As the coronavirus pandemic reaches new corners of the globe, its impacts are beginning to cascade on already stretched aid operations in crisis zones.
The New Humanitarian is collecting updates about how the coronavirus is hitting aid responses in vulnerable communities – from refugee camps and disaster displacement sites, to border crossings and conflict zones.
The UN launched an unprecedented global appeal on 25 March, calling for $2 billion in new funds to tackle coronavirus in countries with critical humanitarian needs. The new appeal warns donors against diverting money from other relief projects – including in 25 countries that already have UN humanitarian operations unrelated to COVID-19.
But the rush to contain the coronavirus is already spilling over to existing responses. Border closures are squeezing relief supply channels in some areas. Elsewhere, lockdowns and quarantines are erecting roadblocks in front of other operations.
The rapidly evolving outbreak is pushing aid groups to plan for new responses in communities already facing long-running crises – and forcing a rethink of how the sector operates when resources are stretched on a global scale.
Here’s a snapshot of what we’re watching. We’ll update this feature frequently.
Do you have information to share or concerns to raise? What have we missed? Email us to let us know.
Horn of Africa: Locusts and ethics
Travel restrictions, staff downsizing, and worries over duty of care (there are no medevac guarantees), make responding to “a sudden-onset emergency a real concern”, a senior aid official, who asked not to be named so they could speak freely, told TNH.
The locust swarms in the Horn are one example. Locusts consume huge amounts of vegetation, exacerbating food insecurity across the region. Some farmers in Somalia and Ethiopia suffered total crop losses when swarms rampaged across parts of eastern Africa earlier this year; now, experts fear new swarms expected to hatch by April could be 20 times larger.
“COVID-19 cases will be at their peak when the new swarms start flying and impacting crops,” the aid official said.
Coronavirus restrictions are already delaying the delivery of pesticides and equipment to control the locusts. With flights cancelled, shipping costs have reportedly increased by 300 percent.
“How do you respect all the different measures put in place by governments to protect their populations, and at the same time serve those people [as humanitarian workers],” the official noted. “There is an ethical question over whether we prioritise for us [limited supplies of masks and gloves] or the health workers on the front line of the response.”
At the same time, coronavirus lockdowns emerging in various countries could lead to potentially dangerous tensions driven by economic hardships. “What would [aid delivery] look like in an environment of extreme competition? In this sort of crisis, the military might be the last resort,” the aid official said. (26 March)
Kenya: Flexible donors and refugee volunteers
The director of an international NGO said COVID-19 had severely disrupted his operations. Programmes were either at a standstill or “operating at 50 percent”. But donors have so far been flexible, agreeing to no-cost extensions. “Everything seems negotiable,” he said. In Dadaab and Kakuma refugee camps, home to 493,000 people, national staff are now far more reliant on refugee volunteers who they monitor and guide by phone. “We’ve invested in masks, gloves, and sanitation for the refugee volunteers,” the director said. Movement into the camps has been sharply reduced. (26 March)
Southern Africa: Keeping food aid flowing
A regional food crisis is affecting tens of millions. South Africa, the port and logistical centre for much of the region’s humanitarian response, has closed 35 of 49 border posts. Ensuring food keeps flowing in and around countries is a top priority, aid groups say. For now, the South African government has assured the World Food Programme (WFP) its food supply chain – which supports some 20 million people in the region – won’t be affected by lockdowns and border closures. “At the moment [food movements have] continued as normal through South Africa [and on to Zimbabwe, Zambia, Namibia and eSwatini],” said Lola Castro, regional director for WFP southern Africa. “What we are hoping is that the transporters will continue to be engaged and not be afraid to move around the region.” There will “probably be [security forces] checks on the road to see where our trucks are going,” but at this stage there is “no need for humanitarian corridors”.
Castro said WFP has asked for three months’ advance funding from the donors. “It will allow us to buy rapidly across the world and move the food before any problem happens with shipping lines,” she said. “As the airlines are closing down, we hope the shipping lines will not be affected.” She stressed that WFP was asking donors for “advanced funds, not more funds. We need to put stocks in-country to allow distribution on time.” WFP is increasing the number of distribution sites to limit overcrowding. Prepositioning food, and providing two to three months’ rations in advance, will also help reduce crowd sizes. Among the priorities for WFP are children who had qualified for school-feeding programmes but are no longer in class, and people living with HIV/AIDS, said Castro. (Updated 26 March)
South Sudan: Tighter lockdown
On 23 March, the government announced the closure of all airports and land crossings. Excluded from the ban are cargo and relief flights, as well as food trucks and fuel tankers. But all drivers are required to undergo medical tests at the border. The UN peacekeeping mission has announced a seven-day freeze on all non-critical travel to South Sudan. Upcoming rotations of peacekeepers are also on hold, and in-country flights have been restricted.
For aid staff still in the country, all R&R leave has been suspended until 15 April, when the situation will be reviewed. “Part of my team is either out of the country or locked up in their apartments,” one aid worker said. “It’s a mindset shift to the new reality,” but after years of war, “this is not the first time working under extreme conditions”. A senior humanitarian official, currently in quarantine, predicted a jump in staff turnover, and said “it will be 10 times harder to find replacements”. (Updated 26 March)
Uganda: Refugee arrivals barred
On 25 March, Uganda announced measures to temporarily bar the arrival of new refugees and asylum seekers. Transit and reception centres will also be closed, while flights in and out of the country have been grounded and borders sealed following a first case of COVID-19. Uganda currently hosts some 1.4 million refugees – mainly from neighbouring South Sudan and the Democratic Republic of Congo. (26 March)
Burkina Faso: Transport bans and access challenges
Aid groups in Burkina Faso were already struggling to provide assistance to almost 800,000 internally displaced people living in hard-to-reach areas. This is getting harder still as coronavirus cases rise. As of 26 March, the country had recorded more than 140 cases – the second highest number in sub-Saharan Africa.
In mid-March, the government closed its air and land borders to all but military personnel and cargo. It also banned public transport nationwide, including buses.
The International Rescue Committee’s country director Jackie MacLeod told TNH that some international staff members have returned home in recent days and have not been replaced, while flexible working hours have been introduced to limit the number of people working at the NGO’s office.
MacLeod said restrictions on public transport – which her team regularly uses – may also affect the NGO’s ability to access certain parts of the country.
“My fear is that this restriction may lead to stricter lockdowns which will affect movements to some of the most vulnerable parts of Burkina and that the results would be catastrophic, and not just in terms of the coronavirus,” she said.
Manenji Mangundu, country director for the Norwegian Refugee Council in Burkina Faso and Niger, said the government should make exceptions for life-saving aid if it imposes further restrictions – such as limiting movement outside of the capital, Ouagadougou. (26 March)
Democratic Republic of Congo: Evacuations and staffing limits
A state of emergency was declared on 24 March as the number of confirmed COVID-19 cases – all in the sprawling, crowded capital of Kinshasa – rose. Borders have been shut, and internal passenger flights to and from the city have been grounded. This could create problems for aid workers who regularly fly from Kinshasa to conflict-affected areas in eastern DRC.
NGOs had stopped non-essential staff from coming in and out of Congo even before the restrictions. This has made it difficult to bring in additional staff and affected day-to-day operations. “We were supposed to have people coming to support the country office on specific work,” said Benoit Munsch, country director for CARE International. “It could be audit, training, consultancy, and all these kinds of movements have been stopped.”
Some non-essential aid workers have been evacuated from Congo on the assumption that the coronavirus will hit the humanitarian hub of Goma, the largest city in the east of the country, and health structures will collapse. High staff turnover in Goma is triggering concerns that people who leave won’t be replaced.
The governor of North Kivu called aid agencies together in mid-March and expressed concerns about them importing cases, emphasising the risk to refugee populations and the internally displaced. Going forward, there is concern about border closures as NGOs frequently use roads through Burundi and Rwanda as supply routes.
On the plus side, there have been discussions about using resources from Congo’s Ebola response to tackle COVID-19. Responders had been looking at ways to shut down Ebola treatment and transit centres, for example, but the process has been suspended while they investigate whether the centres could be used for COVID-19. Some NGOs are also seeking to integrate COVID-19 messaging into their current Ebola prevention programmes. (Updated 26 March)
Central African Republic: Stigmatisation and ceasefire calls
The UN peacekeeping mission, MINUSCA, announced it would suspend the rotation of blue helmets. It also appealed for residents to stop the “stigmatisation” of foreigners – something that could prove a problem for non-local aid workers, particularly in the capital, Bangui. Armed groups that signed a peace deal last year have been asked to better implement a ceasefire to prevent the spread of COVID-19. (Updated 26 March)
Bangladesh: Camp services suspended, virus poses aid dilemma
On 25 March, Bangladeshi authorities ordered the suspension of all relief work, apart from essential services, in the Rohingya refugee camps. Ongoing services include health, nutrition, information hubs, hygiene promotion, protection, reception for new arrivals, and food distribution. Makeshift schools have been shut and authorities have urged Rohingya refugees to stay home. “Everything is closed,” one camp resident told TNH. The NGO Save the Children said its child-friendly spaces are closed and may be “repurposed for medical use”. The new restrictions are seen as necessary, but they do have a cost: education NGOs were set to begin a long-awaited formal schooling programme using the Myanmar curriculum.
The Rohingya refugee camps are one of the top concerns for the humanitarian sector. The packed settlements are home to roughly 900,000 people, and containment efforts like “social distancing” will be difficult. Extremely limited hospital isolation and treatment beds will also complicate response efforts if an outbreak emerges (there were no confirmed cases in the camps as of 26 March, but Bangladesh reported a first case in the nearby town of Cox's Bazar, a hub for aid groups, earlier in the week). Refugees and aid groups say a months-long internet ban is also making it hard to spread hygiene promotion and preparedness advice.
One of the biggest concerns is the possibility of aid workers importing the virus. “We are now facing a very real dilemma, particularly in camps and camp-like settings,” said Pierre Peron, spokesperson for the UN’s emergency aid coordination body, OCHA, in Asia. “Humanitarian workers could themselves be vectors of the virus. How can we stand and deliver the life-saving aid that so many people depend on, without putting them at further risk?”
The government has asked aid groups not to bring in new staff, and to limit travel between the camps and Cox’s Bazar, several aid workers told TNH. Jeremy Wellard, Asia representative for the International Council of Voluntary Agencies, an umbrella group of NGOs, said the risks to refugees – and global travel restrictions – are forcing aid groups to re-assess when travel is actually essential. “It’s been a moment of reckoning for the sector,” he said. “We can still do much of our work remotely without actually putting bodies on the ground.” But as the coronavirus pandemic continues, this will also mean looking at how funding and support – which moves slowly at the best of times – can be shifted to help local responders already doing much of the work. (Updated 26 March)
Afghanistan: Border closures threaten supply lines
The border regions are the main flashpoint for concern – both for containing the virus, as well as the broader impacts on humanitarian operations in a country facing conflict, disasters, and overarching food instability. More than 62,000 Afghans – a record weekly total – crossed the border from Iran between 15-21 March, as Afghanistan’s western neighbour deals with one of world’s largest coronavirus outbreaks. Afghanistan’s neighbour to the south and east, Pakistan, has closed its joint border crossings – the main supply routes for Afghan aid. Pakistan had agreed to allow some levels of commercial and humanitarian transport, but the situation is in flux. A limited number of commercial trucks were crossing via southern Kandahar’s Spin Boldak – one of two main border points – but these had stopped as of 25 March. “It’s obviously something we’re concerned about and will continue to monitor closely,” said Nicholas Bishop, who works on border response in Afghanistan with the UN’s migration agency, IOM.
Staffing levels are a growing concern as some foreign workers leave, and travel restrictions and quarantines prevent others from getting in. About 9.4 million Afghans rely on humanitarian assistance, and the COVID-19 pandemic could begin to affect other programmes, some aid workers told TNH. Staff from four NGOs in Afghanistan told TNH that their organisations were evacuating some or all international workers due to liability issues and concern about the local health system. The organisations declined to comment, citing protocols on “internal risk management”. Some groups said they were staying: “We are trying to keep as many of our regular activities running, but some will have to halt,” said Zia Hannan, Oxfam’s country director. Vicki Aken, country director for the International Rescue Committee, noted that most aid workers in Afghanistan, like elsewhere, are local. “Now, more than ever they need to see that the international community will continue to support their efforts,” she said.
Already, there are early signs of knock-on effects. The UN said some aid groups have suspended livelihood programmes that would have helped 70,000 people. The impact is seen as minimal for now, but it could cause problems if the stoppage lasts longer than a month. (Updated 26 March)
Pakistan: Refugee and migrant returns on hold
The closure of Pakistan’s official border crossings with Afghanistan has shrunk the number of undocumented Afghans returning home (there were only six recorded returns at the two official crossings from 15-21 March, the IOM says). The UN’s refugee agency, UNHCR, has also suspended its separate voluntary returns programme for registered refugees. In the past, rights groups have claimed the UN effectively incentivised involuntary repatriation by offering cash support to returnees and not criticising Pakistan’s mass forced returns, which peaked in 2016. (26 March)
The Philippines: Polio vaccinations suspended, but a tentative ceasefire emerges
Access has emerged as an early constraint as COVID-19 cases rise. Local governments have imposed strict community quarantines to contain the spread of the virus, but these are also delaying a swathe of response programmes – most notably a polio vaccination campaign. “This is a major spanner in the works,” said Mark Bidder, head of office for OCHA in the Philippines. The coronavirus has put yet another emergency on the country’s radar. Over the last year, the Philippines has been hit with multiple earthquakes, a volcano eruption, dengue and measles outbreaks, and the return of polio after a two-decade absence. The polio outbreak had already delayed measles response operations, and now COVID-19 is disrupting programmes across the board. The Philippine Red Cross, for example, has postponed a cash grants programme for survivors of a November typhoon until April or May.
There’s concern particularly in the southern region of Mindanao, where more than 300,000 people are displaced due to conflict or disasters. Local aid groups are trying to continue cash aid programmes, but staff are under strict quarantine or isolation measures as COVID-19 cases rise. Like aid operations around the world, local groups are moving into uncharted territory. “We hope to be of help as much as we can, but we accept our limitations as we have no experience in responding to this kind of crisis,” said Regina Salvador-Antequisa, who heads the NGO Ecoweb.
The coronavirus has sparked at least one positive – albeit tentative – outcome: a communist rebel group in the Philippines announced a ceasefire on 24 March. Days earlier, Philippine President Rodrigo Duterte had declared his own unilateral ceasefire (though the Communist Party of the Philippines said its decision was in response to an earlier ceasefire plea from UN Secretary-General António Guterres). Conflict involving the New People’s Army – the CPP’s armed wing – has killed an estimated 43,000 people over decades in parts of the Philippines. (Updated 26 March)
North Korea: Cash roadblocks and an aid blind spot
North Korea was one of the first countries to close its borders as the coronavirus erupted in China in January. Donor fears of breaking sanctions and government rules have always made direct aid implementation difficult, but new restrictions and mandatory quarantines for foreigners – reportedly lasting weeks – have made it even harder to monitor. “I don’t think anybody has good visibility over the status of things,” one humanitarian based outside North Korea told TNH. Coronavirus travel restrictions have also complicated efforts to get money into the country: the Red Cross said the restrictions have stopped the “physical transfer of funds”, causing “cash constraints” that will delay supply restocks for an ongoing response to September’s Typhoon Lingling until at least May. Most banks have long been reluctant to transfer money into the country.
Mediterranean: Migrant rescues on hold
Sea-Watch 3 and Ocean Viking, whose operations are suspended due to logistical difficulties caused by the coronavirus chaos, were the last two NGO search-and-rescue vessels in operation in the central Mediterranean – the most frequented migration route from Libya to Italy, where at least 10,000 people have drowned since 2015.
With no humanitarian rescue missions operating since 27 February, the risk of losing more lives at sea increases. There is also concern that the coronavirus pandemic could see more migrant vessels pushed back to Libya, which UNHCR has expressly advised against due to the dangers third-country nationals face there. For example, a dinghy with 44 people aboard launched a rescue request on 28 February. After 24 hours without an answer, the boat was taken by the Libyan Coast Guard back to Libya.
Italy: Outbreak slows asylum system
The coronavirus outbreak in Italy – the deadliest in the world – is testing a stretched healthcare system and also affecting tens of thousands of migrants and asylum seekers. Applications and renewals of residency permits for foreigners were suspended for 30 days, starting from 2 March, as police staff normally employed at immigration desks have been re-assigned for emergency coronavirus duties. Courts will also be closed until 3 April at least, so the government has suspended interviews for refugee status determination and appeals hearings for asylum request denials. Services for asylum seekers are also affected, including employment help and language classes seen as key to integration. Legal aid operations, run by both the state and by NGOs, have been heavily reduced.
Groups trying to help asylum seekers have also been limited by government guidelines on social distancing. “We now let only one [migrant or asylum seeker] into our offices at a time, which consistently reduces the number of people we can assist per day,” Simone Alterisio, migration services coordinator for Waldensian Diaconia, a faith-based NGO, told TNH.
Greece: Coronavirus collides with migration challenges
The arrival of COVID-19 in Greece came just as the country faced migration challenges on two fronts: on the Turkish border, where thousands amassed after Turkish President Recep Tayyip Erdoğan claimed he was opening the doors to the EU; and on the Aegean Islands, where pressure to act on overcrowded detention centres had been reaching a breaking point. Greek security forces have been accused of using violence to push back migrants and asylum seekers trying to cross the border. While clashes have continued despite the coronavirus threat, Greece has so far resisted plans to relocate asylum seekers from centres like Moria on the islands of Lesvos, arguing that the risk from COVID-19 is greater on the mainland. More than 20 rights groups and humanitarian organisations have, however, called on the Greek government to prepare an evacuation plan for when the first case of coronavirus is discovered in the unsanitary camps, where refugees are reportedly sewing masks to protect themselves from COVID-19. The transfer of 1,600 unaccompanied children from Greece to at least seven countries in the EU has already been put on hold because of the coronavirus. (26 March)
Lebanon: Lockdown spurs refugee healthcare worries
NGOs working in Lebanon said the country’s lockdown, combined with a months-long economic crisis, is impacting their ability to deliver aid to the estimated 1.5 million Syrian refugees in the country and others who need help. Schools are shut, along with school meals, and almost all “non-essential” programming has been put on hold, including “non-formal education” and many “protection” programmes, such as those related to children and sexual and gender-based violence. Some local NGOs have stopped working altogether for the time-being.
NGO sources told TNH that the country’s economic crash had made it difficult to buy medical supplies, including personal protective equipment (PPE), even before the coronavirus pandemic. This issue has become even more acute as banks have closed and cut off access to US dollars.
With the police and army helping to enforce a lockdown, there is concern that refugees are not seeking help when they need it, including regular healthcare services beyond the coronavirus. Though there were no known COVID-19 cases among refugees in Lebanon’s informal camps as of 26 March, aid groups fear refugees won’t look for treatment if they develop symptoms. This may be more of a concern for refugees who live in cities rather than informal camps, where mobile medical units are still operating. A document published by the group that coordinates Lebanon’s aid response says that “refugees are isolating themselves due to fear of becoming ill [and] being exposed to harassment and violence in the community”. (26 March)
Libya: Refugee resettlement on hold
Authorities in the internationally recognised government, one party in Libya’s ongoing violence, announced the country’s first confirmed case on 24 March. A “humanitarian pause” to combat the threat of COVID-19 – declared mid-March and ostensibly welcomed by the internationally recognised government in the capital of Tripoli and Khalifa Haftar’s eastern forces, which have been fighting a battle for control of the capital since April – has failed to take hold.
The UN announced on 17 March that it would pause refugee resettlement travel around the world due to concerns and restrictions related to the COVID-19 pandemic. This appears to include the evacuation flights that had enabled some vulnerable asylum seekers and refugees to leave Libya – a country with an estimated 645,000 migrants and 356,000 internally displaced people that is struggling under the weight of 11 months of fighting in and around Tripoli.
UNHCR has temporarily halted registering asylum seekers in Libya, as well as work at a Tripoli centre where migrants receive assistance, “in response to the… pandemic and in line with guidance provided by Libyan authorities”. The agency said it is working to find “mitigating measures” to make sure services including healthcare, cash assistance, and relief distribution can continue. (Updated 26 March)
Occupied Palestinian Territories: Quarantines magnify protection concerns
Both the West Bank and Gaza have now registered cases of COVID-19, raising concerns about the potential for quick spread – particularly in the latter territory, where much of the 1.9 million population lives in densely populated refugee camps and urban areas.
There are quarantines and curfews in both areas, many workplaces are shut, and schools are closed. The UN says these measures, coupled with overcrowding and uncertainty, “are expected to increase mental and psychosocial distress, particularly among children, as well as gender-based violence”. It says these concerns are magnified in Gaza, where Israel has imposed a blockade since Hamas took control of the strip in 2007. There are regular violent flare-ups, and 33 civilians were killed by Israeli soldiers in 2019 during weekly protests at the border. At the same time, relief and social services offices operated by the UN’s agency for Palestine refugees, UNRWA, are currently closed in Gaza due to the outbreak.
An UNRWA spokesperson said that while schools are closed, the agency has “vast experience in providing distance learning” due to past conflicts in Gaza and Syria, so they are “putting together now an alternative approach to physically being present inside classrooms”. (26 March)
Syria: Shifting aid distribution
After nine years of war, 11 million people are estimated to need aid inside the country, including nearly a million people who recently fled the recent government campaign in the rebel-held northwest and many more who were already displaced. The impact of COVID-19 response and preparedness restrictions differs depending on location, as parts of the country are controlled by rebels, others by the government of President Bashar al-Assad, and others still by Kurdish authorities. In general, schools are closed, including those in camps. Most protection initiatives and programmes that provide psychosocial support are also on hold. Most NGOs say they are shifting the way they deliver aid – like delivering food to individual tents rather than encouraging people to gather. A recent update from the World Health Organisation and OCHA reported that some aid deliveries have been put on hold while the new methods are sorted out: “mobile medical clinics or other services have been suspended or reduced as teams work to implement precautionary work”.
Several sources told TNH that Kurdish authorities in northern Iraq had recently closed the border with northeast Syria, which had previously been open for NGOs one day a week and for emergencies. This could cause international staff to withdraw from the region and possibly relocate to northern Iraq, although negotiations about the closure are ongoing. (26 March)
Iraq: New restrictions worsen access
Some 1.4 million people are still displaced in Iraq because of the so-called Islamic State. For the past few months, the continuing fight against the group – along with new government rules – mean that aid organisations have had trouble reaching the displaced and others who need help across the country. Now, COVID-19 restrictions appear to be exacerbating the access problems: OCHA said that in late February the governor of Salah al-Din, north of Baghdad, had banned foreign nationals, including aid workers, from entering the province. It also reported that increasing movement restrictions – both inside the semi-autonomous northern Kurdish region and between the region and Iraq – were impacting “humanitarians’ ability to deliver assistance”.
Yemen: Flight bans hamper aid
There are no confirmed cases of COVID-19 in Yemen, a country where five years of war has left 24 million people in need of aid. But a ban on flights in and out of Yemen has already meant the UN has scaled back to essential staff only and stopped medical evacuations for an already limited number of chronically ill civilians. A ban on some road travel within the country is likely to make accessing people who need help even harder. In addition, a key reform that has been demanded by the World Food Programme and donors – the use of biometrics to register aid recipients – may also be further delayed, as Houthi rebels said they have banned the use of fingerprint technology for health reasons.
Venezuela: New pressures on a shattered health system
The closure of the border with Colombia has spurred concerns over how Venezuelans who had relied on buying medical supplies and medicines in the neighbouring country will fare, as well as fears that those who need to cross will rely on unofficial and dangerous routes. Within Colombia, health officials have warned of the vulnerability to the coronavirus of the 1.7 Venezuelan migrants who now reside there. But the greater concern may be for those still in Venezuela, where an economic collapse has seen an exodus of medical staff, the decimation of the healthcare system, and led to huge shortages of key supplies, including fresh water. The broader concern is that a serious coronavirus epidemic could lead to further social and political unrest, and to an authoritarian response from Venezuelan leader Nicolás Maduro. The president has claimed the country’s collapsed pharmaceutical industry will be able to produce a cure for coronavirus – none exists. (Updated 26 March)
US-Mexico: Migrant shelters brace for coronavirus
Under President Donald Trump’s “Remain in Mexico” policy, more than 60,000 asylum seekers have been forced to stay on the Mexican side of the border as they wait for their requests to be heard. This week, the US government delayed court hearings for those due to be heard before 22 April, a move affecting some 25,000 cases. Mexico has temporarily stopped processing asylum requests until at least 20 April as COVID-19 shutters public offices. And, under a new US coronavirus-related policy, any migrants caught illegally crossing the border will be processed in the field and sent back to Mexico rather than being detained and questioned on US soil. As the number of COVID-19 cases rises in Mexico, experts have voiced concerns about the spread of the virus in the crowded migrant encampments that dot cities across northern Mexico, where healthcare is patchy and life-saving ventilators few and far between. (Updated 26 March)
Haiti: Political unrest and fractured healthcare
The first cases of COVID-19 have been a major cause for concern in Haiti, the poorest country in the western hemisphere where months of protests over corruption and food and fuel prices had the government rocking even before the coronavirus. A lockdown has gone into effect but will be hard to enforce in the teeming capital of Port-au-Prince, where many people live in slums and informal settlements. The Caribbean country of more than 11 million people, which has fewer than 30 intensive care beds, suffered a cataclysmic earthquake in 2010 that flattened the capital and nearby Léogâne, claiming between 160,000 and 300,000 lives. (26 March)