Lockdowns and shutdowns won’t help improve dilapidated health infrastructure in Africa

African governments need to rethink strategies presently used to fight the novel Coronavirus pandemic.

The shutdown and lockdown approach may not be ideal to effectively deal with this global threat.

Most if not all the African countries have dilapidated public health infrastructure which is already overstretched, making it particularly challenging for these nations to deal with the virus in the event of widespread community transmission.

Some of these African countries such as South Africa and Zimbabwe have some of the largest populations of people with tuberculosis, a very worrisome issue given that this community of people with tuberculosis is at risk from COVID-19.

The danger is that some of these governments seem to think that lockdowns and shutdowns will resolve the COVID-19 crisis but attention should be on the dysfunctional health systems in the public hospitals. The question is what happens after the lockdowns and shutdowns?

Do the hospitals have capacity to deal with COVID-19?

There are concerns about the lack of adequate personal protective equipment for health-care workers. Ironically, the military personnel deployed to enforce these lockdowns are geared up fully for combat leaving one to wonder if resources were adequately prioritised in the national budgets. The chickens are surely coming home to roost. The inadequacies and misappropriation of resources is now evident. Indeed many African governments will be left with egg on face. This is a wake up call for most if not all.
The dismal state of public health infrastructure regards the majority of African governments implies that basic World Health Organisation preventative procedures are even more relevant in African countries.

But hand washing assumes access to regular running water, which remains a challenge for countries like Zimbabwe and to a certain extent South Africa and perhaps many other African countries. Indeed, for the larger part of Africa soaps and hand sanitizers remain a luxury.

The set up of residential areas most of which feature crowded slums and shanty towns make social distancing measures, designed to slow the virus’s spread a joke and indeed, close to impossible if not downright ineffective. This is due to the high population density in most of the settlements. Crowded urban conditions will complicate contact tracing and isolation in places such as Mbare in Zimbabwe and places like Alexander township in South Africa to just cite those as examples.

Zimbabwe recently the imposed a full lockdown, which came into effect on 30 March 2020. The country’s limited healthcare system would be rapidly overwhelmed if the virus spreads among a population already weakened by malnutrition and diseases such as tuberculosis. Drugs are already rare, with even paracetamol hard to find in Harare, the capital.
In the next couple of days, the ability to care and protect the impoverished and underprivileged will be put to the test in these African countries. While some developed nations in Europe and elsewhere have implemented contingency plans for their citizenry, the same cannot be said for African nations.

It remains unclear what the economic and human costs will be in the African nations. The question is how will the vulnerable in the poorest nations survive these lockdowns?
Though the 21 day lockdown has been largely respected in South Africa, police and soldiers have adopted a muscular approach to defiance. However, it is still early days, hunger has a way of turning things for the worst. People may yet revolt. This is a very worrisome issue and it remains to be seen how South Africans will respond and behave under the 21 day lockdown. It will also be interesting to watch how other African governments will act to enforce their own shutdowns and lockdowns.

Zimbabwe’s heavy-handed military is a concern. What with a hungry and anxious population in lockdown, anything can happen. Running battles with the authorities remain a possibility.

Hence, the call for well thought-out and meticulously planned lockdowns, as opposed to knee-jerk-reaction-type of copy and paste lockdowns. Which are without consideration of the plight of citizens and present economic and other already existent crises pre-COVID-19.

What happens after the lockdowns and shutdowns in most African countries is anyone’s guess.

What is apparent however, is that African leaders neglected their health care infrastructure and allowed for the dilapidation of hospitals in their nations.

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