MSF: Spread of COVID-19 cases in South Sudan Protection of Civilians sites could be catastrophic

MSF hospital inside Bentiu Protection of Civilians (PoC) site.
South Sudan 2020 © Gabriele François Casini/MSF
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The first cases of COVID-19 have recently been confirmed in two of the Protection of Civilians (PoC) displacement camps in South Sudan—one in Juba and the other in Bentiu, where the patient is being treated in a Doctors Without Borders/Médecins Sans Frontières (MSF) hospital.

The country—where the number of people testing positive for COVID-19 has jumped from six to more than 200 in the last two weeks—hosts nearly 1.5 million internally displaced people, with an estimated 188,000 of them living in PoCs. PoC sites formed on existing United Nations (UN) bases in late 2013 in response to a massive displacement crisis during intense periods of conflict to shelter vulnerable people fleeing violence. MSF currently works in two PoCs, Bentiu and Malakal.

South Sudan has one of the most fragile health systems in the world, and an estimated 7.5 million people are in need of humanitarian aid and rely heavily on international organizations. Since the COVID-19 pandemic was declared, MSF has been working with the South Sudanese authorities to strengthen infection prevention and control measures and train healthcare workers on how to screen patients and work safely. Teams have also been reaching out to communities to share advice on how to prevent the spread of COVID-19.

Vulnerable groups, especially immunosuppressed patients and communities living in precarious conditions like congested PoC sites and refugee camps with limited access to healthcare and water and sanitation, are of particular concern. In those settings, the epidemic is likely to spread very quickly and disproportionately affect a population that is already at a higher risk of communicable diseases.

MSF’s Head of Mission in South Sudan, Claudio Miglietta, said the following about the recent cases confirmed in PoC sites:

“This sharp increase in COVID-19 patients is very worrying. What is even more concerning is that now COVID-19 has started spreading among the population of some of the largest and most congested displaced persons camps in the country.

“Tens of thousands of people living in the Protection of Civilians sites in South Sudan, such as Bentiu or Malakal, face a precarious existence in an overcrowded environment, living in dire conditions with flimsy small shelters where up to 12 family members live together, and with poor access to water and soap. Maintaining physical distance and adequate hygiene levels in these settings is nearly impossible.

“If we add the fact that many people—not only in the camps but around the country in general—are at a higher risk not only due to poor living conditions, but also potentially due to co-morbidities such as malnutrition, respiratory tract infections, malaria, tuberculosis, and HIV, it is easy to see how the spread of COVID-19 could have catastrophic consequences in South Sudan.

“The pandemic is having a significant impact on our ability to provide key lifesaving services. Other diseases, as well as conflict and violence, have not been put on hold because of COVID-19. Malaria, measles, pneumonia, and acute watery diarrhea still kill tens of thousands of people, chronic patients continue to need medication, war wounded need surgery, and mothers are still delivering babies every day.

“Just now, a resurgence of violence around Yei, in the south of the country, has caused the displacement of around 12,000 people. With active transmission of COVID-19 in the area, addressing their needs while keeping our staff safe with the global shortage of surgical masks and other personal protective equipment, becomes very challenging. We fear this kind of situation will become more and more common as the virus spreads across the country.”