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Coronavirus and aid: What we’re watching

A snapshot of how COVID-19 has disrupted aid efforts around the globe.

Vincent Ghilione/Unsplash

The coronavirus is hitting emergency responses in vulnerable communities across the globe – from refugee camps and disaster displacement sites to border crossings and conflict zones.

Key services have been scaled back or suspended. Health access has plummeted, particularly for women and girls. Other disease outbreaks are emerging. And more people are facing food insecurity as economies tumble.

The rapidly evolving outbreak is pushing aid groups to plan for new responses in communities already facing long-running crises – and forcing a re-think of how the sector operates when resources are stretched.

Here’s a snapshot of what we’re watching.


Attacks on healthcare: Workers face rising violence


Violence against frontline health staff working on COVID-19 has risen dramatically since the World Health Organisation declared the coronavirus outbreak to be a pandemic in March, according to Insecurity Insight, a Geneva-based group tracking threats in crisis areas. The group has recorded more than 265 violent incidents related to the coronavirus. Some attacks on health workers are driven by fears they could spread COVID-19. Health workers have also reported being threatened for protesting or contradicting official infection figures. (11 June)


Infectious diseases: Outbreaks emerge as millions miss vaccinations

There are early signs of what postponed vaccination programmes may bring: Afghanistan is reporting polio infections in provinces that haven’t seen cases for two decades, according to the UN. Worried that outbreak responses might spread the coronavirus, the board of the Global Polio Eradication Initiative (GPEI) advised countries on 2 April to postpone vaccination campaigns until at least June. Illnesses from other vaccine-preventable diseases like measles and cholera are also expected to rise in the coming weeks as coronavirus restrictions derail immunisation campaigns. Chad was already grappling with a measles epidemic, and aid groups there fear COVID-19 could threaten planned vaccination campaigns. MSF said most humanitarian groups in Chad have shifted their attention to the pandemic, and warned that neglecting measles programmes and health services could lead to a “catastrophic situation”. International flight shortages, “exorbitant” shipping costs, and coronavirus lockdowns are also fuelling “a massive backlog” in vaccine shipments, UNICEF has warned. More than 117 million children will miss out on measles vaccinations as dozens of countries are forced to cancel immunisation campaigns, a global health coalition said on 14 April. On the other hand, polio teams in some countries are now working on COVID-19 responses. (9 April, updated 28 May)


Non-communicable diseases: Severe disruptions to treatment

The coronavirus pandemic has disrupted treatment for cancer, cardiovascular diseases, diabetes, and other non-communicable diseases across the globe, according to a World Health Organisation survey published 1 June. Half of 155 countries polled in May reported disruptions to treatment for diabetes and hypertension, for example, while 42 percent said cancer treatments had been affected. Low-income countries are the hardest hit. Cancellations of planned treatment, a decrease in public transport during lockdowns, and health staff being reassigned to coronavirus programmes were the most common causes of service interruptions. (4 June)


Women’s health: Warnings over funding, abortion access, surge in gender-based violence

Resources diverted from sexual and reproductive health could fuel a rise in pregnancy complications, maternal deaths, and unsafe abortions warns a briefing from the UN Population Fund, or UNFPA. There are similar warnings about reproductive health and gender-based violence (GBV) across the globe: the agency’s estimates in the Philippines, for example, project a jump in birth complications and spousal violence, while aid groups are reporting a rise in domestic violence in Bangladesh’s Rohingya camps amid a lockdown and pared-back services. Data from the International Planned Parenthood Federation (IPPF) shows more than 5,600 mobile clinics and community-based centres offering sexual and reproductive healthcare have shut in 64 countries, from Colombia and Pakistan to Zambia and Zimbabwe. The closures and restrictions affect HIV testing, contraceptive care, abortions, and services for GBV victims. A June survey found roughly 40 percent of local IPPF member organisations worldwide were reporting “critical or severe” reductions in services. These impacts ranged from having to dismiss staff, closing services and clinics, and running low on stocks of contraceptives. (9 April, updated 11 June)

A study by Johns Hopkins University researchers, published in The Lancet on 13 May, projects that between 42,000 and 192,000 more children worldwide, as well as between 2,000 and 9,450 more mothers, could die each month due to COVID-19’s indirect impacts on health and food access. The projections were made using statistical modelling and factoring in elements like vaccine availability, antenatal care, and health coverage. (14 May)


Justice: Coronavirus erodes women’s legal access

Women are feeling the legal impact of COVID-19 – particularly in areas already facing humanitarian emergencies. Lockdown restrictions have meant bigger lag times in getting divorces, restraining orders, and childcare agreements, according to a report published by the Washington-based Georgetown Institute for Women, Peace and Security. The authors recommend using technology to hold judicial proceedings and replacing full legal trials with interim judicial orders to keep women and children safe. Other recommendations include boosting social media messages to communicate to women what legal aid is available and partnering with informal and customary legal systems to protect women’s legal needs. (28 May)


Gender: Report finds inequalities widen, but there’s one ray of light 

There’s good news and bad news about COVID-19 and women. A report from CARE International found that women have been excluded from “high-level” decisions regarding the pandemic. The report also showed major gaps in women being able to access basic needs like food and handwashing supplies, health services, and information on how to avoid the virus. The good news? The pandemic may be shaking up deeply entrenched gender inequalities. CARE interviewed more than 260 people representing communities, health ministries, and local aid organisations in 12 West African countries. The majority of respondents said there had been a positive shift in shared household decision-making. Some women said that meant their partners were doing more chores and child-minding. (21 May)

Aid: Oxfam to end operations in 18 countries

With finances “seriously impacted” by the coronavirus pandemic, Oxfam says it will shut operations in 18 countries, including Afghanistan, Haiti, Sudan, and Burundi. The cost-cutting measure, announced 20 May and first reported by Devex, will see Oxfam reduce its physical footprint to 48 countries. The organisation said some 1,450 staff – and partnerships with 700 organisations – will be affected. The British branch of the 19-member alliance, its largest, was already facing a £16 million shortfall this year – after cutting a similar amount in 2018. The organisation faces further drops in income – pegged at about £434 million for 2018/19 – due to COVID-19. Oxfam has struggled to recover from the loss of public trust after a sex abuse scandal revealed in 2018. (21 May)


Food: Coronavirus could double the number of people in crisis

The number of acutely hungry people worldwide could nearly double from 135 million to 265 million as a result of COVID-19, according to projections from the UN World Food Programme. Many countries facing severe food crises – Yemen, the Democratic Republic of Congo, Afghanistan, Venezuela, Ethiopia, South Sudan, Syria, Sudan, Nigeria, and Haiti, for example – don’t have the resources to stage large-scale coronavirus responses on top of protecting livelihoods and family income, according to an annual report on global food insecurity drafted before the pandemic. (23 April)


Education: Frontline NGOs say girls most affected by school closures

Education NGOs fear school closures caused by the coronavirus are raising the risk of violence, child marriage, and dropouts among girls, a survey by the Washington-based Centre for Global Development found. More than two thirds of NGOs surveyed said girls are disproportionately affected. At the same time, more than 40 percent of the organisations said their budgets had been slashed, and a third are projecting layoffs due to donor funding cuts. (4 June)


Economy: Shutdowns squeeze global remittances 

The World Bank projects that global remittances could plummet by $110 billion this year – a fifth of the $554 billion estimated to be sent to developing countries in 2019 – as migrant workers are laid off in economies hit by coronavirus shutdowns. Money sent home by relatives working abroad far exceeds global aid flows, providing income that can help during crises. In Somalia, for example, the value of remittances is believed to be two to three times greater than humanitarian aid funds. Migrant workers typically send more money home during crises. “This time, however, the pandemic has affected all countries,” the World Bank said in a statement. Research shows that remittances stave off poverty, allow better nutrition, and pay education costs. (23 April)


Protective equipment: Shipping channels (and prices) take flight

It will cost aid groups $280 million to store and ship vital protective supplies, as well as to transport humanitarian workers and other personnel, according to the WHO and WFP. Each month, coronavirus responses around the world will need at least 100 million masks and gloves, 25 million respirators, and 2.5 million diagnostic tests, WHO chief Tedros Adhanom Ghebreyesus said. The “substantial” cost of storing and shipping the cargo is on top of the price of buying the supplies in the first place. Individual aid groups are also trying to procure supplies, but costs have skyrocketed. In Uganda, for example, a pack of 50 disposable masks, once $2, now sells for $40, according to the NGO BRAC, which employs some 4,000 community health workers. “This ongoing cost is not sustainable,” the organisation said. (16 April)


Funding: Humanitarian price tag soars 

The cost of responding to COVID-19’s humanitarian impacts is rising. On 6 May, the UN announced a $6.7 billion appeal, updating the original, half-funded $2 billion plan launched in March. The new tally adds billions on top of existing humanitarian response plans that exceeded more than $28 billion before the pandemic. These pre-coronavirus responses were only 13 percent funded as of early May, but most crises have deteriorated as outbreaks spread, the UN warns. Beyond the immediate humanitarian impacts, the cost of helping the world's most vulnerable to weather COVID-19's socio-economic repercussions could total $90 billion, according to UN estimates. (7 May)



South Sudan: COVID-19 compounds a rash of crises

South Sudan has seen a sharp spike in confirmed COVID-19 cases in the midst of a humanitarian emergency. A political vacuum is also paralysing the coronavirus response, according to the International Rescue Committee (see our story here). The agency is calling for more funding for frontline responders to help strengthen the country’s fragile health system, and enhance infection prevention and control. “The humanitarian crisis in South Sudan is deepening as the double emergency created by the COVID-19 pandemic adds to a streak of hazards,” said Caroline Sekyewa, IRC country director. “An escalation of violence between communities, a COVID-19 induced economic crisis, recent flooding, an oncoming plague of desert locusts, and a drastic drop in oil revenue have converged to exacerbate a legacy of disease, hunger and displacement.” (4 June)

Health messaging and hygiene facilities are being strengthened in South Sudan’s displacement camps after the confirmation on 13 May of three coronavirus cases. “We have doubled the water supplies and increased handwashing facilities in the sites,” said David Shearer, the head of the UN mission. “People have also been given at least two-three months’ food in advance so they don’t have to go out to buy supplies as often as they did previously.” 

Two of the three coronavirus cases were in a camp that shelters 30,000 people in the capital, Juba, and the other was in Bentiu, in northern Unity State, home to 118,385 people. “The UN continues to urge displaced people in the sites to follow prevention measures such as social distancing, handwashing, and isolating themselves if they become sick,” UN spokesman Stéphane Dujarric said in a briefing. Close to 200,000 people who have fled years of conflict are sheltering in camps across the country. (14 May, updated 21 May)

The spike in coronavirus cases comes as South Sudan entered its post-harvest lean season – when food is in short supply. “There is still a real worry that the measures taken to suppress the spread of coronavirus run the risk of disrupting livelihood activities, delaying access to food assistance, and placing additional strain on poor households’ abilities to buy food, seeds and other essentials,” said Mercy Laker, CARE South Sudan’s deputy country director. “They risk having a particularly bad effect on the urban poor and those living in displacement sites.” (14 May)

South Sudan’s first four coronavirus cases were all UN staff members, which triggered social media-driven xenophobic hate speech. A joint UN agency and NGO initiative has begun “rumour tracking” to capture the coronavirus information being transmitted within communities. (23 April, 14 May)

South Sudanese soldiers surrounded UN peacekeeping bases and humanitarian hubs in Juba and Malakal, in northeastern Upper Nile State, when the news broke of the coronavirus cases in mid-April. As a protective measure, the UN authorised only essential movement by staff. Some non-UN aid agencies are following the same advice. (9 April, updated 16 April)

Previously, the government announced the closure of all airports and land crossings on 23 March. 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. Upcoming rotations of UN peacekeepers are on hold, and in-country flights have been restricted, according to the UN peacekeeping mission. (26 March)

The strain on staff working under COVID-19 restrictions is a growing concern, said Jeremy Taylor, regional advocacy adviser at the Norwegian Refugee Council. “We spend a lot of time thinking about it, thinking how to put in place psychosocial support for our teams. The strain is particularly bad for national staff,” he noted. “South Sudan is a dangerous place to start with, but layer on top of that this virus and all the fears that come with it, and it’s definitely a concern.” Staff do have a “right to withdraw” if they feel unsafe, but navigating the restrictions, changing the way we operate to keep staff and beneficiaries safe while balancing that with a “stay and deliver mandate”, is a challenge, Taylor said. (23 April)



Kenya: Dadaab camps’ first positive cases include aid worker

The first coronavirus cases in Kenya’s Dadaab refugee complex – home to 218,000 people – were confirmed in mid-May. One is an aid worker with the International Rescue Committee who had travelled the 1,200 kilometres from Nairobi to Dadaab by road, when protocol states they should have flown. The staff member journeyed before receiving the results of their coronavirus test, and learned they were positive during a standard 14-day quarantine. They were then transferred to an isolation centre. The staffer, a sex and gender-based violence expert, was considered an essential worker, but it’s unclear whether they had government authorisation to travel. The two other cases are cross-border infections from Somalia who tested positive in the Ifo and Dagahaley camps. They arrived despite Kenya’s border closure in May. “We hope there is no local transmission, but we have prepared for months and months for this,” Eujin Byun, a spokesperson for the UN’s refugee agency, UNHCR, told TNH. The Dadaab complex has three isolation centres with a total of 800 beds. There is a single ventilator and UNHCR has appealed to donors for an ICU. (21 May)

The Kenyan government has banned refugee movement in and out of the country's two main camps – Dadaab and Kakuma – home to 493,000 people. Permission for aid workers to travel will be granted on a case-by-case basis. The new restrictions also affect host communities in the vicinity of the camps. (30 April)

The coronavirus pandemic has shut down three quarters of the workload of partner organisations of Hivos East Africa, a development and humanitarian grant-making NGO working in Kenya, Uganda, and Tanzania. What’s needed now is “solidarity and trust”, said Mendi Njonjo, the group’s regional director: “Any well-meaning philanthropist must recognise what partners need is operational support. Now is not the time to insist that our partners stick to schedules, but to be flexible, to move to trust-based grant-making.” (9 April)



Burundi: WHO officials expelled, aid access blocked at quarantine spots


Four senior WHO officials, including the organisation’s country representative, were expelled by the Burundian government on 13 May. No initial reason was given but an unnamed government official who spoke to AFP blamed “interference” in the country’s management of the virus. Mass rallies were held across the small East African nation ahead of the general election on 20 May. Doctors and nurses in Bujumbura – the largest city – told TNH there are at least 10 times more confirmed cases than the government has made public. Read our latest on the situation. (14 May)

In March, Human Rights Watch released a report criticising conditions at quarantine sites in the country and said several humanitarian organisations have been blocked from providing assistance. More than 100 people were released after falling ill at one site where they had been held “without food or water in appalling sanitary conditions for several days”, the report said. Burundi confirmed its first two COVID-19 cases on 31 March – and its first death on 12 April. (2 April, updated 16 April)



Polio: Travel restrictions delay decision on Africa’s ‘polio free’ status

Africa was expected to be certified as free of the wild poliovirus this year. But coronavirus travel restrictions have delayed a final decision, according to the GPEI. The last wild poliovirus cases on the continent were detected in Nigeria in 2016. The Africa Regional Certification Commission, responsible for verifying polio eradication, had confirmed 43 of the 47 countries it covers were polio-free, meaning no reported wild poliovirus cases for at least three years (as well as high immunisation coverage and other detection and response measures being in place). However, outbreaks of vaccine-derived strains – rare mutations that affect under-immunised populations – continue to circulate and cross borders, leading the WHO’s advisory board on immunisation to declare last year that it had “serious concerns about the overall state of eradication efforts”. (14 May)

Niger: New polio outbreak surfaces, border closures leaves thousands stranded

The UN’s migration agency, IOM, has helped several hundred migrants stranded in Niger return to their homes in Mali, Burkina Faso, and Benin. The migrants, including people who had previously signed up for voluntary repatriation, were stranded for about three months in Niger due to the country’s COVID-19 lockdowns. Some 1,400 migrants remained in IOM-run transit centres in Niamey and Agadez as of early June, out of roughly 2,300 people stuck due to being quarantined on arrival, or after being abandoned by people smugglers. The agency said there are roughly 30,000 stranded migrants in West and Central Africa. (2 April, updated 11 June)

A new outbreak of circulating vaccine-derived polio was reported in Niger in late April, just as the WHO was forced to suspend mass vaccination campaigns amid the coronavirus pandemic. Two children were the first affected – one in the capital, Niamey, another in the conflict-affected Tillabéri region. “The poliovirus will inevitably continue to circulate and may paralyse more children as no high-quality immunisation campaigns can be conducted in a timely manner,” said Dr. Pascal Mkanda, WHO’s polio eradication programme coordinator for Africa. (30 April)


Somalia: Floods, locusts, and a pandemic


Somalia is facing a triple threat – flooding, locusts, and COVID-19. “This is as grim as I’ve seen it in six years,” Justin Brady, the head of OCHA, the UN’s emergency aid coordination office, in Somalia, told TNH. The majority of UN and NGO international staff, including Brady, are working outside the country, and most local staff are “in a restrictive environment” as a result of coronavirus, undermining the humanitarian response. “It’s like we’re looking through a keyhole at this problem,” said Brady. After more than two decades of conflict, Somalia’s response capabilities are basic and reliant on emergency aid funding. “The healthcare system couldn’t be weaker, when the idea is to flatten the curve,” said Brady. (30 April)


Horn of Africa: Locust response hampered 


Delays in obtaining pesticides, helicopters, and other vital supplies have set back efforts to combat East Africa’s desert locust outbreak in recent weeks, just as a second generation of the pest has been forming swarms and threatening crops and livelihoods. The UN’s Food and Agriculture Organisation (FAO) told TNH that materials are now arriving and that bottlenecks have been alleviated by diversifying suppliers. But restrictions are still affecting the ability of some NGOs to move around and provide assistance, and further supply chain problems are anticipated. “There are definite impacts on our ability to provide programmes,” said Steven Burak, a coordinator for the Regional Desert Locust Alliance. (26 March, updated 30 April)


Nigeria: ‘Worst fears’ in northeast, as new cases emerge


The monitoring of the porous borders in Nigeria’s conflict-hit northeastern state of Borno remains a problem. Displaced people with unknown health statuses continue to arrive almost on a daily basis in camps and communities in border areas, OCHA reported. On the Cameroon border, checkpoints are being transformed into health posts to screen people for potential coronavirus symptoms. Aid workers fear the impact on the 700,000 displaced people living in the region’s underserviced camps. “We’re making decongestion a priority, but it’s not an easy task,” OCHA spokesperson Eve Sabbagh told TNH. “It really depends on land allocation, and then being able to secure the camps.” (30 April)

The death of a health worker on 18 April was the first confirmed COVID-19 case in Nigeria’s northeastern region. The aid worker had no history of travel outside Borno and worked in a displacement camp in Pulka, on the border with Cameroon. “It’s our very, very worst fears,” said Nigeria’s former chief humanitarian coordinator Ayoade Olatunbosun-Alakija. (23 April)

Aid workers are particularly concerned about the COVID-19 threat to the roughly 800,000 internally displaced living in congested camps throughout Borno State – the centre of the Boko Haram conflict. Handwashing stations are being installed, and “soap and chlorinated solution” distributed where water is not readily available, the UN said in a statement. Aid workers say there are now greater restrictions on accessing Borno’s 229 camps and “camp-like settings” – most of which are poorly serviced.

Prior to the first confirmed COVID-19 case, coronavirus had already had a “very significant impact” on aid operations, said Plan International director Hussaini Abdu. Food distributions now take far longer, as crowd sizes are more tightly managed, he said, noting: “What would have taken one or two days, now takes a week.” The Plan director said distribution timetables have also been upended, and “you have to spend time explaining [why]”. That undermines predictability”, which, he noted, feeds into long-established conspiracy theories over alleged corruption and the political agendas of aid agencies. (2 April)

“What would have taken one or two days, now takes a week.”


The Democratic Republic of Congo: New Ebola case complicates coronavirus response


With the end of Ebola in sight, it was hoped authorities in Congo could shift their attention to help combat the coronavirus pandemic. But on 10 April, just two days before the end of the epidemic was to be officially declared, a new Ebola case was reported in the eastern city of Beni. Health authorities now have to juggle both responses, while also treating people affected by measles, cholera, and Congo’s many ongoing conflicts. (16 April)

Congo declared a state of emergency for the coronavirus on 24 March. Borders have been shut, and internal passenger flights have been grounded. This has impacted aid workers who use humanitarian air services, though some flights are now up and running following negotiations with the government. 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 Benoît Munsch, country director for CARE International. “It could be audit, training, consultancy, and all these kinds of movements have been stopped.” (26 March, updated 30 April)

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, the capital of North Kivu province, 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. 

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. (26 March)


Southern Africa: Keeping food aid flowing amid questions over urban response

Close to 16 million people in 11 southern African countries are struggling with food shortages as a result of poor harvests last year. “What we don’t know is how many more people will go hungry as a result of coronavirus,” said WFP’s southern Africa spokesman, Gerald Bourke. “It’s a fact that urban folk are going to be hit hard – and that will be a big issue.” Governments will need to expand social safety net programmes, “but how able they are to do that, given their fiscal constraints, is a big question,” he said. One key area of welfare support is school feeding schemes. Children are out of school across the region, and WFP is implementing workarounds in several countries, including providing take-home rations.

“What we don’t know is how many more people will go hungry as a result of coronavirus. It’s a fact that urban folk are going to be hit hard – and that will be a big issue.”

Reduced working hours as a result of COVID-19 has cut the number of berths available in regional ports, and warehouses are closing earlier. That is slowing the movement of food, but “these are not insurmountable obstacles,” said Bourke. As the humanitarian community’s logistics cluster lead, WFP is setting up regional hubs in Africa to centralise cargo movements and UNHAS flights. The hubs will serve the needs of all agencies and INGOs – and provide medevac services and clinics for aid workers should they become infected. Two hubs are up and running in Accra, Ghana and Addis Ababa, Ethiopia, and another is planned for Johannesburg in South Africa. (16 April) 

The South African government has assured WFP that its food supply chain won’t be affected by lockdowns and border closures. Food movements are continuing as normal through South Africa and on to Zimbabwe, Zambia, Namibia, and eSwatini, said Lola Castro, regional director for WFP southern Africa. At this stage, there is “no need for humanitarian corridors”, she said. (16 April)

In March, WFP asked for three months’ advance funding from donors. “It will allow us to buy rapidly across the world and move the food before any problem happens with shipping lines,” Castro said. WFP is asking donors for “advanced funds, not more funds”, she stressed. “We need to put stocks in-country to allow distribution on time.” WFP is also 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. (19 March)


West Africa: Don’t ignore existing needs, aid groups warn


Coronavirus is having a deep impact on operations in West Africa, Julie Bélanger, head of OCHA for West and Central Africa, told TNH. “We are reprioritising and looking at what programmes are absolutely essential in terms of life-saving, while making sure aid workers are both safe and don’t spread the virus,” she said. Some aid groups are looking at where cash programmes can be used instead of distributing relief items, in order to avoid large gatherings of people. But there are questions about what will happen if market food prices rise. “We are not seeing it yet, but in some markets there could be a problem with food availability, which will then impact on cash programmes,” Bélanger said. “The food needs to be there to buy.”

“We are not seeing it yet, but in some markets there could be a problem with food availability, which will then impact on cash programmes. The food needs to be there to buy.”

Some aid groups are also warning donors against diverting funding from existing programmes in order to respond to the coronavirus. Current projects will need to be scaled up, not down: an estimated 19 million people are projected to face largely climate-related food shortages from June to August in the Sahel and West Africa. “That’s a 77 percent increase without taking into account the COVID impact,” Bélanger said. (9 April)


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 around the country.

In mid-March, the government closed its air and land borders to all but military personnel and cargo, and banned public transport nationwide, including buses. Restrictions on travel to and from towns and cities with confirmed cases have also been introduced, leaving aid groups based in the capital, Ouagadougou, unsure how they are going to access people in need.

Manenji Mangundu, country director for the Norwegian Refugee Council in Burkina Faso and Niger, said the government should make exceptions for life-saving aid: “Protection and emergency assistance need to continue.”

Jackie MacLeod, Burkina Faso country director for the International Rescue Committee, told TNH that international staff members have returned home and not been replaced, while flexible working hours have been introduced to limit the number of people working at the NGO’s office. For more, watch TNH’s recent webinar. (26 March, updated 16 April)


Central African Republic: Stigmatisation and ceasefire calls


The Norwegian Refugee Council said the suspension of both commercial and cargo flights to and from the country is likely to impact humanitarian operations. With 70 percent of health services provided by aid groups, it is “crucial to maintain the necessary infrastructure to allow supplies and personnel into the country”, the organisation said. (2 April)

The UN peacekeeping mission, MINUSCA, announced in March that 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. (19 March)


Sudan: UN police deployment blocked


Travel restrictions imposed by Sudan to slow the spread of COVID-19 are delaying the deployment of fresh UN police units in Abyei and the disputed border regions between Sudan and South Sudan. The UN’s peacekeeping chief, Jean-Pierre Lacroix, said the security situation remains volatile, with rising tensions between the rival pastoral Ngok Dinka and nomadic Misseriya communities, but the deployment of an additional roughly 420 police is facing “serious delays”. As Sudan is still on Washington’s list of state sponsors of terrorism, it is ineligible to access the IMF-World Bank’s $50 billion emergency fund to help vulnerable countries fight COVID-19. (30 April)


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 were 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)


Asia and the Pacific

Afghanistan: Inadequate testing, infection of health staff raise alarm

Infections among health workers are a growing concern, and aid groups say vital protective equipment is becoming more expensive and harder to source for humanitarian staff, including those working on nutrition, shelter, and other programmes. Healthcare staff comprise at least five percent of Afghanistan’s total confirmed infections, the UN reported. But the country’s caseload is widely believed to be an undercount due to inadequate testing. Roughly 40 percent of COVID-19 tests came back positive as of early June, according to health ministry statistics, indicating the virus is likely spreading undetected – particularly in conflict areas where testing and containment is scarce. There are 11 laboratories nationwide, but labs in Kandahar and Nangarhar provinces were knocked out of service due to contamination; four of five technicians working in the Nangarhar lab tested positive for COVID-19 in May. (4 June)

Inadequate testing and worries about infections at healthcare centres have affected women in particular. Government statistics from April showed women made up only a quarter of confirmed cases at the time. A survey of Afghan health staff by German NGO Johanniter International Assistance and its local partners found women have less access to healthcare and testing, while maternal care and vaccinations have fallen. The research found some clinics have closed or scaled back due to fear of the coronavirus, while special screening for women was only available in half of the surveyed health facilities. “We are very concerned that women in particular no longer go to the doctor or hospital for fear of infection,” Nasreen Afzali, Johanniter’s gender and protection officer, said in a statement. “As a result, the number of treatments in mother-child care, prenatal and postnatal care, and vaccinations has dropped sharply.” UNICEF has also reported similar drops in people seeking healthcare: admissions for severe acute malnutrition fell by roughly 40 percent in March compared to a year earlier, for example. This points to the added importance of mobile health teams during the pandemic and lockdowns, the agency said. (28 May, updated 4 June)

“We are very concerned that women in particular no longer go to the doctor or hospital for fear of infection.”

Simultaneous aid responses are also quickly depleting aid supplies, and some programmes have been put on hold to focus on a coronavirus response. Some livelihood assistance programmes have been postponed, which could become a bigger concern during the upcoming harvest season in a country already facing widespread food insecurity, aid groups say. Stocks of therapeutic food used for children with severe acute malnutrition were shifted to areas seen as high-risk for the coronavirus – leaving potential shortages in places with less risk but high levels of malnutrition, according to the UN. Helping some of the roughly 39,000 people hit by floods, landslides, and other disasters this year means supplies like non-food kits are being “depleted and will require urgent replenishment”, the UN said. (9 April, updated 4 June)

Food prices continued to rise in June compared to March, fuelled by panic buying and domestic trade disruption. At the same time, purchasing power for casual labourers and others has fallen. There are early indications of the impacts: an Oxfam study in five provinces found about a third of people surveyed said they were borrowing money or selling assets to buy food; nearly three quarters said they had exhausted all their food stocks. “Public unrest is building in areas such as Herat city, where people are calling for more support from the authorities, in large part to meet their immediate food needs,” the UN said on 20 May. At least six people were shot and killed during a food aid protest in central Ghor Province on 9 May, sparking calls for an investigation. The protesters claimed that government food distributions, set up during the pandemic, were unfair. In a preliminary report, the Afghanistan Independent Human Rights Commission said police fired on the protesters, contradicting reports by security forces that gunmen in the crowd had fired on them. Food aid protests have also taken place in Nangarhar and Paktika provinces in Afghanistan’s east. Crisis-level food insecurity is emerging among urban households due largely to coronavirus lockdowns and joblessness, the Famine Early Warning Systems Network, or FEWS NET, said in a briefing released in May. (14 May, updated 4 June)

“Public unrest is building in areas such as Herat city, where people are calling for more support from the authorities, in large part to meet their immediate food needs.”

Pakistan opened its two main border crossings with Afghanistan to commercial traffic five days a week as of 1 May (with plans to open six days a week). This relieved pressure on food and aid, but bottlenecks remain. Pakistan’s joint border crossings are a main supply route for food imports and relief supplies, but had been mostly closed for several weeks starting in mid-March. The unpredictable border status was threatening a “pipeline break” of therapeutic food supplies for malnourished children. Kazakhstan, the largest exporter of wheat flour and grains to Afghanistan, re-opened limited exports in April after an earlier suspension, the UN said. (16 April, updated 21 May)

About 9.4 million Afghans rely on humanitarian assistance. Staffing levels are a concern, as some foreign workers have left, while travel restrictions and quarantines prevent others from getting in. Staff from four NGOs in Afghanistan told TNH their organisations evacuated some or all international workers due to liability issues and concern about the local health system. Some groups said they were staying. 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. Among health organisations, 85 percent of Afghan NGOs and 72 percent of international NGOs continue to operate, according to OCHA.

Afghanistan’s border regions are the main flashpoint for concern – both for containing the virus and the broader impacts on humanitarian operations in a country facing conflict, disasters, and overarching food instability. By early June, IOM figures showed more than 310,000 Afghans crossed the border from Iran this year – including a record 150,000 people in March – as Afghanistan’s western neighbour faced one of the world’s largest coronavirus outbreaks. While high return numbers have been common in recent years, those now leaving Iran have far greater humanitarian needs, the IOM says. Nearly all recent returnees need some form of post-arrival help, compared to roughly one in five before the pandemic. (19 March, updated 11 June)

Along the Pakistan border, a surge of more than 70,000 stranded Afghans returning home overwhelmed coronavirus screening measures in April, according to the UN. Aid groups also feared some new returnees might end up in quarantine camps proposed by local governments, which could help the virus spread. The IOM said it is worried about “future uncontrolled waves of returnees”. Many Afghan returnees end up displaced and in need of aid, adding to the country’s many crises. (9 April, updated 16 April)

A UN staff member tested positive for COVID-19, the UN mission in Afghanistan announced on 3 April. Rising infections among humanitarian staff also began affecting services by June. (9 April, updated 11 June)

Facing a financial crunch during the pandemic, Oxfam announced its programmes in Afghanistan would be closed – one of 18 countries where the NGO is closing its country offices. (21 May)

Rohingya boats: Coronavirus propels Bangladesh’s divisive island camp plans as crisis at sea continues

In early June, Malaysian authorities allowed a boat carrying 269 Rohingya to land after earlier insisting it would push back boat arrivals during the coronavirus pandemic. A migration crisis has unfolded on the Bay of Bengal, with several boats carrying Rohingya refugees becoming stranded. In April, some 400 malnourished Rohingya arrived in Bangladesh by boat; those on board said at least two dozen people had died, while survivors had spent weeks at sea after being turned away by Malaysia. Malaysia’s air force said it pushed back a boat carrying 200 people on 16 April, citing coronavirus border closures. On 13 May, Indonesian authorities reported that boats carrying roughly 500 Rohingya were spotted off the coast of Aceh.

Bangladesh’s government earlier announced plans to turn away future arrivals, but instead has taken boat arrivals – many of whom departed from the camps earlier this year – to Bhasan Char, a disaster-prone silt island. Refugees on the island report limited healthcare and food, Human Rights Watch said. Some have alleged they were beaten for using their phones or leaving their shelters. Bangladesh moved about 300 people to the island after they were rescued from ships stranded for weeks. Rohingya refugees have previously refused to relocate to Bhasan Char despite pressure from the government. Aid agencies and rights groups are drawing parallels to the 2015 Andaman Sea crisis, when thousands of migrants and refugees were stranded. (23 April, updated 11 June)

Bangladesh: COVID-19 complicates aid in depleted camps

Government-imposed coronavirus restrictions threaten critical services in Bangladesh’s refugee camps, Human Rights Watch said. There have been “drastic” reductions and humanitarian staff access has been scaled back by 80 percent, which could hinder swift health responses and affect essential services like food and water, the group said. Refugees in four camps told HRW that food rations hadn’t been replenished and drinking water supplies were running low. The government earlier asked aid groups not to bring in new staff, and to limit travel between the camps and the nearby town of Cox’s Bazar, several aid workers told TNH. MSF said a third of its foreign staff meant to be deployed are stuck outside the country. (30 April)

Bangladesh’s Rohingya camps recorded their first coronavirus cases on 14 May, and their first death – an elderly man – on 2 June. Weeks of preparation are being put to the test as aid responders dive into uncharted territory: containing and treating a pandemic in a refugee camp. Refugees and aid groups fear it will be difficult to contain an outbreak in the packed settlements home to roughly 900,000 people. Extremely limited hospital isolation and treatment beds also complicate response efforts.

The “massive and rapid reduction” in aid staff and volunteers in the camps has prompted confusion among some refugees who worry they are being “abandoned” or that services might end, according to a summary of focus group discussions. In late March, Bangladeshi authorities ordered the suspension of relief work apart from essential services like health, nutrition, and food distribution. Makeshift schools have been shut, and authorities have urged Rohingya refugees to stay home. The restrictions were seen as necessary, but the costs are mounting: education NGOs were set to begin a long-awaited formal schooling programme using the Myanmar curriculum. UNICEF said the restrictions will “cripple” other basic services and ramp up the risk of other diseases. Case work for severe acute malnutrition has been constrained by limits on aid workers entering the camps, while groups working on sanitation and hygiene say they’re dipping into their regular budgets to respond to COVID-19. At the same time, fear of contamination and movement restrictions within the camps have kept people from accessing health facilities, where consultations have dropped by half since mid-March. (26 March, updated 28 May)

Humanitarian groups were already reporting an increase in gender-based violence and child marriage as services shrink and movement restrictions escalate. “During this emergency situation, gender issues have been often deprioritised or not seen as life-saving,” the groups said in a statement urging changes and greater consultation with women and girls. (16 April)

“During this emergency situation, gender issues have been often deprioritised or not seen as life-saving.”

Although not in the direct path of Cyclone Amphan, which hit parts of coastal India and Bangladesh on 20 May, the Rohingya camps saw heavy rain and winds that flooded parts of the settlements and caused displacement. At least 60 shelters were destroyed, the UN said. With aid stripped back due to coronavirus restrictions, humanitarian groups are warning that the looming monsoon season could be particularly dangerous. Relocations from high-risk areas have been delayed, and site development work, like clearing drainage and emergency shelter repairs, has been suspended or reduced due to government-ordered coronavirus lockdowns. “There could be life-threatening consequences if annual monsoon preparations cannot be completed on time,” UNHCR said. The camps’ aging tent homes are fragile at the best of times, and floods and storms are a frequent threat. Heavy rains will also increase the risk of diseases like cholera. The monsoon season in Bangladesh typically gets underway by June, while cyclone risks tend to peak in May and November. (23 April, updated 21 May)

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 has 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 move slowly at the best of times – can be shifted to help local responders already doing much of the work. At least two humanitarian staff working on the Rohingya response have tested positive for the coronavirus in Cox’s Bazar, according to the EU’s aid arm, ECHO. (19 March)


Myanmar: Military’s ceasefire doesn’t include its most heated conflict

Myanmar’s military announced a nationwide ceasefire until 31 August, though it has a gapingly large caveat: it doesn’t cover the country’s newest and most heated conflict with the Arakan Army in parts of Rakhine and Chin states. The Tatmadaw, as the army is known, said the ceasefire is aimed at containing COVID-19 “and restoring eternal peace”, but areas held by “terrorist groups” – the government has declared the Arakan Army to be terrorists – aren’t covered. The International Crisis Group called the move “more of a political gesture than a meaningful attempt to halt conflict”, given that fighting elsewhere in the country has been relatively limited in recent weeks. (21 May)

Despite widespread demands for a ceasefire, the conflict in parts of Rakhine and Chin states continues to threaten food supply lines. WFP trucks transporting emergency food supplies came under gunfire in Chin on 2 May, according to OCHA. On 20 April, a WHO driver was killed while transporting coronavirus samples from Rakhine. The government blamed the April attack on fighters with the rebel Arakan Army, which denied involvement. There were no confirmed coronavirus cases in displacement sites as of 1 June, the UN said, though there have been at least two infections in Rakhine. (23 April, updated 4 June)

Roughly 80,000 migrant workers have returned to Myanmar from China and Thailand and other countries, adding to humanitarian needs in a country with multiple ongoing conflicts and a weak health system. The coronavirus has disrupted services across the board in Myanmar’s conflict areas, which are home to some 350,000 displaced people and many more with limited aid access. For example, prevention and outreach services for gender-based violence have been suspended in Rakhine, Karen, and northern Shan states, according to OCHA, along with all education programmes and most shelter projects in conflict areas. Some schools have also been taken over for use as quarantine and isolation centres, which could make it harder for classes to resume (and have a lasting impact on children learning in places that might be used to treat coronavirus illnesses or deaths), aid groups say. (23 April, updated 28 May)

Thailand: Inadequate testing in increasingly aid-dependent border camps

Coronavirus restrictions are making some 90,000 refugees along the Thailand-Myanmar border increasingly dependent on long-term assistance, aid groups say. Refugees from Myanmar have lived in a series of Thai camps for years, though numbers – and funding – have fallen over the last decade as donor focus shifted to Myanmar. There were no reported COVID-19 cases in nine official camps as of 22 May, but screening and reporting vary, and there are no testing or referral options in at least four camps home to more than a third of the refugees, according to UNHCR. The Border Consortium, a coalition of international groups, said curbs on movement in or out of the camps have eroded already limited chances to earn money, leaving most entirely dependent on aid. Refugees in the border camps have been stuck in limbo for years: resettlement numbers have dwindled and refugees have felt pressured to return home, but conflict continues to flare in parts of Myanmar. (28 May)

Malaysia: Rising xenophobia drives fear and uncertainty for refugees and migrants

Refugees and asylum seekers in Malaysia say they’re facing an increasingly critical situation as arrests and xenophobia escalate. In recent weeks, authorities in the Southeast Asian nation have scaled up immigration raids, as well as arrests for alleged violations of nationwide coronavirus containment measures. UNHCR and refugee groups say unregistered asylum seekers are likely among those newly detained in overcrowded immigration detention centres, where case clusters have emerged. The UN agency hasn’t had access to Malaysia’s detention centres since August 2019. Much of the burden for finding and helping refugees and asylum seekers falls to refugee-led community groups, but they also face new pressure and at least one has suspended its services. Already pushed to the margins with few legal protections, refugees and asylum seekers describe a new climate of fear, confronted by job losses and dwindling food supplies, the threat of arrest or deportation, and the virus itself. “Anyone can be arrested when going out the door,” a refugee organiser told TNH. (28 May)

Pakistan: Missed immunisations drive new disease fears

Weeks of missed immunisations could drive new outbreaks of preventable diseases, according to doctors in Pakistan. Routine immunisations have been at a standstill since late March, when the government imposed coronavirus lockdown measures that shuttered schools and public transport. Overwhelmed with COVID-19 patients, many public and private hospitals also closed the out-patient departments where newborns and mothers would normally receive immunisations. Fear of contracting the coronavirus, as well as transit shutdowns, also continue to keep many parents away. “The government has diverted all its resources and staff to tackle the coronavirus,” said one doctor, who warned there were already early signs of a rise in measles cases. The government says out-patient departments and immunisation clinics started to re-open as lockdown measures partially eased beginning 9 May, but several doctors told TNH many facilities were still closed. Human Rights Watch said closures are worsening “an already grim situation” for women and girls in particular. In early May, for example, the government shut a maternity ward in the capital, Islamabad, and a gynaecology unit in Peshawar, near the Afghan border, according to local media. (14 May, updated 21 May)

“The government has diverted all its resources and staff to tackle the coronavirus.”

Muslim Aid said social distancing and partial lockdowns have forced the UK-based charity to suspend latrine-building and hygiene programmes for children. The programmes had operated in areas prone to drought and floods. Coronavirus movement restrictions have also forced the closure of several sites that treat children suffering from severe acute malnourishment, according to UNICEF. (9 April, updated 16 April)

Long distrustful of NGOs but facing a growing outbreak, Pakistan’s government in late March eased restrictions on aid groups working on coronavirus responses. It temporarily waived obligations for international NGOs to obtain so-called “no-objection certificates” for coronavirus-related projects as long as the organisation has already been approved by the government. Pakistan has pushed some INGOs out of the country in recent years, and layered onerous requirements onto those that remain – forcing some to scale back programmes. (2 April)

In March, UNHCR 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: COVID-19 complicates storm evacuations

Coronavirus lockdowns complicated evacuation and response efforts ahead of Tropical Cyclone Vongfong (known as “Ambo” in the Philippines), which bounded across the main island of Luzon as well as Eastern Samar Province in seven separate landfalls beginning 14 May. The storm damaged or destroyed nearly 20,000 homes and caused about $30 million in agricultural destruction, according to government figures. Some 180,000 people were evacuated, but this was slowed by coronavirus lockdown measures that kept evacuation centres only half-filled. The storm also damaged Bicol Region’s only COVID-19 testing facility, OCHA reported, and damaged or destroyed two thirds of isolation beds in Eastern Samar. (21 May)

Access has been an early constraint as COVID-19 cases rise nationwide. 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. Movement restrictions and safety precautions are also delaying measles vaccinations and other humanitarian programmes. Hundreds of health centres and clinics are reporting reduced or interrupted tuberculosis services and uncertainty over how long TB medicine supplies will last. The Philippines has extended community quarantines in the capital, Manila, and other high-risk areas, but Save the Children Philippines called on local communities to resume suspended health and nutrition services for children and newborns, including immunisations. Oxfam Pilipinas says the coronavirus response must better include reproductive health services. (19 March, updated 7 May)

The coronavirus has put yet another emergency on the Philippines’ radar. Over the last year, the country has been hit with multiple cyclones, earthquakes, a volcanic 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. 

There’s concern particularly in the southern region of Mindanao, where displacement has actually increased despite coronavirus lockdowns. More than 370,000 people are now displaced due to conflict or disasters, with at least 26,000 people uprooted in recent weeks mainly by clan feuding. Some 127,000 people are still displaced three years after the siege of Marawi, where clashes between insurgents and the Philippine army levelled parts of the city. Already minimal services for people in evacuation and transit sites, in particular, have been strained across the board by coronavirus quarantines, according to UNHCR. This includes access to water and hygiene, food, jobs, and even basic information. Local aid groups are trying to continue cash aid programmes, but staff have been 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. (19 March, updated 7 May)

A tentative ceasefire between a commnist rebel group and the Philippine army collapsed in late April, snuffing out an early bright spot amid the pandemic. The Communist Party of the Philippines announced a ceasefire on 24 March, but this expired on 30 April. The party said its armed wing, the New People’s Army, would resume “an offensive posture” while continuing a public health response in areas it controls. The government called the ceasefire’s end “the final nail in the coffin”. Clashes appeared to continue even during the truce, according to the Armed Conflict Location and Event Data Project (ACLED). Conflict involving the New People’s Army has killed an estimated 43,000 people over decades in parts of the Philippines. (26 March, updated 7 May)

North Korea: Cash roadblocks, food shortage fears, and an aid blind spot

Coronavirus containment is exacerbating food shortages and malnutrition, the UN’s special rapporteur for North Korea warned in June. North Korea was one of the first countries to close its borders as the coronavirus erupted in China in January, causing trade to plummet. 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 the restocking of supplies for the ongoing response to September’s Typhoon Lingling until at least May. Most banks have long been reluctant to transfer money into the country. (19 March, updated 11 June)

Iran: Protests flare as economy stumbles

New waves of protests have been reported in Iran. There are multiple causes, including unpaid wages during coronavirus lockdowns. Iran was an early coronavirus epicentre – the first cases in several neighbouring countries were linked to Iran – and new daily cases were escalateding again as lockdowns eased inin late May. Economic grievances drove large-scale protests last year. Parts of the country are already facing heavy flooding and a locust infestation projected to destabilise food security for a third of the population. (4 June)

Cyclone Amphan: Powerful storm tests pandemic containment and recovery

Mass evacuations saved countless lives as Cyclone Amphan struck parts of coastal India and Bangladesh with wind speeds reaching roughly 140 kilometres per hour on 20 May. However, as with recent storms on the Bay of Bengal, there was extensive damage (totalling at least $130 million in Bangladesh) despite a relatively low death toll. Bangladesh’s government and aid agencies have launched a response plan calling for $25 million to help some 700,000 people. Bangladesh ordered the evacuation of some two million people ahead of Amphan in an operation complicated by coronavirus distancing measures. (21 May, updated 4 June)

Cyclone Harold: Lockdowns and quarantines hold back help

Coronavirus restrictions and strict quarantines slowed aid and equipment deployment in Vanuatu following April’s Cyclone Harold, which swept through four Pacific Island nations. In Vanuatu, one of the worst-hit countries, only 20 percent of households in need had received shelter assistance more than a month after the storm hit, aid groups reported. Some 600 people were still displaced in Fiji as of mid-May. Vanuatu is not allowing foreigners to enter, according to UNICEF, and humanitarian cargo goes through days-long protocols before offloading. A shortage of COVID-19 testing is making it difficult to relax restrictions. Cyclone Harold caused widespread damage in Vanuatu’s northern islands. The government set up local distribution hubs, but one doctor in hard-hit Sanma province told Radio New Zealand there was a desperate need for medical personnel. Even restrictions thousands of kilometres away impacted aid: the Vanuatu Business Resilience Council, which connects local private sector groups with disaster responses, said lockdowns in Australia and New Zealand have slowed relief imports. (23 April, updated 21 May)

South Asia: Malnutrition warnings across the region

Essential health and nutrition services are falling by the wayside as coronavirus lockdowns continue across South Asia, UNICEF warns. Access rates for acute malnutrition, immunisations, and safe deliveries are plunging across the region, according to recent assessments. In Afghanistan, in-patient admissions for children with severe acute malnutrition have dropped by a third, and tens of thousands fewer women in Bangladesh are going to health facilities for safe deliveries, for example. Coronavirus containment measures in Sri Lanka’s Eastern Province are also forcing children suffering from severe acute malnutrition to miss treatment programmes. Services have been maintained elsewhere on the island, but most health and nutrition programmes have been affected in some way, UNICEF said in April. (16 April, updated 7 May) 

Indonesia: Papua immunisation programmes continue

Immunisation programmes have been scaled back but are continuing “on a smaller scale” in parts of Papua province in Indonesia, according to the WHO. Papua and neighbouring West Papua provinces have some of the region’s worst health outcomes, and rights groups accuse Indonesian authorities of neglecting Papuans’ basic health rights (in addition to broader violations in campaigns to quash pro-independence movements). In 2018, a case of polio – the first in Indonesia since 2006 – emerged in Papua, while a measles outbreak killed roughly 100 children. (30 April)


Mediterranean: Migrants rescued at sea held on ferries in Malta

Malta held 425 asylum seekers and migrants on tourist ferries just outside its territorial waters in a showdown with other European countries over migration during the coronavirus pandemic, the Times of Malta reported on 28 May. The people on the ferries were rescued at sea after fleeing Libya during several operations by the Armed Forces of Malta over the previous three weeks. The Maltese government did not say whether it was implementing any public health measures, such as quarantining or testing, drawing criticism from human rights groups. At the beginning of May, the Maltese government vetoed funding and withdrew support for the EU’s recently launched naval mission tasked with enforcing an arms blockade on Libya over disagreements with other European countries on migration. The Maltese government says the island nation does not have the capacity to host any more asylum seekers, and that it has been abandoned by other European countries to shoulder the burden of hosting asylum seekers and migrants departing from Libya alone. (28 May)

Early on in the coronavirus pandemic Malta and Italy closed their ports to people rescued at sea. War is still raging in Libya, and NGO search-and-rescue operations have been curtailed, but migrants are still attempting dangerous trips on small boats across the central Mediterranean. Hundreds reportedly became stranded over Easter weekend. After a week adrift, one boat was eventually rescued by a commercial Maltese vessel but not before 12 of the more than 60 people originally on board – Eritrean and Sudanese nationals – had drowned. Evidence has emerged that the Maltese government is employing private vessels to intercept boats and return migrants to Libya. In what rights activists described as an illegal pushback orchestrated by the Maltese authorities, 63 survivors on one of the Easter weekend boats were returned to Tripoli, forced to wait 12 hours before disembarking, and were then taken to a detention centre. The Libyan capital has seen intense fighting in recent weeks between those allied to the internationally recognised government and eastern forces led by general Khalifa Haftar. Reuters reported that 280 migrants brought back to Tripoli by the Libyan Coast Guard earlier in April had to wait overnight before disembarking due to shelling, raising further concerns about returns. “We have no clarity as to the procedures that are followed or will be followed from now on,” the IOM’s Libya office told Reuters in an email. (16 April, updated 28 May)

The Alan Kurdi, a search-and-rescue ship run by Sea-Eye, a German humanitarian organisation, rescued 146 stranded migrants in waters off the Libyan coast on 6 April but was unable to find a safe place to dock, having been rejected by Italy and Malta. On 20 April, the migrants, along with 34 more rescued by another vessel, began a 14-day quarantine on a ferry moored off the Sicilian capital, Palermo. This quarantine ended on 4 May and there are reportedly plans to transfer most of the migrants to other European countries, although no relocation deal has yet been announced. The Italian government confirmed on 15 April that all migrants rescued would have to undergo similar maritime quarantines before being allowed onto Italian soil. A Tunisian man reportedly drowned on 20 May after throwing himself off one a quarantine ship off Porto Empedocle in southwestern Sicily. The Alan Kurdi had been the only migrant rescue boat on patrol in the central Mediterranean – the most frequented migration route from Libya to Italy, where at least 16,000 people have drowned since 2014. On 5 May, the Italian Coast Guard impounded the Alan Kurdi, citing “irregularities” after inspecting the vessel. Two other NGO ships, Sea-Watch 3 and Ocean Viking, had their operations suspended in March due to logistical difficulties caused by the coronavirus. Miriam Edding, a volunteer with Alarm Phone, an emergency hotline that supports rescue efforts in the Mediterranean, told TNH a deadly rescue gap had been created. “What we are seeing now is a really dangerous escalation of tendencies we have seen before,” she said. “We are in a special situation, but I don’t know of any law that says if you have a pandemic you’re allowed to let people die in the sea.” (19 March, updated 21 May)

“We are in a special situation, but I don’t know of any law that says if you have a pandemic you’re allowed to let people die in the sea.”

Greece: First asylum seekers test positive for COVID-19 on Lesvos

Greek authorities confirmed on 12 May that two asylum seekers had tested positive for the coronavirus on the Aegean island of Lesvos, where aid agencies have long warned that the overcrowded and unsanitary Moria detention centre is a ticking time-bomb for a major COVID-19 outbreak. The asymptomatic patients reportedly had no contact with migrants at Moria – which has so far remained coronavirus-free – and were staying at a separate quarantine facility for new sea arrivals from Turkey under a scheme started on the island on 1 March. COVID-19 has ratcheted up tensions on the islands between the local population and the mostly Afghan, Iraqi, and Syrian residents of Moria, effectively Europe’s largest refugee camp. The two asylum seekers were among 70 to arrive from Turkey in two boats, on 6 May and 10 May – the first arrivals to the island in more than a month. Designed to host 3,000 asylum seekers, Moria now holds more than 18,000, spilling out into makeshift tent camps in the surrounding olive groves. The implementation of a controversial EU-Turkey deal, signed in March 2016 to curb migration, requires tens of thousands of asylum seekers and migrants to be contained on Lesvos and a few other small Aegean islands while their claims are processed, which can take years. (14 May)

Italy: ‘Right to stay’ plan for migrant workers approved

Plans to give tens of thousands of illegal migrants in Italy permits to stay and work were finally approved after weeks of political jockeying. The measure was supposed to pass in April as part of a 55 billion euro ($59 billion dollar) emergency bill, but the Five Star Movement, a member of the ruling coalition, came out against the amnesty. Ministers in favour of the proposals praise the efforts of migrants to care for the elderly and produce food supplies during the pandemic. They also argue that the migrants will be needed to work the fields and keep food on the table as Italy emerges from the crisis in the autumn, and that giving them access to public healthcare will help contain the virus. Up to 560,000 migrants live without papers in Italy, but only those working as labourers or carers will be eligible. Under the plan, each will get a renewable six-month permit. (7 May, updated 14 May)

Bosnia and Herzegovina: Stranded migrants hard to help

Aid agencies are warning that strict COVID-19 prevention measures are hampering assistance to many of the 8,000 migrants and refugees stranded in the country as they try to get into the EU. A field study by CARE International in Tuzla, in northern Bosnia, showed that three quarters didn’t have sufficient access to water and were living in unsanitary and unhygienic conditions. Those unwilling to risk the squalid conditions in overcrowded camps fend for themselves on the street, and CARE said it was struggling to reach them with assistance due to the coronavirus restrictions. In late April, the government started relocating hundreds of migrants from an improvised tent camp in the northwestern town of Bihac to an emergency tent facility nearby where they can have more space and better services during the coronavirus lockdown. Local authorities reportedly cut off the water supply to Vučjak camp on 20 April to put pressure on the government and NGOs to speed up the process. As other routes through the Balkans have closed off in recent years, Bosnia has become one of the main arteries for those trying to reach wealthier countries in northern and western Europe, via EU member Croatia. (23 April, updated 14 May)

Portugal: Government grants temporary residency rights for migrants

In late March, the government of EU member state Portugal took the highly unusual step of granting full citizenship rights to migrants and asylum seekers until at least 1 July, due to the coronavirus outbreak. In addition to access to the national health service, all those who can provide evidence of an ongoing residency request will receive welfare benefits, bank accounts, and work and rental contracts. (2 April)

Middle East

Occupied Palestinian Territories: ‘Dramatic’ rise in calls for help among women facing violence

UNFPA reports a “dramatic increase” in calls for help from women facing gender-based violence in Gaza and the West Bank during lockdowns and restrictions on movement. Most counselling services and “safe spaces” for women have had to shut down due to COVID-19, but the UN agency says nine organisations that provide services for GBV in Gaza and more than 15 in the West Bank have switched to remote operations, setting up hotlines and online chat groups. “Organisations are racing to adapt to these new circumstances,” a UNFPA statement said, “often without adequate funding”. (4 June)

Both the West Bank and Gaza have registered cases of COVID-19, raising concerns about the potential for quick spread – particularly in the latter territory, where many of the 1.9 million population live in densely populated refugee camps and urban areas

There have been quarantines and curfews in both areas, with many workplaces shut. Schools and other social services are closed, although this may begin to change as the West Bank eases restrictions following a decline in new cases. Early on in the outbreak, the UN said lockdown measures, coupled with overcrowding and uncertainty, “are expected to increase mental and psychosocial distress, particularly among children, as well as gender-based violence”. A May OCHA report said that cash assistance to women and girls with disabilities, usually provided by the Ministry of Social Development, has been interrupted, “reportedly without any follow-up on their needs” during the outbreak. (26 March, updated 28 May)

COVID-19 has led the UN’s agency for Palestine refugees, UNRWA, to adjust the way it distributes food aid in Gaza. Between the end of March and 23 April, the agency said 73,000 families received food parcels that were delivered to their homes, rather than asking people to pick them up at distribution centres. UNRWA is also now sending medication to patients with diabetes or who are older than 70, and has set up health and telemedicine hotlines to compensate for a drop in patients at primary health centres. While such centres have reduced their services in favour of telemedicine, UNRWA in Gaza says it is now re-opening for some patients, including those who need antenatal checks. (2 April, updated 21 May)

Libya: Vaccine shortages put a quarter million children at risk

The WHO and UNICEF say that access to routine immunisation services across Libya has been disrupted since mid-March due to coronavirus lockdowns, putting more than 250,000 children at “severe risk” of preventable diseases. Orders of vaccine stocks have been delayed because of lengthy government approval processes, and there are already acute shortages of some vaccines, including the oral polio vaccine and the hexavalent vaccine, which protects against diphtheria, tetanus, pertussis, poliomyelitis, haemophilus influenzae type b, and viral hepatitis. (4 June)

Aid groups say ongoing clashes – as well as curfews, requirements for special permits, and other coronavirus-related travel restrictions – are hampering access and movement for aid and medical workers. On 12 May, OCHA said it had begun a temporary “deconfliction” mechanism to help avoid delays and risks, which will see UN agencies and international NGOs notify the competing centres of power of their movements. The Tripoli-based, internationally recognised Government of National Authority (GNA) and forces loyal to the Khalifa Haftar-led Libyan National Army have been fighting for control of Libya for over a year. The WHO says the work of 80-90 percent of primary healthcare centres across the country has been impacted in some way by COVID-19, with many closing altogether. (9 April, updated 14 May)

Authorities in Libya’s internationally recognised government announced the country’s first confirmed coronavirus case on 24 March. Repeated calls for a ceasefire and a “humanitarian pause” to combat the threat of COVID-19 failed to take hold. It was first declared mid-March and ostensibly welcomed by both the recognised government and Haftar’s eastern forces.

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 nearly 400,000 internally displaced people that is struggling under the weight of more than a year of fighting. (26 March, updated 21 May)

Yemen: UN cuts back foreign staff

Fighting has escalated on key front lines in Yemen, despite the Saudi Arabia-led coalition’s announcement of a unilateral ceasefire, made in part to “confront the corona pandemic and prevent it from spreading”. The ceasefire was announced 8 April and extended for a month on 24 April. Houthi rebels called the move a “political and media manoeuvre”, and negotiations over terms have so far been unsuccessful. On 26 April, the separatist Southern Transitional Council declared “self-rule” in south Yemen, including the port city of Aden, and fighting has since broken out in some parts of the south between the STC and forces loyal to the government of President Abd Rabbu Mansour Hadi. (9 April, updated 21 May)

Five years of war have left 24 million people – 80 percent of the population – in need of aid. Reduced funding for aid projects (including a reduction from USAID on grounds of corruption) is impacting relief operations, including food and healthcare, according to the UN. The first case of COVID-19 in Yemen was reported on 10 April, and since then numbers and deaths have continued to rise, especially in Aden. But reports suggest that both the Houthis and rival authorities in the south are suppressing the true numbers, and it is possible many more infected Yemenis are going untested and unreported.

The UN has pulled out over half its remaining international staff from Yemen’s capital to protect them from the spread of COVID-19, according to several UN sources. This brings the number of foreign UN staff in the capital to about 60, down from 158. The UN still has some expatriate staff in Aden, and the majority of UN staffers in Yemen are Yemeni nationals. (21 May)

A ban on flights in and out of Yemen had already meant the UN has scaled back to essential staff only and stopped already limited medical evacuations for chronically ill civilians. In addition, a key reform that has been demanded by the WFP 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. Lockdown and curfew rules vary across the country. (26 March, updated 21 May)

NGOs and aid agencies are also shifting how they deliver aid. ACTED, for example, said it had upped the number of days it gives out food vouchers in the northern province of Sa’adah to avoid creating crowds, and asked people to stick to a schedule it had set for distribution. UNHCR says it has increased the number of payment points for people who receive cash assistance, and added hand-washing stations at larger branches. (2 April, 23 April)

Syria: Border crossings in flux

In mid-March, Turkey stopped allowing patients in need of medical treatment to cross into the country from Syria’s northwest, part of a coronavirus-related border closure. This has left hundreds of people with complex conditions like cancer struggling to find medical help. (21 May)

After Turkish authorities in northern Iraq temporarily closed the border with northeast Syria to NGOs, the main crossing they use has been re-opened one day a week and for emergencies. OCHA says that while supplies are entering once a week, “the volume has decreased and delays are noted.” In yet another challenge to aid in the Kurdish-controlled region, UN agencies have been told to stop funding medical operations carried out by private NGOs that cross the Iraq-Syria border. (16 April, updated 21 May)

After nine years of war, 11 million people are estimated to need aid inside Syria, including nearly a million people who fled the recent government campaign in the rebel-held northwest (an estimated 854,000 of whom have not returned home) and many more who were already displaced. There are now curfews, lockdowns, and in some parts of the country a ban on travel between provinces. 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. In the northwest, many schools had been shuttered before the pandemic, either because of insecurity or because they were being used as emergency shelter. The “most pronounced impact” is said to be in education, programmes that provide psychosocial support, and protection initiatives, which all generally require people to gather. UNFPA says the majority of mobile teams that provided support for gender-based violence are no longer able to move, but it is trying to adapt by providing some remote services and setting up WhatsApp groups for women and girls who are no longer able to access safe spaces. (26 March, updated 28 May)

OCHA and the WHO have said quarantine requirements and movement restrictions are disrupting aid workers’ ability to deploy in Syria, especially internationals who may be unable to enter the country at all. They added that limits on travel, particularly between urban and rural areas, have impacted aid workers’ ability to reach communities in remote parts of the Syria. (30 April, updated 7 May)

Lebanon: Lockdown spurs refugee healthcare worries, child protection concerns

Aid groups say Lebanon’s restrictions on movement and business, combined with a months-long economic crisis, have impacted their ability to deliver aid to the estimated 1.5 million Syrian refugees in the country and others who need help. Schools were shut, along with school meals, and almost all “non-essential” programming was put on hold, including “non-formal education” and many protection programmes, such as those related to children and sexual and gender-based violence. (26 March, updated 28 May) 

According to a survey conducted by Plan International, 83 percent of women and girls said they were not accessing sexual and reproductive health services because they feared COVID-19 transmission. Thirty-five percent of all Lebanese and Syrian adolescent girls said they could not get menstrual pads, and 69 percent of those were Syrian refugees. Even more girls – 66 percent – said they could not purchase pads. (7 May)

Human Rights Watch said on 11 May that people with disabilities were having trouble accessing medication and medical care because of restrictions on movement, and that some people who need ventilators for conditions not related to COVID-19 were struggling to find them. In addition, the watchdog said those schools that had set up distance learning had not accommodated the needs of children with disabilities. (14 May)

With the police and army helping to enforce the lockdown, there is ongoing concern that Syrian refugees are also not seeking help when they need it, including regular healthcare services beyond the coronavirus. Aid groups also fear refugees won’t look for treatment if they develop symptoms, especially given many municipalities have put in place restrictions specific to the Syrian population, including on the hours of the day refugees are allowed to visit a supermarket or pharmacy. In at least one municipality, refugees have been told they are barred from leaving their homes. UNRWA says its health centres for Palestine refugees in Lebanon are offering only “critical services” to reduce crowds. (9 April, updated 21 May)

Instability in Lebanon’s banks due to both the country’s economic crash and COVID-19 is having an impact across the aid sector. NGO sources told TNH the country’s economic crash had made it difficult to buy medical supplies, including personal protective equipment (PPE), even before the pandemic. Banks have closed some ATMs, limited their opening hours, and introduced new charges, making it harder for refugees to access cash aid. This has also made it harder for NGOs to send that aid, as well as pay suppliers and their employees. In addition, some Palestinian refugees who turned up to receive one-time cash aid distributions from UNRWA found that transfer offices did not have enough money on hand. (26 March, updated 28 May)

Jordan: Clinic access cut off for refugees in border encampment

Jordan, which registered its first COVID-19 case on 28 March, has closed its land, sea, and air borders, but eased one of the world’s strictest lockdowns in late April in an effort to begin re-opening the economy. Some movement restrictions remain.

The border closure has led to people at Rukban – an encampment in a desert no man’s land between Syria and Jordan – being cut off from medical care at a UN-funded clinic located inside Jordan. It is not known exactly how many people remain at Rukban after a series of returns to government-held parts of Syria, but recent estimates put the population at around 12,000 (down from 70,000). Aid is infrequent, and conditions are often described as “desperate”. Jordan hosts more than 656,000 Syrian refugees: 81 percent live in urban areas like the capital, Amman, and the rest mostly live in official camps. (9 April, updated 28 May)

Despite the fact that some movement restrictions have been lifted, many refugees who live outside camps say aid has still not reached them and the eased conditions have not brought significant relief to make up for the income they have already lost. An assessment on the impact of COVID-19 on women and girls in Jordan says that gender-based violence has increased since the start of the pandemic, and it has become more difficult to access help because of closures. Some women said they had been using new virtual services for GBV and sexual and reproductive help, but adolescent girls (10-17) were more likely to use the technology than older age groups. (9 April, updated 21 May)

Iraq: Concerns about future cash aid

NGOs say restrictions on movement are hampering their ability to deliver aid for the COVID-19 response and other programmes. Lockdowns and movement restrictions differ between Iraq and the northern Kurdish region (where restrictions have been eased) and rules also vary between provinces.

UNHCR and its local partners are going door to door, or tent to tent, to distribute cash and hygiene kits to refugees and displaced people in Iraq’s camps. But aid groups are still struggling to reach people in need, in part due to COVID-19 related rules, especially on movement. They are having problems accessing displacement camps, and a 26 April OCHA update warned that “thousands of highly vulnerable” displaced people in camps, as well as returnees, may soon not be able to get planned cash or in-kind assistance due to store closures, problems using financial service providers, or the inability of aid workers to get to the camps. An OCHA report published at the end of April said “humanitarian access significantly deteriorated in Iraq” in the first quarter of 2020. Among the aid programmes currently on hold are cash-for-work schemes, vocational training, and “asset replacement” activities, which help people start over after losing their income sources to conflict. (2 April, updated 21 May)

Some 1.4 million people are still displaced in Iraq because of the so-called Islamic State. Even before COVID-19 restrictions, the continuing fight against the group – along with new government rules on how access permissions are given out – meant aid organisations have for months had trouble reaching the displaced and others who need help across the country. (19 March, updated 16 April)

Western Sahara: Aid and travel on hold in Sahrawi camps

With COVID-19 cases confirmed in Algeria’s Tindouf province, all aid activities have been suspended other than basic services and food distribution, and travel between the five camps that house Sahrawi refugees has been banned. This has led to concerns about food security as day labour and taxi driving – some of the few available sources of income in the camps – are on hold.

Although counts vary, it is estimated that more than 170,000 Sahrawi refugees live in camps in Tindouf – part of a territory claimed by both the Algeria-backed Polisario Front and Morocco. For decades, most people in the camps have depended heavily on international aid for their basic needs. (14 May)


Haiti: Hurricane season doubles threats as outbreak surges

A peak in the spread of COVID-19 in Haiti may coincide with this year’s hurricane season, authorities warn. The country’s meteorological agency is projecting between three and six major hurricanes to develop during the season, which typically lasts from June through November. Haiti’s prime minister, Joseph Jouthe, said the hurricane season will be “active and difficult”. Shelters normally used during disasters are currently being employed to quarantine people with COVID-19, regional media reported. (4 June)

Days after a Haitian government panel asked the United States to suspend deportation flights until the coronavirus pandemic was over, a flight chartered by US Immigration and Customs Enforcement arrived in Port-au-Prince with 50 passengers, including 14 with criminal backgrounds, on 11 May. This was half the original passenger list, which had included five people who tested positive for COVID-19 and later removed, according to the Miami Herald. Only 111 beds in four hotels are available in Haiti to quarantine people suspected of being infected with the virus, the newspaper reported.

While confirmed cases of COVID-19 were relatively low in Haiti, Carissa Etienne, director of the Pan American Health Organisation (PAHO), warned that a large-scale outbreak could lead to civil unrest. “There is a real risk that growing food insecurity will result in famine,” the public health chief said on 5 May. Etienne said the supply of essential health and sanitary equipment has been complicated by political instability, describing the situation as “a perfect storm approaching”. (7 May, updated 14 May)

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 rocked the government 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 suffered a cataclysmic earthquake in 2010 that flattened the capital and nearby Léogâne, claiming between 160,000 and 300,000 lives. Some doctors and nurses have reportedly refused to show up for work at hospitals because of a lack of equipment and infection fears. A 2019 study by the Research and Education Consortium for Acute Care in Haiti, a Haitian-led group of doctors and nurses, found an “insufficient” level of critical healthcare services. For a population of 11 million, the country has only 124 ICU beds and perhaps as few as 20 working ventilators. (26 March, updated 16 April)

Latin America and the Caribbean: the new coronavirus epicentre  

Lockdown measures in Latin America and the Caribbean could create a food crisis driving hunger among nearly 14 million people, the WFP said. The number of people facing “severe food insecurity” could quadruple in 2020 compared with last year. Countries in Latin America and the Caribbean emerged as new epicentres for the pandemic by early June. Michael Ryan, the WHO’s emergencies director, said that Central and South American countries have become “intense zones of transmission”, with the steepest rises in confirmed cases in Brazil, Colombia, Chile, Peru, Mexico, Haiti, Argentina, and Bolivia. “I don’t believe that we have reached the peak in that transmission. And at this point, I cannot predict when we will,” Ryan said. (4 June)

Venezuela/Colombia: Migrants set up camp on outskirts of Bogotá

Venezuelan migrants continue to suffer under the coronavirus lockdown in Colombia, which has now been extended in Bogotá until the end of June. It was due to end on 1 June. This has pushed desperate Venezuelans over the edge and many are now unable to pay for accommodation or make ends meet, migrants have told TNH reporters in recent weeks. At the beginning of June, a group of around 500 began to camp out near a highway in the north of Bogotá. They have fabricated tents from sheets of plastic taken from bins and stuck together with adhesive tape (the shelters can be viewed in this video). One group of about 300, who have no money, are looking to the Colombian government for transport to the Venezuelan border; another of 200, who have money for bus fare, are waiting for migration authorities to authorise travel – restricted due to the lockdown – to Cúcuta, a main border city between Colombia and Venezuela. Hundreds more migrants are expected to arrive at the camp in the coming days. (4 June)

Having lost their sources of income and unable to pay rent following coronavirus lockdowns, thousands of Venezuelan migrants have already returned home. With public transport in Colombia shut down, many made their way back on foot. The border has been closed since 14 March. However, a humanitarian corridor is in operation, allowing around 200 to pass through each day. Many others use dangerous informal crossings dotted along the 2,200-kilometre border. UNHCR told TNH on 21 April that “conditions in Venezuela cannot allow for large-scale dignified returns”. (23 April, updated 4 June)

A 26 May report by Human Rights Watch and Johns Hopkins University researchers said Venezuela’s health system was “grossly unprepared” for the COVID-19 pandemic, which may “contribute to the regional spread of the illness”. The report’s authors recommended that countries press Venezuela to allow for a full-scale UN-led humanitarian response. Donors pledged nearly $2.8 billion to support Venezuelan migrants during a joint EU-IOM-UNHCR virtual conference on 26 May, including $653 million in grants. The funding is aimed at helping some of an estimated five million Venezuelan refugees and migrants – particularly hard-hit by the pandemic – as well as host countries. Recently, the United States pledged some $138 million in humanitarian assistance to Venezuelans, including to people in Venezuela itself. (28 May)

While Venezuela has reported relatively few coronavirus cases, a study by the country’s Academy of Physical, Mathematical, and Natural Sciences argued that infections have been under-reported by at least 63 percent. It stated that only one lab has been designated by the government to process COVID-19 tests despite the availability of other laboratories. (21 May)

Venezuelan leader Nicolás Maduro is under increasing pressure due to the collapse in global oil prices, as the country’s crippled economy relies heavily on oil revenues. On 26 March, the Trump administration, which recognises opposition leader Juan Guaidó as Venezuela’s rightful leader, charged Maduro and other senior officials with “narco-terrorism”, before offering to lift sanctions if he agreed to step aside and let a transitional council govern until fresh elections. (2 April, updated 7 May)

In Venezuela, the returnees are reportedly being quarantined in towns near the border in unsanitary conditions. On 14 April, A UNHCR spokesperson told TNH that the Venezuelan government has asked the UN system to help with the returns, but added that the agency currently did not have access to border areas where migrants are arriving. Meanwhile, Human Rights Watch called on the US government to grant temporary protection to Venezuelans who may otherwise be deported from the country, due to the “increased risk COVID-19 poses in Venezuela”. The earlier closure of the border with Colombia spurred concerns over how Venezuelans who had relied on buying medical supplies in the neighbouring country will fare, as well as fears that those who need to cross will rely on unofficial and dangerous routes. The 1.8 million Venezuelan migrants who live in Colombia are not covered by the financial aid packages being rolled out to Colombian citizens and have lost income as well as services like soup kitchens and shelters. (19 March, updated 14 May)

Nicaragua: Medical associations, but not the government, call for national quarantines

Medical associations in Nicaragua called on the population to voluntarily quarantine for at least three to four weeks to contain the spread of the coronavirus, in contrast to the government’s refusal to enact any measures, the Associated Press reported. “The exponential increase of COVID-19 cases has caused the collapse of the public and private health systems,” an open letter by nearly three dozen organisations said. (4 June)

A week after PAHO said Nicaragua had breached its requirement to report COVID-19 cases and deaths, the government of the Central American country on 26 May finally reported 480 new infections and 18 deaths for a total of 759 cases and 35 fatalities. Citizen Observatory, a Nicaraguan NGO, said the real number as of 20 May was 2,300 infections and 400 deaths. Ciro Ugarte, PAHO’s emergencies director, said community transmission was happening in the country, and that while PAHO experts were eager to carry out a full evaluation of available health services and Nicaragua’s epidemiological situation, Managua has so far not accepted the assistance offer. (21 May, updated 4 June)

The government had confirmed only a small number of cases – 25 infections and eight deaths by 20 May – raising suspicions the country’s coronavirus toll was far higher. Families in Nicaragua had reported quick burials of their loved ones under armed guard. The country’s vice president and first lady, Rosario Murillo, denied the pandemic is spreading, and instead accused the media of “creating false realities”. The World Bank recently described Nicaragua as one of the region’s poorest countries, where the pandemic is expected to stop any progress achieved in poverty reduction. (21 May)

South America: Displaced indigenous communities ‘dangerously exposed’

As COVID-19 deaths continue to rise in Brazil and other South American countries, Shabia Mantoo, a UNHCR spokesperson, said on 19 May that displaced indigenous communities are now “dangerously exposed”. In Brazil and Colombia, several thousand indigenous people who fled Venezuela are “threatened by physical and cultural extinction” due to malnutrition (which may increase the risk of infection), inadequate health services, and loss of livelihoods. Nearly 5,000 Warao, Eñapa, Kariña, Pemon, and Ye’kwana community members are in Brazil’s hardest-hit Amazon region. Members of other ethnic groups, such as the Wayuu, Bari, Yukpa, Inga, Sikwani, and Amorúa, whose lands straddle the Venezuela-Colombia border, are undocumented in Colombia and face threats from armed militias. In several Amazon countries, including Peru, church groups have stepped in to fill gaps in the response. (21 May, updated 4 June)

Meanwhile, COICA, the largest indigenous group in the Amazon region, appealed to the UN on 19 May, requesting urgent humanitarian assistance to protect the health and rights of their people, whom they said are at the “edge of genocide”. The Catholic Pan-Amazonian Church Network has tallied more than 174,000 COVID-19 cases and more than 7,800 deaths in the Amazon region as of 1 June. This number includes cases among non-indigenous people. Addressing the threat, Etienne, PAHO’s director, said indigenous communities will face a disproportionate impact if “immediate action” is not taken. For more, read this recent TNH story on the growing fears for indingeous groups. (21 May, updated 4 June)

Brazil: Government enlists Cuban doctors

Facing one of the world’s largest burdens of coronavirus cases, Brazil’s government has rehired Cuban doctors to help fight the virus’ spread. More than 150 physicians who had remained in the country after Havana cancelled an assistance programme following the inauguration of right-wing President Jair Bolsonaro received new licenses to practice. The programme, known as Mais Medicos (More Doctors), was launched in 2013 and involved more than 8,000 doctors sent to underserved health facilities around the country. The Institute for Health Metrics and Evaluation at the University of Washington is projecting nearly 90,000 deaths in Brazil by August; there had been roughly 18,000 as of 20 May. Meanwhile, the Brazilian health ministry loosened restrictions for the use of chloroquine, the anti-malaria drug, to treat COVID-19 in spite of the WHO position that there is “insufficient data” that it would be effective. Two health ministers resigned over the past month in part due to their disagreements with Bolsonaro over chloroquine. (21 May)

In Brazil, the state of Amazonas has seen some of the country’s highest infection rates, which are a risk to indigenous communities in particular. On 5 May, Arthur Virgilio, the mayor of the region’s capital, Manaus, asked world leaders for help in fighting COVID-19, saying hospitals there are on the brink of collapse. At the same time, the country’s leader, President Jair Bolsonaro, continues to encourage Brazilians to ignore social isolation, while downplaying the severity of the disease. Before becoming the second Brazilian health minister to resign within a month, Nelson Teich, said lockdowns may be required in several cities. Coronavirus cases continue to soar, hitting 190,000 on 14 May. A study by Brazilian health researchers based on official statistics reported that coronavirus infections may be up to 15 times higher than the official count. The study estimated the real number of infections at somewhere between 1.6 and 2 million. (7 May, updated 21 May)

Read more → How Brazil’s COVID-19 response has fallen to community leaders


US-Mexico: US plans to extend coronavirus asylum restrictions

The United States plans to seal its borders to asylum requests indefinitely, intending to extend restrictions meant to contain the coronavirus pandemic, The New York Times reported. Rights groups say the US has effectively shut its borders to those seeking safety. Since 23 March, the country has allowed only two refugees who entered via the US-Mexico border to stay, the Independent reported, citing unpublished immigration statistics. Meanwhile, migrant shelters on the US side of the border were beginning to empty, according to the Arizona Republic. Shelter directors attribute the fall in numbers to coronavirus social distancing rules in the shelters, and many families choosing to return home or not travel. Since late March, US authorities have turned away some 20,000 migrants from the US-Mexico border. Another 60,000 Latin American asylum seekers had already been turned back under an earlier policy, known as "Remain in Mexico", which means that asylum seekers can no longer stay in the US while their claims are adjudicated. Those asylum hearings and processes have also now been suspended indefinitely due to the coronavirus. (14 May) 

US coronavirus-related immigration rules force migrants caught illegally crossing the border to be processed and deported rather than questioned on US soil. Over a two-week period from late March to early April, nearly 400 migrant children intercepted at the US-Mexico border were swiftly deported by US authorities, Reuters reported. Some 120 of the minors were sent back to Guatemala, Honduras, and El Salvador; it was unknown whether the remainder were returned to Mexico or sent back to their home countries. (9 April)

On the other side of the border, Mexico has nearly emptied its government-run migrant shelters by deporting people – mainly back to Guatemala, Honduras, and El Salvador – according to official data published 25 April. Only 106 people remained out of 3,759 held in shelters at the end of March, according to data from the National Migration Institute (INM), the government department that oversees migration. The INM said the move to release migrants was aimed at following coronavirus health and safety measures. None of the remaining migrants have tested positive for COVID-19, the INM statement said. Even as deportations rise, however, asylum seekers continue to seek safety in Mexico itself. UNHCR said on 28 April that asylum requests in Mexico increased 33 percent during the first three months of 2020 compared to the same period last year. Mexico is now considered a destination country by many in the region fleeing violence and poverty, a spokesperson for the refugee agency said. (30 April)

While government facilities are emptied, Mexican shelters run by NGOs and volunteer groups continue to host migrants. However, many of these shelters along Mexico’s northern border have also closed their doors to newly deported migrants, citing an inability to maintain adequate hygiene and social distancing, according to the Mexican news site Animal Politico. Fifteen migrants in a shelter in the border city of Nuevo Laredo tested positive for COVID-19, Mexican authorities reported in mid-April. The cases are believed to be linked to a shelter resident previously deported from Texas. (23 April)

Guatemala: US accused of ‘exporting’ COVID-19 through deportation flights

Health officials in Guatemala said nearly all the deportees on a 14 April US deportation flight tested positive for COVID-19. On 11 May, Erick Muñoz, the vice-minister for health, said 71 of the 76 passengers were infected, a sharp rise from the original number reported. After an 18-day pause, flights transporting deported migrants from the United States to Guatemala resumed on 4 May. These were suspended again mid-month before resuming in June. (7 May, updated 11 June)

A study by the Centre for Economic Policy and Research, a Washington-based think tank, reported that 40 confirmed COVID-19 cases in detainees deported from the United States to Guatemala originated at an Immigration and Customs Enforcement (ICE) detention facility in Alexandria, Louisiana. The facility is run by a private prison company called GEO Group, the report said. Between February and April, at least 230 deportation flights – like those out of Alexandria – effectively exported the coronavirus virus to 11 Latin American countries, the study reported. (30 April, updated 7 May)

On 19 April, Guatemalan President Alejandro Giammattei said 50 migrants deported by the United States in March and April had tested positive for COVID-19, including 14 on a single flight from Texas. At the time, Guatemala had fewer than 300 total coronavirus cases, including the 50 deportees, Reuters reported. Guatemala’s health minister has blamed deportations for increasing the country’s COVID-19 caseload. The deportations are part of a deal reached between the two governments in 2019 that made aid to the Central American country conditional on continued deportations. (16 April, updated 23 April)

Mexico: Criminal groups distributing aid packages 

Mexican President Andrés Manuel López Obrador on 20 April asked drug cartels to stop distributing food packages in regions they control and to instead put an end to violence that last year contributed to a national total of more than 34,500 homicides. In Matamoros, on the border with the United States, a criminal group called Cartel del Golfo was photographed handing out food parcels to local families affected by coronavirus-related lockdowns. Elsewhere, the daughters of imprisoned drug lord Joaquín Guzmán handed out food and toilet paper to the elderly, The Guardian reported. (23 April) 


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