I REMEMBER last time as a guest columnist for NewsDay, I wrote an article concerning the lack of political will and poor preparedness concerning the devastative impact of tropical Cyclone Idai in some parts of our country, Zimbabwe. We are still trying to respond and recover from the aforementioned impacts, trying to figure out what we missed in our national disaster preparedness strategy.
What is actually tricky is that Cyclone Idai was a natural disaster of climatic nature, the COVID-19 is infectious and not limited to time and space like earthquakes and floods. Should it so happen that, hypothetically, we reach 30 cases per province, are we going to curb this spread or are we going to hide behind the avalanche of our emergency management inadequacies?
While we appreciate our non-pharmaceutical response to the threat of the spread of the virus, we should always question the equitable nature of these interventions. We have witnessed as of now the mitigation (slowing, but not necessarily stopping) interventions which are ideally essential, but practically blind to our demographic profile.
Zimbabwe’s healthcare standard is below almost all of the globally agreed standards, making quality healthcare an exclusive domain for the elite. Let us look at the position of the poor and marginalised in this predicament. Are we doing enough in our awareness strategy? Are we doing enough in our advocacy strategy? Are we doing enough in our capacity development strategy? Are we doing enough in our resilience and control strategy? Or perhaps these are even wrong questions, do we actually have these strategies and frameworks, well outlined and articulated, collaboratively scrutinised and shared with the public?
We can have Press briefings, hospital visits in protective gear, publicise articles reminding us of the same things such as washing your hands etc, circulate repetitive texts and concurrent headlines of how and what others are doing; but is this really all we need to do? While it remains essential, let’s remember 2019, we did all this ahead of Cyclone Idai; the chain messages from Civil Protection Unit, Press statements, detailed weather reports and forecasts, publication of academic and professional newsletters, yet we were still hit hard when the cyclone reached our country.
The impact is to be seen to be believed. What is, therefore, to be scrutinised is in our national emergency management. Is our emergency management resilient enough to counter the spread of COVID-19 when it failed during Cyclone Idai?
One would ask, what exactly do you mean emergency management? Preparedness for outbreaks is part of a larger process known as the principles of emergency management. It begins with prevention and mitigation.
These are strategies that can help a country prevent and reduce the impact of an emergency. The next step is preparedness and readiness.
These are actions that should take place before an emergency. And once the emergency happens, there is response.
These are activities in response to a known or suspected event. After response we go to recovery.
This is where we should evaluate the prevention, mitigation, preparedness and response efforts. Countries should seek to return to normal and build better, meaning they should learn from their emergency response.
So what is preparedness in healthcare? This is the knowledge capacities and organisational systems developed by governments and recovery organisations, and communities and individuals to effectively anticipate, respond to and recover from the impacts of likely imminent, emerging or current emergencies.
These actions will take place before an emergency and increase facilities’ ability to respond when the emergency occurs. This should happen at all levels, national and regional.
In this light, everyone is a stakeholder in the fight against COVID-19, but our responsibilities differ and the nature and scope of comnunities and individuals to act is directly affected by the above structural capacities and systems.
It, therefore, becomes rational to advise shops like OK and Pick n Pay to use sanitisers, but we have to remember cornershops in townships and village shebeens (ndari). It is also logical to advise people to call their general practitioners when they suspect to have contacted the virus, but we have to also consider that some of the marginalised community members do not even have cellphones and if they resort to going to a local clinic it will be walking 16km to a malfunctioning health facility.
While we also understand that, we clearly require a comprehensive national awareness strategy or policy because as we speak, we have thousands of people who only knew about coronavirus when they were told that schools are closing.
People in remote areas may have lesser chances of spreading the novel coronavirus yes, because they are not densely settled, but if the COVID-19 penetrates, the effects might be irreversible.
I personally advise in my professional capacity that, this is the time to focus more on tangible campaigns, particularly among the elderly in rural areas, orphans and vulnerable children groups, prisoners and remote communities.
There should be a comprehensive framework for this task so that we won’t be shocked in our ease. Remember, at one time Italy also discovered its first case, just like what we also did, but they are now struggling against the pandemic. Imagine if it can happen to a country like that with a very high ranking in quality healthcare, what about Zimbabwe?
The best we should now do is to focus more on our non-pharmaceutical interventions of mitigation, but with clear and precise frameworks becasue if cases increase, the intervention of suppression methods will be because difficult maintaining such a virus until a vaccine becomes available (potentially 18 months or more) will be difficult in Zimbabwe.
It is no secret that we are all aware of the malfunctionality and resouce inadequacy of our clinical response to infectious diseases as a country. This undeniable fact then brings us to question our emergency management and the need to decipher the recommendations and lessons learnt during typical cases of disease outbreaks. We have been there we know how devastative outbreaks of typhoid, cholera and malaria were during the past years. Lessons from our emergency management during and ahead of Cyclone Idai should always guide us, lest our emergency management will just be as dismal as that of 2019, becoming just a side of the same coin.
In addition, there is a deliberate need to address the issues of false information and panic reporting.
The populace and even the medical practitioners should be taken through a daily comprehensive update of the COVID-19 situation and safety measures.
For instance, a lot of us only wear those protective masks just to feel and appear like others but from the 20 people I interviewed lately, only two understood how to wear, adjust, dispose and follow all safety procedures concerning those masks. Measures to educate the public, media and medical practitioners about differences between suspected cases, probable cases and confirmed cases should be put in place to avoid speculation on cases as well.
As we try to get rid of the pandemic, let’s also work effectively on getting rid of the infodemic, lest the effects of this wave may become more precipitous than that of the 2019 tropical cyclone.
We need to educate the masses, particularly vulnerable groups without access to the internet, televisions and newspapers and other contemporary media, and this should be done ahead of schedule in the preparedness stage and not the response stage of our emergency management.
As a collective, let us work towards our global objectives which can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of the cases, identification and follow-up of the contacts, infection prevention and control in healthcare settings, implementation of health measures for travellers, awareness-raising in the population and risk communication.
The Health and Child Care ministry should give the public a comprehensive daily public report on the stage at which we are, our position with international community, our objectives and deliverables, the monitoring and evaluation tools they are using, summarised district reports of cases, our daily outcome and output, our budget and how we are allocating it, our activities and our schedule and cost performance indexes, among others.
This dissemination of information can be done through a website, specifically meant to address the COVID-19, print publications and or Government mobile applications.
In addressing equity for those who cannot be exposed to such information through the aforementioned channels, the Government should also establish non clinical grassroots committees, adequately trained and each village should have a representative in community committes. These memebers will adequately train their fellow villagers on prevention and mitigation and act as a bridge between civil societies, medical facilities and their fellow villagers. Such community linkages effectively help in leaving no stone unturned. They help to carter for those who cannot read, those without access to radios and the tele, those who do not even know what a sanitizer is and those circumstantially relegated to the periphery of quality healthcare.
It is therefore critical to avoid a repeated case of the Cyclone Idai when it comes to preparedness in emergency management. Lets stand pressing on the principle of collabirative partnership and understand that everyone has a role to play. While we appreciate the US$26 million preparedness and response plan for coronavirus aimed at building an integrated and coordinated strategy on preventing the spread of the virus causing Covid-19 and mitigating its effects allocated by the State, we call for a speed up in schedule performance and cost performance and consideration of the aforementioned overlooked issues. Lets therefore make sure we stay focused in consideration of the 8 pillars set by WHO in tackling this virus, not only on paper, but on ground, it is only through this way that we minimize a repetition of the questionable preparedness plan like that of Tropical Cyclone Idai.
Gaylord Munemo is a research consultant and emergency management practitioner, who has worked for and with over 10 INGOs. He can be contacted on firstname.lastname@example.org/+263773420704