How copying and pasting Western solutions to the pandemic was unrealistic for Uganda and Africa
THE LAST WORD | ANDREW M. MWENDA | When COVID-19 struck, the world held its breath. In early 2020, there were doomsday predictions that the pandemic would devastate Africa, given the continent’s poverty leading to poor healthcare services. Yet more than a year since the pandemic, Africa is the least affected continent. Ironically, the most affected country in Africa with 1.5 million infections is South Africa. It is also the most developed and industrialised economy on the continent. Meanwhile the poorest countries of Africa such as Central Africa Republic, South Sudan, Eritrea, Burundi, Liberia, Malawi, Niger, Guinea Bissau, Sierra Leone etc. have been least affected. Why?
Of course the poorest countries have the least testing capabilities – so their low infection rates may just be a reflection of that. Yet if infection rates were high in those countries, and if infections caused severe symptoms leading to mass sickness and death as we see in USA and Europe, governments would not be able to hide such information. This is especially so in this age of smart phones and social media. Besides, there is a huge army of save-Africa-from-itself do gooders in the West and their cheerleaders on our continent who would seize this opportunity to paint themselves our saviors.
Let us not forget that each time there has been a pandemic like Ebola, a war, a natural calamity or famine leading to mass deaths in an African country or countries, the cameras of the world have turned on us. The absence of these mass infections and deaths in Africa and their accompanying cameras does not tell us how great our public healthcare systems have been. That is the mistake some analysts have made. Rather they tell us a lot about how COVID spreads and affects different demographic segments of the society. These dynamics help us understand why the virus has been devastating to largely rich countries compared to poor ones, and how the response in poor countries has been shaped by the risks in rich countries not their own context.
What has actually saved most of Africa is our poverty, which makes our people live in very unhealthy physical environments, without proper healthcare systems (well-trained medical workers plus accessible and well equipped hospitals). As a result many Africans die before their first or fifth birthday. To survive the vagaries of our environment (sanitation and hygiene) requires someone to have a strong immune system. Those are the people who live in Africa. When COVID enters their bodies, it hits on a brick wall, hence not the low infection rates but the low symptomatic rates.
If the virus spreads as we have been told it does, there is no way Ugandans who trade in down town Kampala markets such as Owino, Kikuubo, Nakasero, etc. could have avoid mass infection. And if the virus were the lethal killer that we see it is in the USA and Europe, large sections of the Ugandan urban poor would be coughing and sneezing themselves to death. The fact that we have no social distancing, no use of masks and no sanitising in downtown markets only tells us that its spread levels are slow and low, and where it spreads people are largely asymptomatic.
Another lesson even from the rich countries of Europe and North America is that COVID tends to be lethal to people in old age and/or who have preexisting conditions such as high blood pressure, diabetes, cancer etc. These are lifestyle diseases that are not common in our poor countries. In any case, the majority of people in our poor countries who get these diseases die early because of lack of effective medical care. So most Africans in rural Africa are healthy human beings with very strong immune systems.
On the other hand, the existence of high quality medical care in rich countries means that many people who would have died of diabetes or high blood pressure or other lifestyle diseases are kept alive through medical services. They also live to old age. These are the two categories that either die or are badly affected by COVID. It is this category of people that scared the West leading to massive shutdowns of the countries in order to slow down the pandemic. Poor Africa got scared and followed similar draconian measures yet they were largely not necessary; at least not to the degree we did.
One year later, this is the lesson we should walk away with and begin to reopen our churches, schools, bars etc. When I travel to my village I never hear stories of people dying of cough. Yet I think there is COVID there. I visit markets where people trade without social distancing, sanitising or wearing masks. Even the few election rallies we had did not lead to the spike we saw in the USA. We therefore adopted measures meant for countries with old populations who are also filled with large numbers of people with preexisting conditions.
We can say that our governments did make a mistake that was understandable. Here was a new disease with little information about it. Therefore from this perspective, the shutdowns are understandable. However what is intriguing is that one year later and with mountains of evidence and hindsight, we are slow to change our attitude. Schools, bars, etc. remain closed to the detriment of many income earners. Children remain home yet they are the least affected demographic in the COVID killing brackets.
What can Uganda do based on what we have learnt in the last one year? First we need to open the country back to normal. We can emphasise use of masks, sanitising and social distancing in public buildings. We can also insist schools put in place some procedures to reduce the risk of infection. In fact this is better for the kids and their parents because both now go to markets where these procedures are not followed. Therefore the kids or their parents can bring the disease from markets to homes. One wonders the wisdom of government of Uganda fearing children getting COVID from schools but not from markets where they are not spending most of their time.
The biggest problem most nations of Africa face is a lack of originality in the design and implementation of practically every policy except sex and marriage. We tend to copy and paste the solutions based on textbook theories, which are based on the Western experience – an experience that does not reflect our reality. COVID has taught us that we need to study our reality and design a response based on our specific reality. Will anyone hear this message?