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Ibrahim El-Salahi Pain Relief at The Saatchi Gallery, London

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“ I don’t want to imagine what will happen in Sudan with all these challenges and difficulties to get people’s essential living needs – it would be a disaster if coronavirus took hold in Sudan”

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Neimat Issha, our Country Coordinator, Sudan 

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In title photograph and above, children from Jebel Aulia, Khartoum. With no electricity or running water, high levels of poverty-related disease and illiteracy, Jebel Aulia is desperately vulnerable to Covid-19.

Neimat writes:

“We started to make bread at home to avoid the crowds after my husband yesterday waited in the row for two hours and in the end he couldn’t get it because it had run out.

So, we decided not to purchase bread although it is cheaper than making it at home because we have to buy commercial flour.”

“The priority now is to keep ourselves safe and eat anything which will keep us away from any gathering… 

As case number 6 was confirmed this morning and the curfew now starts at 6.00pm instead of 8.00pm, it will mean that many people will not be able to get bread.”

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As of 27th March, there were 5 cases officially confirmed in Khartoum, two deaths and 85 suspected cases in Sudan according to Akram Elton Sudanese health minister, quoted in Radio Dabanga. It is, however, impossible to be sure of actual Covid-19 infection and death rates in Sudan. 

See update, 4th April here Sudan records first case of coronavirus infection through contact

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Sudanese Ministry of Health Corona prevention poster Stay at Home. Sudan’s Stay at Home containment approach faces profound challenges borne out of economic and cultural realities. See more in coming posts.

“Fragile and vulnerable at the best of times, African economies are staring at an abyss. Officials warn Africa is at “break the glass” moment

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This is a literacy post for Women’s Education Partnership.  See At a Glance  and Facts and Figures to learn more about our mission and impact.

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Stepping Back from the Abyss – Covid-19 in Sudan 

This is the first of five blogposts this month on the impact of Covid-19 in Sudan. This post will provide a brief overview of Sudan’s Covid-19 health context; Realities on the Ground 

Coming posts will focus on 2) Economic and Geopolitical Challlenges, 3) Sudan’s Response to the Pandemic and the Challenges of Applying Social Distancing, 4) Covid-19’s Impact on Women and 5) Our Covid-19 Awareness and Relief Programme

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Stepping Back from the Abyss  – Covid-19 in Sudan

Realities on the Ground    Economic and Geopolitical Challenges   Sudan’s Response to the Pandemic and The Challenges of Social Distancing  Covid-19’s Impact on Women  Our Awareness and Relief Programme 

“Africa imports 94% of its pharmaceuticals. At least 71 countries have banned or limited exports of certain supplies deemed essential to fight the disease”.  

At least 300,000 Africans expected to die in pandemic

Realities on the Ground 

Three weeks ago, on the eve of the country’s total lockdown,  Spanish Prime Minister, Pedro Sanchez, announced relief funds amounting to an eye-watering 25% of Spain’s GDP to tackle the economic and social aftermath of the Covid-19 pandemic as it threatened to overwhelm one of the most advanced health systems in Europe. My Spanish friends and I looked on in numb disbelief as the death toll soared and Spain turned to 3D printer volunteers to patch up ventilators for its collapsing intensive care units.

Now imagine Covid-19 hitting a country where 47% of the population live below the poverty line and where there are only seven doctors for every thousand inhabitants, 80-odd ventilators in total and where only forty of the country’s 200 critical care beds are in public hospitals. (Source: Coronavirus reaches Sudan) That is the reality in Sudan. While Spain battles to set up emergency field hospitals in the capital, Sudanese hospitals, blighted by decades of underinvestment, and the brain drain of qualified medical workers to the Gulf, face a daily struggle to operate amidst frequent power outages and the lack of the most basic sterilization equipment and medicines. The country’s health resources are concentrated in the capital. Health facilities in Sudan’s periphery are even more acutely vulnerable and under-resourced.  

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Civil society movements, so effective in mobilizing grassroots support for last year’s revolution, are marshaling their forces to fill the gap, providing voluntary medical and health support and awareness campaigns but their capacity will be quickly overwhelmed by a large-scale outbreak. 

See more on Sudan’s heath volunteers below:

“It’s like the Titanic not having enough rescue boats. If the country is hit, it will definitely sink.” 

Sudanese clinician quoted in Coronavirus reaches Sudan

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Coronavirus in Africa Tracker

Although Sudan’s population is young, it is also one suffering from high levels of malnutrition, the prevalence of chronic diseases such malaria and dysentry, and the lack of any form of economic and health safety net for the poor. All factors which mean an uncontrolled outbreak of Covid-19 would be brutal and deadly; Bill Gates is reported as estimating the death toll in Africa if the disease goes unchecked as a staggering ten million. 

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Children peering into our literacy circle at Jebel Aulia 

While The World Health Organization were urging governments to “test, test, test”, Spanish ministers were forced to apologize after procuring thousands of substandard testing kits, explaining they were having to contend with a ferociously competitive international market.  Now put that in the context of Sudan, where there is as yet little reliable mass testing or contact tracing, where both urban and rural poor can little afford or easily access testing and where lack of hard currency makes purchasing tests and other vital equipment painfully slow and prohibitively expensive. Although the government moved swiftly to seal  Sudan’s vast borders, they remain porous to those who have not been tested – smugglers, undocumented returnees from neighboring countries suffering rapidly rising infection rates such as Egypt, and refugees.

“We knew that thousands of people had returned from Egypt, and the majority of them haven’t been subjected to 14 days of isolation,” the doctor, who also requested anonymity, told MEE. “Two buses carrying more than 100 people coming from Egypt refused isolation and the police couldn’t stop them at Argeen border crossing.”

Confusion reigns hundreds escape quarantine

Isolation centers both on borders and in key towns, though swifty established,  lack basic equipment, monitoring systems and services for those quarantined. Radio Dabanga reported that Sudanese quarantined after entering Sudan from Egypt complained of water and food shortages and having no beds to sleep on. Some isolation centers appear to lack the consent and trust of those quarantined there, as reports of mass fleeing of quarantine centers and Khartoum hospitals would indicate. (See: Confusion reigns hundreds escape quarantine)  Isolation protocols, initially criticized for being based on voluntary compliance, have shifted to include force and compulsory detention, causing unrest, violence and mistrust, undermining both containment strategies dependent on consent and the credibility of Sudan’s fragile post-revolution democracy. 

Coronavirus: Sudanese returning from abroad have to undergo one-month self-quarantine,

“Tilal, a resident of the Kober neighbourhood near Universal Hospital, told MEE that he saw hundreds of people fighting with police that night as they attempted – and succeeded – to exit the hospital.” 

“There was huge chaos, people refused to stay in the isolation centre and even clashed with the police when they tried to prevent them from leaving,” 

Confusion reigns hundreds escape quarantine

The government, while being praised for acting “ahead of the curve in closing ports and airports and sealing land borders,  has been accused of missteps and inconsistencies in its Covid-19 containment policies, allowing substantial numbers of potentially infected people to go untraced.  The United Nations recently reported that 413 people returned to Sudan during a two-day exceptional re-opening of Khartoum airport, Port Sudan  and the Chad border.

Sudan is home to more than a million refugees, as well as vast numbers of internally displaced persons, living in crowded and often desperately unsanitary conditions and with only rudimentary access to water, health care and basic food supplies.   A Covid-19 outbreak in any of Sudan’s numerous camps would be devastating.  

See more on Covid-19 and the fears of refugees in Sudan in this short video:

“Years of conflict have impacted millions of people. Some 1.9 million people remain displaced and face protection risks and threats even as they attempt to rebuild their livelihoods or return to their homes. Disease outbreaks, malnutrition, food insecurity, and climatic shocks, continue to affect the lives and livelihoods of many Sudanese.” 

OCHA Sudan

The overview above makes for grim reading but all over Sudan, government agencies, NGOs, trade unions and civil society movements are actively working to initiate and coordinate Covid-19 prevention and containment programs.  The sense is there is still time.

We are working with Sudanese government health programs to deliver Covid-19 programs for the communities we serve – some of the poorest and most vulnerable  in Khartoum – in our women’s literacy work.  Read coming posts to learn more on our Covid-19 program.

Our focus is on women and women are especially vulnerable in this pandemic.

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“60% of the gross domestic product relies on the informal sector, and estimations indicate that women, who are simultaneously responsible of their nuclear and expanded families, make more than 80% of the informal labor in Sudan.

This means that if complementary measures are not taken, the implementation of social distancing would destroy the livelihoods of a large segment of the population of Sudan, particularly those living and working in urban slum communities and rural areas. (SIHA) 

 Do’s and Don’ts: Coronavirus response advice does not see the reality of women in Sudan

See coming posts for more on how containment measures will effect women in Sudan and how they can be mitigated 

This is a literacy post for Women’s Education Partnership.  See At a Glance  and Facts and Figures to learn more about our mission and impact.

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http://www.womenseducationpartnership.org

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