Nigeria’s Fight against COVID-19

As the coronavirus continues to spread around the world, the states of the Global South prepare to confront a pandemic that has until now largely been centred in countries with comparatively high levels of industrialization and robust healthcare systems. One of the hardest hit countries in Africa thus far has been Nigeria, with 800 cases as of 22 April and no signs of slowdown. Angela Odah of the Rosa-Luxemburg-Stiftung’s Regional Office for Western Africa spoke with Mallam Yunusa Yau of the Centre for Information Technology and Development to get an impression of the government’s response in that country and where improvements still need to be made.

AO: Is Nigeria prepared to face the challenges of the COVID-19 pandemic, given the performance and challenges facing the Nigeria Centre for Disease Control (NCDC)?

MY: To assess whether Nigeria is prepared or not, one would have to look at the actions the government took before we had widespread confirmed cases. That is taking into account whether the government is being proactive or reactive. I think the government has been reactive.

The government had sufficient notice that COVID-19 was coming, and it should have used that notice to prepare. One of the preparations it should have done would have been to establish isolation centres in the major international entry points to the country—Lagos, Port Harcourt, Kano, and Abuja—but it didn’t, and missed an important preparatory phase before the pandemic came to our shores.

Second, had the government established these isolation points, there would have been no need for self-isolation. It should have imposed compulsory quarantine on people suspected of having the virus or people returning from countries where the virus is endemic. That means that once they arrive at the airport you hold them for the 14 days required, so that if they don’t show signs you can then release them. Right now people are asked to self-isolate, and we know many people will not do so. There was a case in Bauchi state where a person had been confirmed but refused isolation until the government intervened.

The third point is that, ultimately, the government should have anticipated that we would enter a stage of lockdown, and therefore before the lockdown the government should have prepared people for what to expect so that, psychologically, they were prepared. This also would have helped people to prepare in terms of basic needs, food, water, and other essential necessities so that they could have coped better. The government should also have planned what sort of palliative measures it could roll out for vulnerable groups during the lockdown. As it is, the government just locked down without sufficient plans for palliatives, and thus is just now responding to the fact that people need these palliatives. The response has been ad hoc and not effective. In a number of places, the lockdown is breaking down and creating challenges with containing the virus as well as maintaining law and order.

Fourthly, Nigeria is a huge country with a huge population but very limited testing centres. At the beginning, there was only Abuja and Lagos. A patient from Maiduguri (Northeast Nigeria) would have to fly to either Abuja or Lagos to be tested. There is presently very limited capacity for testing. Testing is an important ingredient in curbing the spread of the virus, thus the government should have used the long notice period to establish more testing centres—after all, they don’t cost much to set up.

Finally, the response of the Nigeria Centre for Disease Control (NCDC), which is coordinating all this action, has been poor. Last week CITAD did an experiment: we deployed about 15 monitors and asked them to phone, text, tweet, and use all numbers and contacts advertised by the NCDC for people to contact them. Surprisingly, none of the calls were responded to. Only one Twitter account responded seven hours after it had been contacted. So, if that person who had called was in distress and it took the NCDC seven hours to respond, that is unacceptable. Out of 45 messages, only one was responded to—that shows that the NCDC is not proactive, not responsive, and therefore is not prepared for the work assigned to it.

There was another case where some travellers were coming to Kano and a person died before arriving. They took the corpse to Hisbah in Kano. The Hisbah personnel said they were not going to touch the body because they did not know whether the person died of coronavirus or not. They kept on calling the NCDC to come and verify if the cause of death was coronavirus or not for over 12 hours, but there was no response. Eventually, they had to get some medical staff to get protective equipment so they could bury the corpse. This shows the lack of preparation of the NCDC in particular and the country in general. Nigeria is definitely not prepared to fight the coronavirus pandemic effectively.

Behavioural changes, such as washing hands regularly, social distancing, and staying at home are recommended to curb the spread of the virus. What are the challenges to achieving this in Nigeria?

Let’s start with washing hands. How many people have access to running water in this country? It’s basically limited to urban centres. Asking the masses to wash their hands with running water when they lack access to water is a big challenge. More than 60 percent of Nigerians don’t have access to clean water—how should they practice washing hands regularly?

On the surface, social distancing looks easier than washing hands regularly. However, when you consider our urban centres, where people live in “face me, I face you”-accommodations (large families living in one room in big tenement houses) where they share toilets and kitchens, social distancing is a big challenge. You can talk to them, but there is a limit to which they can socially distance themselves in such situations.

The third point is that you have people who are unprepared to accept the reality of COVID-19. I speak to people and they say this thing is a ruse, not a reality. So there isn’t sufficient awareness being created by the government. Some Non-Governmental Organizations (NGOs) are doing sensitization but it’s extremely ineffective, insufficient and not adequate. There are challenges on the resources level, people don’t have access to water and soap. In some communities, soap is a luxury. They burn ashes to wash their clothes and bathe, so when you tell them to wash hands with soap and water, which soap do you mean? The ashes, or the soap which is a luxury beyond their reach?

Sanitizers are even more expensive than soap and prices have skyrocketed with the onset of the pandemic. There is no price control in Nigeria. Nigeria didn’t prepare to produce sanitizers in bulk so they could be cheap and accessible. The government’s message is not reaching the people, and even when it does reach them, they don’t have the resources to stick to the guidelines of washing hands with soap and water, social distancing, etc. The government needs to do more in terms of providing these needs.

Nigeria has a large informal sector of workers who depend on daily earnings for their livelihood, and most of the population lives in poverty. In light of experiences in other countries, what can the Nigerian government do to cushion the effects of the lockdown in these times of uncertainty and fear?

Nigeria should have identified the critical groups that need to be supported during the lockdown. It is not just about procuring relief materials and sharing them on the streets. It requires identifying the target groups and planning the delivery. The only place that had any distribution of food items was Lagos, and even that was rowdy. You are asking people to respect social distancing and you have crowds running after food distributors to get their share of the relief materials. That means we have not learnt any lessons.

It would have been better to identify targets ahead and then deploy mechanisms to effectively distribute relief materials. The government response as of now is about the Social Investment Programme (SIP) giving out 20,000 Nigerian naira (about 50 euro) to support families. How are we sure that the money will get to the right people? How are we sure there will be transparency and accountability in terms of how the money is distributed?

Thirdly, the government waited too long until the private sector began initiatives to support the people. Right from the moment it established the Presidential Task Force on COVID-19, it should have been one of the issues the task force deliberated on and planned, and designed resource mobilization, procurement, and eventual distribution. We are not learning from the successful experiences of some countries. I saw a lot of information online on Rwanda, for example, where relief materials were packaged and distributed to households in an orderly way.

In light of the crowded nature of most of our urban centres, what are the constraints to social distancing? Some people have argued that in the African context physical distancing should be promoted instead of social distancing. Is there a difference?

There is a difference. Physical distancing is about separating yourself—don’t come close. Social distancing also encompasses physical distancing. It emphasizes no ceremonies, no social gatherings such as religious services in the mosques or churches, funerals, parties etc. It is a much broader concept than physical distancing.

Nigerians are incredibly difficult people to deal with. CITAD did an assessment in Kano that we released two days ago. We sent monitors to the major mosques and football pitches, wedding ceremonies, etc., and discovered that a number of the major mosques still conducted Friday prayers. In a number of places—including high institutions—we saw people playing football matches on a daily basis. We saw people conducting wedding ceremonies, including one in which a Commissioner of the Kano State Government was giving out his sister in marriage. This turned out to be a huge political gathering. These are the really big challenges.

Then you have border closures that are ineffective. People go in and out, paying bribes as low as 100 naira to get into the state and out of it. The markets are still open in most states except for Lagos, Abuja, and Ogun state, where there are restrictions due to the lockdown. Social distancing collapsed at the level of markets, it collapsed at the level of worship places, it collapsed at the level of weddings, funerals, etc. It is not being respected and we are facing a serious threat that the virus will spread across these places where social distancing is not being respected.

The government needs to do a lot more. Even with the lockdown in Abuja, people are still being smuggled into other states. Two days ago, a medical doctor died of coronavirus in Daura, Katsina state, where he ran a hospital. He had travelled to Lagos, Kogi state, and Abuja, and even during the lockdown was able to travel back to Katsina state where he died the next day. This shows people are still able to circumvent the lockdown, and therefore are spreading the virus across the country. The government needs to do a lot more to address these challenges.