdown.

“We are dealing with death here. Look at this, this is what we’ve managed to get today,” the 56-year-old said showing a meagre measure of rice meant to feed his family of six. “I sent my son to beg and I bought this from that money.”

Riots and stampedes over the lack of food have already been seen across the world from Niger and Kenya to India and Venezuela. As hunger spreads, it will most likely have major political ramifications as class divides are exposed and people begin to fight over land and resources. 

What could make the hunger crisis worse?

Experts say there are two things could make the hunger crisis far worse. 

First, some fear that as the pandemic puts more strain on national resources, key food producers – like India, Indonesia, Thailand and Russia – will start to block exports. This would be catastrophic for many countries in sub-Saharan Africa, which rely heavily on imports of staple foods like rice and wheat.

“In Kenya, we import about 90 per cent of our rice, mainly from Asia. And we import about 70 per cent of our wheat mainly from Ukraine and Russia,” says Timothy Njagi, Senior Research Fellow at the Tegemeo Institute of Agricultural Policy and Development in Kenya.

Any problems with that international supply could make food prices soar on the streets of Nairobi, Dakar or Kinshasa, experts say.

Thankfully, while some countries like Belarus and Ukraine have toyed with minor export restrictions on grain, so far only Vietnam and Cambodia have placed major limitations on rice exports.

People shop for spices during preparations for the holy month of Ramadan amid concerns of the spread of Covid-19, in Sanaa, Yemen CREDIT: Reuters

As a rule, closed borders or trade barriers make for catastrophe. Take the extreme example of North Korea, which has a long history of major food shortages and famine. Over 12 million North Koreans – about half of the population – are chronically food-insecure, according to the UN. The secretive country imports vast amounts of food from China, its main trade partner.

In January, North Korea shut its 880-mile border with China, in an extreme effort to keep the virus out. Reports indicate the border may now be partly reopening to obtain essential goods. 

However, this closure has most probably wreaked havoc on food supplies. This month the WFP said that North Korea was among 39 countries that would suffer chronic food insecurity because of the pandemic and would be worst hit after Nigeria, Bangladesh and Ethiopia.

The second thing experts fear is what happens if the virus spreads into rural areas in sub-Saharan Africa and South Asia.https://cf-particle-html.eip.telegraph.co.uk/13b5940f-9536-42ad-897e-5ef8a85a9382.html?ref=https://www.telegraph.co.uk/global-health/climate-and-people/hunger-makes-us-forget-disease-famines-threaten-greater-devastation/&title=%E2%80%98The%20hunger%20makes%20us%20forget%20the%20disease%E2%80%99:%20Famines%20threaten%20greater%20devastation%20than%20coronavirus

Food production in poorer countries is far more labour intensive than in the mechanised West. Farmers do not have combine harvesters to plough their fields and must do it by hand. Ageing and vulnerable farmers often make up the backbone of the economy and local food supplies in developing countries, making food systems very vulnerable to shock from diseases.

“We are yet to see [Covid-19] spread in rural areas. If that happens, we’re going to see a huge disruption in Kenya’s rural food supply chains in three months,” says Mr Njagi. “It would be dire.” 

Back on the road outside Dassasgo market, Adama Kabore is fretting about what he can take back to his wife and child. 

Normally, the 28-year-old sells handbags in the market but now he barely manages to sell anything. For the last few weeks, he’s managed to scrape together about 1,000 CFA (£1.33) to buy food for one evening meal for his family. But today, he hasn’t managed to find anything.

“The hunger is making us forget the disease,” he says. 

  • Additional reporting by Oumar Zombre in Ouagadougou, Joe Wallen in New Delhi, Ben Farmer in Islamabad and Nicola Smith in Taiwan.

African jobseekers change their names to overcome ‘racist’ recruiters

Yasin Kakande CREDIT: SWNS

African jobseekers are “whitening” their CVs by Photoshopping their skin and changing their names to overcome “racist” recruiters, an author has claimed in a new book.

Yasin Kakande, a Ugandan born migration expert and Reuters journalist, said some black applicants are digitally modifying their profile images to give the appearance of lighter skin to avoid a “colour cull” from discriminatory employers in the UK.

Mr Kakande, 39, also revealed that traditional African names are being replaced with anglicised versions, including Dafari for David and Salama for Sarah, as jobseekers suggest they are of dual-heritage to try and improve their recruitment prospects.

For his latest book ‘Why We Are Coming’, he interviewed 1006 academically qualified African job applicants aged between 21 and 50 over three years and found that 90 percent changed their resumes to conceal ethnic features.

A third of the applicants, who were from Sudan, Nigeria, Kenya, Tanzania, Uganda, Cameroon and the Ivory Coast, used a false UK residential address to mask their true nationality, while others underwent elocution lessons to sound more “British”.

Many of the respondents also said they avoid profile photographs in order to hide their skin colour “for as long as possible”.

Despite the alterations, only five percent of the applicants were offered a position in the UK corporate job market- even though some had applied for up to 100- over the course of the study.

Many had to to accept minimum wage jobs in the manual labour or care sectors instead.

Mr Kakande, whose latest book probes the historic and contemporary reasons behind why African people migrate to the West, says Britain’s largest companies are thought to be “anti-Africa”.

He explained: “There is an attitude hanging over from the colonial era that is prevalent among British employers that Africans should stay where they are until needed.

“In any event, a ‘whitened’ CV is not in itself a ticket to employment because an applicant cannot continue to conceal his or her identity at interview.

“In my experience, many African professionals were on course for a job until the interview stage when they noticed a distinct cooling in enthusiasm from their potential new employer – something that I attribute to an unconscious bias against Africans.”

We face coronavirus discrimination – Africans in China

Ade* was given until midnight to vacate his apartment.

Five months earlier, the Nigerian student had moved to Guangzhou, southern China, to study computing at Guangdong university. He had just paid his university fees for the new semester when his landlord informed him that he needed to leave.

He scrambled to pack his belongings. The police were waiting for him and his roommates outside.

‘In hiding’

When he attempted to drop off his bags at a friend’s warehouse, he was prevented from entering. He spent several nights sleeping on the streets.

“Look how they are treating us, how they forced us out of our houses and forced us to self-quarantine,” he told the BBC from a hotel in the city.

“They told me that the [test] result is out and I am negative. Still they don’t want me to go out.”

Notice in McDonald's restaurant saying "We've been informed that from now on black people are not allowed to enter the restaurant".
Image captionMcDonald’s in China apologised after a branch in Guangzhou barred black people from entering

African community leaders in Guangzhou believe the vast majority of the city’s African population have been forced into quarantine or are sleeping on the streets.

“Some are in hiding,” said one community leader over an encrypted social media app.

Every African national tested

In early April, online rumours began to circulate that parts of the city where Africans live and trade were under lockdown after two Nigerians who had tested positive for the virus escaped. Chinese media reported that a Nigerian patient had attacked a Chinese nurse.

The health commission began widespread testing of African nationals.

The local authority says it has tested every African national in the city for the coronavirus. It found that 111 of the more than 4,500 Africans in Guangzhou tested positive.

“They just came with their ambulance and medical team and took us. All they said was that it was Chinese law and an order from the government,” said Hao*, a businessman from Ivory Coast.

Closed African restaurant is seen in Guangzhou, Guangdong province, China, 13 April 2020.
Image captionBusinesses in Guangzhou, including in the area popular with Africans, have been shut because of coronavirus fears

Guangzhou has become a hub for Africans in China.

Towards the end of the century’s first decade, hundreds of thousands were thought to live in the city. Many of them entering the country on short-term visas to buy goods from nearby factories and send them back to the continent.

By some estimates there were more than 200,000 dwelling in the city. Some settled for the long term. Many overstayed their visas.

‘Africans friendly with locals’

In recent years, the numbers have dwindled. Businessmen have complained of unfair visa restrictions and unfair treatment. In 2018, small hotels in Xiao Bei Lu, a popular area for African traders, temporarily turned away Africans from several nations, they told the BBC.

“Most of the Africans living there are nice and friendly with the locals, and they are doing business as normal for the past years,” said one Guangzhou resident who did not want to be named.

“If there is a problem, it may be that some Africans are overstaying and doing some illegal things.

“The conflict over the virus test, I think it is something of a misunderstanding. It is not about racial discrimination. That’s not the style of the Guangzhou people,” he said.

“People are not hostile to Africans in their mind, unless some Africans are doing things against the local rules,” he added.

The Chinese government dismissed claims of racism, insisting China and Africa are friends, partners and brothers and that it has zero tolerance to racism.

But many of those the BBC spoke to say they have been singled out because of their race.

“Ninety-eight per cent of Africans are in quarantine,” said one community leader who did not want to be named.

Wuhan lockdown continues – for some

Africans across China say they are facing increased scrutiny. On the deserted campus of Wuhan University African faces outnumber Chinese.

“We are the ones that are left behind,” says Michael Addaney a Ghanaian graduate student studying in the Chinese city where coronavirus was first detected.

For more than two months he has waged a social media campaign demanding his government bring his countrymen and women home.

Passengers wave from a car as it passes a toll station
Image captionThings started to get back to normal as the lockdown in Wuhan ended on 8 April

At the height of the outbreak, an estimated 5,000 African students were stranded in Wuhan and neighbouring cities, after most sub-Saharan nations failed to evacuate their citizens.

“We feel like sacrificial lambs for no reason. The plan was to keep the people safe by sacrificing us,” asked one student who did not want to be named.

“What was the point as our countries didn’t put measures in place to protect the people from the virus?”

When Wuhan officially ended its lockdown on 8 April, normality began to creep back into the city.

More than a week on, African students on campuses remain unable to leave the grounds of the university. They have no information of when their own lockdown will be lifted.

A woman passes by billboard in part of the town where most of the African people lives and works in Guangzhou, Guangdong province, China, 13 April 2020.
Image captionPart of Guangzhou has become known as Little Africa, because of the large number of Africans who live and work there

Back in Guangzhou, a student from Sierra Leone said she believed Africans were being singled out.

“All of this is happening because there has been a rise in foreign imported cases, [but] the majority are from Chinese nationals,” she said.

“Only a small percentage is made up of Africans.”

She received a letter from her university stating that all Africans needed to be tested. Despite being tested twice she remains in quarantine.

‘Others not treated like this’

“With all this happening, the Chinese have exhibited racism and discrimination against black people here in Guangzhou.

“I know people from my church who are white and non-Africans who are not going through what we are going through – quarantine and multiple testing,” she said.

“Quarantine hotels are like forced detention for blacks.”

A Nigerian businessman under quarantine said that “it was the police that removed me from my apartment and put me on the streets”.

“I don’t have any problem with my landlord. He didn’t even know I had been evicted. My children slept on the streets for many days.”

On social media, hundreds of Africans in Guangzhou have organised groups supplying each other with regular updates. They send photos of numerous hotels and hospitals where businessmen, residents and students are being held across the city.

Some post test results showing that they are negative. Others post medical and hotel bills that they say they cannot afford to pay. Videos of Africans sleeping on the streets have gone viral.

The Guangdong government has publicised a hotline for “foreigners who experience discrimination”. But for those in quarantine, suspicions remain high. Videos continue to circulate online of Africans being moved between hotels by ambulance.

Xiao Bei Lu is known as “China’s little Africa” but social media videos show that its streets, at one time packed with African traders, are now deserted.

The names of the interviewees have been changed.

Debunking 9 popular myths doing the rounds in Africa about the coronavirus

Somali women on a coronavirus awareness campaign.
Abdirazak Hussein/GettyImages

By Neelaveni Padayachee, University of the Witwatersrand and Lisa Claire du Toit, University of the Witwatersrand

In the second week of March the World Health Organisation (WHO) declared COVID-19 a pandemic. By mid-March the disease had spread rapidly in many countries around the world.

Governments are taking drastic steps, including the complete lockdown of cities, as well as extensive health interventions to try and stem the disease which is caused by a new coronavirus called SARS-CoV-2.

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There is still a great deal that’s not known about SARS-CoV-2. This limited scientific information has contributed to a slew of myths and misconceptions. Some claims being made are harmless. Others can be potentially dangerous.

We have identified nine misconceptions doing the rounds on social media in Africa and set out to counter them. The purpose of debunking these myths is to provide people with trusted information. And to provide people with valid scientifically backed answers which they can share on social media to counter the misinformation and disinformation out there.

Myth 1: SARS-CoV-2 does not affect Africans

Across the continent rumours have been rife that the virus does not affect black people. This was fuelled partly by the fact that a Cameroonian student in China, who was among the first people to contract the disease, responded well to treatment.

But there is no proof that melanin protects black people from the coronavirus. There is also no scientific evidence that African blood composition prevents Africans from contracting the coronavirus.

This misinformation persisted even after the deaths of high-profile black Africans, such as legendary Cameroonian musician Manu Dibango, and Zimbabwean media personality Zororo Makamba.

This myth is not limited to Africa. Twitter has recently been abuzz with claims of African-Americans being immune to coronavirus

Myth 2: SARS-CoV-2 cannot survive in Africa’s warm climate

This myth arose after research, which hadn’t been peer reviewed, pointed to temperature having a role in the survival of the virus. One of the most widely quoted sources was John Nicholls, a pathology professor at Hong Kong university who said that “in cold environments, there is longer virus survival than warm ones”.

This claim, however, was not based on verified research. It was nevertheless seized on as proof that the virus cannot thrive in Africa’s warm climate.

According to the WHO, the virus can be transmitted to all areas, event hot and humid countries.


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The only continent that has no cases of COVID-19 is Antarctica. This could change.

Myth 3: Spray alcohol and chlorine all over your body

Using hand sanitisers that contain 60% or more of alcohol has been found to kill the coronavirus. But, there has been a myth that spraying alcohol and chlorine will kill the virus.

Alcohol and chlorine will not kill the virus if it has entered the body already.

Spraying alcohol all over your body can be harmful, particularly to your eyes and mouth. Importantly, the alcohol in the sanitiser is not the same as the alcohol that people drink. The latter ranges up to 40% while hand sanitisers need to be 60% and above.

Myth 4: Drink black tea first thing in the morning

The media in Kenya have been reporting on false claims that drinking black tea first thing in the morning is effective against the COVID-19 disease.

This is untrue. There is no evidence to suggest that tea can protect a person from the virus. These claims can result in a sense of false security and can be dangerous.

World-renowned Cameroonian musician Manu Dibango’s death from coronavirus hasn’t stopped people claiming blacks are immune to it.
EFE-EPA/Daniel Karmann

Coronavirus can be prevented by maintaining a safe social distance and washing your hands with soap and water for 20 seconds.

Myth 5: Pepper soup with lime or lemon flushes out the virus

The pepper soup myth has been circulating mostly in Nigeria.

Pepper has anti-oxidant, detoxification and antimicrobial properties. But, there is no evidence that it prevents or kills SARS-CoV-2. It is also a rich source of vitamin C, which helps maintain a good immune system.

Likewise, lemon and lime also contain high amounts of vitamin C. But there is no evidence to support the claim that they flush the virus out of an infected person’s system.

Myth 6: Steam your face with and inhale neem tree leaves

There have been claims, mostly in Ghana, that steam therapy with neem can prevent COVID-19. What we know is that according to ayurvedic medicine experts, neem can assist in strengthening the immune system and prevent viral infections.

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Neem is known to exhibit immunomodulatory, anti-inflammatory, antihyperglycaemic, anti-oxidant and anticarcinogenic properties. But, the Centres for Disease Control and Prevention has emphasised that there is no clinical evidence to suggest that steaming and inhaling with neem will prevent coronavirus.

Myth 7: Vitamin C tablets prevent COVID-19

Vitamin C is a known anti-oxidant. It prevents damage to tissue in the body by neutralising free radicals, which are charged particles that cause damage to cells and tissues and result in inflammation. Vitamin C is also known to protect against pathogens.

But there is no proof that vitamin C can prevent one from contracting COVID-19 though there are trials being undertaken on the use of vitamin C among COVID-19 patient. None has provided conclusive proof.

Myth 8: Having had malaria makes one immune

There have been several social media posts that suggest that malarial endemic countries have a decreased risk of acquiring new coronavirus cases.

There is no evidence to support this.

Malaria – which is caused by a parasite and is transmitted from the bite of an infected Anopheles mosquito to humans – used to be treated with the drugs chloroquine and hydroxychloroquine. These have been used, respectively, as an anti-malarial and as an auto-immune disease drug for inflammation.

The over-hyping of chloroquine has led to worldwide shortages and resulted in people self-medicating. Experts have warned that high doses of the drug are toxic.

Myth 9: The flu injection will protect you

The fact that health practitioners encourage people to vaccinate themselves against the flu, might have led to the mistaken view that the flu shot protects against the new coronavirus.

No, it does not. The flu vaccine is only effective against the influenza virus – and even then against only some flu viruses.

Humans have been known to be affected by six coronaviruses, four causing the common cold. The other two were the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2002 and 2012, respectively.

Now there is a seventh coronavirus, the SARS-CoV-2.

There is no scientific evidence that a flu shot can protect people against coronaviruses.

Neelaveni Padayachee, Lecturer, Department of Pharmacy and Pharmacology, University of the Witwatersrand and Lisa Claire du Toit, Associate Professor, University of the Witwatersrand

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus in Africa: what happens next?

Just seven weeks after Africa recorded its first case of Covid-19 – an Italian national in Algeria – the virus is creeping across the continent, infecting more than 10,000 people and causing 487 deaths. Three of the region’s 54 countries – São Tome and Principe, Comoros, and Lesotho – remain apparently virus-free.

“Case numbers are increasing exponentially in the African region,” said Dr Matshidiso Moeti, the World Health Organization (WHO) regional director for Africa. “It took 16 days from the first confirmed case in the region to reach 100 cases. It took a further 10 days to reach the first thousand. Three days after this, there were 2,000 cases, and two days later we were at 3,000.”

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In the Democratic Republic of the Congo, coronavirus has spread beyond the capital, Kinshasa, to the easternmost regions of the country, which until recently were still in the grip of an Ebola outbreak, according to the WHO.

In South Africa, which has the highest viral incidence on the continent, all provinces are now fighting the outbreak of Covid-19. Confirmed cases in Cameroon, Senegal and Burkina Faso are also widespread.

While transmission rates are still low, the key fear is over what happens next.

“The issues with Africa – like many places but even more so – are that the lack of testing means we don’t have any secure understanding of the true amounts of infection,” said Dr William Hanage, professor of epidemiology at Harvard. “We would expect it to be in the early stages now, given that in general the major metropolitan centres are less connected than, say, New York.

“Without better understanding of the way the virus operates – such as the immunological or genetic factors that may protect some people – it is impossible to say how severe the impact of Covid-19 will be on the continent, said Prof Thumbi Ndung’u of the African Institute for Health Research.


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“We don’t yet have a good answer as to why rates are lower in Africa than in Europe or China. One possibility is that that coronavirus hit during the European winter and the virus doesn’t spread perhaps as efficiently in warmer and more humid climates, which one study has shown. Another possibility is that Africa, in general, has a much younger population [than Europe or China].Advertisement

“The last possibility is that it may just be a matter of time before it hits Africa as much as it’s hit other places. If that’s the case, and we get community transmission in sub-Saharan Africa at the rates that we’ve witnessed in Italy, we could be staring at a catastrophe,” Ndung’u said.

He added: “We don’t have the hospitals, the ICUs or the ventilators to deal with massive amounts of [infected] people, so if the spread is comparable to that seen in Europe or China, the outcome could be devastating.”

If the spread is comparable to that seen in Europe or China, the outcome could be devastatingProf Thumbi Ndung’u

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In South Africa, which has the highest prevalence of HIV in the world and among the highest for tuberculosis, people have already been hit by lockdowns and reduced access to health clinics, according to Dr Michelle Moorhouse, of Ezintsha, Wits Institute in Johannesburg.

“We are telling people to stay home and avoid the clinics so this will impact testing, starting treatment, and potentially could see people interrupting treatment, if they are afraid to venture out and collect their medication,” she said. “We have been urging, where possible, that clinics dispense more antiretrovirals (ARVs) at each visit to try to keep people living with HIV out of clinics and so reduce their exposure.

“We do not really have any clear idea what Covid-19 will do in a population where overcrowding, TB and HIV are highly prevalent.”

In Uganda, at least 1.4 million people are living with HIV. Milly Katana, a public health specialist, told the Guardian that the coronavirus lockdown is “unfortunately” not locking up HIV.

“I have information from Ankole districts [in western Uganda] where patients are in a desperate situation, walking for seven hours, sleeping at health facilities and going back the following day,” said Katana, warning that the situation could lead to drug resistance.

“Many of our friends are running out of ARVs. This is more worrying given that dolutegravir (DTG), the first-line drug of choice, has a very short ‘temper’. Miss a few doses and one gets a resistant strain of HIV. The next HIV epidemic will be resistant to not only DTG, but the drugs in the same class.”

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For Helen Jenkins, epidemiologist at Boston University School of Public Health, the suspension of research into – and vaccination of – infectious diseases is likely to have a profound impact. “I am very concerned for when the pandemic truly hits a high-TB-burden country, of which there are many in Africa,” she said.

HIV patients are in a desperate situation, walking for seven hours, sleeping at health facilities and going back the following dayMilly Katana

“There is likely to be greater severity of Covid-19 infection in people with TB, or damaged lungs from previous TB. In addition, research into all infectious diseases is stopping in many places, vaccination campaigns are stopping, so we are likely to see increases in vaccine-preventable diseases such as measles or polio.”Advertisement

Malaria symptoms can also present similarly to coronavirus, leading to confusion.

“Anyone whose body temperature is higher than normal is suspected to be infected with coronavirus and put in isolation wards and in quarantine locations where people who have arrived from abroad are being observed,” said Chris Macoloo,director for the US development charity World Neighbors in east and west Africa.

“The possibility is that a person who has merely a raised temperature (maybe unrelated to the virus) is likely to be infected when brought closer to people under isolation. There is a likelihood that lower-order health facilities such as dispensaries are referring malaria patients to the Covid-19 health teams. So in the incubation stage, a lot of confusion is occurring.”

Dr Joyce Samoutou-Wong of the Congo-based charity New Sight Eye Care says her charity has distributed more than 12,000 leaflets and posters and recorded several broadcasts in Congo and abroad regarding the virus.

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“We had to close our clinic on 31 March and we normally serve 200 patients per month. Cargo supplies are still running, for now, but we depend on visits from abroad to bring a lot of our supplies, which have obviously been suspended, plus we’ve had to postpone the construction of an eye hospital.”

Samoutou-Wong said a European-style lockdown would be totally impossible in Africa. “A lot of myths are out there. People think Congo bololo (a plant) or lemon and garlic can protect them from the virus.

“We are on the edge of the rainforest, so there is no panic buying because people don’t have the resources to stock up on supplies, and quarantine is impossible because people share clothes, beds, floor space, utensils. Water pumps are a hotspot for the virus, so the hardest measure to implement is simply hand washing.”

How the spread of coronavirus is testing Africa

Africa has passed the grim milestone of 10,000 reported cases of coronavirus, along with more than 500 deaths, according to the Africa Centres for Disease Control and Prevention (ACDC).

As the daily number of new infections appears to be falling in parts of the world, some fear the epicentre of the virus could move to the continent.

Despite efforts to lock down cities and countries, despite donations of protective equipment, testing kits and ventilators from China, one thing is clear: Africa has not yet flattened the curve and the room for manoeuvre is getting smaller.

‘Delay in action’

“What we are seeing is that this opportunity is no longer there or almost not there for some countries,” says Dr Michel Yao, who runs the emergency response programme for the World Health Organization (WHO) in Africa.

“The worry is also now that [countries] cannot adequately manage this phase, they are moving to [in country transmission]. But we are seeing there is some delay in addressing [this]… to mobilise more people, train more people, think about capacity.”

South African Police Service (SAPS) walk past shoppers queuing outside a food store during their operation in Sunnyside, Pretoria on April 7, 2020
The lockdown in South Africa means that the number of shoppers in supermarkets are restricted

It is difficult to compare regions with different cultures, economies, travel links and infrastructure, but some comparisons paint an urgent picture.

In studying the daily increases in the number of those who have tested positive for coronavirus around the world, Africa appears to be controlling the spread better than in the US and Europe so far.

But the comparison with Asia, where some countries appeared to reduce the daily increase in the number of new cases relatively quickly, does not fare so well.

Spreading in communities

Perhaps a better comparison could be with the Middle East. There, cases have steadily risen, along with deaths, and the region has now recorded more than 78,000 cases in total, according to the WHO.

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Nearly every African country has reported cases, and while most began with patients bringing the virus in through international travel, it is now spreading within communities.

Different variables make predictions difficult, but the worst-case scenarios are still jarring. “Cases can easily pick up,” Dr Yao says, “even triple, maybe multiply by seven to 10 from what we have right now”.

Confirmed coronavirus cases in South Africa

Source: WHO

In South Africa, the last two weeks of March saw a 20-fold increase in the number of confirmed cases. In response to the growing numbers, President Cyril Ramaphosa declared a country-wide three-week lockdown that began on 27 March.

He has since extended that to the end of April as the number of daily new cases has dropped – though it is too early to say conclusively if the lockdown the reason.

What is significant is the rise in testing capabilities in South Africa.

Medical staff prepare to test another person for Covid-19 Coronavirus at a reutine testing station on day 13 of the 21 day national lockdown following President Cyril Ramaphosa declaration of a National Disaster in Johannesburg, South Africa
South Africa has mobile testing units to try and test as many people as possible

The country has so far conducted around 60,000 tests for Covid-19, the disease caused by the virus, and is now testing at a rate of nearly 5,000 a day, according to Health Minister Zweli Mkhize.

But compared to other countries in the grip of the virus, that amount is still woefully inadequate. Italy – one the hardest hit countries in the world – has a similar population to South Africa and has conducted more than 700,000 tests.

Testing numbers are even more worrying across the rest of Africa.

Doctors prepare to administer the mandatory COVID-19 coronavirus test for detainees of a Government designated quarantine facility in Nairobi on March 29, 2020
In Kenya, health workers have been testing people who have been put in quarantine

Nigeria and Kenya have each conducted around 5,000 tests. Compare that with 600,000 in South Korea, who many see as having waged the strongest campaign against the virus.

“We are seeing an increase in the number of tests but I think we could do much more,” argues Dr Abdhallah Ziraba, a research scientist and epidemiologist at the African Population and Health Research Center.

Testing bottlenecks

African countries have been fighting hard to raise their testing capacity.

Health ministries have worked to convert private laboratories into Covid-19 testing centres and major laboratories like the Pasteur Institute in Dakar have – through the ACDC-organised Covid-19 training seminars for laboratories around the region.

Still it has not been enough.

Bottlenecks in the supplies of reagents necessary for testing have limited capacity.


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Chinese billionaire Jack Ma recently announced donations of more than one million sample extraction kits to African countries. It is unclear whether the full testing package will be included, but if so, the donation could prove critical to boosting tests continent-wide.

“We know there are challenges around the development of the tests, the cost of the test and the logistics involved but we can’t be complacent and just think that people are not going to die,” says Dr Ziraba.

According to a study written by epidemiologists in London and Johannesburg, a single reported death could mean a country already has hundreds or even thousands of cases.

Confirmed coronavirus cases in Africa

Source: WHO

The more tests that can be conducted, the more confident the continent can be in its data and the systems it has in place to fight the rising tide.

One of the major problems Africa will face in the coming weeks is exactly how to fight the virus.

So far South Africa’s lockdown strategy has shown signs of promise. Other countries have followed suit.

Africa’s most-populous country, Nigeria, has locked down Lagos, restricting movement to essential activities.

A member of local hygiene services wears a protective suit and face masks, disinfects a mosque to stop the spread of coronavirus disease (COVID-19), in Dakar, Senegal April 1,
Sanitation workers have sprayed disinfectant into mosques in Senegal’s capital, Dakar, to help prevent the spread of coronavirus

One suburb of the capital of the Democratic Republic of Congo, Kinshasa, has followed suit.

Dakar in Senegal and Nairobi in Kenya have imposed curfews, allowing people to continue working but preventing social activity and travelling at night.

The spectre of a total lockdown however risks a complete halt of economic activity across the continent.

More than a third of the population of the continent lives below the poverty line. While most of those live in rural areas and potentially have access to subsistence farming, around 20% live in urban areas, relying on casual labour to feed themselves and their family.

Risk of malnutrition

If it proves necessary to completely cut them off from jobs and markets, the potential death toll is unknown.

“Economic recession and deteriorating livelihoods mean impoverishment, malnutrition, worsened access to routine health services, and that in turn all means lives lost as well,” says Dr Francesco Checci, a professor of epidemiology at the London School of Hygiene and Tropical Medicine.

“Lives lost not just among the old but also among children and younger people. So there is a really difficult equation there.”

Countries like Rwanda have started to distribute food and resources in anticipation of those consequences. In Cape Town, in South Africa, even notorious street gangs have begun to help distribute food.

In other countries, the plan is less clear.

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In Kenya, civil society groups have started collecting funds and food for lower income families. Ethiopia has declared a state of emergency, despite Prime Minister Abiy Ahmed recently saying that “we can’t impose a lockdown like more developed nations, as there are many citizens who don’t have homes”.

African nations have limited resources to replace the incomes of their citizens. Those difficulties again highlight the importance of testing.

If we can test and have a more localised strategic approach to restricting movement that would really help resources,” says Dr Ngozi Erondu, an infectious disease epidemiologist at the Chatham House think-tank.

“I think we can be more creative about which villages can go to markets on which days doing rotations so that there are less densely populated areas.”

A trader sleeps next to items to be sold at a market following a directive from Ugandan President Yoweri Museveni that all vendors should sleep in markets for 14 days
Market traders in Uganda have been told to sleep by their stalls to prevent the spread of coronavirus

Ultimately, it will be the efforts and resources deployed by African countries themselves that determine the course of the outbreak

“Governments need to invest in this, you can’t tell people to stay away from work and make sure you stay hygienic when you don’t give them a way to do so,” says Dr Erondu.

“We really will start seeing if these lockdown measures, these quarantine measures – if they’re actually working towards the end of April.”

Shaping Africa’s urban areas to withstand future pandemics

Urban areas are a fertile ground for contagion
Getty Images

By Astrid R.N. Haas, International Growth Centre

The power of cities comes from the number of interactions they enable, between people, firms and markets – they are centres of social interaction. For all their virtues, however, cities have a major downside. They are a fertile ground for contagion, such as the rapid spread of COVID-19.

This is because cities are by definition places of density, with large numbers of people living and interacting in close proximity. Furthermore, many cities are deeply embedded in national, regional and global networks. This is embodied by infrastructural features such as airports, ports and other transport terminals ferrying goods and people at a high frequency. As such, the potential for transmission rates of COVID-19 within them may be far higher relative to national averages.

This is aptly illustrated by New York City, which already accounts for approximately half of all known cases in the US. Perhaps even more shocking, it accounted for 5% of all confirmed cases in the world – and it is just one city of about 8.6 million people.

Contagion in African cities

Given the characteristics of many African cities, the situation, without appropriate mitigation measures, could be far worse. For example, density levels in certain parts of African cities, most notably in slums and other informal settlements, may be even higher than New York’s. It is estimated that about 2/3rds of Nairobi’s population lives on just 6% of its land. In Kampala, 71% of households sleep in a single room.

These congested settlements have few amenities. Only an estimated 56% of the urban population in sub-Saharan Africa have access to piped water. And even those with access, they can spend 30 minutes or longer sourcing it.

This begs the question whether frequent hand-washing – one of two of the main measures to prevent transmission – is even feasible. The same goes for social distancing, the second recommended preventative measure, both given density and also because it runs contrary to many African societal norms, which are inherently deeply communal.

At the same time, one of the drivers of rural-urban migration in Africa is the relatively better access to services in the city. This includes health services. Data from the countries with already well-developed and funded health systems show that they are experiencing immense strain with COVID-19 patients. In the US, it is predicted that at least 200,000 intensive care unit (ICU) beds will be needed in the case of a moderate outbreak. The whole of Uganda on the other hand has 55 ICU beds in 12 operational units. It is clear that with similar infection rates African health systems would collapse. Yet people are still more likely to be treated in urban areas. In Uganda’s case, 80% of these ICU beds are located in Kampala.

Economic distress from lockdowns

To reinforce social-distancing, many governments in Europe and US are enforcing strict temporary lockdown measures. African governments, which still lag behind in terms of the known infection rate, are quickly following suit – some with even harsher measures. Given that urban centres are major economic nodes they will naturally bear a disproportionate economic burden of any lockdowns. This effect will rapidly percolate through the whole economy.

Urban dwellers working in the informal sector will be the first and potentially some of the hardest hit. About 85% of workers do not receive a reported wage. Rather in many African cities, the majority earn their daily keep from the informal service sector, particularly selling or providing manual labour. Here there is no option to work from home: both because of the lack of necessary infrastructure such as power and more importantly because their jobs are predicated on face-to-face interactions.

Even though they are working, their daily earnings are small. In Kampala, for example, a survey of informal sector firms showed that 93% of them are already operating below the poverty line. Therefore lockdowns, for these populations, will mean not earning a wage and affect their survival.

This is exacerbated as urban populations are largely beholden to food prices, given in general they are not able to grow their own food. Early indications already show that some countries like Ghana have seen rise in food prices by nearly 30% already due to panic buying and disruptions in food supply chains.

This is particularly worrisome for some countries already concerned about a food crisis this year, due to the plague of locusts affecting supplies. With the timelines of the overall COVID-19 crisis remaining unclear, feeding one’s family, particularly in urban areas, with no income and rising prices is already becoming an increasing struggle.

Lockdowns may support curbing transmissions, but by potentially pushing millions more people across the continent below the poverty line, it could have other detrimental, and potentially worse, longer-lasting effects beyond the health impact. Therefore, reshaping African cities in the pandemic’s aftermath to ensure they can be engines of economic growth in the future, will be key.

Shaping the urban future

Cities across the globe and throughout history have adapted and reinvented themselves in the face of crisis and disaster. Some analysts are predicting that cities in the US, will emerge and be reshaped by this crisis, for example, as a result of people working from home. This means the need for centrally located offices will diminish.

The nature of jobs is different in African cities. Working from home is not likely to be an option. Rather, it may even be that, in the aftermath of the crisis, rural-urban migration actually increases as people flock to cities in search of more economic opportunities.

Preparing for this by ensuring urbanisation is well managed will be critical to providing the engine to ramping up national economic growth.

A critical element of this and in particular to prepare for the next pandemic, is the need for cities to invest in productive infrastructure, focused on improving health outcomes. This includes water and sewage infrastructure as well as increasing the number of health facilities.

The density of cities that make them susceptible to disease, also make them more efficient to provide infrastructure to a large number of people. In managing and shaping Africa’s urban future there should be a central role for public health officials, working alongside planners, economists and others. This can help reduce the potential of contagion whilst maintaining the power of cities.

Astrid R.N. Haas, Policy Director, International Growth Centre

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus cases in Africa pass 2,400 amid fears for health services

There has been widespread panic buying in South African since the lockdown was announced. Photograph: Rogan Ward/Reuters

There are now more than 2,400 confirmed cases of Covid-19 across Africa and growing warnings that the pandemic will cause major challenges for the continent’s under-resourced health services.

World Health Organization officials have said the statistics are likely to significantly underestimate the true number of cases. There have been 60 reported deaths so far.

About a third of the cases are in South Africa, which recorded a steep rise overnight. The country’s health minister, Zweli Mkhize, said on Wednesday that the number of coronavirus cases had reached 709, up from 554 a day before.

South Africa will go into a strict 21-day lockdown at midnight on Thursday in an attempt to avoid a “catastrophe of huge proportions”, said the president, Cyril Ramaphosa. He called on the 56 million people in sub-Saharan Africa’s most developed economy to show patience, courage and unity.

The lockdown will confine all but essential workers to their homes, though journeys to buy groceries or seek medical attention will be allowed.

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“The numbers will continue to rise. It is clear that we need to urgently and dramatically escalate our response,” Ramaphosa said, warning of the prospect of tens or hundreds of thousands of cases within weeks if nothing was done.

Though South Africa has a young population, and Covid-19 is deadlier among older people, there are millions who are vulnerable because of HIV or malnutrition. The healthcare system has long had an acute lack of resources and critical facilities are extremely limited. There has been widespread panic buying since the lockdown was announced.

Other countries with high numbers of cases include Algeria, with 264, and Egypt, on 402. The first case has been reported in Libya.

Most African nations have imposed restrictions and taken a range of extraordinary measures to try to combat the crisis. Many flights have been suspended, with entries for travellers from much of Europe and the US effectively impossible.

Rwanda, Kenya and the Democratic Republic of the Congo (DRC) have all imposed curfews and lockdowns in recent days.


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Authorities in the DRC, which has recorded 48 cases, are seeking to isolate the capital, Kinshasa, from the rest of the country, while Ethiopia is to release more than 4,000 prisoners in an effort to decongest crowded jails, according to state media.

Neighbouring Mali recorded its first cases on Wednesday. Officials in the poor, unstable state recently denied reports it had only one ventilator for its 17 million inhabitants, saying it had 56.

There are fears that lockdowns will bring significant hardship for the continent’s poor, many of whom live hand to mouth without formal employment.

 A police officer guards the deserted border crossing between the Democratic Republic of the Congo and Rwanda. Photograph: Olivia Acland/Reuters

Health officials across Africa know hospitals can deal with only a fraction of those needing care if the virus spreads through crowded cities, remote villages and among vulnerable populations such as refugees, malnourished people or those with HIV and other chronic conditions.

South African authorities have said they will work to protect overcrowded neighbourhoods where social distancing and self-isolation are virtually impossible. The human settlements minister, Lindiwe Sisulu, said the government would reveal its strategy after consulting with communities.

Nombulelo Tyokolo, 41, a domestic worker in Cape Town who shares a one-bedroom shack with her son, said she was concerned about how the lockdown will work. “I am scared, worried and panicking about 21 days indoors,” she said. “We have to fetch water outside and go outside to the toilets. God have mercy.”

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False beliefs about who is vulnerable to the virus, and how to fight it, are a serious problem on the continent, as elsewhere. Officials have warned of the danger of spreading erroneous information, and many religious leaders have called on their congregations to avoid spreading fake news.

Fartun Mohamed Nur, a 36-year-old mother of three in Mogadishu, Somalia, said she had once believed the disease would only hit non-Muslims or white people but had changed her mind after attending an information session run by a local NGO.

“I have learned that this is a virus and affects all humans. I am now going home with my children. We were told to wash hands very well,” Nur said. “I am now prepared to protect myself and my children from coronavirus.”

Christian Mulamba, a 35-year-old shoe seller in the commune of Kasa-Vubu, near Kinshasa, said coronavirus did not exist but was an excuse for politicians to make money from aid programmes. “This information is false … I don’t give a damn about the rules of hygiene,” Malamba said.

Additional reporting by Abdalle Ahmed Mumin in Mogadishu and Esdras Tsongo in Kinshasa

'People still hurt': the forgotten survivors of Cyclone Idai

The sound of the rising wind and the heavy rain trigger fear at Garikai camp in Ngangu, Chimanimani, eastern Zimbabwe.

Villagers here are haunted by traumatic memories of the aftermath of the cyclone that swept over this region last March, when they were forced to bury the dead in makeshift coffins. Some people have never found their loved ones.

A man stands near the wreckage of vehicles washed away by Cyclone Idai in Chimanimani, eastern Zimbabwe, in March 2019. Photograph: Zinyange Auntony/AFP/Getty Images

Driving towards Ngangu village one is greeted by a vision of the storm’s path of destruction, dotted along the red mud roads and gullies. Broken bridges, rubble from smashed homes and stone boulders strewn across fields are a constant reminder of Cyclone Idai.

Thousands are still living in tents brought in by the UN refugee agency after the government of Zimbabwe failed to resettle its citizens or build replacement accommodation.

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Makeshift shelters at Garikai, the largest of three displacement camps in Chimanimani, are ageing. Soon the families attempting to live in them will be left homeless again.

Water supplies and food are scarce. Exactly a year ago, the marooned villagers were showered with medical attention and international sympathy, with donors stampeding to offer assistance, food and temporary shelters.

But those donors are disappearing, and the villagers at Garikai feel abandoned.

Women in Ngangu, Chimanimani, walk past tent shelters. Supposedly a temporary measure, the shelters remain in place a year after Cyclone Idai struck. Photograph: Aaron Ufumeli/EPA

Kesima Ndlovu, 61, suffered back injuries in the cyclone. “The tents are getting old and we fear that if another storm comes, we will be swept away,” she says. “I cannot afford medical supplies. I can only afford medical attention if I do menial jobs, but I cannot because my back still hurts from the injuries I sustained when I was marooned.”

Ndlovu, who stays with her husband and two grandchildren in a small tent, says the government should provide land to allow the people to rebuild their lives themselves.

“We are asking for land to build our own houses. Government should remember us, we are still its citizens. These tents are not safe. The donors came and left us in this predicament. We are suffering in these tents. We are appealing for medical attention, people still hurt,” Ndlovu says.

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Joshua Sacco, the member of parliament for Chimanimani, has pleaded for patience. He says the government is in the process of relocating the villagers in Ngangu.

With colder weather approaching, the noisy winter rains already keep families under canvas awake at night.

“There is hunger, because our farmlands got washed away. People need food aid and jobs so that we can survive,” says Timothy Mlalazi, 40, a father of two.

Villagers in Kopa, Chimanimani, search for missing relatives after Cyclone Idai. Photograph: Aaron Ufumeli/EPA

Mlalazi says it remains difficult to find work a year after the cyclone destroyed Ngangu’s economy.

“I lost all my cattle and [my] banana business. I have nothing, I need help to rebuild my business. My children can no longer eat twice a day. Without a home I cannot do anything,” he says.

Doreen Hove, 63, limps towards a makeshift fireplace where she will prepare the day’s meal. When Idai struck, she saw her seven-year-old grandchild crushed to death by rock boulders that the storm tossed around like footballs. She is still traumatised.

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“It is painful, I normally do not want to talk about this,” says Hove. “I cannot even sleep at night sometimes because of the trauma. On the day, I even told my grandchildren that they should not go to school.

“After we had dinner, we retired to bed. When we heard people crying, we rushed outside to help. Suddenly we heard a roaring sound, I didn’t know they were rock boulders. Before I could get back into the house to seek refuge, the rock had crushed my grandchild. I cried for help but no one heard me.”

According to the Regional Psychosocial Support Initiative, many villagers experience traumatic flashbacks during the rainy season. The organisation says more needs to be done and that villagers in Ngangu require psychological help.

 Chipo Ruwo sits on a bed in her tent in a makeshift camp in Chimanimani, Zimbabwe, a year after Cylone Idai made landfall. Photograph: Aaron Ufumeli/EPA

Chipo Ruwo, who lives in one tent with seven other family members, laments the lack of healthcare at the camp. All she has is a stand number; she has been told it could be another year before she is allocated a housing stand by the government.

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“This place is not comfortable,” she says. “We don’t have clothes and blankets, we always ask for help from donors. There are seven people staying in my tent, my husband and extended family also stay here.

“We need food and blankets because we are approaching winter, we fear for the children. I was also injured during the cyclone and I still carry the pain, there is no money for tablets. They are asking for US dollars at the nearby clinic but most of us cannot afford.”

The slow pace of road construction is another complaint levelled against the government.

Cotilda Shupikai Ngwengwe, left, helps her mother Gladys Chiremba to weed her fields in Buhera. Chiremba is among beneficiaries of 36 houses built by the Methodist Development and Relief Agency for people whose homes were destroyed by Cyclone Idai. Photograph: Jekesai Njikizana/AFP via Getty Images

Oxfam says more than 100,000 people are still living in makeshift shelters, while others are in dire need of food after they failed to recover from the cyclone’s impact on farms and livelihoods.

Women are the hardest hit, left without sanitary wear, clean water or medical supplies for children. Girls are being forced into early marriage for survival, according to Plan International.

With donor funding dwindling, children are suffering from malnutrition since food shortages mean they can only eat once a day.

To fight hunger, the UN’s World Food Programme (WFP) has been providing food aid to more than 300 families in the camps

A young boy jumps across a stream in Praia Nova village in Beira, Mozambique, most of which was flooded during Cyclone Idai. One year on, 2.5 million Mozambicans remain in urgent need of assistance. Photograph: Karel Prinsloo/UNCDF/AFP via Getty Images

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Cyclone Idai was one of the worst natural disasters in the history of the southern hemisphere, killing more than 1,000 people and leaving a further 3 million without food, water, shelter and critical infrastructure across Zimbabwe, Mozambique and some parts of Malawi.

In Zimbabwe, close to 17,000 households were displaced, while an estimated 1.4m hectares (14.5m acres) of arable land – accounting for one-third of national agricultural production – was destroyed, affecting 50,000 mainly smallholder farmers and exacerbating already high levels of malnutrition.

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“We can see that a year on, many people still are without shelter. WFP is continuing to provide essential food assistance to over 300 families who are still without essential food,” says WFP communications officer Claire Nevill.

Amnesty International has called for a continuation of international supportfor these families.

“Concerned governments, and international partners, should renew their commitment, step up reconstruction and ensure that these efforts are done in a way that truly delivers human rights,” Amnesty said.

Coronavirus: Africa impose strict restrictions

Kenya has ordered all schools to close

Several African states have imposed far-reaching restrictions in a bid to curb the spread of coronavirus.

South Africa has declared a national disaster and announced a ban on travel from the worst-affected countries, while Kenya has also imposed sweeping travel restrictions.

The measures are an attempt to prevent a major outbreak on a continent with poor health services.

At least 27 African states have so far been affected by the virus.

Liberia, Somalia and Tanzania are the latest African countries to report cases.

In total, nearly 350 people have been diagnosed with the virus across Africa. Seven people have died while 42 have recovered, the World Health Organization (WHO) said.

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Most of the cases involve people arriving from Europe and North America.

What happened in South Africa?

South Africa has imposed the most severe restrictions on its citizens since the end of white-minority rule after reporting its first local transmission, increasing the number of cases to 62.

In an address to the nation on Sunday, President Cyril Ramaphosa declared a national disaster.

“Initially, it was people who had travelled out of the country, especially from Italy, who had positively tested for the virus,” he said.

“It is concerning that we are now dealing with internal transmission of the virus,” Mr Ramaphosa said.

Mr Ramaphosa said he would chair a government command council that would “coordinate all aspects of our extraordinary emergency response”.


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Among the measures he announced are:

  • The closure of nearly half – 35 out of 72 – of South Africa’s land border crossings from Monday, along with two of its eight sea ports
  • Banning foreign nationals from eight countries – including the UK and US – from entering South Africa from Wednesday
  • Advising people to avoid domestic travel
  • Shutting all schools with immediate effect until the end of the Easter holidays
  • Banning all public gatherings of more than 100 with immediate effect. This would affect the biggest annual event in South Africa – an Easter religious service attended by several million followers of the Zion Christian Church at its headquarters in northern Limpopo province.
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President ends ‘dithering’

Analysis box by Pumza Fihlani, southern Africa reporter

South Africans have been waiting for this moment – of transparency, decisiveness and leadership. President Ramaphosa’s strict measures are seen as a clear message that his government is finally taking the coronavirus crisis seriously. There were concerns that it had been dithering since the first case was detected 10 days ago.

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To be fair to the government, South Africa, like much of Africa, has not been severely affected so far. But the mood has changed, with health officials reporting that the number of cases is rising at an alarming rate.

Health Minister Zweli Mkhize has called on South Africans to take responsibility for their health and safety, and that of fellow citizens. And with good reason – the public health sector, which caters for about 80% of the country’s mainly poor population, is overstretched. It will not be able to cope with a huge outbreak.

The steps being taken now are aimed at containing the outbreak and protecting vulnerable people. If the crisis worsens it will require building a bridge of compassion between those who have access to good quality private health care and those who do not.

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What about Kenya?

In an address to the nation, President Uhuru Kenyatta announced:

  • A ban on travel from any country that is known to have the virus
  • Any Kenyan or foreigner residing in Kenya would have to go into quarantine if they arrive from an affected country
  • The closure of all education institutions.

But Kenya’s efforts to tackle the global pandemic have been hampered by nurses who have started a go-slow at a coronavirus isolation ward at the Mbagathi Hospital in the capital, Nairobi.

The nurses say there is a shortage of protective gear and they have not received adequate training on how to deal with patients.

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The hospital has admitted 22 people who came into contact with the first confirmed case in Kenya.

Meanwhile, a 23-year-old man has been arrested in the eastern town of Mwingi for publishing “false information”, Kenya’s Directorate of Criminal Investigations said in a tweet:

The man would be charged under cybercrime legislation, and risked a fine of up to $50,000 (£40,000) or a maximum prison sentence of 10 years.

Kenyans back tough measures

By Ferdinand Omondi, BBC News, Nairobi

Normally it takes me an hour to get to work, but on Monday morning it took barely 15 minutes. Kenya is slowly shutting down. Schools have closed, and people are starting to work from home.

A mother tweeted that she was suspending the leave of her house help as her children were unexpectedly at home. A relative sent me a financial SOS – she needed transport money to get her children back from boarding school.

School children pack their books to take home, following a directive by the Kenyan government to suspended learning in all institutions of learning as a preventive measure against the spreading of the COVID-19 coronavirus, on March 16, 2020, in Nairobi
Image captionAll schools and universities have been ordered to close

Some county governments have imposed stricter restrictions than those announced by the president by banning public gatherings.

This has forced the closure of nightclubs in the popular coastal city of Mombasa, and open-air markets and athletics training camps in Nandi, where foreign athletes live for high-altitude training.

DJs in affected areas are wondering how they can work from home, and a musician has lamented the cancellation of shows all through to May.

With many restaurants shutting down because of a lack of customers, waitresses and cleaners – who are casual workers on low pay – may lose their jobs.

There are genuine concerns about the well-being of those who live hand-to-mouth, but overall Kenyans seem willing to cooperate with the authorities in the bid to stem the spread of coronavirus.

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A bishop who disregarded restrictions on public gatherings by calling for a “Miracle Service” was criticised so heavily on Twitter that she deleted the post.

Some supermarkets were unusually full on Sunday, as people piled up with goods. The Competition Authority of Kenya has called out a supermarket for raising the price of hand sanitizers by $2 (£1.60). The supermarket swiftly blamed an employee at the branch for the “unauthorised” increase and promised full refunds.

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What’s happening in other African countries?

Other African states that have announced measures to curb the spread of the virus include:

  • Ethiopia – the closure of all schools and a ban on all public gatherings and sporting activities
  • Ghana – a ban on all public gatherings and travel from countries with more than 200 cases of coronavirus. As a result, all football matches in the country have been suspended.
  • Tunisia – the closure of all borders and the suspension of prayers in mosques
  • Algeria – a ban on all travel to and from Europe
  • Mozambique – a ban on all gatherings of more than 300 people
  • Morocco and Djibouti – the suspension of all international flights.

Coronavirus: ‘Do not let this fire burn’ – WHO warns Europe

The World Health Organization has stepped up its calls for intensified action to fight the coronavirus pandemic, imploring countries “not to let this fire burn”, as Spain said it would declare a 15-day state of emergency from Saturday.

Tedros Adhanom Ghebreyesus, the WHO director general, said Europe – where the virus is present in all 27 EU states and has infected 25,000 people – had become the centre of the epidemic, with more reported cases and deaths than the rest of the world combined apart from China.

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Across the continent and beyond, governments on Friday closed schools, sealed borders, cancelled top-flight cultural and sporting events and imposed tough social distancing measures. Some declared a state of emergency.

Maria van Kerkhove, the head of the WHO’s emerging diseases unit, said it was impossible to say when the pandemic will peak globally. Tedros stressed countries must take a comprehensive approach.

“Not testing alone,” he said. “Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all. Find, isolate, test and treat every case, to break the chains of transmission … Do not just let this fire burn.”


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As the number of confirmed cases in Spain passed 4,200 and the death toll rose to 120, the prime minister, Pedro Sánchez, said the government would “mobilise all resources”, including the military, to contain the outbreak. “This is an emergency that affects the life and health of all,” he said.

Sánchez said the cabinet would on Saturday activate article 116 of the constitution, allowing it to limit the movement of people and vehicles, requisition goods, take over factories and businesses and ration the consumption of basic items.

But he added that victory over the virus would depend not just on decrees but on “each and everyone of us, in our homes, in our workplaces, with our families and with our neighbours. Being a hero is also about washing your hands, staying at home, and protecting yourself in order to protect others.”

Madrid’s regional government announced that all shops, cafés, bars, restaurants, cinemas, gyms and non-food shops would be closed for two weeks from Saturday.

Confirmed cases of coronavirus
Last updated: Friday 13 March 16:20 GMT

Guardian graphic. Source: Johns Hopkins CSSE, WHO, CDC, NHC and Dingxiangyuan | Note: Spain, 4334; Switzerland, 858; Netherlands, 804; Denmark, 788; Norway, 702; Sweden, 599; Belgium, 556; Austria, 302; Qatar, 262; Bahrain, 189; Singapore, 187; Israel, 157; Finland, 155; Hong Kong, 134; Greece, 133; Czech Republic, 117; Portugal, 112; Iceland, 103; Slovenia, 89; Kuwait, 80; Egypt, 80; Iraq, 79; Lebanon, 77; Romania, 70; Ireland, 70; San Marino, 69; Indonesia, 69; Saudi Arabia, 62; Poland, 58; Philippines, 52; Taiwan, 50; Vietnam, 47; Estonia, 41; Albania, 33; Croatia, 31; Serbia, 31; Slovakia, 30; Panama, 27; Belarus, 27; Palestine, 26; Luxembourg, 26; Algeria, 26; Georgia, 24; Bulgaria, 23; Costa Rica, 23; Argentina, 21; Pakistan, 21; Cyprus, 19; Hungary, 19; Oman, 18; Ecuador, 17; Latvia, 17; Azerbaijan, 15; Bosnia and Herz., 13; Colombia, 13; Malta, 12; Brunei, 11; Macau, 10; Armenia, 8; North Macedonia, 7; Afghanistan, 7; Tunisia, 7; Lithuania, 6; Morocco, 6; New Zealand, 5; Dominican Republic, 5; Senegal, 5; Paraguay, 5; Sri Lanka, 5; Cambodia, 3; Bangladesh, 3; Cuba, 3; Ukraine, 3; Moldova, 3; Bolivia, 2; Cameroon, 2; Burkina Faso, 2; Turkey, 2; Kazakhstan, 2; Honduras, 2; Ethiopia, 1; Kenya, 1; Mongolia, 1; Togo, 1; Guinea, 1; Andorra, 1; Bhutan, 1; Sudan , 1; Cote d’Ivoire, 1; Nepal, 1; Monaco, 1; Liechtenstein, 1; Gibraltar, 1; Jordan, 1; Guyana, 1

Denmark said it would close its borders to all except its own nationals and legal residents at midday on Saturday until 13 April. “All tourists and foreigners who cannot prove they have a recognised purpose in Denmark will not be allowed to enterthe prime minister, Mette Frederiksen, said.

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France, which has reported 3,600 confirmed cases and 79 deaths, on Friday restricted all gatherings to a maximum of 100 people, hours after President Emmanuel Macron said the country faced its worst public health crisis in a century. France would do “all it takes” to preserve its economy, jobs and businesses, he said.Advertisement

Following Belgium’s example, Austria on Friday closed all shops except food stores, supermarkets and pharmacies, ordered bars and restaurants to close at 3pm, and told employers to allow home working, while Switzerland closed schools, banned public gatherings of more than 100 and restricted bars and restaurants to 50 customers.

Italy, by far the hardest-hit European country, with 17,660 confirmed infections and 1,266 deaths, is already in a nationwide lockdown, with all travel banned unless certified necessary on professional or health grounds and the 62 million population expected to stay mainly at home.

The Covid-19 pandemic has infected more than 135,000 people and killed just over 5,000, according to the Johns Hopkins University tracker, disrupting travel, closing schools, shutting factories and cancelling sporting, cultural and political events.

In the US, President Donald Trump was expected to declare a national emergency, freeing up federal funds for testing and treatment as well as help individuals and businesses struggling with the economic impact. The state of Louisiana postponed its Democratic and Republican presidential primaries for two months.

After calling Trump and other leaders in the G7 group of leading industrial nations, Macron announced an extraordinary summit of leaders – by video conference – on Monday to coordinate work on vaccine and treatment research as well as “a global economic and financial response”.

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In other developments:

  • Jair Bolsonaro’s son denied local media reports that the Brazilian president had tested positive.
  • The Canadian prime minister Justin Trudeau governed remotely from home, in self-imposed quarantine after his wife tested positive following a visit to the UK.
  • Iran said its Revolutionary Guards will clear streets, shops and public places of people within the next 24 hours, in a dramatic escalation of the country’s containment efforts. Its death toll rose to 514, with 11,364 confirmed cases.
  • India and Norway announced their first deaths, while Ghana, Kenya and Ethiopia confirmed their first infections.
  • France joined Italy, Spain, the Netherlands and others in cancelling professional football. The Champions League was postponed.
  • The Louvre, the world’s most visited museum, closed until further notice.
  • The Portuguese government put the country on a state of alert and the Bulgarian parliament voted unanimously to declare a state of emergency.
  • The entire Romanian cabinet went into quarantine after coming into contact with a senator who has tested positive.
  • The Czech government banned all foreign travellers from entering and all Czechs from leaving the country from 16 March.
  • Hungary’s nationalist prime minister, Viktor Orbán, said foreigners and migration were to blame for the emergence and spread of the virus inHungary.

Coronavirus updates

Confirmed cases

128,343

Data correct at 12:59pm UTC, 12 March

Deaths

4,720

Recovered

68,324

Germany reported 3,634 conformed infection on Friday, and eight deaths. In a brief press conference, Chancellor Angela Merkel pledged government support for the economy and for society “on all levels”.

She described the widespread closure of schools, the announcement of a massive credit programme for businesses and a work reduction programme to support workers and employers as far-reaching measures that would help ease the burden.

In contrast to the financial crisis of 2008/9, she said, “the opponent – if I may put it like that – is a virus that we don’t know, we don’t know how to combat it either, through vaccines or medicine. And that’s why we have to act where we can do so in the most vigorous way we can.”

In Asia, meanwhile, evidence grew that in China the outbreak has passed its peak and in South Korea it is easing. For the second day in a row Wuhan, the Chinese city at the centre of the outbreak, reported a single-digit tally of new cases, while surrounding Hubei province has recorded no new infections for eight days.

South Korea, once the biggest centre of coronavirus cases after China, on Friday reported more recoveries than new infections for the first time: 177 people were released from hospital, while 114 new cases were confirmed.

Officials said new clusters of infections remained a concern and warned the epidemic was not yet over. “We’ve managed to turn the corner, but there are concerns about overseas inflows, as well as possible infections around call centres, computer cafes and karaoke rooms,” the prime minister, Chung Sye-kyun, said.

In Brussels, the European commission president, Ursula von der Leyen, said member states “should feel comfortable to take any measures they need” to support their economy, adding that the commission would allow “maximum flexibility on state aid” and fiscal rules to help national governments counter the crisis.

The bloc would also establish a €37bn (£33bn) investment initiative to cushion Europe’s economy, Von der Leyen said. Individual member countries are responsible for health and public safety, which do not fall within the remit of the EU’s institutions.

What Ebola taught me about coronavirus: panic will get us nowhere

We must take care, but not lose sight of the bigger picture. Fixating on the virus means we often ignore wider social and economic priorities.

Sierra Leone health officials check passengers crossing at the border with Liberia to curb the spread of Ebola. Photograph: Zoom Dosso/AFP

Coronavirus has become inescapable, with more than 100,000 confirmed cases and almost 4,000 deaths globally to date. Even for those of us who have not had direct contact with the virus, it has our attention. It dominates the news and our conversations. Livelihoods, healthcare, travel, and social life are being impacted in ways that are difficult to quantify.

As the virus – and the associated fear – spreads, containment controls, and their consequences, are likely to become more severe.

This feels eerily familiar to me. I am a social anthropologist who unexpectedly became a specialist in the 2014–2016 Ebola outbreak.

In 2014 I was doing long-term fieldwork in an ordinary neighbourhood of Freetown, Sierra Leone’s bustling capital city, when the Ebola virus hit. As with coronavirus, Ebola was declared a public health emergency of international concern by the World Health Organization. Freetown was at the heart of the crisis.

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In a matter of weeks, life in the city transformed as heavy-handed regulations went into effect. Schools and colleges were suspended. Travel was restricted and there were daily curfews. Commercial airlines and businesses started pulling out. Local clinics were shut down, complicating treatment for routine illnesses, which could also be deadly. Ordinary people were asked, in effect, to put their lives on hold.

This feels eerily familiar to me. I unexpectedly became a specialist during the Ebola outbreak

I was struck by my friends’ and neighbours’ responses to the emergency. Unsurprisingly, precautions against the epidemic were taken seriously. Ebola was genuinely scary and novel. The family that I was staying with set up a chlorine hand-washing station at the entrance to their home. Bodily contact between strangers was minimised, aided by innovations such as the “Ebola handshake”. In most cases, the authorities were notified when there was death or illness in the community.Advertisement

Yet, life went on. Those who had lost their jobs looked for new work. Some young friends of mine joined the official Ebola response. Teachers in the community set up home-based classes so children could continue with their education. Religious and social commitments remained priorities. My neighbours discovered new, less risky ways to observe Easter and Eid, and mark important family occasions. Avid football fans even developed methods to keep up with the Premier League and La Liga when the small cinemas that normally screened games were shut down.


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Living an ordinary life during the emergency demanded active prioritisation in the face of draconian restrictions on movement and association. Taking genuine precautions against the virus was also deemed important. Both relied on people’s abilities to come together and co-operate in new ways, and to adapt in a time of uncertainty. Surviving Ebola was not only a matter of avoiding contagion or receiving treatment, but a broader social matter of living through the crisis in a dignified and meaningful way.

At the height of the epidemic, James and Aisha, a young couple that I lived with, had a baby. As a result of the crisis, James had been laid off from his work at a local guesthouse, and Aisha’s studies in business management were suspended. They were unmarried and did not have a stable support network around their little family. Despite regulations on movements and gatherings, they decided to perform an adapted version of a traditional baby naming ceremony.

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This meant holding the event later than usual, getting approval from local authorities, and inviting people who could assist with raising the baby to perform key roles, such as James’ former boss and Aisha’s classmates. This approach balanced both the immediate concerns of the crisis and the long-term challenges of childrearing. It was a stark contrast to the global hysteria around the outbreak, stoked by highly speculative experts, comment and sometimes media reporting.

Empty streets in Freetown during a lockdown to prevent the spread of Ebola. Photograph: Michael Duff/AP

The international response had a narrow focus on containing the virus at all costs. We are seeing similar panic-driven responses to coronavirus. Fixation on the virus displaces attention to the – often equally serious – social, economic and political consequences of public health interventions. It ignores the priorities of affected people, like James and Aisha, who need to be looking to the future.

By choosing to continue with their lives during the Ebola outbreak, my friends and neighbours in Freetown did not lose sight of the bigger picture. In hindsight, their responses make a lot of sense, even if they were actively discouraged at the time. A few years on, with health services and the economy still desperately poor in Sierra Leone, it is clear that a multi-billion-dollar international response was too preoccupied with Ebola and ignored the wider priorities of ordinary people.

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If there is one lesson I learned from my research on Ebola in Sierra Leone, it is this: take care but don’t panic about the virus and lose sight of the bigger picture. I hope that in responding to coronavirus, we as individuals – and our institutions – can learn something from those who have been through this before.

Dr Jonah Lipton is a postdoctoral researcher at the Firoz Lalji Centre for Africa, London School of Economics

Coronavirus tests ‘ready within weeks’ across Africa

The World Health Organization’s regional director for Africa says she expects that all nations in sub-Saharan Africa will be able to test for the coronavirus “within a couple of weeks”.

Matshidiso Moeti told the BBC that 33 countries in the region already had the facilities in place. A month ago only Senegal and South Africa did.

“We expect in the next couple of weeks that all 47 of our member states will have the facilities to diagnose this virus,” she said.

Dr Moeti said the worst case scenario would be if the virus spread rapidly to African cities with no facilities to contain and treat people.


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Officials in Senegal have confirmed the country’s first case of coronavirus. The only other confirmed case in the sub-Saharan region is in Nigeria.

Kenya is one of the countries that has been hit by a locust swarm

US pledges $8m to fight locust plague

The US has pledged to provide $8m (£6m) to control desert locusts in Ethiopia, Kenya and Somalia.

Kenya is one of the countries that has been hit by a locust swarm
Kenya is one of the countries that has been hit by a locust swarm

US Secretary of State Mike Pompeo announced this support in a joint press conference with Ethiopian Foreign Minister Gedu Andargachew in Addis Ababa.

Last week the UN’s Food and Agriculture Organisation (FAO) asked the international community to provide nearly $76m (£58m) to fund the spraying of the affected areas with pesticide.

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The UN agency warned that the East African region could be on the verge of a food crisis if huge swarms of locusts devouring crops and pasture are not brought under control.

There are fears that the locusts – already in the hundreds of billions – will multiply further.

Efforts to control the infestation have so far not been effective.

Want to know more of this story? BBC Africa covered how it all started here

I didn’t want to take corona virus to Africa – Cameroon student

When Kem Senou Pavel Daryl, a 21-year-old Cameroonian student living in the Chinese city of Jingzhou, contracted the coronavirus he had no intention of leaving China, even if that were possible.

Kem Senou Pavel Daryl is the first African to contract the virus in China

“No matter what happens I don’t want to take the sickness back to Africa,” he said from his university dormitory, where he is now under a 14-day quarantine.

He was suffering from a fever, a dry cough, and flu-like symptoms.

When he became ill he thought of his time as a child in Cameroon when he contracted malaria. He feared the worse.

“When I was going to the hospital for the first time I was thinking about my death and how I thought it was going to happen,” he said.

For 13 days he remained in isolation in a local Chinese hospital. He was treated with antibiotics and drugs typically used to treat HIV patients. After two weeks of care he began to show signs of recovery.

The CT scan showed no trace of the illness. He became the first African person known to be infected with the deadly coronavirus and the first to recover. His medical care was covered by the Chinese state.

Mr Senou says he did not want to take the disease to Africa

Egypt has become the first country in Africa to confirm a case of the coronavirus. Health professionals warn that countries with weaker health systems may struggle to cope with a potential outbreak of the illness, which has led to more than 1,770 deaths and infected more than 72,000 people, mostly in China.

“I don’t want to go home before finishing studying. I think there is no need to return home because all hospital fees were taken care of by the Chinese government,” says Mr Senou.

To evacuate or not?

Since late January governments around the world, led by the US, began evacuating their citizens out of Wuhan and neighbouring cities.

But thousands of African students, workers and families, remain in lockdown across the central Hubei province – the outbreak began in the provincial capital Wuhan – and some think their governments should do more to help them.

“We are sons and daughters of Africa but Africa is not willing to come to our rescue when we need it the most,” says Tisiliyani Salima, a medical student at Tongji Medical University and president of the Zambian Wuhan student association.

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For close to a month Ms Salima has been living in self-quarantine.

Time has begun to lose meaning for the 24-year old student. She spends her days sleeping and checking updates on Chinese social media apps.

She acts as the liaison between her embassy and the 186 Zambian students living under quarantine in Wuhan. Many worry about food safety, supplies, and lack information in a city that this week has seen an average of 100 deaths a day.

She watched other international classmates evacuated from the city while her countrymen and women were left behind.

“South of the Sahara most African countries have had a similar response,” says one student who agreed to talk under the condition of anonymity.

“Publicly or privately African countries say that China can handle the situation. But the situation is not under control. When you listen to the official response it tells you that the African countries do not want to offend China. We don’t have the bargaining power,” the student says.

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China is currently Africa’s largest trading partner and the ties between the two have blossomed in recent years.

In the process China has become home to 80,000 African students, many attracted to the middle kingdom by scholarship programmes. But community leaders say families, young and old are stranded in Hubei province with little aid or assistance from their governments.

“People are saying: ‘Don’t bring us back because Nigeria can’t handle us.’ I feel conflicted but at the end of the day I am also human,” says Angela, a recent graduate from Nigeria, who only gave her first name.

“I would appreciate if they would recognise that there are Nigerians here but we don’t seem to be a priority. We didn’t get any response from our government,” she says.

Last week, for the first time in 22 days in lockdown, dwindling supplies forced Angela to venture out of her apartment to buy some essentials.

“The city is like a ghost town. When I left my complex I didn’t know if I would even be allowed back in. People are checking temperatures outside the gate,” she says in a phone interview from her apartment.

The Institut Pasteur de Dakar, in Senegal, is one of the laboratories that has the reagents needed to test samples

On 30 January the Cameroonian community penned an open letter to the president urging their government to evacuate citizens stuck in the epicentre of the outbreak.

Weeks on Dr Pisso Scott Nseke, a community leader in Wuhan, says Cameroonians are still waiting for a response.

He accepts that the community is not united in the desire to be evacuated but says they are disappointed by the lack of assistance from the government.

As of mid-February, Egypt, Algeria, Mauritius, Morocco and Seychelles had moved their citizens out of Hubei province.

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Other nations such as Ghana and Kenya are reportedly considering evacuating.

‘We feel abandoned’

Some nations have sent financial support to their citizens.

According to the head of the Ivory Coast student association in Wuhan $490 ($380) was given to the 77 Ivoirians in the city following weeks of discussions with their government. But many are growing increasingly frustrated by their government’s stance.

Ghana has reportedly sent financial assistance to its nationals as well.

“Staying here doesn’t guarantee our safety. We are just in a country that has better medical facilities,” says Ms Salima.

“We feel abandoned. The Chinese clearly were angered by the Americans pulling their people out as they felt it caused panic,” said one student who agreed to talk on the condition of anonymity. “There is a lot of distrust here of the authorities,” he added.

Some are calling for a continent-wide strategy to help African nationals in China.

“The decision to evacuate is not a question of ‘solidarity’ with China or the lack of it. It is the responsibility of every country to ultimately look after the health of their citizens wherever they are, including in China,” says Hannah Ryder from Development Reimagined, a Beijing-based international development consultancy.

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As for Mr Senou, he says has no plans to return to Cameroon.

“It would be a bad and dangerous idea. The biggest fear I had from the virus was psychological and emotional. Going back home is not an option now.”

People at the African Union headquarters in Addis Ababa are given disinfectant. Ethiopia is one of several African countries where coronavirus tests have so far proved negative. Photograph: Anadolu Agency via Getty Images

Africa braced for ‘inevitable’ arrival of coronavirus

Health centres step up preparations as World Health Organization raises fears about ability to cope with major outbreak.

People at the African Union headquarters in Addis Ababa are given disinfectant. Ethiopia is one of several African countries where coronavirus tests have so far proved negative. Photograph: Anadolu Agency via Getty Images
People at the African Union headquarters in Addis Ababa are given disinfectant. Ethiopia is one of several African countries where coronavirus tests have so far proved negative. Photograph: Anadolu Agency via Getty Images

African health authorities are stepping up preparedness for coronavirus after the head of the World Health Organzation described the outbreak as a “very grave threat for the rest of the world”.

Although the number of cases in China appeared to have stabilised and started to decline, “this outbreak could still go in any direction,” said Dr Tedros Adhanom Ghebreyesus on Wednesday.

Speaking after the WHO’s decision not to describe the status of the Ebola epidemic in the Democratic Republic of the Congo as a public health emergency of international concern, Tedros emphasised the need to improve health systems against the new coronavirus and other deadly outbreaks.

“Our greatest fear remains the damage the coronavirus could do in a country like DRC,” he said.

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Around the world, there are now more than 60,000 confirmed cases of COVID-19 infection, as the disease is now being called officially, and almost 1,400 deaths.

But the numbers outside China are relatively small, with just over 500 cases in 24 countries and one death in the Philippines. Person-to-person transmission outside China was still happening in only about 22% of cases, said Dr Michael Ryan, WHO’s head of emergencies. “We have a window of opportunity to shut this virus down.”

Ryan also urged caution after one Chinese scientist predicted that the epidemic would be over by April. Huge efforts by China to contain the virus may have had an effect, but while the slowdown – and the apparently less aggressive behaviour of the virus outside China – buys time, it does not necessarily mean it will be brought under control.

“It is no guarantee,” he said. “We are not going to speak about numbers or dates. We need to focus on the task. I think it’s way too early to try to predict the beginning, middle or the end of this epidemic right now.”

The number of African countries that can test for the virus tripled to 15 this week, with more expected to have testing labs up and running in the coming days. The head of the Africa Centres for Disease Control and Prevention (Africa CDC) said health centres were on “high alert” for new cases.

Confirmed cases of coronavirus

Updated Saturday 16 February 06.00 GMT

Note: Taiwan, 18 cases; Hong Kong, 42 cases; Cambodia, 1 case; Italy, 3 cases; Philippines, 3 cases; Spain, 2 cases; Macau, 10 cases; North Korea, 1 case; Others, 64 cases

There have been no confirmed cases of coronavirus in any of Africa’s 54 countries so far, but experts say a case is inevitable, given the large amount of traffic between the continent and China.

Michel Yao, the WHO’s head of emergency operations in Africa, warned it could happen “at any time”, adding that most hospitals would be unable to cope with large numbers requiring intensive care.

Roughly 15% of patients infected with the virus require hospital treatment, up to a quarter need intensive care and 5-10% require mechanical ventilation, according to WHO scientists.

More than 1,000 people have died of the disease in China, where almost 45,000 cases have been confirmed. Fewer than 500 cases have so far been confirmed in countries and territories outside China.

Confirmed cases of the coronavirus have risen to almost 45,000

Note: cases in Hong Kong, Macau and Taiwan counted outside mainland China. Data correct at 8.44pm, 11 February

Deaths from the coronavirus rose to 1,115 by 11 February

Note: all but two of the deaths have occurred in China. Data correct at 8.44pm, 11 February

“The lack of reagents is what delayed the capacity in African countries for confirmation,” said Yao. “We are working around the clock to ensure they receive reagents (so they can test for the virus).”

About 45 suspected cases in Africa have been reported to the WHO so far, with Ethiopia, Kenya, Ivory Coast, Ghana and Botswana among the countries affected. A total of 35 of those cases were found to be negative, while the remaining 10 have been placed in quarantine until tests are carried out.

A week ago, only six laboratories in Africa, including the Institut Pasteur in Senegal and the National Institute for Communicable Diseases in South Africa, were able to test for the virus, raising concern that undetected cases might already exist. Last weekend, Africa CDC ran a workshop in Senegal for scientists in 15 countries, sending them home with diagnostic tests including reagents.

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Seven of the countries now able to run tests are on the WHO’s priority list of countries that are especially vulnerable, mainly because of their contact with China. They include Algeria, Angola, Ethiopia, Ghana, Nigeria, Tanzania and Zambia.

The WHO is also sending kits to 29 laboratories on the continent.

Asked about the ability of health systems in African nations to cope with the intensive care needs of a coronavirus outbreak, Yao said it would present “quite a challenge”.

“I can tell you straight away the capacity to manage a large number of patients is not there in many African countries. We remain concerned. That’s why we are ensuring heath systems are on high alert,” he said.


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“With the exception of large countries like Kenya and South Africa, most African hospitals have very limited intensive care facilities. A hospital may have only 10 beds capable of intensive care. Imagine having a cluster of cases that requires intensive care. That could be quite a challenge.”

John Nkengasong, the director of Africa CDC, said the increased ability to test for the virus in Africa would encourage those with suspected symptoms to come forward, adding that one theory for not seeing cases in Africa was a shortage of testing facilities.

“The hope is that this new turnaround time, in hours rather than days, [will make] people feel, if they have the symptoms, they will report for testing,” Nkengasong said.

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“If you keep someone for days, human behaviour suggests people will stay away. Now that many countries have the ability, there is the possibility that we will see cases in the coming weeks. Time will tell.”

Africans are angry over Trump’s travel ban

New rules will severely restrict visas for nationals of Eritrea, Nigeria, Sudan and Tanzania but could be costly for US influence in the region.

New US travel restrictions will significantly affect four African countries, as well as Kyrgyzstan and Myanmar. Photograph: Carolyn Kaster/AP

New travel bans imposed by Donald Trump on four African countries have prompted anger, concern, disappointment and resignation on the continent.

The measures significantly restrict visas that could end with permanent residency in the US for Eritreans and Nigerians, and end so-called “diversity” migration visas from Tanzania and Sudan.

Chad Wolf, the acting homeland security secretary, said the countries hit by the new measures failed to meet US security and information-sharing standards. Kyrgyzstan and Myanmar were also included in the list.

Trump has made cracking down on immigration a focus of his 2020 re-election campaign, and his travel ban policy is popular with Republican supporters – but experts say that it will harm US efforts to roll back the growing influence of Russia and China in Africa.

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previous ban, introduced in 2017, barred nearly all immigrants and travellers from three African countries – Libya, Somalia and Chad – and five elsewhere. The policy sparked outrage and was revised amid court challenges before the US supreme court ultimately upheld it in June 2018.

“I think we are seeing a domestic political agenda steamrolling foreign policy concerns,” said Matthew T Page, an associate fellow with the Africa programme at Chatham House, London.

Eritrea is a minor economic and diplomatic player on the continent, but is strategically situated on the Red Sea. The repressive, authoritarian regime has been courted by Moscow, which wants to build a major logistics base there to rival the vast US base in nearby Djibouti.

Eritrea’s foreign minister, Osman Saleh Mohammed: ‘We find this move unacceptable.’ Photograph: Vladimir Smirnov/Tass

The Eritrean foreign minister, Osman Saleh Mohammed, said the government saw the ban as a political move that would hurt the country’s relations with the United States.

“We find this move unacceptable,” he told Reuters by telephone.

An official statement from Asmara said the measure was an “unfriendly act”.

Page said that the new measures sent an alienating and patronising message to Nigeria, Africa’s most populous country with 206 million inhabitants – and its biggest economy.

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The country sent 7,900 immigrants to the US in 2018, by far the biggest number for any African nation. Almost all visas went to relatives of US citizens.

Geoffrey Onyeama, Nigeria’s foreign affairs minister, said he was “disappointed” by the decision, and President Muhammadu Buhari has appointed a minister to examine the problems that led to Nigeria’s inclusion.

Nigeria has been a key ally of the US in Africa, consistently voting with Washington in international forums. Economic and cultural ties between the more than 400,000 Nigerian Americans and the country are strong.

Atiku Abubakar, an opposition leader, said he was saddened by the decision.

“The ban does not take into account the pro-American sentiments of the Nigerian public … and the solidarity previous Nigerian administrations have had with the United States,” Abubakar said on Twitter.

The ban also seems to run counter to a new US policy for Africa – unveiled in 2018 by Trump’s then national security adviser, John Bolton –prioritising trade and the fight against Islamic militants. At the time, Bolton accused “great power competitors, namely China and Russia” of “predatory practices”.

Russia’s president, Vladimir Putin, greets Nigeria’s president, Muhammadu Buhari, at the 2019 Russia-Africa summit in Sochi. Photograph: Sergei Chirikov/Pool/AFP via Getty Images

n recent years, Russia has sought to increase influence in Nigeria, offering military cooperation to help Abuja’s weak military fight a tenacious Islamic extremist insurgency in the country’s north-east. The country is also a fast-growing market for Chinese exports, and Beijing’s state-owned companies have built airports and railways financed by major loans from Chinese banks.

Beyond the geopolitics, the new US measures will have significant impact on individuals.


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“Trump’s new law is very hurtful for us,” said Awet, an Eritrean refugee who is now a US citizen.

Awet, who used a nickname to avoid reprisals against his family, was resettled to the United States in 2009. When a 2018 peace deal between Ethiopia and Eritrea made it possible for his four children to leave Eritrea safely, Awet began trying to bring them over on family visas.

“At least let the children in … those who want to come to be with their mother or father,” he said.

According to official figures quoted by Fox News, 1,674 such visas were awarded in Sudan last year.

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A fierce battle for influence in Khartoum is under way, pitting western powers against Middle Eastern states as well as Russia and China. General Abdel Fattah al-Burhan, who took power following the fall of the dictator Omar al-Bashir last year, recently received an invitation to visit Washington as part of a new push by the US to improve relations.

But the decision to restrict visas has disappointed many Sudanese young people.

“It was disappointing. I was thinking that could be an opportunity to upgrade oneself in terms of work and study in America”, said Muzamil Abdulmola, 31, who has a degree in agricultural engineering.

Trump is viewed coolly across much of the continent – though he has significant popularity in some places, including Nigeria. The president prompted fury after it was credibly reported he had described African nations, as well as Haiti and El Salvador as “shitholes” and questioned why so many of their citizens had ever been permitted to enter America.

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Ahmed Abdulkarim, a Sudanese who works with an NGO helping refugees and has applied three times for the diversity visa, said the ruling had dismayed many family members and friends.

“Trump is racist and hates Sudan … I hope opportunities open up and we get treated equally like other nations,” Abulkarim, 41, said. “It could have been an opportunity to let my daughter have a decent life in the States.”

Additional reporting by Zeinab Mohammed Salih, Khartoum

How we will end female genital mutilation

From the Gambia to Kenya, FGM has been fought most successfully at grassroots level. The world must pay heed.

I underwent female genital mutilation at the age of seven, while on holiday in Djibouti. When I returned to school in the UK my teacher told me that this happened to “girls like me”.

Thankfully, this type of reaction is no longer common, and this country is much better equipped to protect girls at risk. FGM is now seen as a global issue, which we know has affected more than 200 million women and girls around the world.

But a further 68 million girls are estimated to be at risk over the next 10 years, and ending FGM is a huge challenge. Funding – particularly to frontline activists – is almost non-existent. Yet this is where change starts; efforts to end FGM are led from the grassroots, usually by survivors.

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The groundbreaking activism of Jaha Dukureh, the Nobel peace prize nominee and founder of Safe Hands for Girls, has regenerated the African movement to end FGM. In 2015, she almost single-handedly got the country to unite in pressing the Gambian government to ban the practice.

In recent years, Safe Hands for Girls has partnered with the Gambian education ministry to launch a vibrant, nationwide pink bus tourthat has reached thousands of students, firing up their passion to end FGM in this generation.

The campaign was heavily supported on social media and the positive message of changing Gambian society gained traction very quickly. The ministry contacted every school in advance, asking them to encourage young people to participate fully. This meant that activists were able to lead assemblies, speak to entire classes, and spend a lot of time in each school talking with girls, boys and their teachers.

Prevalence statistics due to be released later this year are expected to show a decrease in FGM in the Gambia, where cutting of infants and very young girls is so common that any change is likely to become apparent more quickly than it would elsewhere.

Jaha Dukureh has spearheaded efforts to end FGM in the Gambia. Photograph: Mae Ryan/The Guardian

Kenya, meanwhile, where the practice was banned in 2011, has led the way globally in terms of reducing FGM prevalence.

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Led by Dr Josephine Kulea, Samburu Girls Foundation uses education to protect girls from FGM and promote their human rights. More than a thousand young women have been rescued and given a place to stay in the organisation’s rescue centre. The institution also does outreach to Somali, Maasai, Samburu and Pokot communities by speaking in Swahili in an effort to unite these diverse cultural groups against FGM and child marriage.

This work aside, Samburu Girls Foundation helps to bring cases against policymakers who do not implement the 2011 FGM ban, which is not applied in certain regions. The Samburu region, where more than 80% of women and girls are cut, is one of several where prevalence remains high.

The foundation has also helped to defend the case of medical professional Dr Tatu Kamau, which is currently being heard at the Kenyan high court. Kamau is trying to have FGM legalised for adult women, which could have severe consequences not only in Kenya but around the world.


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The UN has set a 2030 deadline to end FGM. I co-founded the Five Foundation, a global partnership to end FGM, with this in mind – and to fill a gap in the movement.

The Five Foundation partners with large charities such as ActionAid, Plan International and Women for Women International, as well as with dozens of grassroots groups like Samburu Girls Foundation and Safe Hands for Girls. We must all work together as much as we can.

But we are also calling on foundations and governments to change the way we fund efforts to end FGM. This means finally trusting and supporting frontline activists like Dukureh and Kulea, who are the most credible and effective agents of change – but who have been left out of the equation for far too long.

Cameroonian student becomes the first African to contracts coronavirus

A 21-year-old Cameroonian student in China has become the first African known to be diagnosed with the deadly coronavirus.

Live updates: All you need to know about the coronavirus as it happens

Coronavirus has caused panic around the world

In a statement, Yangtze University said the student was being treated in hospital in southern Jingzhou city after contracting the illness while on a visit to Wuhan city, the epicentre of the outbreak.

He had returned to Jingzhou, where he lived, on 19 January, before a lockdown was imposed in Wuhan to prevent the spread of the coronavirus, which has killed more than 200 people.

Killian Ngala reports from Cameroon’s capital, Yaoundé that the case has renewed concerns about the safety of some 300 Cameroonians quarantined in Wuhan with little access to water, food and surgical masks.

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In its statement, the university said:Quote Message: The university has provided psychological comfort to the student and has reported the situation to his parents and the embassy.

The university has provided psychological comfort to the student and has reported the situation to his parents and the embassy.Quote Message: At present, the student is actively cooperating with the treatment in the hospital.

At present, the student is actively cooperating with the treatment in the hospital.Quote Message: His body temperature has been normal for two consecutive days.

His body temperature has been normal for two consecutive days.

He has good spirit and a healthy appetite and his vital organs are stable.”

He has good spirit and a healthy appetite and his vital organs are stable.”

Thousands of African students study in China. They have made desperate appeals to their governments to evacuate them or to give them more support while they are trapped in Wuhan.

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Last week, Cameroonians in Wuhan wrote a letter to President Paul Biya, saying their embassy in Beijing had been largely uncooperative and they were short of basic necessities.

More stories about the virus

Handing gun to civilians against militants

The authorities in Burkina Faso, struggling to grapple with a growing wave of Islamist militant attacks that is affecting the region, are planning to give weapons to civilians, as Louise Dewast reports.

The violence in Burkina Faso has forced more than 500,000 people to flee their homes

The Burkinabe government is under pressure to take new measures to try and curtail the militants.

In January alone, at least 60 people were killed in four separate attacks in the north of the country.

Members of parliament recently unanimously voted in favour of arming civilians in a move they said would help combat the armed groups. It is due to be signed into law.

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The attacks by militants linked to al-Qaeda and the Islamic State group have significantly increased in the past year, causing more than half a million people to flee their homes.

Critics have questioned whether the new measure will make people safer, but the government insists that armed volunteers are necessary to stem the spread of violence.

Why get civilians involved?

The law says that the army’s capacity to fight the militants is limited in terms of numbers of soldiers and lack of appropriate training.

“In light of the persistent threat, populations have… expressed their desire to actively engage in the defence of the homeland,” it states.

But this is not proof of the army’s weakness, the government insisted. Speaking to the BBC, Communication Minister Remi Dandjinou likened the future volunteers to members of the French resistance during Germany’s occupation of France in the World War Two.

Remote villages like this one in northern Burkina Faso are under threat from violence

But there is a concern that the new measures could heighten ethnic conflict and fuel tensions between rival hunting and farming communities.

“The Burkinabe security forces are themselves implicated in very serious abuses against suspects,” Corinne Dufka from Human Rights Watch told the BBC. “That is why subcontracting any defence responsibilities to armed civilians is so potentially problematic.”

“It could exacerbate rising communal tensions and lead to more abuses, which would in turn push more people into the hands of the jihadists.”

Burkina Faso’s government has previously denied claims of widespread abuse.

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Who will be armed?

Any national aged 18 and over can be considered for recruitment and there is no maximum age. But recruits cannot be part of any political group or party.

Volunteers must be patriotic and loyal and have a “spirit of sacrifice” which could include making the “ultimate sacrifice”, according to the law that the MPs backed.

But, after it was passed, Defence Minister Cheriff Sy insisted recruits would not be used as “cannon fodder”.

The army in Burkina Faso is backed by a French force which is also operating in other parts of the Sahel

Recruitment will be carried out at a local level at an assembly where village leaders will be supervised by the army.

But the volunteers will not be a route to legitimising self-defence groups, made up of people who are sometimes referred to as vigilantes.

In Burkina Faso, as in Mali and Nigeria, civilians have armed themselves to defend their homes, and in some cases, gone on the offensive.

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These self-defence groups are not officially sanctioned by authorities. They are often composed on ethnic lines and have in many cases targeted rival communities.

One of the concerns raised is that parts of the country – up to one-third according to some estimates – are believed to be under the control of militant groups, making it far too dangerous and impractical to hand out weapons in those areas.

The north and north-eastern border areas with Mali and Niger are the most affected by attacks, but so are increasingly the southern border areas.

What training will volunteers get?

It is unclear when the recruitment will start and whether people are actually keen to sign up.

The law states that at least 10 volunteers should be recruited per village or area of residency.

Once they are recruited, the volunteers will undergo 14 days of training, which will include how to handle weapons, basic combat methods, the rules of discipline and civic and moral education.

It is unclear who will be providing the training and whether it will be followed up.


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After their induction, the recruits will be given weapons, along with communication and observation equipment. But they will not get uniforms.

While volunteers, who are expected to sign up for at least a year, will not be paid, the groups will receive financial support from the state for equipment and other mission-related expenses. They are also allowed to receive donations.

They will get medical bills paid if they are injured and compensation if they are left with permanent injuries. Funerals will be paid for if those who die in action.

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Nationally, the ministry of defence will oversee the work of the civilian force, but locally the village chief will be responsible.

What is their mission?

Volunteers are expected to be available at all times in their village.

They are expected to support the work of the army and police force, to help secure their village or district.

This could involve conducting surveillance and providing intelligence to the army but they are forbidden from conduct policing activities.

The volunteers will be expected to abide by a code of conduct, which for now has not been made public.

Africa continues colonize English language

The British empire forced its colonies to abandon their own languages. Now they are making English their own.

Anthony Ikolo, former president of the Nigeria Scrabble Federation, arranges his tiles during a competition in Abuja, January 2020. Photograph: Afolabi Sotunde/Reuters

There is one expression I have grown up hearing from relatives of a certain age, but never been able to accept. It’s the description of Twi – the Akan language spoken by my family – as “the vernacular”, a term which implicitly compares it with the colonial language, English, and somehow finds it wanting. The word itself is a revealing symptom of the colonial project. Just as nations like the Yoruba, with a population of more than 40 million, were patronisingly described as “tribes”, when in fact they were substantial nations, African languages were downgraded to “the vernacular”. It’s a term more befitting of a regional dialect than a nation’s language, with its own history, politics and literature.

The attempt to discourage Africans from speaking our own languages not only failed, but has had the glorious result of backfiring, to the extent that now Britain’s own inhabitants are officially adopting African vocab. This month the Oxford English Dictionary (OED) added Nigeria’s first entries to already recognised gems like “howzit” from South Africa. Other Africans will recognise lots of the latest lingo to get the OED stamp – “chop”, to eat or to misappropriate funds; “next tomorrow”, the day after tomorrow; “sef”, a great Pidgin flourish for emphasis.

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Nigerian pre-eminence in the English language is nothing new. One of the first global literary successes by a black author was The Interesting Narrative, by the Igbo writer Olaudah Equiano, the beautifully written 1789 account of his enslavement and subsequent freedom.

As a Booker prize judge last year, I was struck – although not surprised – by just how many entries there were from Nigerians, with two on the longlist, and the joint winner, Bernadine Evaristo, of Nigerian heritage. The sheer number of legendary authors from the nation makes it often overrepresented in the English canon. But Nigeria’s relationship to the English language, like that of all English-speaking African nations, is a complicated one. Chinua Achebe – one of the legends – wrote of the English language, “we may go on resenting it, because it came as part of a package deal that included many other items of doubtful value, especially the atrocities of racial arrogance and prejudice which may yet set the world on fire … If [English] failed to give them a song it at least gave them a tongue for sighing.”


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English was imposed on Africans by force. “In Kenya, English became more than a language: it was the language, and all the others had to bow before it in deference,” wrote the great Kenyan novelist Ngũgĩ wa Thiong’o. In his seminal book Decolonising the Mind, he described children at his English-speaking school in Nairobi being beaten if they were caught speaking Gĩkũyũ.

One of my favourite grievances with that colonial legacy, and the ongoing failure to give the descendants of empire equal status, came via the unlikely topic of weather systems. “Yo why storm Brendan?” wrote the doctor and TV presenter Dr Ronx earlier this month, “I’m out here waiting to be blown away by storm Oluwatunde! We need to decolonise storm names!” Why storms always have European names can be added to a growing list of questions: why don’t British schools teach the history of empire; why does it have no national museum; why do we glorify colonial violence as personified by figures like Cecil Rhodes; why do we know the name of William Wilberforce but not Equiano, a key abolitionist as well as celebrated author?

The great thing about language though, is that it waits for no one. While calls to decolonise curricula – and weather – seem likely to continue falling on deaf ears, culture moves on. Several years ago I wrote about how the situation of “the Queen’s English” in Ghana – once associated with superior education and intelligence – has become more perilous, with the potential to attract derision under the acronym LAFA – locally acquired foreign accent.

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Not just English but other European languages are finding their centre of gravity shifting to Africa. Portuguese currently has its greatest number of speakers in Brazil – where Yoruba and indigenous languages have moulded vowels and expressions utterly different from the language of Portugal – but some believe that by the end of the century, the growth of Angola and Mozambique will make Africans the most numerous speakers of Portuguese. The history of colonialism by France and Belgium means that since 2010, 68% of the world’s new French speakers now live in West and Central Africa. The African capacity to survive the brutality of colonialism means French is now the fifth most widely spoken language in the world.

The paradox of empire is perhaps most visible in its legacy of language. The psychology of colonisation could not have worked without suppressing expressions of existing culture, and “educating” its subjects to believe in their own inferiority. But the independence of the African continent in the 20th century could not have come about when it did without the unity that was forged out of common languages brought by colonisers – English, French and Portuguese. The resulting ambivalence towards English is shared not just on the African continent but in the diaspora as well. As the great African-American writer James Baldwin once wrote, “my quarrel with the English language has been that the language reflected none of my experience”. But, Baldwin conceded, “it might be made to bear the burden of my experience, if I could find the stamina to challenge it.”

His words reflect a fatigue with the colonial story, which I often share. But at the same time, we always did find the stamina to challenge it, whether or not that was recognised by dictionaries.

  • Afua Hirsch is a Guardian columnist

World’s 22 richest men wealthier than all the women in Africa

Startling scale of inequality laid bare as Oxfam report highlights chronically undervalued nature of care work.

A teenager in Malawi hauls a bucket of water before school. Women in poor countries spend hours carrying water home from distant sources. Photograph: Helen H Richardson/Denver Post via Getty Images

The world’s 22 richest men have more combined wealth than all 325 million women in Africa, according to a study.

Women and girls across the globe contribute an estimated £8.28tn ($10.8tn) to the global economy with a total of 12.5bn hours a day of unpaid care work, a figure more than three times the worth of the global tech industry, claims an Oxfam report published on Monday ahead of the World Economic Forum in Davos.

The charity says women around the world, especially those living in poverty, do more than three-quarters of all unpaid care work, which is chronically undervalued and taken for granted by businesses and governments alike.

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Ageing populations, cuts in public spending, and the climate crisis will exacerbate gender and economic inequality, the report warns.

“When 22 men have more wealth than all the women in Africa combined, it’s clear that our economy is just plain sexist,” said Oxfam GB’s chief executive, Danny Sriskandarajah.

“If world leaders meeting this week are serious about reducing poverty and inequality, they urgently need to invest in care and other public services that make life easier for those with care responsibilities, and tackle the discrimination holding back women and girls.”

In spite of increasing awareness about the wealth divide, most world leaders continue to pursue policy agendas that benefit the rich and hurt the poor, the report claims, pointing to tax cuts for billionaires promoted by US President Donald Trump and Brazil’s leader Jair Bolsonaro.

Jeff Bezos, centre, is the world’s richest man, ahead of Bill Gates (left) and Warren Buffet. Composite: Ludovic Marin/ AFP via Getty Images;Anadolu Agency via Getty Images;Paul 

“The richer should be paying their fair share of tax, not dodging their tax or avoiding paying it,” said Katy Chakrabortty from Oxfam GB.

“Getting the richest 1% to pay just 0.5% tax on their wealth – just on their wealth, not their income – would create enough money over the next 10 years to pay for 117m jobs, in education, health and elderly care.

“If we really value care, then we need to be helping to shoulder the responsibilities so that women and girls can find the time to get an education or pursue their own, better remunerated activities.”

An estimated 2.3 billion people will be in need of care by 2030, an increase of 200 million from 2015, said the report. But governments are increasing taxation on the poorest, cutting public spending and privatising education and health, according to Oxfam.

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The climate crisis will mean an estimated 2.4bn people living with water shortages in the next five years, and already women and girls are disproportionately affected, having to walk further to find water.

Solutions lie in governments thinking beyond profit and investing in water, sanitation, electricity, child and healthcare to improve quality of life and free up hours of work a day, according to Oxfam.

“Feminists used to say women held up half the world – well now it’s the majority of women holding up a very small group of men on very high precipices,” said Beverley Skeggs, a professor of sociology at the University of Lancaster.

“This report challenges us to think differently. What if we plan our economy based on the fundamental social premise of caring for others?”

The second-biggest diamond in history leaves Africa

The largest rough diamond discovered since 1905, the 1,758-carat Sewelo, was revealed with great fanfare last April, named in July and then largely disappeared from view. Now it has resurfaced with a new owner — and it’s not a name you might expect.

Louis Vuitton has bought the Sewelo, the biggest diamond discovered since 1905.Credit…Grégoire Vieille/Louis Vuitton.

It is not, for example, Jeff Bezos, the richest man in the world, on the hunt for a trophy asset. It is not a royal family, searching for a centerpiece for a new tiara. It is not the De Beers Group, who could be seen as the creator of the diamond market and owner of the Millennium Star diamond, which, uncut, was a 770-carat stone.

It is not even the diamond specialist Graff, the owner of the Graff Lesedi La Rona, a 302.37-carat diamond that is the world’s largest emerald-cut sparkler.

It is Louis Vuitton — the luxury brand better known for its logo-bedecked handbags than its mega-gems, which has been present on Place Vendôme, the heart of the high jewelry market, for less than a decade.

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And it is the latest sign, following the $16.2 billion purchase of Tiffany by the French behemoth LVMH (the parent company of Louis Vuitton) in November, that LVMH is out not just to compete, but to utterly dominate the high jewelry market. Taken together, the double punch of purchasing (brand and stone) in less than two months is the luxury equivalent of shock and awe.

“There are less than 10 people in the world who would know what to do with a stone like that or how to cut it and be able to put the money on the table to buy it,” said Marcel Pruwer, the former president of the Antwerp Diamond Exchange and the managing director of the International Economic Strategy advisory firm. “To buy and then sell what could be a $50 million stone, you need the technical qualifications, as well as the power to write the check and take the risk.”

Michael Burke, the chief executive of Louis Vuitton, declined to say how much the company had spent on the stone, though he acknowledged it was in the “millions” and that “some of my competitors, I believe, will be surprised” that Vuitton was the purchaser.


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“Nobody expects us to put such an emphasis on high jewelry,” Mr. Burke said. “I think it will spice things up a bit. Wake up the industry.”

According to Jeffrey Post, the curator in charge of gems and minerals at the Smithsonian Institution, “if you buy a diamond like that, it gives you immediate credibility.” It is also, especially in the case of the Sewelo, more risky than you may imagine.

The Karowe diamond mine in Botswana.Credit…Mine Karowe / Lucara Diamond Corp.

Discovered in April 2019 at the Karowe mine in Botswana (owned by Lucara Diamond Corp, a Canadian miner), the baseball-size Sewelo is the second largest rough diamond ever mined.

The largest was the 3,106-carat Cullinan diamond, which was discovered in South Africa in 1905 and eventually yielded two enormous high-quality stones — one of 530.4 carats and one 317.4, both now part of the British crown jewels, as well as many smaller stones.

The Sewelo is also the largest rough diamond ever found in Botswana (a country that has become the poster child for responsible mining) and the third very large diamond discovered in Karowe.

The mine also produced the 813-carat Constellation, uncovered in 2015 and sold for $63 million to Nemesis International in Dubai, a diamond trading company (in partnership with the Swiss jeweler de Grisogono) and the Lesedi La Rona, discovered in 2016 and sold to Graff for $53 million.

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When Lucara held a competition to name the Sewelo, 22,000 Botswana citizens submitted entries. “Sewelo” means “rare find” in Setswana.

Unlike both the Constellation and the Lesedi, however, it is covered in carbon (at the moment it looks like a big lump of coal), which makes exactly what kind of diamond material is inside a “mystery,” according to Ulrika D’Haenens-Johansson, a senior research scientist at the Gemological Institute of America.

It also makes “the risk that much greater,” Mr. Pruwer said. When the stone was unearthed, there was a fair amount of speculationthat it may be worth significantly less than its not-quite-as-giant siblings.

The profitability of any large stone depends on its yield: how many gem-quality carats can be gotten out of it once cut to maximize the price, which is in turn a function of the impurities in the stone — though, as Ms. D’Haenens-Johansson points out, even the impurities have value in a stone this size. They can reveal when the diamond was created and at what depth in the earth.

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The mine, which has examined the diamond through a tiny “window” in the dark covering and scanned it with lasers, describes the stone as “near gem quality,” with “domains of high-quality white gem.” There are thousands of gradations of diamonds, ranging from D-flawless (the most rare) to industrial stones used in cutting and manufacturing.

“Is it D or D-flawless, and how big is the flawless part? I don’t know,” Mr. Burke said, acknowledging that the purchase “took a little bit of guts and trust in our expertise.” (To be fair, LVMH can afford it; its revenues in 2018 were 46.8 billion euros, or $52 billion.)

Still, Mr. Post said, “You don’t buy a stone like that unless you have some plan for what you are going to do with it and some belief that there is enough clear material that you can cut it and make a profit.”

The Lesedi La Rona diamond at Sotheby’s in 2016.Credit…Donald Bowers/Getty Images for Sotheby’s

Mr. Burke said when he showed the stone to Bernard Arnault, the majority owner and chief executive of LVMH, and “he had it in his hand, he smiled.” A smile from Mr. Arnault, a famously taciturn executive, is the equivalent of a scream of triumph from another chief executive.

After all, along with the potential profits, LVMH also bought the less quantifiable, but nevertheless palpable, bragging rights to the diamond in an industry where mythology and romance are part of the price.

Mr. Burke said that when his team suggested that Vuitton consider buying the Sewelo, his initial reaction was: “What took you so long?”

“It’s a big, unusual stone, which makes it right up our alley,” he said. It is also the first time Vuitton has bought a rough stone without having presold it to a client. (According to Mr. Pruwer, most branded fine jewelers buy stones that are already cut and polished.)

The 302.37 carat Graff Lesedi La Rona.Credit…Donald Woodrow

“We are experimenting with a different way of bringing a stone to market,” said Mr. Burke, who said Vuitton would not cut the stone until it had a buyer, and that the company did not plan to hang on to the stone as a showpiece, the way Tiffany has kept its 128.54-carat namesake stone.

Vuitton’s partners in Antwerp are building a scanner able to see through the stone’s coating, though with the imaging already in place, including a CT scan, they have estimated it may yield a 904-carat cushion-cut diamond, an 891-carat Oval or several stones of between 100 and 300 carats.

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As for the fact that the acquisition happened around the same time as the Tiffany acquisition, Mr. Burke said it was a coincidence. Yet he acknowledged, with some understatement, that LVMH “typically likes to become leaders in whatever field we go into.”

And if the Sewelo doesn’t prove to be quite as lucrative as LVMH is betting? “I’ll go jump in a river,” Mr. Burke said.

Africans are getting healthier and wealthier

IN MANY ways the story of Africa in the 21st century is one of success. Great strides have been made tackling diseases such as HIV/AIDS and malaria.

A baby born in Africa today is less likely to die young, and more likely to go to school than one born in 2000. Life expectancy at birth increased by nearly ten years, to 60, between 2000 and 2015. But many Africans also feel less secure than they did a decade ago. Civil wars and social unrest have proliferated, according to an index of how Africa’s leaders are performing.

The Ibrahim Index of Governance, produced by the foundation of Mo Ibrahim, a Sudanese-British telecoms-billionaire-turned-philanthropist, has been trying to quantify how well countries are run since 2007.

It is an ambitious effort involving 100 indicators of such things as political participation, respect for human rights and sound economic management. The latest data, released on November 20th, show a worrying divergence. Of the 26 indicators related to health, welfare and education, 21 have improved over the past decade. But 18 out of the 26 measures of safety, stability and the rule of law have deteriorated.

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Civil wars in several countries, such as Libya, South Sudan and the Central African Republic, drag down the numbers. At the other end of the spectrum, improvements in health, education and social services were led by Rwanda, Ethiopia and Togo. In 28 countries development indicators improved, while security indicators deteriorated.

Overall, instability on the continent has increased. But optimists will note that the trend has slowed in the past five years. Meanwhile, most of Africa’s children are healthier and better educated than ever. That is undoubtedly cause for cheer.

France threatens to pull out troops from Africa

Facing hostility in five former colonies over a stalled fight against extremists, President Emmanuel Macron has taken a harsh public stance. Few expect him to follow through.

French soldiers setting up a temporary base in northern Burkina Faso in November.Credit…Michele Cattani/Agence France-Presse — Getty Images

France has called five African presidents to a meeting on Monday to disavow rising anti-French hostility in their countries, work out how to stop the rapid advance of armed Islamist extremists in their region and determine whether France will remain deeply engaged in that fight.

France could withdraw its 4,500 soldiers, President Emmanuel Macron has said, if the leaders of Mali, Niger, Burkina Faso, Chad and Mauritania do not answer questions to his satisfaction. That warning came as the United States also considers pulling troopsfrom the region.

Many analysts say the French and Americans are making empty threats when they talk about leaving the Sahel, a semiarid area stretching more than 2,000 miles across West and Central Africa that is plagued by violent groups loosely affiliated with the Islamic State and Al Qaeda. But their warnings illustrate the allied nations’ frustration with extremist gains, and with one another.

France, the five countries’ former colonial ruler, initially intervened in 2013 to oust rebels and Islamist militants who had taken control of northern Mali in the wake of Libya’s descent into chaos. The militants regrouped, and now extremist-related violence is rising fast, doubling every year since 2015.

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Mali suffers attack after attack. This month children were killed in Burkina Faso when their school bus ran over a roadside bomb, the latest in a long list of recent deadly episodes in that country. Seventy-one soldiers died last month in Niger’s deadliest ever attack on a military camp.

“The militants have got the upper hand,” said Héni Nsaibia, a researcher at the Armed Conflict Location and Event Data Project, a nonprofit organization.

The bodies of 71 military personnel killed in an attack last month on Niger’s forces by an Islamic State affiliate.Credit…Boureima Hama/Agence France-Presse — Getty Images

On the other side, the national armies fighting these militants — trained and funded by France, the United States and the European Union — have themselves committed grave atrocities. Ethnic militias, some with government support, carry out massacres, which have pushed more people into the militants’ arms.

However, many people in these countries increasingly blame the French.

Urban Malians are demanding the departure of Operation Barkhane, the French counterterrorism force, while protesters in the capital, Bamako, chant slogans against France and have burned the French flag.

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Demonstrations have also taken place in neighboring Niger, where France and the United States have military bases, and in Burkina Faso, where their footprint is much lighter, but where violent attacks on civilians and soldiers have prompted France to intervene in the past year.

At the summit meeting on Monday in Pau, a town in southern France, Mr. Macron has said he will be asking the African nations, known as the G5 Sahel countries, to clarify their governments’ stances on both the French presence and those who oppose it.

“I can’t have French troops on the ground in the Sahel when there is ambiguity toward anti-French movements and sometimes comments made by politicians and ministers,” he said on a trip to Britain in early December, adding that whether France stayed would depend on the presidents’ responses to his concerns.

Protesters with signs reading “France get out” in Bamako, Mali, on Friday.Credit…Annie Risemberg/Agence France-Presse — Getty Images

Most analysts think Mr. Macron is unlikely to make good on his threat to leave, and French officials say privately that they expect to be in the region indefinitely. Mr. Macron’s foreign minister, Jean-Yves Le Drian, is seen as being firmly invested in the French intervention, which he first drove as defense minister under the previous president, François Hollande.

French troops have been killed in Operation Barkhane, including 13 in a helicopter crash in November, and two who died in May while rescuing hostages held by militants. But the overall toll has not risen enough to spur demands from the French public that the soldiers be brought home.

If it happened, a French withdrawal would have a far greater impact than an American one, as France has a far greater presence in these nations.

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Without Barkhane, countries would collapse in on themselves, causing uncontrolled terrorism and hugely increased migration to Europe, Gen. François Lecointre, head of France’s armed forces, told CNEWS, a television channel, in July.

But some experts say that these threats are much exaggerated, and that pulling out could force the region’s elite to find political and social solutions to a crisis entangled in disputes over access to land and resources.

“It’s they who have the solutions, not the French,” said Marc-Antoine Pérouse de Montclos, a French political scientist specializing in Africa.

How contrite the African leaders are willing to be with Mr. Macron is not just a matter of pride and posturing, but of retaining power. They will be carefully calibrating what they say publicly, and what they say to the French in private.

In effect, critics say France is helping shore up governments that lack confidence in their own armies, either doubting their ability to fight extremists or worrying about the possibility of military coups. Yet the presidents also have to satisfy voters unhappy with the presence of the former colonial power.

The president of Burkina Faso, Roch Marc Kaboré, hit back at Mr. Macron’s “summons” to Pau, where the official agenda includes seeking more international support for Sahel countries and reassessing France’s role there. Calling for mutual respect, Mr. Kaboré, who plans to run for re-election in November, said in a televised address last month that the “tone and the terms” used posed problems.

President Emmanuel Macron with President Mahamadou Issoufou of Niger in Niamey last month.Credit…Ludovic Marin/Agence France-Presse, via Pool/Afp Via Getty Images

When France sent troops to Mali seven years ago, officials argued that if they did not intervene, Mali would become another Afghanistan. French ministers still present their fight in the region as a crucial piece of the global war against terrorism.

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But none of the militant groups in the Sahel have ever carried out attacks outside the region and, with weak links to the international terrorist groups they pledge allegiance to, they seem more focused on local disputes.

Mr. Pérouse de Montclos, the French author of “Une Guerre Perdue: France Au Sahel” (“A Lost War: France in the Sahel”) said France would be better off getting out.

“The official narrative is that we are fighting terrorist groups, but actually we are protecting corrupt regimes, and some of them are quite authoritarian,” he said. “This foreign military presence is also used as a kind of a life insurance for these regimes.”

Mr. Macron should use the opportunity to announce the end of a mission that was never meant to last this long, Mr. Pérouse de Montclos said, forcing the Sahel leaders to handle the situation.

At the moment, however, these leaders have other priorities. Burkinabe politicians are “all focused on the election” rather than protecting citizens from further suffering, said Mahamoudou Savadogo, a researcher working on violent extremism in the Sahel.

The human cost of failing to resolve the crisis is heavy. In Burkina Faso, more than half a million people have fled their homes because of the violence.

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A report released last week by Human Rights Watch documented Islamist groups’ killing of more than 250 civilians in nine months there, including several dozen in a camp in Arbinda, where one witness survived by hiding behind a clay stove while 22 of her neighbors were killed.

“Two terrorists opened my door but didn’t see me. Then they entered my neighbor’s hut, killing her,” the report quoted her as saying. “They argued about whether to kill her baby … but eventually shot him.”

Adam Nossiter contributed reporting from Paris.

The tiny ostrich eggshell beads that tell the story of Africa’s past

You can tell a lot about a person by the things they wear, and this has likely been true throughout human history. The earliest kind of decoration was probably ochre, which we know humans have used for at least 200,000 years.

By 75,000 years ago, people begin wearing beads. Since that time, ornaments and other symbols have been central to the way we express our identities and signal our relationships. In fact, this is probably one of the things that makes us human.

Ornament production really took off about 50,000 years ago, when we see the earliest standardised jewellery in the form of small disc beads made from ostrich eggshells. In Africa, ostrich eggshell beads are one of the most common type of archaeological artifacts, particularly from sites dated to the last 10,000 years. They are also found in smaller numbers throughout Asia where 12,000-year-old ostrich eggshell beads have been discovered in China.

Since ostrich eggshell bead jewellery is still produced today, this is one of the longest running cultural traditions in the world.

Beaders in Botswana. Pixabay.com

But what can these beads tell us about the ancient peoples who made and wore them?

In a recently published paper, we analysed 1200 ostrich eggshell beads from 22 sites in southern Africa and 8 sites in eastern Africa. Although beads are found at many African archaeological sites, they tend to be overlooked in research. Many of the bead measurements for this study were taken from decades-old, unstudied collections and are being reported for the first time. We believe that this research demonstrates the importance of studying existing museum collections and approaching old questions in new ways.

Our aim was to see how ostrich eggshell bead size has changed over the past 10,000 years. Bead size has become an informal way to estimate the age of archaeological sites in southern Africa. Yet beads overall have received relatively little attention compared to other types of artefacts and there is much we still don’t know. Our study increases the number of published bead measurements from less than 100 to over 1000, allowing us to study patterns on a larger scale and gain new perspectives on the African past.

Ostrich eggshell beads at an archaeological site. Elizabeth Sawchuk

Our findings provide important insights into how ancient peoples responded to change. Topics like migration and the economy dominate today’s new cycle. Yet ancient peoples also faced issues like climate changecultural contact, and economic shifts. The things that people made and used, like ostrich eggshell beads, can help us understand the impacts of these changes on their lives.

Herders versus hunter-gatherers

Three decades ago, the archaeologist Leon Jacobson noticed a pattern in ostrich eggshell beads from Namibia. Those associated with hunter-gatherer sites tended to be smaller than those associated with herder sites. Since we know that herding entered southern Africa around 2000 years ago, Jacobson suggested that sites with beads larger than about 7.5mm might be younger than that.

Other studies confirmed the same pattern within the western part of southern Africa. Some researchers also argued that bead size might help distinguish which sites were used by herders versus hunter-gatherers. But this remains contested.

Until now, the idea that ostrich eggshell beads changed with the introduction of herding had only been tested in the southern part of Africa, and with a limited number of sites. We therefore decided to test this with a much larger dataset, and in other places like eastern Africa where herding also spread some 3000 years earlier.

Modern ostrich eggshell beads. Hans Sell

Regional variations

At the southern African sites, we also found that larger beads appeared after 2000 years ago. However, contrary to previous studies, our data show that these larger beads did not replace long-standing bead traditions. In fact, the vast majority of ostrich eggshell beads continued to be quite small. On the other hand, beads from the eastern African sites were highly variable in size and showed no change when herding entered that region around 5000 years ago.

Ostrich eggshell beads in eastern and southern Africa seem to tell a different story about herding’s spread. Cattle, sheep and goats are not native to either of these regions and must have been introduced by contact with peoples living farther north.

In both places, groups also made ostrich eggshell beads before and after herding spread.

In eastern Africa, the lack of change in bead size could suggest that local hunter-gatherers adopted livestock, or that incoming herders possessed similar traditions and/or quickly adopted local styles.

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In southern Africa, the appearance of larger beads around 2000 years ago suggests the introduction of livestock stimulated a change in bead traditions, or that new styles were introduced at the same time as sheep.

Yet in both places, local bead traditions remained dominant. Curiously, the larger beads in southern Africa fall within the range of eastern African beads, hinting at contact between these regions as suggested by other archaeological evidence and ancient DNA.

Our research findings suggest that the spread of herding into new areas did not lead to the replacement of local peoples and practices. Rather, people responded in more nuanced ways and maintained certain cultural traditions.

This research not only helps us understand the African past, but is important for considering how we as humans use culture to cope with the changes in our world.

Ebola, or just a drill? How to test a public health crisis response

There wasn’t an Ebola outbreak in Lesotho – but for a few hours in November 2019, you may have heard that there was.

On November 14, Lesotho public health authorities conducted a simulation exercise involving a woman who was rushed to hospital and tested positive for Ebola after crossing the border from South Africa. Media picked up on this event and reported it as if it were true. But a few hours later it was revealed that there had been no Ebola case in Lesotho, and this event was only a drill.

The Lesotho government was conducting a public health simulation exercise. When done properly, a simulation exercise is a useful tool for evaluating preparedness for a public health emergency. When done poorly, a simulation exercise can cause unnecessary panic in local or international communities. Here, we’ve drawn on our experience in Liberia to outline how to properly plan and execute a simulation exercise.

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What is a simulation exercise?

A public health simulation exercise is a test of an emergency response system. Simulation exercises are used to develop emergency response protocols, train staff, and monitor and evaluate the capability of the public health system to respond to emergencies. Regular exercises make it possible to identify areas for improvement and ensure that a health system will be able to respond appropriately to a true crisis.


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The World Health Organisation (WHO) lays out guidelines for planning various types of simulation exercises. Simulation exercises can range from tabletop discussions to partial tests to full-scale field exercises.

The simulation in Lesotho was a full-scale exercise. This is the most complex type, intended to mirror real-life emergency situations as closely as possible. It tests many components of an emergency plan and may involve many organisations and multiple countries. Full-scale exercises are immensely valuable for testing emergency management plans under close-to-real conditions. But they are difficult to plan and can cause alarm in the wider community if not executed thoughtfully and deliberately.

Planning a simulation

Planning a simulation exercise should involve discussions with key stakeholders about the purpose, scope and objectives of the exercise. An exercise management team should be created to develop and conduct the exercise. This will typically include a project management plan, identification of participants and logistics management.

The people being tested – such as local health workers – should not be told that they are undergoing a simulation exercise. After all, the purpose is to assess what would occur in a true emergency. That said, key stakeholders who are not being tested should be made aware that a simulation exercise is under way. Otherwise they may respond as if there were a real crisis, leading to unnecessary mobilisation.

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Key stakeholders may include the leaders of ministries such as health, information and internal affairs; members of the media; and leaders of partner organisations who may be involved in a public health response. If the simulation involves multiple countries, stakeholders in each country should be informed.

Stakeholders should be informed in advance and updated while the simulation exercise is under way. It is very important that the word “simulation” or “exercise” is displayed prominently in all communication.

Media organisations should be informed ahead of time. If news media outlets hear about the event but are unaware that it is a simulation, they may report it as if it were true. This can cause unnecessary panic.

WHO guidelines for simulation exercises recommend creating a strategy to communicate with media, local communities and the public. There should be a designated media point person and clear lines of communication should be publicised. News outlets should be able to contact the exercise management team and receive reliable information.

The exercise management team should anticipate potential media and public relations issues and help prevent misinformation from spreading.

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Running the exercise effectively

The exercise will begin with a message sent containing the prompt. In a full-scale exercise, teams of health workers are physically deployed to the location to respond as they would in an actual emergency. Actors may play the role of patients – for example, in a simulation exercise testing infection prevention control and management, an actor may play a person who is exhibiting Ebola symptoms. The exercise management team will observe and evaluate the emergency response.

If the initial team of health workers fails to respond appropriately, the exercise management team will escalate the response to the next level. For example, if health workers at a village clinic fail to properly isolate a suspected Ebola case, the management team may call an ambulance, and then test how the ambulance workers respond. Eventually, the response could grow to the national or international level.

A full-scale simulation exercise will last for at least one day and up to four or five days. At the end, the project management team will review what happened and whether the response was appropriate. Findings are used to improve emergency protocols, train staff and solve other problems that arose.

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Lessons

A simulation exercise strengthens health systems – and helps countries prepare for real public health emergencies.

It’s difficult to determine if Lesotho’s public health simulation exercise was a success because lessons about emergency preparedness were overshadowed by panic. With proper planning and management, Lesotho and other countries can conduct future simulation exercises without making headlines.

How Reinhard Bonnke, the ‘Billy Graham of Africa,’ Died at 79

He was a German-born evangelist whose open-air Christian revivals drew millions of followers, many of them hoping to be healed of their afflictions.

The Rev. Reinhard Bonnke speaking in Lagos in Africa in 2017. “From Cape to Cairo for Jesus” was a rallying cry of his organization, Christ for All Nations.Credit…Pius Utomi Ekpei/Agence France-Presse — Getty Images

The Rev. Reinhard Bonnke, a German-born Pentecostal faith-healer whose open-air revivals in Africa attracted so many followers that in one case people were trampled to death hoping to be cured of their afflictions, died at his home in Florida on Dec. 7. He was 79.

The evangelical organization that he founded in 1974, Christ for All Nations, confirmed the death but did not give a cause of death or specify where in Florida he lived.

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In a petition for prayers posted on his personal Facebook page last month, Mr. Bonnke (pronounced BON-key) said he had undergone “a right femur bone surgery” and was “learning to walk again.” Followers from Nigeria to India responded with 41,000 prayers.

“Heavenly Father, remember this man, a great general of the faith,” wrote one follower, Nugari Mugi-Irenge, from Kikuyu, Kenya.

From the time he left his home in Hamburg for the kingdom of Lesotho in 1967, by his account, Mr. Bonnke felt called to bring the word of God to the people of Africa. Often called the “Billy Graham of Africa,” he asserted that he had inherited the mantel of a healing evangelist from the British preacher George Jeffries (1889-1962), whom he had encountered in London.

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“From Cape to Cairo for Jesus” was a rallying cry on which Mr. Bonnke founded Christ for All Nations, which grew to become a multimillion-dollar operation that claims to have brought more than 79 million people to follow Christ, first in Africa and later in Asia, Europe and North America. It also claims to have brought a dead man back to life.

“I am interested in bringing Africa to the foot of the Cross,” Mr. Bonnke said in an interview with The New York Times in 1984. “I believe that the preaching of the living word of God is something that Africa hungers for.”

Nigerians attending one of Mr. Bonnke’s outdoor revival meetings. His organization said more than a million people would show up for any one of his events. Credit…Markus Matzel/ullstein bild, via Getty Images

President Muhammadu Buhari of Nigeria said in a statement posted on Twitter that Mr. Bonnke’s death was a loss “to Nigeria, Africa & entire world.”

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Reinhard Bonnke was born on April 19, 1940, in the historically Prussian city of Königsberg. (Today it is known as Kaliningrad, Russia.) His father left the military for the ministry after World War II, and the family settled in northern Germany. Mesmerized by tales of 19th-century missionaries like David Livingstone, Mr. Bonnke studied at The Bible College of Wales.

From the earliest days, technology was part of his preaching. His sermons, held in the 1980s in a giant tent that seated 35,000 and stood seven stories high, incorporated flashing lights and videos shot by camera teams that would accompany his journeys throughout Africa.

The videos were sold to followers eager to take the message home with them. The advent of the internet allowed him to increase his outreach through daily messages posted on social media, and a 10-part film series recounted his journey of faith.

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But his refusal to take a political stance against repressive African leaders earned him criticism as well as praise. While living in and maintaining his ministry’s headquarters in an all-white area of Johannesburg in the 1970s and ’80s, he refused to join South African church leaders in speaking out against the country’s apartheid regime, insisting that politics and faith did not mix.

As many as 1.7 million Africans at a time would flock to one of his revivals, requiring them to be held in open-air locations. Many of those attending were ailing with AIDS, cancer and other maladies, drawn by promises of being healed.


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In 1991, at least eight people died in violence that broke out in the northern Nigerian city of Kano after thousands of Muslims took to the streets to protest a decision by the police to grant Mr. Bonnke permission to hold a revival meeting. In 1999, also in Nigeria, at least 14 people were trampled to death trying to reach the stage to receive Mr. Bonnke’s professed healing powers.

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Two years later, a Nigerian minister, the Rev. Daniel Ekechukwu, was pronounced dead after the car he was driving smashed into a stone pillar. His wife, saying she had had a vision, took her husband’s body in its coffin to the basement of a church where Mr. Bonnke was preaching. During his sermon, the man’s wife said, her husband sat up in his coffin and spoke.

“The raising of Daniel from the dead is a story that will offend some people,” Mr. Bonnke wrote in his book “Raised From the Dead” (2014). “I can guarantee it.”

He added: “I tell of the miracle now because it towers over my life and ministry like the steeple of a great cathedral. It points to the heavens, and to the God I serve.”


In 2013, at the age of 73, he took his ministry to the United States, which for decades was the source of most of his organization’s funding. Although he never attracted a following in America as large as he had in Africa, he made regular appearances on Christian television and spoke to conferences. The Associated Press reported in 2014 that he lived in a roomy $3 million Ritz-Carlton condo near West Palm Beach with prime ocean views.

He is survived by his wife of 55 years, Ann (Sülzle) Bonnke; their three children, Kai-Uwe, Gabriele, and Susanne; and eight grandchildren.

Mr. Bonnke’s organiza