Coronavirus control in war-torn nations
Conflict doesn’t stop for a pandemic. In this way, Australia is a lucky country. We enjoy a relative peace. Beyond our shores though, there are communities that face the destructive dual perils of war and Covid-19. From Syria to South Sudan, Myanmar and Yemen, families who survived gunfire and shelling must now prepare to endure this invisible threat. But they shouldn’t have to do this alone – by its very nature, a pandemic demands a collective global response. This virus doesn’t discriminate. It ignores borders. It targets the rich and famous, too. But there is a paradox here. Even as it exposes our collective vulnerability, it will hit some communities harder than others. In war-torn countries, its impact could well be catastrophic. Australia needs to be acutely aware of this possibility. This is a call to think of those caught between virus and conflict.
In Australia, some will also feel the impact of this pandemic more than others. Our children have lost time in school. We have lost time with friends, family and loved ones. Australians have lost livelihoods. We have lost lives. Our bars and borders are closed but, at the same time, I can still buy groceries when I need to. I can still visit the doctor, exercise or talk to a neighbour. Around the world, not everyone feels safe enough to enjoy even these limited freedoms. Despite everything, Australia’s relative peace makes us lucky in a way some countries are not. The tragedy here is real, but it’s not ours alone. Working for an organisation that helps people caught in conflict, the International Committee of the Red Cross (ICRC), my colleagues and I see examples of human resilience every day. But conflict’s devastating impact is only compounded by the coronavirus. Conflict ravages a community’s capacity to adapt; it wrecks the hospitals and schools needed to promote health and education. It destroys the roads and markets that allow for commerce. It turns neighbours against one another. When we fight, we reduce our ability to respond to issues collectively. For communities caught in conflict, this pandemic turns bad to worse.
I am scared of the damage this pandemic could do to the world’s most vulnerable communities. People living behind bars offer just one example. In the Philippines, social distancing is a privilege not available to people held in the country’s congested detention facilities. From police lock-ups to provincial jails and immigration detention centres, overcrowding and limited health services mean infectious diseases, including Covid-19, pose enormous risks to the people held inside. The ICRC has been working with Philippine prison authorities, with the support of the Philippine Red Cross, to address the causes and consequences of jail congestion. Access to adequate healthcare is vital. So is support for people in detention enabling them to contact family over the phone or otherwise in this age when meeting face to face can put entire communities at risk. The tragedy is that these measures may not be enough to contain an outbreak.
In my work for the ICRC over the past two decades, I have been lucky enough to spend time in Zimbabwe, live in Nairobi and work across the Horn of Africa. I remember the warmth and kindness of the people I met and worked with – but I also remember the struggles of trying to reduce the impact of conflict in southern Africa, where HIV/AIDS was one of the leading causes of death. The virus was a perennial issue, throughout society, and remained at the forefront of our minds as we worked on the conflict-related concerns. Because conflict and disease don’t stop to let each other pass – they run into each other. They overlay and overlap. They are the makings of a humanitarian crisis.
Conflict cripples a country’s healthcare system, effectively damaging a community’s capacity to respond to other crises. It escalates tensions and heightens the risk of descent into chaos. In 2009, about a year after I left Nairobi, I heard news of a suicide bombing that targeted a graduation event for medical students in Mogadishu, the capital of Kenya’s neighbour Somalia. Nineteen students died. It was a city I had travelled to many times with the ICRC, an incredibly vibrant place ravaged by the country’s civil war for nearly two decades by that point. When health professionals are targeted like this, society suffers, because they play such an essential role in limiting the damage of conflict and disease. This reality is also why countries in conflict – their health systems already damaged and inundated with casualties – will now face greater difficulty in preventing and containing Covid-19.
We’ve already seen the coronavirus disrupt and overwhelm the world’s most advanced health systems. For war-torn countries, the stakes couldn’t be higher. In South Sudan, people can walk hours, even days, to reach medical care. Even in the capital, Juba, there is only one doctor for every 65,000 people. This figure worsens in rural areas. Across the country, only two out of every five health facilities are even functioning. At the same time, armed violence remains an ongoing issue. In the past two months, the ICRC has treated more than 200 people for gunshot wounds. The wards of the health centres it supports are full of patients. Where health systems have been weakened by war, this pandemic threatens to overwhelm them. Even in the toughest of circumstances though, our shared humanity can be incredible. More than 1400 people have volunteered to work with the South Sudan Red Cross to run health education campaigns on Covid-19, distributing soap and water buckets to where they are most needed. The hope generated when we work together is tangible.
In the Asia-Pacific region, in Myanmar, the ICRC is racing against the impending rainy season to provide communities stricken by conflict with emergency assistance. Life-saving operations are ongoing in the states of Kachin, Rakhine and Shan to aid people affected by the different armed conflicts and other situations of violence. Together with the Myanmar Red Cross Society, we are providing hospitals with essential items such as soap, while also sharing public health messaging with communities. In Rakhine, the focus is basic water and sanitation systems for communities displaced by the ongoing armed conflict. We are supporting state health authorities in Kachin by renovating existing facilities being prepared for quarantine. Across the country, our humanitarian response has to adapt, quickly, to the new realities of Covid-19 – and engage all relevant segments of society in this response, from non-state armed groups to ethnic health organisations, religious leaders to local media. Our role now is not only to protect and assist people affected by armed violence, but also to safeguard the health of all communities we work with, including our own staff. We’re all in this.
Given the scale of this challenge, I am glad the ICRC is far from alone in the global response. Around the world, our partners from the International Red Cross and Red Crescent Movement are often on the front lines of this crisis. Meanwhile, governments, private organisations and people everywhere are open to engaging in conversations about the importance of solidarity across borders. As restriction measures are taken to flatten the Covid-19 curve, we must ensure these don’t hinder the work of humanitarians, the travel they require or the transfer of desperately needed aid. We are calling for particular care to be given to especially vulnerable communities: those who are displaced, detained or affected by conflict. We stand with the health workers who witness the human toll of this pandemic up close on a daily basis. Respect for their safety and protection is paramount.
Australia is not through this pandemic yet. But there are communities caught in conflict for whom this crisis could mean utter devastation. Just as the coronavirus has exposed our collective vulnerability, it has also exposed our obligation to each other. It has exposed our shared humanity – something that underpins the work of every humanitarian. For Australians waiting out the worst of this at home, we need to extend our concern beyond our immediate community, to those who may be oceans away, living through this trial of pandemic against the backdrop of violent conflict. This is about broadening our circle of empathy. The challenge we face is global; its solutions need to be, too.
This article was first published in the print edition of The Saturday Paper on Apr 25, 2020 as "War in the time of Covid-19".
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