A Coronavirus Refugee Crisis Looms in Nigeria
WHY YOU SHOULD CARE
Nigeria, Africa’s most populous nation, is home to millions of refugees and displaced people — all of whom are extremely vulnerable to coronavirus.
As countries around the world begin to impose travel restrictions and lockdowns to slow the spread of the coronavirus pandemic, grave concerns are springing up about the fate of some of the most vulnerable, especially refugees and internally displaced people (IDPs). Nowhere is that concern more urgent than Nigeria, where officials are working to head off a calamity in the making.
As of Wednesday night, there were still fewer than 600 confirmed cases across the continent, but approximately a dozen African countries have begun to close their borders. The European Union, now the epicenter of the pandemic, has banned all nonessential travel for 30 days, while ISIS has advised its members not to travel to Europe.
But what will become of homeless people, refugees and IDPs, especially children and the elderly in camps?
They are incredibly vulnerable and there is literally nothing anyone can do once this hits.
Ayoade Alakija, former chief humanitarian coordinator, Emergency Coordination Center
More than 2.4 million people have been displaced by the decadelong Boko Haram insurgency and many live in informal settlements in host communities as well as in government-regulated camps across northeast Nigeria. There are also IDPs fleeing a kidnapping scourge and the pastoralist conflicts between herdsmen and farmers in the northwest and central regions. In addition, a lingering crisis over the past three years between separatist fighters in Cameroon’s two Anglophone regions and government security agencies has sent citizens scrambling into nearby Nigeria.
Nigeria is the poverty capital of the world, with 98 million people living in extreme poverty (on less than $1 a day). But it is also caring for close to 60,000 Cameroonian refugees in camps across southern Nigeria, according to figures from the United Nations Refugee Agency. These holding camps, mainly converted schools, churches and other government properties, are already barely able to handle the influx of refugees and IDPs.
The refugees live in squalid conditions, with some camps home to tens of thousands of people, making them susceptible to a coronavirus outbreak. In the town of Dikwa in Borno state, the epicenter of the Boko Haram insurgency, there are approximately 50,000 people. Worse still, there are concerns about the degree to which residents can self-quarantine and isolate themselves in camps lacking electricity or potable water, and medical facilities are already stretched thin. While the rest of the world scrambles to stockpile goods and medical supplies, the primary focus in the camps has been food and shelter.
“They are incredibly vulnerable and there is literally nothing anyone can do once this hits,” says Dr. Ayoade Alakija, Nigeria’s former chief humanitarian coordinator for the Emergency Coordination Center who has a degree in epidemiology and infectious diseases. “There are very limited medical facilities in [northeastern Nigeria] and certainly no intensive care facilities of piped oxygen … [but] the greatest problem is the large number of humanitarian workers floating in and out of Maiduguri — from the U.S., EU, U.K., etc. Those for now are the most likely vectors and are highly mobile,” she explains.
So far, Nigeria has had only twelve confirmed coronavirus cases. Rounds of testing have been conducted at its airports, but Africa’s most populous country is notorious for its porous land and sea borders. Nigeria and Niger have not yet locked down their borders.
Alkasim Abdulkadir, spokesman for the National Commission for Refugees, Migrants, and Internally Displaced Persons, says both the federal Ministry of Health and the Nigeria Centre for Disease Control (NCDC) are working with organizations that are closer to the IDPs. “At the moment, in formal camps operated by the National Emergency Management Agency, there are arrangements being made to ensure temperature testing regularly … in addition to other testing that goes on regularly,” he says.
Abdulkadir adds that advocacy and awareness about frequently washing hands with soap and general personal hygiene are being introduced. Arrangements to supply masks to the camps are ongoing. “In the event of any large-scale outbreak, we will have support from ICRC [International Committee of the Red Cross] and [the] Nigerian Red Cross,” he says. “Nigeria has done a lot regarding detection via airlines, tracking index cases from countries of origin. If any country with land borders with Nigeria becomes a very bad case, we may have a lot more danger on our hands.”
The country scored a massive win with its 2014 containment of Ebola and has so far appeared to be competently managing the current crisis. The government formed a task force on Tuesday to support the NCDC’s work and marshal resources on a larger scale. But skeptics fear that the abysmal state of public health care in Nigeria may make it cumbersome to handle both coronavirus and an ongoing Lassa fever epidemic in parts of the country.
Emeka Oguanuo, a representative for the NCDC, said the agency is providing guidance to states and “we also advocate for state health authorities to take ownership, further raising awareness.” But the agency is clearly overworked, with Director-General Chikwe Ihekweazu tweeting about the crush of nonstop calls from across the country: “Please be patient with us and help us by pulling together.”
A lack of faith in the system might also complicate matters. Even the president, Muhammadu Buhari, took a three-month medical leave to London in 2017, one of more than five such trips to the United Kingdom since he was elected, in 2015.
There is also the sense that government agencies might be complacent and arrogant due to their success in overcoming Ebola, but this is not the time to rest on their oars, says Alakija. “The 1918 Spanish flu killed over 500,000 Nigerians at the time when population was approximately 15 million,” she warns. “So extrapolate for today. We need a greater sense of urgency.… We need pandemic preparedness.”