Can South Sudan Afford a Total Lockdown at this Phase of the COVID-19 Pandemic?

By Jur Chol Dhuol, Juba, South Sudan

Tuesday, June 02, 2020 (PW) — With the current pandemic, South Sudan like any other countries in the world had been beginning the year 2020 as a new decade that promise to be one of dreadful disruption in the world where South Sudan like other African countries is holding the weakest end of the stick in coping with the pandemic. This year, a global health pandemic that has caused the global economic crisis and certain it into synchronized recession (if not depression) was triggered by the second largest economy, China.

Unlike before, multilateralism and global coordination framework are at their weakest. National (local) self-defence is the rule. As before, the rich world with its generous welfare system and huge financial war chest, is taking care of itself (the US alone has US$2.2 trillion stimulus package). Covid-19 caught the world totally unprepared, and with no proven and available medical response (South Sudan included).

Ad-hoc cocktails and learning-by-doing constitute the strategic package. In most western countries, the cocktail of response has included a coterie of defensive measures including: border closure; prepare isolation centres and mobilize medical personnel/facilities; implement “STAY AT HOME” orders or lockdowns except for food, medicine and essential services; campaign for basic hygiene and social distancing; arrange welfare packages for the vulnerable; and also economic stimulus packages to mitigate the effects on the macro economy.

Many African countries have largely copied the above template, to varying degrees. An extension of “stay at home” or lockdown orders as in many western countries have also been copied in South Sudan. But the question is: Can South Really Afford A Total Lockdown? and Can It Be Effective? Put differently, given the social and economic circumstances of Africa and the impending ‘economic pandemic’, can South Sudan too successfully and sustainably defeat Covid-19 by copying the conventional trial-and-error template of the western nations?

In confusion and desperation, the world seemed to be throwing any and everything the pandemic. Recall President Trump’s assertion that hydroxychloroquine “might help”? The evidence so far (from limited sample) is that it might probably actually worsens the disease. The trial has left huge human toll and economic ruins, and there is still no solution.

Total Lockdown in South Sudan may make the population suffer from hunger given no strategy in place authorities is unaffordable and could potentially worsen the pandemic in this country. YES, Covid-19 won’t be the end of disruptions or health pandemics even in this decade: this is an opportunity to think outside the box—to engender greater self-confidence in our capacity to think through our problems, with authentic sustainable solutions. 

First, monitoring the spread requires effective testing, and South Sudan cannot afford effective testing of its approximate 12 million people. Check out the number of testing centres and facilities in other African countries relative to their populations. A joke in the social media narrated that the health minister of Burundi was asked to explain the miracle in his country whereby the number of infections was reported as zero.

His response was: “it is simple: we don’t have any testing kits”. Besides, there is stigma associated with the infection, and on the average Africans only go to the hospital as the last resort (Meaning no voluntary testing. There are also asymptomatic cases, and only the critically ill ones will report. So, there will always be massive under-testing, and gross under reporting.

Furthermore, Since we cannot sustain lockdowns indefinitely or even until the spread stops/declines, it means that we would sooner or later remove the restrictions. What happens then? There would still be infections, which can still spread anyway. Why not then adopt sustainable solutions early enough without weeks of avoidable waste and hardship? Let us think this through!

Next, South Sudan cannot pay for lockdowns. Many countries depend on budget support from bilateral and multilateral donors, and with acute balance of payments problems. Most are now begging for debt relief and applying for urgent loans from the IMF and the World Bank. In our country, both the governments and the people are begging for “Funding from the charity organizations”.

In the western societies from where we copied the lockdown/border closure, their citizens are literally paid to stay at home (by silently dropping monies into their accounts plus other incentives). Check out the trillions of dollars, Euros, and pounds in support to the vulnerable and stimulus packages.

Despite these, check out the restiveness/protests in several of these countries and the unrelenting pressure to eliminate the restrictions (even in countries where thousands are dying each day due to Covid-19 like Italy and US). Given the fact that our government cannot pay for lockdowns, over six million South Sudanese are left to survive if they can or perish if they must.

Without government support, no more than 20% of South Sudan 12 million people can possibly survive any prolonged lockdown on their own finances. Most of the others have no assets or savings to live on for any prolonged period of two to three weeks or more period, and there is no social insurance (welfare system).

Most of our population are living from hand to mouth on daily basis

In most cases, the order may simply create opportunities for extortion by security agencies: those who pay, move about! Attempts to force everyone into lockdown for extended period may indeed be enforcing a hunger/stress hence, inducing mass genocide. More people could, consequently, be dying out of hunger and other diseases than the actual Covid-19.

In normal times, thousands die every day in due to other illnesses and communicable diseases like cholera, malaria, lassa fever, lower respiratory infections, diarrhoeal diseases, tuberculosis, heart diseases, stroke, HIV/AIDS, yellow fever, zika virus, measles, hepatitis, typhoid, small pox, Rift valley fever, monkeypox, chikungunya virus, pregnancy and child-birth related deaths, renal failure; pneumonia, etc.

Total Lockdowns may worsen these as many of the victims of the proposed order now have little or no cash to attend to themselves. Soon the pharmacy shops will run out of imported drugs. Even local pharmaceutical manufacturing firms need imported inputs but cannot efficiently source them under lockdowns/border closure. Soon local, adulterated ones may fill the gap.

A summary point is that the millions of persons in the street, who are struggling between life and death each day with numerous other challenges do not, and will never, understand why so much additional hardship is being foisted upon them because of the novel coronavirus. For most of them (wrongly though), it is an elite problem since for them, the “hunger/other disease virus is more dangerous than corona virus”.

The hungry and desperate millions may be forced to take desperate actions to survive, and little surprise that crime has spike in several parts of the community with lockdowns.

What Should South Sudan Do?

1. We should think and act locally and opportunistically to survive and prosper, and exploit the global opportunities offered by the crises. Every shock or pandemic presents opportunities. Solutions need to be multidimensional, far beyond economics and western medicine. Welcome to the decade of rapid creative destruction!

2.  Governments should lead in the mobilization, education, and possibly equipment of the people to take personal responsibility for their safety; and the government should do its utmost best in providing public healthcare. Those with pre-existing conditions might receive special treatment. The president of Madagascar is reported to have announced that his country has found its own cure for Covid-19 and has ordered schools also to reopen. 

3. Our model should be learning-by-doing while mainstreaming basic common-sense tips such as: mandatory wearing of masks in public, basic hygiene, disinfection of all open markets every early morning and all places of public gatherings, practical social distancing tips

4. Provision of hand washing facilities in public places, production and use of hand sanitizers, gloves, etc. For example, all public transport vehicles—taxi, buses, trains, airplanes might require disinfection of the vehicle before use, and for all passengers to wear masks and with hand sanitizers. Can you imagine the thousands of jobs to be created in producing facemasks, hand sanitizers, gloves, etc for our people? But this cannot happen under a lockdown.

New opportunities! Everyone wants to live, and South Sudanese will learn and adapt quickly. Staying at home will become a choice, not a compulsion. The slogan could be: “stay at home if you can, or smartly go to work if you must”. We can only defeat the challenge by confronting it, and not by playing the Ostrich only to still confront it the day after.

The writer, Jur Chol Dhuol, is a 3rd year Medical student at the university of Juba and can be reached via email: johnjur95@gmail.com.

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