Militarized models and approaches produce a public health approach that is not trauma-informed. This breeds confusion and cannot generate the parameters for modelling a clear end game. Without moral imagination and political will that roots for an all-government and all-people approach to COVID Management Star Gazing will remain the hallmark of our national response, an unhelpful place to be both in the short and the long term.
On 13th March 2020 Kenya recorded its first case of a patient who turned positive for Corona one day after the World Health Organization (WHO) declared COVID 19 a Global Pandemic. This flu like epidemic, was then reported to be ravaging the small town of Wuhan in China, but unknown to the world, a pandemic was in the offing as related deaths were growing. As the virus acted more aggressively in several nations, the steep rise in infections and fatalities exposed how frail health systems all over the world were.
The exponential spread of the virus imposed the instant expansive need for adequate infrastructure, public awareness, critical equipment and sufficient training and numbers of healthcare professionals as well as financial and other resources to cope with the emergency situation and efforts to control new infections.
In Kenya where the government had the benefit of learning from Countries that had experienced the worst effects of the pandemic, the Health Ministry declared a raft of draconian measures to contain the spread, control personal and community infections and mitigate the medical emergency as well as prevent deaths from the virus.
Due to the pandemic’s long and unrelenting embrace the extraordinary measures have included an aggressive information campaign, through a daily media address to the country, a fund to support the war, tax austerity measures to release resources to critical areas of need.
The public health measures have been four pronged. One, containment and control of movements (closure of institutions and businesses, dusk to dawn country-wide curfew, cessation of movement into and out of select counties, self-quarantine, forced quarantine). Two, measures to frustrate personal infection (promoting frequent hand – washing with soap and running water/use alcohol-based sanitizer, sensitizing the public to avoid handshakes, hugs and sensitizing the public to avoid touching mouth, eyes and nose), Three, measures to frustrate chronic corona-caused sickness and deaths (identification and deployment of adequate and appropriate: physical infrastructure, specialized equipment, well-trained and kitted personnel and tools of trade and an information infrastructure ). Four, measures to frustrate the spread within the community (by appealing to the public to embrace ‘stay home’ approach except for essential needs, appealing to the public to maintain social distancing of at least 1.5 metres between persons and promoting the wearing of masks by anyone venturing into public spaces).
These measures impose restrictions to freedom of movement and the freedom to enjoy many other human rights and in the process have inadvertently affected peoples’ livelihoods and security, their access to health care (for other ailments), food, water, sanitation, work, education and leisure.
The impact of these measures have been swift and dramatic and the consequences on the economy, the poor, politics and democracy far reaching, in a country that has been a victim of destructive politics, unaccountable governance and frail institutions.
The measures come at a time when civic and democratic space was already deteriorating as a result of recent amendments to various laws (Public Order Act, The Prevention of Terrorism Act, Prevention of Torture Act, Cyber Crimes Act, Kenya Information and Communications Act) and administrative actions that criminalize the work of human rights defenders and the media. Vocal civic actors have had to bear unprecedented personalized attacks by state institutions a situation that has had far-reaching ramifications on civic space – limiting the enjoyment of the freedoms of expression, assembly and association.
In Mombasa County and the Coast in general communities have been at the forefront in pushing back state-led assaults such as the crackdown on individual human rights defenders and organizations, deregistration of citizens’ groups on flimsy grounds, threats and intimidation of actors among other things.
Though the Covid crisis has been with us for a full four months, government does not seem to have a coherent framework that is guiding its decisions in managing the pandemic. Government response is largely militarized, is confused and lacks a clear end game. There does not seem to be moral imagination or political will to consider a long term horizon in managing the impact of this pandemic. Here are three postulations that explain why government response so far has short legs.
- The National COVID response strategy does not advance a pro-poor agenda. Social distancing, cessation of movement and staying at home as mitigation measures in an emergency have serious limitations when implemented in communities of density, the homeless, wage employees, rural and urban poor, fishermen, farmers, street vendors, boda bodas, wet market traders and small businesses in the informal economy if they are not accompanied by safeguards to address the needs of these populations. Most households in Mombasa as elsewhere have had to make difficult choices for example between having to stay at home and go hungry or buy a face mask and forego a bunch of Kales for the family’s subsistence. Balancing these realities with the need to protect these groups from catching the virus and transmitting it at home remains a delicate act.
- The public health approach has not been trauma-informed. The militarized models and approaches have produced the unintended consequence of over and above restricting free movement and association, also restricting the freedom to enjoy other human rights. Inadvertently many people are finding their lives, livelihoods and security compromised because they cannot access food, water, work, education, leisure, sanitation and healthcare for other ailments. Although this was later rescinded, the decision to impose blanket quarantine for people found in breach of the curfew produced mixed results. Apart from chaos that was witnessed in most centres the centers were also found to be sub-standard, unfit for habitation and too crowded to guarantee social distancing. The quarantine centres turned out to be breeding grounds for the spread as curfew offenders were mixed with traced contacts and saddled with bills most were unable to afford irrespective of their economic status. Additionally most County Governments do not have the physical facilities and equipment needed to handle patients from diagnosis, treatment and contact tracing and neither do they have the preparedness that healthcare workers need for effective response. A public health approach would pay attention to allocation of emergency funds for mass testing and diagnosis, make criteria for admission, testing and quarantine a purely health matter and limit the involvement of the police and language to the effect that Kenyans lack disciplined.
- Without an all-government and all-people approach to such a crisis and with a government that is known for its firm reputation for dithering converting the COVID grief and rage in to a massive solidarity movement has been hampered by the lack of transparency in the use of funds, grants and loans extended to the government for its response. There are no attempts to include citizen organizations on state committees to win public support for mass testing, strong contact tracing and tools from indigenous and other forms of knowledge from community practices. Even the COVID Emergency Fund launched by the President lacks representation from civil society.
Mr. Patrick Ochieng is an activism shaping narratives on exploitation, inequality and injustice. He has been associated with Ujamaa Center, a social justice NGO based in the Coastal region of Mombasa, for the last 20 years.