Apart from imposing curfew, the West African country has adopted a comprehensive communication strategy to raise awareness
As the novel coronavirus disease (COVID-19) outbreak had the world scrambling for measures to curtail the spread, the West African country Senegal declared a state of emergency and imposed a dawn-to-dusk curfew on March 23, 2020.
The emergency is touted to remain in force for three months, subject to a review and predicated upon the situation at the expiration of this period.
At the time of the declaration, the country registered 86 confirmed cases — up from a single case three weeks earlier. The first such case was that of a French national resident who had returned to Dakar from France.
At least 1,500 people have been presumed to have come in direct contact with confirmed cases and are now in quarantine. But the number of infected people has only increased since the imposition of state of emergency.
The declaration came close on the heels of the government closing schools and banning public gatherings. The ban on religious ceremonies faced resistance with some imams in the capital city of Dakar defying the order, triggering police crackdown and arrests.
The country has also sealed its land borders and aerial space from the rest of the world.
According to President Macky Sall, the raft of measures will help health workers in their effort to identify, isolate and treat people infected with the virus (SARS-CoV-2).
“It is in response to an imminent peril. The emergency gives us the means to strengthen our ranks and intensify our efforts to defeat our common enemy,” he said.
The country, with a population of over 16 million, adopted a comprehensive communication strategy to raise awareness about the disease and how to curtail its spread.
The approach comprises using social media channels such as Facebook and Twitter, and radio and television stations and flyers to communicate with people in the language they understand.
New transport sector regulations
Six of Senegal’s 14 regions have registered positive cases as of March 30, 2020. Three of these, including Dakar, Thies and the holy city of Touba, were the most affected.
Transport Minister Omar Youm said passengers will be allowed to travel in buses, mini-buses and taxis depending upon the number of seats. Passengers will have to maintain one-meter distance from each other.
Cars would be allowed to carry half the number of passengers.
Transport operators would be required to install hydro-alcoholic sanitiser and disposable tissues on their vehicles, and provide passengers with hand gloves and face masks.
Ousmane Ndiaye, a local transport union official, said that they could only provide face masks and gloves for their members as they “cannot afford it for everybody.”
Paucity of food
Among other challenges faced by the Senegalese is the paucity of bread. Tapalapa bread is the first meal of the day for many of them — but their sale has been banned by the government at kiosks.
The bread is now sold only at bakeries, which leads to overcrowding there. This has induced fear over ‘social distancing’ measures recommended by public health experts.
“The crowds are not regulated and I am afraid people would get infected,” said Ba (34), a regular buyer.
Some hair salons have shut and restaurants have switched to home delivery. Restauarant owners, too, have fully supported the government’s decision.
Meanwhile, price of food items has increased marginally. According to residents, a 25 kilogram bag of rice that was earlier sold for 9,000 francs CFA ($14), was being sold for 11, 500 franc CFA ($17).
Senegal heavily relies on importation of goods, stoking fears that the longer the country remains closed, the harder life will become for the poorest of the society.
Lessons from the 2014 Ebola outbreak
The COVID-19 pandemic comes almost six years after Senegal treated its only confirmed case of Ebola in the 2014 outbreak in West Africa that affected Liberia, Guinea and Sierra Leone.
The experience from that outbreak has guided authorities in properly designing and closely coordinating efforts in containing the current pandemic.
“The first response to this pandemic was to set up an emergency operations centre to lead and coordinate all operations,” said Abdoulaye Bousso, director, Public Health Emergency Operation Center, Ministry of Health.
He added there was a need to “learn from the past experience to clearly define and design messages for public awareness.”
Senegal’s effective management of infectious diseases such as measles-rubella, meningitis, tuberculosis and rabies over the years places it in a better position among regional neighbors.
To bolster people’s understanding of the pandemic, the government has resorted to mobilisation of communities and dissemination of vital information. It is also using social influencers such as musicians and clerics to drive its messages to their followers.
“The country has a strong integrated disease surveillance and response to include community-based surveillance reporting,” said Alpha Barry, epidemiologist and public health specialist from Guinea. He led the fight against the 2014 Ebola outbreak in West Africa.
At the onset of the COVID-19 outbreak, Dakar’s Pasteur Institute was one of few laboratories in West Africa that could test for the virus.
However, the escalating speed and geographic spread of the pandemic and the economic disruption is nothing like the country has experienced in recent years. It has cast doubts over the country’s ability to cope in the long run.
The military, with some of the best doctors in the country, has been called upon to build mobile clinics for testing as well as to ensure that measures are enforced.
What about the marginalised?
But with almost half of the country’s population living under poverty, there are concerns that a prolonged lockdown could lead to a social disorder. People may ignore the ban, especially on movement, and go out in search of their daily bread.
To extend support to the marginalised, the government approved 50 billion francs CFA ($85 million).
The Alliance for International Medical Action (ALIMA), which collaborates with the Institute Pasteur of Dakar on testing, has called for immediate deployment of health experts, medications and other necessary medical supplies to Africa.
The organisation is warning that in many African countries — whose health systems are among the most fragile in the world and who have fewer resources than those available in Europe, China or the United States — the situation is potentially catastrophic.
In sub-Saharan Africa, health systems are already crumbling and the pandemic’s spread could lead to a much higher mortality rate than the rest of the world, according to ALIMA’s executive director Augustin Augier.
“Since human and material resources such as hospitalisation and resuscitation beds are largely insufficient, the mortality rate linked to COVID-19 is expected to be three-five times higher than the rest of the world,” said Augier.
He added that preventive measures taken by African countries to date are legitimate and welcome.
However, some of them have made the circulation of humanitarian personnel and delivery of materials almost impossible.
Nature of cases
Several African countries have reported moderate to severe cases so far. However, according to Public Health Emergency Operation Center, cases recorded so far are moderate in Senegal for now.
“We are very lucky. We just need to isolate the patients and administer oral medication to them,” Bousso said.
The authorities are now trying to understand the moderate nature of the disease in patients, more than half of whom are young people.
The government has announced creation of one trillion franc CFA ($100m) response and solidarity fund as well.
Urging wealthy countries to support countries with weaker health systems, ALIMA's regional advocacy director for West Africa, Eric Hazard, warned: “If we ignore the COVID-19 outbreak in one country, it will quickly lead to more cases in another.”
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