Friday, December 8, 2023

Hygiene-COVID-19 nexus

A few weeks ago, Africa seemed almost immune to the Novel Coronavirus that is challenging the world at a grand scale. It was the Egyptians who first reported the first coronavirus infected patient on the African soil.

Before the deadly virus was officially decalared a global pandemic by the World Health Organization (WHO), the government of Ethiopia was already talking about preparation and measures to combat the coronavirus or COVID-19 as it slowly advanced to Ethiopia.

In just about a week following the announcement of the first confirmed case on March 13, 2020, Lia Tadesse (MD), Minister of Health, in the middle of the night, has twitted that the number of COVID-19 cases have jumped from six to nine. Until now, an Australian, a British, two Ethiopians and five Japanese have been infected with an 82 years old Ethiopian being in a severe condition.    

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As part of a precautionary measure, hygiene and sanitation, social-distancing, staying away from social events and gatherings have been strongly recommended to fight the spread of the virus. To that effect, as of March 16, 2020, schools have been closed down and will remain on lock down for two weeks. Since then, more than 20 million preschool, primary and secondary school children are staying at home. Prime Minister Abiy Ahmed (PhD) has forbidden mass gatherings and large meetings as well. He requested essential meetings to be guided by the direct supervision of the Ministry of Health.

However, such warnings seemed to have fallen on deaf ears; and even among his Prosperity Party members who reportedly were in an intensive training over the week. To the bewilderment of many commentators, while the rest of the country, anxiously, watched the mounting number of new confirmed COVID-19 cases, thousands of Prosperity Party members didn’t mind to postpone their scheduled political meetings. On the other hand, staff of the Ministry of Foreign Affairs, one of the top tier ministries in the cabinet of PM Abiy, have also moved to defy these directives by conducting a field visits to the Unity Park, laying within the Palace of the Prime Minister, and later posed for a group picture.

“Safe hands,” a hand washing campaign launched by Tedros Adhanom (PhD), director general of WHO, as one of hygienic ways to help curb the infection, has been trending on social media for weeks. Prime Minister Abiy took on the challenge immediately and posted a video of group hand washing contributing to the fight against COVID-19.

This proactive response of the leadership was quickly acknowledged by many people who joined the movement. On the street, people have already began providing water and soap for any passersby to wash their hands. To that end, things appeared to be moving to the right direction. Simply, the scarcity and inaccessibility of clean water as much as needed together with the unavoidable public contacts could be hard to accept amid the alarming spreads of COVID-19.

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For one thing, water is rationed in many parts of Addis Ababa leaving the sustainability of the wash campaign under serious doubt. Statistically speaking, every six out of 10 people in Ethiopia that is almost 62 million people do not have access to clean water. More than 97 million or one in 10 people do not have access to “a decent toilet” facility leading to open defecation, compromising basic sanitation and hygienic requirements of the country. Despite some progresses, for years, as many as 60 percent of diseases in Ethiopia are attributable to poor sanitation; and the arrival of the coronavirus was like adding an insult to injury. 

Recent studies indicate that almost half of Ethiopians do not have access to hand washing facilities. According to Lifewater International, a California-based Non-profit organization operating in Ethiopia, 41 percent of households found out to be having no hand washing facilities, altogether. Perhaps, 51 percent who have some form of washing facilities, lack a reliable source of water or soap. The organization states that only eight percent of the population in Ethiopia have both “basic access” meaning they have access to water and soap, and “this makes maintaining a healthy hygiene and sanitation extremely difficult for most communities in Ethiopia”, Liftwater reports.

What is more, the average person’s per capita water consumption in Ethiopia indicates sharp contrast between rural and urban communities. As far as rural Ethiopia’s consumption is concerned it is equivalent to an ordinary Brit. In Britain, for instance, the average person might use 160 liters of clean water in every single day while in Ethiopia people might only have access to some 5 to 10 liters of water per day per person. How far that is true, well the above mentioned figures clearly point out how dire the situation is in Ethiopia.

While, sanitary and hygienic concerns are growing, a USD 6.5 billion nationwide water supply, sanitary and hygiene (One National WASH) project has been implemented since 2018; and concludes this year with a second phase slotted for the coming three years. However, the national water, sanitary and hygiene strategy, which was introduced in the early 2000, is still grappling with poor hygiene and sanitary conditions, even after 20 years.

Now when one zooms in on hygiene and sanitation, with the context of COVID-19, let alone countrywide scarcity and lack of access to clean water, the capital city for years has remained embattled with lack of proper access to clean water. In a 2018 article: “development of a generic domestic water security index, and its application in Addis Ababa, Ethiopia”, written for Asian Institute of Technology for School of Engineering and Technology of Thailand, Yonas T. Assefa and his colleagues presented how water availability is scare in the city.

“The water supply service only covers 55 percent of the city area, half of the population is served for less than 12 hours per day, and a quarter of the population have no formal service at all,” the article details. Addis is believed to be home to 25 percent of the urban population of Ethiopia and yet a growing water supply shortages and sometimes acute scarcity hits most part of its neighborhoods as the researchers have indicated.

With its expansion and rapid urbanizations, Yonas and colleagues argue that the lifestyle of residents of Addis is changing, every day. The construction of new condominiums, for instance, requires modern water and sanitary facilities, and creates a cumulative and swelling demand on the city’s water supply. Furthermore, the city is undertaking sums of expansive projects with increasing number of industries, buildings, offices, and hotels and other edifices taking shape adding pressure to the already handicapped water supply.

Reacting to the water supply needs amid the coronavirus crisis, the Addis Ababa Water and Sewerage Authority has stated that water production will take a 24 hours cycle and the distribution patterns will also be improved with the addition of more workforce to accommodate the new shift that will work until midnight. In times of water inaccessibility, even during ration hours, the utility is said to be planning to supply door to door with the help of 28 trucks assigned specifically for the task.

According to Zerihun Abate, general manager of the Addis Ababa Water and Sewerage Authority, densely populated areas with high mobility trends will have free access to water services for people in an effort to aid hand washing campaign. Since Thursday, in places such as Kaliti, Asko, Mercato, Zenebework, and Lamberet, the utility has started to provide free hand washing water. In fact, scores of responsible residents and businesses have initiated such undertakings earlier than the government. Yet, both have failed to have improved services.

Compared to what Rwanda has done in the streets of Kigali where, nicely created hand-washing tankers and hygiene facilities are set up, the effort undertaken in Addis has a long way to go. The washing appliances are not appealing and not only have they lacked creativity but the water is seen soaking the streets and perhaps could expose the city for other water related diseases.

 In addition to the lack of ample access to clean water, scarce supply of sanitary solutions such as alcohols, sanitizers, wipers and the like have forced people to stand in long queues. Many anxious people who have been worryingly waiting turns to buy these necessities at public drug stores seemed less concerned about the likelihood of coronavirus transmissions in such highly crammed conditions. The panics and worries of contracting COVID-19 have undermined the very basics of protections.

Lack of verified facts and widespread rumors have contributed largely to misconceptions and exacerbated panic. The new virus having no vaccine for treatment, most remedies, so far, seem to treat symptoms with timely medical care. Experts are suggesting that some 80 percent of the people who contracted COVID-19 have mild symptoms and with recoverable outcomes in two weeks. 

Amid more than 200,000 cases with growing fatalities, coronavirus is closing in on Africa, and the world health chief is warning the worst is yet to come. According to Tedros, Africa seemingly registering lower rates of infections but that he said should be taken as a wakeup call and sternly warned Africa should be prepared for the worst of the pandemic. “Africa should wake up. My continent should wake up,” Tedros said.

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Earlier before the first incident was officiated, Ethiopian officials have formed a ministerial committee for COVID-19 preparedness in an effort to reinforce communication and to convey effective and appropriate information to the public. A toll-free hotline service has been made available in order to alert and report suspected cases.

The ministerial committee urged the public to take all the necessary measures so as to contain the spread of possible cases. The committee also advised the public to increase sanitation practices, washing hands frequently and restraining avoidable touching, collaborate and alert public health officers on suspected cases.

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