Urban areas in Zimbabwe are the most at risk to the virus in southern Africa, Dr. Ndumiso Tshuma, a public health specialist from Zimbabwe now working in Johannesburg, told The Africa Report.

Zimbabwe is struggling and health infrastructure is in a “dilapidated state”, he says. Information needs to be dissimilated to prevent the spread of the Coronavirus disease, but this requires electricity which is often lacking.

The country has three confirmed cases of coronavirus and one death. The best hope lies with civil society and community-based organisations who are able to provide clear and actionable information to the grassroots. “They are the foot soldiers.”

Tshuma, who advises health organisations on capacity building, worked for 10 years in the health sector in Zimbabwe, before worsening conditions prompted him to leave in 2017.

- People won’t want to go back to Zimbabwe for confinement periods, Tshuma says, as they need basic resources.

- Lack of roads in Zimbabwe may also hamper transmission to rural areas, he says – the virus can’t move without people to transport it.

South Africa is more advanced, he says, but is at risk because of its huge regular influx of visitors. “At least South Africa has access to information.”

The country has done its “very best” to reduce transmission, he says. But the widespread existence of compromised immunity systems due to HIV means that much remains to be done.

Consistent Messages

Health systems in Africa “won’t be fully prepared,” says Katie Waller, director of strategic partnerships at global health organization Concern. Many African countries have an acute shortage of health workers, she says, with Sierra Leone being an example.

- “Equipment will be a problem across most countries. Prevention is key.”

Waller has worked with Concern in Sierra Leone, where she was dealing with Ebola, as well as in Kenya, Somalia and Malawi.

- Correcting false information during Ebola was a key challenge, she says.

- It’s important to understand that hoarding masks will not prevent you from getting sick, she says.

- “The Ebola experience will be useful as it taught the importance of prevention.”

Countries with strong community health systems are best placed in terms of ability to get messages out.

These include Kenya, Ethiopia and Rwanda, with Sierra Leone and Liberia being more recent additions to the list, she says.
The countries facing the greatest dangers, she says, are fragile states that have recently experienced conflict and have large displaced populations. Coronavirus “could push them over the edge.”
A shared response by governments, the United Nations, NGOs and civil society will be crucial to maximise resources, she says. “Co-ordination is key.”
“People need to communicate clear messages” which are consistent and concise, she says. “Governments, NGOs and religious leaders must be saying the same thing.” This will help to overcome a lack of trust from many Africans in their public health systems, she says.

During the Ebola outbreak, Waller says, hand-washing stations were highly visible across Sierra Leone, often dispensing a low-cost bleach and water mix.

Such stations, she says, need to spring up everywhere. The training and protection of health workers has to take top priority. “They are the number one resource.”

Bottom Line: Civil society will be in the front line of the fight against coronavirus in Africa’s weakest states.