Ensuring continuation of humanitarian access as COVID-related movement restrictions are tightened
First case: 19 March 2020
Total cases: 726 (as of 29 May 2020)
Total deaths: 65
Borders/flights: All borders closed.
Containment measures: Chadian authorities have adopted containment measures, including passenger flight suspension (starting in March 19 until April 25), closure of borders with CAR and Sudan, quarantine for nationals returning from high risk countries, closure of shops and stores (excluding basic goods), shortened banking working hours, cancellation of events and gatherings of more than 50 people, closure of worship places as well as schools and universities.
Situation: As of 29 May, Chad reports 726 confirmed cases in 10 provinces (N’Djamena, Ouaddaï, Lac, Logone Oriental, Wadi-Fira, Moyen-Chari, Logone occidental, Batha, Kanem, Mayo Kebbi-Est) and 65 deaths. A total of 8,335 people have been placed in quarantine since the beginning of the pandemic, 6,681 of them have been released after a 14-day observation period. COVID-19-related mortality rate in Chad has reached 9,9%, one of the highest in the world. There is considerable delay in testing and results as well as a shortage of tests which are only applied to people with clear symptoms. This impacts the statistics and may explain this high mortality rate. Health sources report that test machines have been out of order for days. The new health crisis management committee (CGCS) set up this week by the President started a complete reorganization of the government structures for the response to the health crisis. A number of high-profile government officials, including the head of the now-disbanded structure previously responsible for managing the response to the epidemic, have tested positive for COVID-19. Such cases within a number of Ministries, affecting decision-makers, has a direct impact on the coordination and delivery of the national response and the interaction with this by humanitarian partners.
Following the measures taken by the government to limit the movement of people between the capital and regional urban centres, certain activities were disrupted as a result of the inconsistent application of the measures in some provinces, leading to challenges for humanitarian staff to move outside urban centres, including N’Djamena. In principle, the central government remains keen to support and maintain humanitarian action. The current measures do not apply to the movement of humanitarian materials, including trucks and vehicles carrying the essential equipment for the pursuit of humanitarian activities. Movements of partner vehicles within Ndjamena and provincial towns is allowed. UNHAS internal flights have also been able to continue. To mitigate the challenges in some areas, discussions have been underway with the authorities with a view to obtaining a general waiver for the staff of humanitarian partners to ensure the continuity of the COVID and non-COVID response. Humanitarian partners reaffirmed their will to respect the measures taken by the government to break the virus’ chain of transmission. In this spirit, it has been proposed to the government to authorize a limited number of vehicles belonging to the United Nations and INGOs to have official authorization for more general movement within the framework of critical programmes, particularly in the following areas: health emergency; distribution of nutritional inputs and food; water, hygiene and sanitation and shelter programmes; and vaccination campaign.
The health status of the population is a major concern, particularly among the oldest population, people with underlying conditions and women whose access to health services remains dependent on social and cultural norms. There is widespread malaria and an ongoing measles epidemic. Vaccinations are impacted by restrictions on movement and large gatherings. Major challenges pertain to limited, poorly equipped and under-staffed health facilities, even in the capital.
Chad anticipates significant deterioration in nutritional status as it is the lean season. The closure of schools impacts on both essential education and nutritional support for 3 million children. Containment measures have significantly restricted the protection space and exacerbated the vulnerabilities of forcibly displaced persons.
In the context of the relocation exercise, humanitarian partners have worked closely with local authorities on COVID-19 prevention measures. A more extensive campaign for administrative, traditional and military authorities is now underway. Since the notification of a first confirmed case on 1 May, a total of only two cases of COVID-19 have been confirmed in Lac province, while 573 persons have been quarantined there.
An inter-ministerial management committee meets daily to monitor developments. 16 community teams have been deployed in N'Djamena province to sensitize the population on prevention measures. Radio spots are broadcast in local languages on 17 local radio stations in the 10 major urban centres. In the meantime, UN agencies and international NGOs are working closely with WHO and the Ministry to accelerate and help deliver the response. MSF-France, for example, is currently finalising an agreement with the Ministry of Public Health so its staff can provide epidemiologic monitoring, health and hygiene promotion, and treat COVID-19 cases in public health centres in N’Djamena and other areas. MSF-F is already an essential partner for Government in other direct health interventions, such as measles vaccination and treatment. Chad’s Government is now implementing progressively stricter measures to reduce population movement, and thus curtail transmission between N’Djamena and other urban centres. The use of masks is now required in all public spaces until further notic