Humanitarian actors in Myanmar are doing everything they can to support the preparedness and prevention efforts for COVID-19 while continuing life-saving assistance for internally displaced men, women and children.

The outbreak of COVID-19 is having an unprecedented impact across the world. But for those countries already experiencing humanitarian crises, the consequence is exacerbated by pre-existing challenges, such as a lack of access to basic services, as well as challenging living conditions, particularly in camps and displacements sites for internally displaced people (IDPs).

Months before Myanmar confirmed its first case of COVID-19, humanitarians engaged with the government and organizations, as well as the communities to prepare for a possible outbreak. Where necessary, programmes have been adjusted and modalities amended to reduce the risk of introduction of or exposure to the virus, maintain critical operations, prepare communities and prevent a possible outbreak.

In Kachin, the northernmost state of Myanmar, about 97,000 people are displaced across 136 camps or camp-like settings as a result of the armed conflict that reignited in 2011. While the intensity of the conflict has declined significantly since August 2018, the families who remain displaced continue to rely on humanitarian aid to make ends meet.

For these IDPs, the prevailing scarcity of water hampers their ability to protect themselves from the virus. The Kachin Baptist Convention (BKC), a humanitarian and development department of the Kachin Baptist Church, is one of hundreds of local actors who are at the forefront of response to address this challenge. The KBC has made the most of the financial support by the Myanmar Humanitarian Fund and worked with local communities to install a network of handwashing stations with soap across 15 IDP camps. Over 2,400 vulnerable men, women and children can now take the necessary hygiene measures to contain the spread of the virus. Around 2,000 people have also received drinking water, as hot season in Myanmar has reached its peak.

“I know washing hands regularly will keep me away from the virus, but we do not have enough water in our camp as there are about 100 families living here,” said Daw Khawng Nang*, a resident of one IDP camp. “Now we have a basin with soaps for all of us,” she continued with a contented smile.

Daw Khawng Nang is one of thousands who are benefitting from ongoing operations by humanitarian actors, not only in Kachin, but also in other conflict-affected areas like Chin, Rakhine and northern Shan. While no case of COVID-19 has been confirmed in camps and displacement sites in Myanmar, humanitarians have ramped up their efforts to prevent and prepare for a possible outbreak. Programmes to raise awareness about the risks of the virus and promote prevention messages have reached over 280 camps and displacement sites, while activities, such as installation of handwashing stations, distribution of soap and personal protective equipment continue across many camps and displacement sites.

Addressing pre-existing needs remains a priority

Around 900,000 people in Myanmar continue to need humanitarian assistance. Efforts to contain the spread of the virus go in tandem with other life-saving operations to address people’s pre-existing needs in a principled and impartial manner. Over 360,000 most vulnerable people and IDPs have received food assistance in March alone. More efforts continue to address people’s needs in healthcare, shelter, essential items, access to education, water, hygiene and sanitation.

A reserve allocation by the Myanmar Humanitarian Fund in the amount of US$4 million is expected to boost these efforts, while aiming to ensure a coordinated response to COVID-19 related actions for displaced people and other vulnerable people in all conflict-affected areas.

*name changed to protect privacy

The ongoing conflict between the Myanmar Armed Forces and the Arakan Army in Rakhine and southern areas of Chin State has been again marked by increased civilian casualties and population movements in recent weeks.

Last week alone, more than 30 civilians were reportedly killed or injured, including children, by shelling and small-arms fire.

On 20 April, a World Health Organization staff member was killed, and a government health-care worker was injured while on a mission in support of the COVID-19 response, after the UN vehicle they were travelling in came under attack in Rakhine State.

The Humanitarian Coordinator, Ola Almgren, has highlighted that continued conflict is also a major impediment in the fight against the COVID-19 pandemic. Myanmar is now facing the very real threat of the pandemic, and the UN is working closely to support national prevention and response efforts.

On 27 April, Mr. Almgren renewed his call to all parties to conflict to heed the Secretary-General’s call for a ceasefire, put down their guns and come together to fight against the common enemy, COVID-19.

Intensified fighting in Minbya has forced some 4,000 people flee their homes over a two-day period last week, while smaller-scale displacement continues in other townships.

Overall, nearly 78,000 people are currently displaced in Rakhine and Chin states due to the ongoing conflict – a more than 50 per cent increase since the beginning of the year.

The UN and humanitarian partners are working to provide essential food, shelter and sanitation to those who have been displaced, as well as continuing assistance to long-term internally displaced people and others in need across the country. Ongoing conflict continues to hamper these efforts.

(Read full Op Ed by the UN Resident and Humanitarian Coordinator)

In its present iteration, the Humanitarian Country Team (HCT) COVID-19 Response Plan is primarily focusing on health system support interventions and will need regular updating to match the unique and evolving nature of this crisis, one which is expected to have a disproportionate impact on the poorest and most marginalized communities and further exacerbate pre-COVID 19 social inequalities, such as the occurrence of gender-based violence .

On 10 March, WHO, OCHA and UNICEF convened an extended Inter-Cluster Coordination Group (ICCG) planning meeting, including donors, World Bank, faithbased groups and the private sector, to discuss priority lines of action from humanitarian partners, identify highly vulnerable groups and the outline the HCT COVID-19 response strategy.

The overall goal of the humanitarian response is to support the national government and Local Government Units (LGU) in strengthening the health system and upholding the overall safety and well-being of people at risk, especially the most vulnerable groups, and to delay the spread of infection, for an initial duration of four months, March to June 2020.

HCT response objectives:

1. Support the Government’s health-led COVID-19 response, to protect lives and alleviate suffering through principled access to multi-sectoral assistance and critical services.

2. Ensure the most vulnerable and at risk people, such as but not limited to the elderly, indigenous peoples, persons with disabilities, internally displaced persons (IDPs), remote and conflict-affected communities, the urban poor, women and girls vulnerable to gender-based violence, and other people at heightened risk of being affected by COVID-19, have equal access to assistance, services, information and are protected against stigma and discrimination.

(DOWNLOAD FULL RESPONSE PLAN)

Less than a month after the World Health Organization (WHO) declared COVID-19 a global pandemic, Category 5 Tropical Cyclone Harold slammed into Vanuatu devastating large parts of this Pacific small island developing state. As several other countries in the Asia-Pacific region enter their cyclone, drought, heatwaves or monsoon seasons, the potential for a repeat of such an ‘unprecedented double disaster’ is increasing. How can countries confront a major climate-related or other disaster on top of ongoing prevention, response, and recovery measures to deal with COVID-19?

This brief, developed by the UN Office for Disaster Risk Reduction, Regional Office for Asia-Pacific:

• Builds on early lessons from Cyclone Harold in the Pacific.

• Examines ongoing prevention and preparedness measures at the national and local level in other high-risk countries.

• Provides recommendations on how to address climate and disaster risk in an era of COVID-19.

• Points the way forward with a massively reinvigorated localization agenda.

The brief reflects the interventions and feedback from the 16 April webinar under the same title, which UNDRR co-organized with the UN Office for the Coordination of Humanitarian Affairs (OCHA).

(Download full report)

In response to COVID-19, the UN and humanitarian partners have delivered water, sanitation and hygiene kits and tailored hygiene promotion activities to more than 100,000 people in Afghanistan.

They have also reached nearly 84,000 people with awareness-raising materials and have supported more than 29,000 women and children with psychosocial support services to cope with the emotional consequences of the virus.

Humanitarians continue to monitor the secondary impacts of extended lockdowns on vulnerable households and warn these may exacerbate existing needs and push households to adopt negative coping strategies.

Alongside the COVID-19 response, the UN and humanitarian partners continue to respond to conflict- and natural-disaster emergencies, which continue to displace thousands of families.  These pre-existing vulnerabilities make Afghans potentially more susceptible to exposure to and transmission of COVID-19.

A COVID-19 Humanitarian Plan for Afghanistan is seeking US$108 million to reach more than 6 million people with life-saving assistance over the next three months. The plan is being revised and integrated with the 2020 Humanitarian Response Plan for Afghanistan, which requires $733 million, to help 9.4 million people in need.

(Latest COVID-19 Flash Update)

(Latest Operational Situation Report)

As of 25 April, 33 out of 34 provinces had implemented lockdown measures, with Qala-e Naw being the latest city to announce a lockdown on 17 April (see figure 1). Specific restrictions vary across provinces, and several Provincial Governors have announced extensions/tightening of initially imposed measures, including in Jalalabad, Kandahar and Kabul. While the Afghan government remains committed to allow humanitarian movement during the lockdown, a nationwide solution to facilitate humanitarian movement remains outstanding, leaving it to provincial authorities to define rules and regulations.

In Kunar, Nangarhar and Hirat provinces, provincial authorities issued permits to humanitarian organizations, while in Balkh, the Provincial Governor published a letter to facilitate humanitarian movement.

Nonetheless, challenges in the implementation remained, with several reports of impeded access. In Kunar Province, an NGO was blocked from entering Asadabad City and only allowed to pass an Afghan National Forces (ANSF) checkpoint after the OCHA regional office engaged the Provincial Governor. In Kandahar City, a number of humanitarian organizations faced challenges when trying to pass ANSF checkpoints, with reports of their staff members being verbally and physically harassed by ANSF members. Another organization reported that their vehicles were stuck for hours at the Jalalabad city gate, despite their drivers showing their NGO IDs.

Generally speaking, restrictions seem to be more stringent on the first few days following a new announcement, which is likely due to the information taking time to trickle down from the decision makers to the ANSF members manning the checkpoints. Additionally, it seems that big and well-known organizations, with high-visibility (eg. logo on their vehicles) appear less impacted by the movement restrictions than smaller organizations traveling in low-profile vehicles. The lockdown impacts specific sectors and staff members differently: Staff members relying on (shared) taxis to come to work are encountering difficulties, with taxis having either stopped operations or not being allowed passage at checkpoints. Movement is particularly difficult for support staff, including day laborers employed by humanitarian organizations but not in possession of organizational ID cards. Meanwhile, organizations working with cash delivery mechanisms faced difficulties when a number of financial service providers had to stop operations during the lockdowns. The continued movement restrictions create serious safety and security concerns for humanitarian organizations, with long queues at checkpoints being a potential target for attacks. by non-state armed groups While the movement restrictions of humanitarian partners might not lead to the suspension of humanitarian activities, they continue to seriously delay and hamper a swift C-19 response.

(READ FULL REPORT)

HUMANITARIAN RESPONSE PLANS AND STRATEGIES

COVID-19 Multi-Sector Humanitarian Country Plan

Afghanistan Humanitarian Access Strategy

Dr. Nasir Farhan has only been a doctor for a year. But he is now facing the biggest challenge of his life as one of 40 medical staff (16 doctors, 24 nurses) responding to the COVID-19 outbreak in Hirat city in the west of Afghanistan.

“I have been here since the beginning of the outbreak,” he said while putting on his personal protective equipment, which consists of a full-body gown, plastic sleeves to cover his shoes, gloves, medical mask and goggles. This is part of his daily routine as he prepares to see patients in the former paediatric hospital that has since been converted to a COVID-19 isolation ward.

On any given day, nine doctors are required to provide 24-hour care to some 80 patients who are in urgent need of medical care. Health workers such as Dr. Nasir, who are providing direct care to patients, are particularly at risk of getting the virus and often underprotected and overworked.

According to the World Health Organization (WHO), 30 health-care workers contracted COVID-19 in Afghanistan and one doctor died from the virus on 6 April. “We fear we don’t have enough protective equipment and ventilators,” said Dr. Nasir. A new health facility with 150 beds has just been built to accommodate additional COVID-19 patients.

“We are receiving 20 new patients per day and we are not just seeing old people, we are now seeing a lot of young people who are sick,” Dr. Nasir said.

Many of the patients who are just 27 and 28 years old – now in isolation – struggle to sit up as the doctor does his rounds. In a separate area, a mother and her three daughters are waiting for their test results.  

In Hirat, schools and businesses are closed. Billboards line the street and bright orange flyers on COVID-19 prevention are being distributed in banks and other popular locations. Local authorities have implemented measures to restrict movement, with just a few stores selling essential items still open.

But new cases continue to be reported daily. On 1 April alone, 40 people in Hirat were confirmed to have COVID-19. Nationally, 367 people across 23 provinces were confirmed to have the virus as of 5 April. Nearly two thirds are from Hirat due to the proximity of the border crossing with Iran, but also due to the testing capacity in the city.

To date, eight people have died from the virus, while 17 others have recovered, but many experts fear that many cases have likely gone unreported. “It doesn’t matter where people are coming from because sooner or later the virus will be everywhere, not just in Hirat. It doesn’t matter where it came from, we’re all in this together,” added Dr. Nasir.

Decades of conflict and poverty have eroded the country’s health system. The 2019 Whole of Afghanistan Assessment found that almost half of shock-affected households could not access a health centre in the previous three months. More than 82,000 people in displacement sites in Hirat are living in sub-standard and overcrowded conditions, with limited access to basic services, particularly water, sanitation and hygiene. 

The health response in Afghanistan is supported by WHO polio surveillance staff and 34,000 polio surveillance volunteers within health facilities, the private sector and communities. To date, 6,000 people have been trained and all 34,000 volunteers will be trained and begin country-wide surveillance and case detection in all districts in the coming weeks.

To increase testing capacity, WHO has supported the Government to establish two testing facilities in Kabul, two in Hirat, one in Mazar-e-Sharif and one in Nangarhar Province. Additional testing facilities are also expected to begin operations in Kandahar and Paktya Provinces. The Government, with technical support from WHO, plans to increase the number of testing facilities across the country to 15.

In March, US$1.5 million from the Afghanistan Humanitarian Fund helped to scale up capacities to detect and treat people infected by COVID-19. Pooled funds provided a combined US$78.3 million to COVID-19 pandemic responses across 15 countries. 

COVID-19 Addendum to 2020 Myanmar Humanitarian Response Plan (HRP): An addendum to the 2020 HRP for an initial period of three months (April-June) and a target of over 900,000 people (over 850,000 included in the 2020 HRP and an additional 50,000 returning migrant workers) is being finalized. The Addendum will be reflected in the revised Global HRP scheduled for release in early May. Financial requirements will reflect activities covered under the existing 2020 HRP for Myanmar as well as additional health and non-health activities.

CERF and Myanmar Humanitarian Fund: The Central Emergency Response Fund (CERF) has allocated US$75 million to the COVID-19 response globally, including a $20 million allocation (9 April) to WFP for global logistics and medical evacuation services. WHO and UNICEF headquarters have apportioned US$500,000 and US$749,000 respectively of the total allocation they received to their Myanmar operations.

The Myanmar Humanitarian Fund (MHF) has launched a reserve allocation of US$2 million (with a contribution of $1 million by the Access to Health Fund) to scale up RCCE, prevention and response activities across IDP camps. In addition, close to US$200,000 from existing projects has already been reprogrammed for COVID-19 activities by the MHF.

(Latest Situation Report)