Asia Pacific countries are experiencing a ‘second wave’ of outbreaks, with tightened border controls, restricted movement and many nationwide lockdowns. All countries where CARE is operating have domestic travel and country entry restrictions in place.
Afghanistan has seen an increase in cases as thousands of Afghans return from Iran; Bangladesh has seen its first case in the Rohingya refugee settlements in Cox’s Bazar; Nepal is under lockdown until 31 March; Pakistan has imposed travel restrictions; the Philippines has implemented a nationwide curfew. Some ongoing programmes have been temporarily paused in accordance with government directives and CARE country programmes are finalising contingency planning and response plans.
For example, in the Philippines, CARE has distributed flyers and put up community banners with COVID-19 preparedness and mitigation messages in the local languages; these are strategically placed at high-risk operational areas e.g. evacuation centres as well as urban and rural poor settlements where population density is high, with minimal health services. A full response strategy has been developed targeting internally displaced people, host communities, and people currently targeted by existing CARE programmes, and including (dependent on funding availability): i) Risk communication and community engagement, ii) Community-based surveillance, iii) Handwashing, iv) Provision of WASH and personal protective equipment to vulnerable communities and local health personnel partners, and v) Cash support for vulnerable people.
CARE is implementing various measures which include appointing COVID-19 focal points in our country programmes to coordinate with national health ministries and other relevant platforms.
Our specific response differs from one country to another, depending on the type and size of our portfolio and the country context. We are also scaling up our activities to ensure that clear guidance on risk, prevention and awareness of symptoms are available in the communities where we work. This includes promoting handwashing and providing soap and handwashing stations, conducting demonstrations and tackling barriers to good hygiene.
Where feasible, we are also looking to scale up water supply activities to facilitate good personal and household hygiene. This could mean increasing frequency of water trucking or providing cash or vouchers for the most vulnerable to access private water and other supplies.
We are also ensuring that the specific risks for women and girls are accounted for as we continue to develop response plans. For example, in countries where CARE implements sexual and reproductive health and rights (SRHR) programmes, we are working to ensure that critical services related to family planning and sexual health are continued, particularly as primary health resources are diverted to COVID-19 response. We know, for example, from the Ebola outbreak in West Africa, that school closures and decreased SRHR services resulted in increased rates of unplanned pregnancy.
As the first case of coronavirus is confirmed in Syria, CARE is deeply concerned about the health and safety of over three million people in Northwest Syria, over half of whom are internally displaced and live in crowded camps. Nirvana Shawky, CARE’s Regional Director for the Middle East and North Africa, said:
Nine years of conflict have left Syria in shambles. Not only are many vulnerable people living in tents and makeshift shelters, but civilian infrastructure, including hospitals and health care centers, have been decimated. With many healthcare professionals having either left the country or become displaced, providing sufficient medical assistance at scale is nearly impossible. As developed countries struggle to cope with responding to the virus, an outbreak will have devastating consequences on the war-torn country, where millions are in need of aid.
In response to the spread of the coronavirus, CARE has put in place COVID-19 prevention, mitigation and response programming, focusing on supporting clean water and sanitation services. In Northwest Syria, CARE continues to ensure the delivery of clean water. Due to the need to increase handwashing, CARE has put plans in place to increase water trucking to people in the area. CARE also will increase the distribution of soap, cleaning material and information material for hygiene promotion.
CARE is commited to adapting our programming and where possible scaling up our work in response to the COVID-19 pandemic. This will focus mainly on support for clean water and sanitation services in countries with weak infrastructure. Sally Austin, CARE International’s Head of Emergency Operations, said:
Now is the time to show solidarity with countries yet to be critically affected and that have insufficient health services to cope with an outbreak of COVID-19.
We are particularly concerned about people in conflict hotspots who already rely on humanitarian aid; people in refugee camps; and people around the world already facing poverty, inequality and lack of access to services. Austin says:
For months we have been facing serious access issues in some of the humanitarian hotspots such as Yemen, Syria or Iraq. If COVID-19 spreads in those hard-to-reach places, the consequences could be devastating. People here are already weakened by months and years of violence, lack of health services and malnourishment.We are also tremendously worried about big refugee camps such as in Bangladesh or Kenya and not least for local communities in regions that have suffered from chronic poverty and poor health, from Niger to Laos to Papua New Guinea.
For months we have been facing serious access issues in some of the humanitarian hotspots such as Yemen, Syria or Iraq. If COVID-19 spreads in those hard-to-reach places, the consequences could be devastating. People here are already weakened by months and years of violence, lack of health services and malnourishment.
We are also tremendously worried about big refugee camps such as in Bangladesh or Kenya and not least for local communities in regions that have suffered from chronic poverty and poor health, from Niger to Laos to Papua New Guinea.
CARE is working in 23 countries to increase water and sanitation support, 14 country teams are scaling up health and reproductive health services and a further 19 countries are working on needs such as income, shelter and education. In other countries, programmes have been forced to close as national lockdowns are imposed; which is likely to have a devastating impact on the most vulnerable communities in the days and weeks to come. Austin says:
We have a limited period of time in which to act and continue programming before the situation gets really bad and COVID-related travel restrictions stop our work. We are already seeing this scenario playing out in many of the most vulnerable countries where we work – it is crucial we act now, before it is too late.
CARE is undergoing a contingency planning process in order to be able to respond rapidly to assist vulnerable communities in the countries where we work.
CARE is already working day-to-day in places where healthcare systems are weak and long-lasting food supplies have been wiped out by disaster and conflict. Sheba Crocker, Vice President for Humanitarian Policy and Practice at CARE USA, said:
As COVID-19 spreads, it is more evident than ever that there are far too many vulnerable people and too few resources for vulnerable communities. We also see how pandemics disproportionally affect women and girls. There’s no question that women will be on the frontlines of the response to COVID-19, increasing their risk of contracting the virus. We want to be sure their needs are met as this crisis unfolds.
CARE is also concerned about the rights of refugees, internally displaced populations, migrants and other people of concern should restrictions on entry, travel, and freedom of movement be imposed. In the event that restrictions on movements are imposed, alternatives to protect vulnerable people and ensure they can access critical services must be put in place.