“We are all fragile, but we are not all equally fragile”: Humanitarian operations amidst the COVID-19 pandemic

Illustration: Prachatai via Flickr

As the COVID-19 pandemic is spreading across the globe, its impact touches all corners of society. What happens when the pandemic reaches areas that were already dealing with various sorts of humanitarian challenges, and in what ways are humanitarian operations being impacted both directly and indirectly? In a time where the news are being flooded with information related to the pandemic and much of national authorities’ time and resources are being spent at mapping domestic repercussions, this post is an attempt to highlight some of the potential impacts COVID-19 can have or is already having on humanitarian operations around the world.

Responding to the pandemic and related repercussions has become a key priority for humanitarian actors, and humanitarian information hubs are now posting regular updates related to the pandemic response. The United Nations has launched a Global Humanitarian Response Plan for COVID-19, and SPHERE and its partners have developed a manual with guidance on how to apply humanitarian standards to the COVID-19 response. Reliefweb has established a page devoted to the COVID-19 pandemic, including an interactive map showcasing the pandemic in locations with a humanitarian response, appeals and response plans, manuals and guidelines, maps and infographics, reports by humanitarian actors and more. The Humanitarian Data Exchange (HDX) provides global COVID-19 epidemiological data.

While all areas of humanitarian operations may be critically affected by the pandemic and related mitigation efforts, four thematic areas have emerged in humanitarian circles as the most discussed so far: 1) Health infrastructure and health information; 2) Exacerbation of existing vulnerabilities; 3) Refugees and other migrants; and 4) Access and delivery of humanitarian aid.

Health infrastructure and health information

As the disease has brought some of the world’s most advanced and well resources health systems to their knees, many humanitarian practitioners have expressed concern for what will occur when the virus reaches countries with less developed health infrastructure. UN Secretary General Antonio Guterres has warned that developed countries must assist those less developed, or potentially “face the nightmare of the disease spreading like wildfire in the global South with millions of deaths and the prospect of the disease re-emerging where it was previously suppressed”. Coordinated global action is also the key message of the recently published UN report Shared responsibility, global solidarity: responding to the socio-economic impacts of COVID-19.

These concerns are not unfounded. For instance, the Central African Republic, a country with a population of almost five million people, only has three ventilators for the whole country. In Venezuela, now with 165 confirmed COVID-19 cases, hospitals were lacking basic resources and health personnel had been fleeing the country already before the arrival of the virus. Moreover, if a large number of people all fall ill at the same time, the efforts to take care of patients contracting the virus is likely to divert resources away from other lifesaving work, such as other health programmes. Senior Policy Fellow at the Center for Global Development Jeremy Konydyk gave a stark reminder that during the Ebola outbreak in West Africa, other diseases caused more deaths than what Ebola did.

Konydyk is not the only one to make comparisons to the Ebola outbreak. On a slightly more optimistic note, it has been pointed out that developing countries with recent experience in fighting epidemics such as Ebola are to some extent better prepared for handling COVID-19. For instance, existing Ebola screening systems have rapidly been converted to screen for coronavirus disease at airports and border crossings. Given many African countries’ recent experience with fighting epidemics, overall young populations and less frequent travel, Gunnar Bjune argues that a targeted response towards the most vulnerable populations would be more efficient and appropriate for the region.

Another important lesson from the Ebola epidemic is the importance of accurate and trusted public health communication to reduce misinformation and distrust amongst the public, as pointed out by Christopher Wilson and Maria Gabrielsen Jumbert in their 2018 article on communication technology in humanitarian and pandemic response. Providing accurate information and building trust in health officials will be a key issue also for combating COVID-19.

Exacerbation of existing vulnerabilities

As with all emergencies, the repercussions tend to be distributed unequally in society and exacerbate existing vulnerabilities. The COVID-19 pandemic and the measures taken to mitigate the spread of the disease are likely to follow the same pattern. Those without existing safety nets will be hit the hardest. In the words of Senior Editor at the New Humanitarian Ben Parker during a recent webinar: “we are all fragile, but we are not all equally fragile”. 

The world economy, which was already weak before the pandemic, is falling into recession. Reduced fiscal revenues will negatively impact welfare programmes, leaving the most vulnerable without access to essential services. While a plummeting global economy and international travel restrictions have severe impacts in their own rights, they may also create difficulties in obtaining imported goods like food and medical equipment. Trade-dependent countries will be particularly vulnerable. In a recently published report, the World Food Programme predicts that global food insecurity is likely to increase.

Vulnerabilities on the basis of gender are also likely to be exacerbated, in particular due to the mitigation strategies employed to fight the pandemic. As Margot Skarpeteig, Policy Director at the Norwegian Agency for Development Cooperation (NORAD), writes for Bistandsaktuelt, men are more likely to contract the disease, but the repercussions will hit women and girls the hardest. Based on lessons learned from the Ebola outbreak, Skarpeteig points out that lockdowns could lead to an increase in domestic violence, that closure of schools could result in an increase number of rapes and child marriages, and that rerouting of resources could lead to worse maternal care, all of which mainly impact women and girls. Several of these concerns are echoed in the COVID-19 Global Humanitarian Response Plan.

Other vulnerable groups who are likely to be severely affected include the urban poor, refugees and other migrants, and groups generally marginalized in terms of access to economic welfare and health services.

Refugees and other migrants

As the pandemic is also turning into a mobility crisis, refugees and other migrants are facing mutually reinforcing vulnerabilities, as they are often housed in crowded areas with limited health and sanitation facilities and now also experiencing enhanced immobility.

Many governments have imposed lockdowns and closed their borders to stop the virus from spreading. This has devastating impacts on many migrant workers, in particular those relying on daily wages, many of which do not have a social network to rely on. UN High Commissioner for Human Rights Michelle Bachelet and UN High Commissioner for Refugees Filippo Grandi call for refugees and other migrants – regardless of their formal status – to be an integral part of national systems and plans for tackling the virus, as many of them do not have access to basic health services.

Further, several frameworks put in place for refugees are now temporarily being removed. On 17 March, IOM and the UNHCR announced a temporary suspension of resettlement travel for refugees. In Uganda, authorities have put up a temporarily bar on arrivals of refugees and asylum seekers. Syrian refugees in the two main refugee camps in Jordan have been on lockdown since 21 March. In Greece, there have been major concerns for and calls for evacuation of camps with very limited health and sanitation facilities, and in early April the refugee camp in Ritsona was quarantined as 20 refugees tested positive for COVID-19.

Kristin Bergtora Sanvik and Adèle Garnier have called attention to how the pandemic is reshaping refugee and migration governance through ‘legal distancing’. Countries hastily adopt restrictive regulation on migration and asylum processes on the one hand, while simultaneously slowing down due process mechanisms. The results are further exclusion and marginalization of already vulnerable groups.

Delivery of humanitarian aid: Access and localisation

While humanitarian organizations are working hard to maintain their existing operations, most humanitarian work is affected by the pandemic and mitigation efforts in some shape or form. Through travel restrictions, imposed regulations, and withdrawal of staff, the pandemic is affecting the delivery of humanitarian aid in multiple countries, and the impacts are cascading as the disease reaches new corners of the world.

Amongst the effects on aid operations covered by The New Humanitarian over the past week are: aid access is blocked for ’unsanitary’ quarantine spots in Burundi; transport bans in Burkina Faso create access challenges for humanitarians; non-essential aid workers are being evacuated from the Democratic Republic of Congo creating limits on staff; border closures in Afghanistan threaten supply chains; and flight bans hamper aid delivery in Yemen. Imposed restrictions on gatherings and travel are hampering both delivery of humanitarian assistance and general access to vulnerable populations. On 25 March, the Norwegian Refugee Council (NRC) reported that they were unable to reach 300,000 people in the Middle East alone.

As large international organizations are struggling to reach people in need, the pandemic might turn out to have an unexpected effect on localisation. The so-called ‘localisation agenda’, and outcome of the World Humanitarian Summit 2016, vowed to increase funding to national and local partners, and involve them in decision-making and assistance in humanitarian response. Since 2016, the humanitarian system has been criticised for failing to support localisation (see for instance Sandvik and Dijkzeul’s blog post from 2019). The conditions caused by the pandemic, however, might change how international and local staff coordinate and operate. Similar to how many enterprises are being forced to speed up digitalization to keep in touch from various home offices, the restrictions on travel and limits on international staff might force international humanitarian actors to increasingly rely on local partners in delivery, coordination and management of humanitarian assistance, as well as enhancing communication structures between the local responders and international assistance providers.

Uncertain outcomes and long-term consequences

While the four themes mentioned here seem to be the most frequently discussed in humanitarian circles so far, the range of repercussions caused by the pandemic and mitigation efforts has yet to be seen.

It is highly likely that other issues may emerge as the situation develops, and the long-term consequences remain unknown. Technological measures applied to keep the pandemic at bay are amongst the issues that might cause severe and unintended long-term consequences (such as tracking mobile devises, drone surveillance, collecting biometric data etc.). Humanitarian data governance is not a new issue (see for instance Katja Lindskov Jacobsen and Larissa Fast’s 2019 article for Disasters), as it often deals with sensitive data from vulnerable populations. During previous health crisis people with diseases have faced discrimination and stigma, such as people living with HIV and Ebola survivors. Keeping in mind also future consequences, it is therefore of vital importance that ethics and privacy is considered, and that actors employ responsible data governance and management.

The lack of testing capacities in many countries and overworked international and local staff may also result in the exact impact of the pandemic being hard to state specifically at any point. Yet, there is no doubt that the impacts will be large and long-felt for humanitarian operations and the people already in need of humanitarian assistance.