Aid workers face new tests and challenges from the coronavirus

On the small Greek island of Lesvos (also known as Lesbos), 21,000 people are crowded into the Moria camp, which was originally designed for 3,000 refugees. With no electricity and no drinking water, it meets all the criteria for the site of a rapid outbreak of the new coronavirus, if it were to get into the camp. “What happened at the beginning of March was an absolute scandal, a disaster,” says Thomas van der Osten-Sacken, a German aid worker who came in a personal capacity in 2017 to help the Greek association, Stand By Me Lesvos. He saw the shortage of human resources when he arrived in Greece, and he has also seen the lack of political response to the attacks by the far-right in recent months against refugees, aid workers and journalists.

Each country had a different reaction at the start of the pandemic. But the case of Lesvos, which was at the heart of an international campaign under the hashtag #SOSMoria to “bring refugees to safety immediately”, illustrates the initial abandonment by the international community. More than ever, countries hit by the virus turned their backs on other problems in the world. So much so that Jens Laerke, spokesperson for the United Nations Office for the Coordination of Humanitarian Affairs, had to state in a speech on 20 March that “the world must continue to support the most vulnerable, in particular through plans for humanitarian intervention and aid to refugees”. This helped make things happen in Lesvos, somewhat. “The Greek government is supposed to start evacuating several at-risk migrants to the mainland or to hotels here on the island. It is a direct response to the coronavirus crisis and it is a welcome step,” says Osten-Sacken. However, it has also frozen all asylum requests since 1 March, and the condition of the accommodation to be provided are sub-standard.

Meanwhile, on the ground, all NGOs have had to redefine their logistics, one way or another.

Stand By Me Lesvos has joined existing refugee support groups created by pharmacists and engineers. “We print posters, and we travel around the camps with loud speakers to inform people about the virus,” explains Osten-Sacken. “We have also set up hand-washing stations, at least when they leave and re-enter the camp. We are also working together to solve the huge problem of dealing with the waste, and that problem is nearly behind us now.”

The association and the refugees have also tried to introduce social distancing measures. “But such advice is met with great cynicism when you are talking about overcrowded camps with appalling sanitation”. Although two refugees, new arrivals to Lesbos, tested positive for COVID-19 at the beginning of May, according to the authorities, they were not in contact with the other refugees in the camps, who are currently confined until May 21. “A few weeks ago we were bracing ourselves for a terrible disaster, but today we feel almost positive,” says Osten-Sacken.

Protecting teams: an essential condition for field work

The situation is very different in Yemen, where Doctors Without Borders (Médecins sans frontiers, or MSF) works. In this country plagued by war since 2015, a war that has left more than 100,000 dead according to the NGO ACLED, MSF set up road convoys between Dubai and Sana’a, the capital of Yemen, to supply its teams on the ground with medication and medical equipment. But, as elsewhere, the borders have now closed. “We are trying to set up an airlift to supply our Sana’a teams,” explains Caroline Seguin, MSF-France director of operations for the Middle East.

The priority is still to protect MSF teams on the ground. “We cannot treat anyone if we cannot look after ourselves,” she says.

The NGO is also experiencing the effects of the current global race for protective equipment and hasn’t been able to get any delivered. There is still the local market, but “prices have risen enormously,” says Seguin “and we don’t want to be a part of that. It becomes racketeering. We have a small amount of stock on site which will allow us to maintain our activities at least for a few weeks.”

It is the only way that MSF will be able to achieve its other objective: to maintain its existing, life-saving activities. In some countries, such as Jordan, MSF has stopped reconstructive surgeries, which are considered less urgent. Such operations do not take place in Yemen, where teams carry out “vital” interventions only.

In addition, just like many companies, some NGOs have started teleworking. This is the case for some of the teams from the French law association GRDR Migration – Citizenship – Development, which operates mainly in west Africa, as well as in France. The employees of this small NGO, with an annual budget of €5 million, work as much as possible from home – even though the internet connection can be capricious, as in Guinea-Bissau where Assane Coly works and lives. “We always manage to send documents to each other after a while,” jokes Coly, who comes from neighbouring Senegal.

The Bioforce Institute, based in Lyon, France, is a special case. Specialising in the training of humanitarian workers, it has switched entirely to telework. Its two centres – in Lyon and Dakar, Senegal – have closed, but training continues online. Bioforce is even contributing to the essential process of raising awareness, with free online training. In two to three hours, a module explains, in very simple terms, the particularities of the virus, the way it spreads and the preventive measures that can be taken. “It usually takes about three months to develop this kind of training: in this case, we did it in ten days,” says Rory Downham, who supervised the initiative.

Aid workers staying put, despite fears of catching the virus

Despite the threat from the coronavirus, the majority of aid workers have remained on the ground. It is true that some volunteers left Lesvos because of the very unpleasant atmosphere. “But they left in early March,” says Osten-Sacken, and that had nothing to do with the coronavirus. It is still impossible to renew the teams, since the borders are closed and each new arrival is a potential threat, as a possible carrier of the virus. The Lesvos-based association is not lacking in helpers, however, since “the refugees are our volunteers,” notes Osten-Sacken.

On the MSF side, “expatriates are at the end of their missions. They are very tired because they have had no rest for a long time. They have been working completely independently for over a month with more work than usual,” says Seguin. MSF is therefore trying to organise an evacuation with the International Committee of the Red Cross. But that means losing people: it is currently impossible to bring the next cohort into the country.

“We don’t think the situation will get better in the coming weeks. Even if we manage to bring in expatriates, we will have to wait for the 15 days of quarantine”.

MSF’s Yemeni workers have also seen their numbers diminish, after at-risk staff – either because they are over 60, have high blood pressure or are diabetic – were placed on preventive sick leave. That means extra work for those remaining – work that has to be done in the knowledge that their health system cannot protect them effectively if they catch the illness or if they pass it on to their families. “Obviously, they are very worried,” says Seguin. “We are in the process of getting masks ready so that they can protect themselves, and their families.”

Admittedly, for the moment, there is officially only one case of a coronavirus patient in Yemen. But there could certainly be more: the country simply does not have the capacity to test a large number of people. “We have already seen what happens with other epidemics. Diphtheria, measles, cholera …” says Seguin. According to Oxfam, Yemen’s cholera crisis became the largest recorded epidemic of the disease. “If the coronavirus spreads, it will be very, very complicated,” she adds. “All that, and the bombs too”.

A dangerous domino effect

The aid workers’ concerns extend beyond the health effects of the coronavirus itself. “During the Ebola epidemic in West Africa, more people died from other diseases [not treated because of the epidemic] than from Ebola,” recalls Jeremy Konyndyk of the Centre for Global Development. Border closures and the slowdown of the global economy threaten to weaken the supply of medicines to treat diabetes or AIDS, for example. The financial resources used for the prevention of other diseases and their causes could be redirected towards the urgent fight against the coronavirus. This is why some long-term development programmes have already stopped, such as the one GRDR was working on in Guinea-Bissau which consisted of restoring fragile habitats.

These gaps in the continuity of aid and programmes, however essential, for an indefinite period are still difficult to quantify. But it will have a long-term impact; for example, WHO fears 500,000 excess deaths due to diseases linked to HIV/AIDS. New humanitarian crises, linked to the explosion of poverty, are also likely.

In addition to the loss of jobs in less-developed countries, there will be a fall in the remittances sent by migrant workers who, as the most precarious workers, are the first to be affected in the event of an economic crisis. These transfer revenues are set to drop by nearly 20 per cent according to the World Bank, “with the loss of a vital source of income for many vulnerable households”.

In response, NGOs are calling on decision-makers to keep the programmes running as far as possible and to launch fund-raising campaigns all over the world. The immediate needs of major humanitarian organisations are already estimated at US$5 billion, or €4.6 billion, according to the calculations of The New Humanitarian news website. The challenges are immense and they will put international humanitarian organisations to the test. But they will also be able to learn from these difficult times, as we’ve already seen with other epidemics. “Basically, it’s a huge coordination challenge,” says Konyndyk. “This will really force local and international partners to work in a more efficient, more understanding, more respectful and more balanced way, as has never been seen before.”This story has been translated from French.