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Updated Mar 25, 2020

Zimbabwean lawyer and humanitarian Karsten Noko, whose work takes him all over sub-Saharan Africa, has written an opinion piece for Al Jazeera on why World Health Organization (WHO) guidelines to prevent the spread of the COVID-19 virus are particularly difficult to uphold for many of Africa’s poorest inhabitants. Starting with borders, Noko ponders the futility of South Africa’s plan to build a forty-kilometer fence on its border with Zimbabwe, because there are thousands of “irregular crossing points” or areas where Africans can easily cross the border to reach family or their place of employment. Such irregular crossings explain how the 2014 Ebola outbreak that began in Guinea was able to spread to neighboring Sierra Leone and Liberia so quickly.

Noko also finds the provisions for social distancing and self-quarantine to be nearly impossible to maintain for most sub-Saharan Africans. Far too many depend on the informal market to make a basic living. Whether it’s selling meager produce or artisanal items, many people do not have the means or ability to afford the risk of transitioning to an online marketplace. Traveling to physical markets puts one in close proximity with potential infected patients, if one hasn’t contracted the virus already on crowded public transit. Faced with the choice of their families starving or getting infected, few would choose the former option.

Finally, there is the reality that infrastructure is patchy across sub-Saharan Africa. This then leads to difficulties accessing water, which is essential for prevention measures such as regular hand-washing.


Why It Matters

Noko is demonstrating that guidelines established by the WHO to manage COVID-19 may be applicable in Europe and North America, but it does not consider how many of their recommendations can only be instituted by people who have the privilege to miss work and still keep their homes, or who have running water without fear of shutoff or discontinued service. This isn’t to say the guidelines are useless, but that health organizations will have to take into account the living conditions of numerous sub-Saharan Africans to draw up more effective protocols that will achieve the same effect: slowing the tide of infected patients to prevent the pandemic from overwhelming Africa’s healthcare systems.

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