What’s Happening in Tanzania and Kenya

May 8th, 2020

Both countries share a long border in East Africa, with expansive coastlines into the Indian Ocean. They have a similar sized population, between 53-59 million people. Tanzania is approximately ½ as big again as Kenya with large areas of natural preserve. Kenya has a dry, more sparsely populated northern region, around Lake Turkana, in the heart of the Rift Valley, home to many of the most important archaeological finds in the world concerning the origins of our species.

The capital of Kenya is Nairobi, with about 4 million people. The second largest city is Mombasa, with over 1 million people. The capital of Tanzania is Dodoma, with a population of 410,000 as the capital moved from the biggest coastal city of Dar es Salaam 25 years ago which has a population of 4 million.

To Lockdown or not to Lockdown

During the COVID19 crisis, both countries enacted different strategies. Kenya chose to lockdown, with a nightly curfew and restrictions on travel within the country. Much of daily business has ground to a halt and the police embarked on a strict lockdown policy, with incidences of violence against its people, including at least 12 deaths from police enforcing a strict curfew. Tanzania chose a more voluntary method of containment, with the use of masks, limiting large gatherings and voluntary social isolation, but not enforcing strict lockdown or limiting movement of people within the country.

As of May 4th each country had the following figures:

Country Population Deaths
Kenya 53 million 24
Tanzania 59 million 16

There is no point putting figures in for the numbers of cases as testing of cases is not consistent in either country, although it seems more tests have been done in Kenya. The main consideration is mortalities and numbers of diagnosed cases with distinct symptoms of COVID19. The most important factor to consider is that in both countries, with similar populations and similar demographics of a few large built up urban areas and quite large rural and semi-rural regions, the numbers of deaths are minimal. Even of those who died, the majority had co-morbidities and like elsewhere in the world, it is not even clear if COVID19 was the main cause. The fact remains that there is currently no serious pandemic and that the two strategies have not shown any significant change in outcome. However, the social and economic impact in Kenya has been dire. Millions are now without work, and living hand to mouth.

The Challenges of mass testing

More people in both countries are being tested now. However, in a somewhat hilarious situation, President Magufuli of Tanzania decided to try the tests used in Tanzania on a goat and a papaya. Both tested positive. The tests were apparently imported from abroad but it is not clear where from.

The false positive tests led to the resignation of the Tanzania’s National Health Laboratory boss. President Magufuli is also reported to be interested in importing a herbal treatment from Madagascar made from the Artemisia plant, which has purportedly had good results in preventing and treating COVID19, according to the government, even though the World Health Organization (WHO) has warned against it.

However, given that the WHO is deeply influenced by the interests of the Bill and Melinda Gates Foundation whose focus is on a vaccine as the only solution, it is not surprising that they are not open to the possibility that a herbal treatment could work. The WHO justifies this by saying more research should be done on the plant before it can be safely used. However, given that it is already a widely used plant medicine, it would seem that the empirical use of the plant in COVID19 cases might be sufficient for now, especially given the urgency at this time.

Tanzania has also been criticized by the WHO for not enacting a stricter lockdown, and suggesting it has led to a spike in positive cases. This reveals more about the pressure from the WHO for all countries to follow the call for lockdown as the numbers in Tanzania are no greater than Kenya and, as seen, the tests may not even be accurate. Much of what the WHO is now saying should be taken with a pinch of salt.

Projections of what will happen in Africa: Science or Conjecture

Many experts expect the situation in Africa to get worse, especially the WHO. Currently, only 28,000 cases have tested positive in the whole of Africa, with a population of around 1.3 billion and with a death toll of around 1,300 people. However, the WHO and others initially predicted between 3-10 million could become infected with COVID19 in the next six months. A report widely distributed on May 8th, stated that the WHO now thinks up to 190,000 people could die in Africa from COVID19 in one year. That is quite a difference. The article says treating and isolating are key, but how do these experts think people are going to be isolated in much of Africa. 190,000 is a lot of people, but in a population of 1.3 billion it’s 0.014%. The expense and trauma of testing and isolating may well be too great.

No one really knows what may happen in Africa but many observers and organizations from western countries default to the worst possible scenario for Africa, and often in a patronizing way. Also, as has been seen in the rest of the world, having COVID19 does not mean getting very sick. As the majority of the population in Africa is young, the chances of getting very sick is minimal. What is clear though is that the timing of the report coincides with some countries relaxing the lockdown while the WHO is still firmly enamoured with the benefits of this strategy. Now that the lockdown is beginning to be loosened, the WHO is pushing its next phase. To quote from the BBC article above: “Covid-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region,” Dr Moeti says in a WHO statement. “We need to test, trace, isolate and treat.” This brings up a number of questions. Who do we test? Just the sick or everybody? How do we isolate? If you look at facilities available, is this really possible? How do we treat it? No one really knows. If increased testing is done on healthy people, that will not show anything apart from the fact that many people tested positive without getting sick.

The Collateral Damage of Lockdown and Testing: The Abuse of Authority

Kenya is now attempting to ramp up its own testing, but as with all current tests, false negatives and false positives can be an issue. The strategy of widespread testing of otherwise healthy people makes the same presumption as that for lockdown – that the spread of the virus can be contained. This is debatable. Testing can only prevent spreading infection if enough people are tested who are then voluntarily or forced into quarantine. This is a big challenge. Over 90% of people who test positive experience little or no symptoms. So, attempting to test as many people as possible and encouraging people to come forward, even if they have no symptoms, may only make matters worse. It increases fear as it seems the numbers are rising, when in fact they are not – only testing is increasing. Then the question is what to do with those who test positive. Do you quarantine them in facilities or tell them to voluntarily quarantine in their own home?

Things can get worse. Governor Joho of Mombasa County, Kenya, according to citizentv, has threatened that residents of Old Town in Mombasa would be tested for coronavirus by force if they do not participate willingly. Apparently in some areas, residents are not showing the necessary willingness to be tested. Why would they? Again, the presumption is that by testing one can isolate people and prevent the spread of the virus. But in Kenya as in most countries, one is never going to be able to test the majority of people. It is not South Korea and the current numbers don’t justify it. Many people live in remote places which are not easily accessible. Even in urban areas, including the slums of Kibera and Mathare in Nairobi, with a congested population of nearly 1 million people, the logistical challenges of testing people is simply too much. Why would people volunteer to be tested when the implications of being found positive to COVID19 are a serious threat to being able to earn a living? As it is, most people are living day to day. Imagine the consequences of being forced into quarantine, whether in home or in quarantine centres?

Kenya was given 200,000 testing and sampling tubes from China in March, along with 4,000 shoe covers and 76,500 N95 masks and face visors. Where are the other millions of tests going to come from if they want to test everyone? There has been a backlash against the facilities Kenya has used to quarantine people who entered the country before full closure of the borders, or who have tested positive. According to voanews.comRights groups say the government is treating those held in quarantine like prisoners, but health authorities say the tough measures are needed to prevent the virus from spreading unchecked. A signed statement released Tuesday by 24 Kenyan rights groups expressed concern after authorities extended the quarantine period. It noted that it was not clear how many people were in mandatory quarantine in Kenya and how many of those had been tested for the virus.” The Kenyan government has now extended the mandatory quarantine to 28 days. According to the article The civil society consortium is calling the government to action because the government has not been forthcoming with information to those who have been held in mandatory quarantine,” said Allan Maleche, executive director at KELIN, a Kenyan group that advocates for health rights. “The government has not been clear on who is paying for the cost; the government has not been clear on when people are supposed to be tested.”

Kenya has designated 57 quarantine centres in Nairobi and Mombasa, which are hosting hundreds of people at their own cost. Some have complained also about the sanitation in Kenya’s quarantine centers. A resident at another Nairobi quarantine center, who asked that his name not be used, called the conditions “deplorable. In a floor, we are, like, 30 people sharing three toilets and three bathrooms. The toilets don’t flush, so we have to use buckets. So if there’s any place we can contract the disease, it’s in these facilities.”

He said no one in his quarantine centre had tested positive for the coronavirus. His claim could not be independently verified.

All this is happening on the basis of 24 deaths apparently from COVID19. In the same newspaper, another article revealed how in one of the biggest slums in Africa, in Kibera, Nairobi, there were stampedes as residents rushed to get food aid being distributed. As in many highly congested slum areas found not only in Kenya, but in other countries where full lockdown is being imposed, the harm being done to people and the economic impact on their lives is inconceivable. To quote from the article:

“Thousands of people surged for food aid in a brief stampede Friday in Kenya’s capital, leading police to fire tear gas and injure several people, witnesses said.

Desperate for help as coronavirus-related restrictions make it more difficult to go out and make a living, residents of Nairobi’s Kibera slum gathered for a food distribution near a district office. They tried to force their way through a gate for their chance at supplies to keep their families fed for another day.

The scene in Kenya’s largest slum reflected the fears of millions across Africa as nearly 20 countries have imposed full lockdowns and others have shut down cities or imposed curfews. A vast population of informal workers, with little or no savings, worries about the next meal as no one knows when the measures will end. Already, Rwanda and South Africa have extended their lockdowns by two weeks.

In the Nairobi chaos, men with sticks beat people back as they fought over packages of food, some with face masks dangling off their chins. Some people fell and were trampled. Dust rose. Women shrieked. Injured people were carried to safety and placed on the ground to recover, gasping for breath.

“The people who have been injured here are very many, even we cannot count,” said one resident, Evelyn Kemunto. “Both women and children have been injured. There was a woman with twins, she has been injured, and even now she is looking for her twins. … It is food we were coming for since we are dying of hunger.”

The crowd had heard that popular opposition leader Raila Odinga had donated the food, said witness Richard Agutu Kongo, a 43-year-old who operates a motorcycle taxi. But in fact the distribution was from another well-wisher who had given selected families cards to turn in and receive aid, he said.

“They didn’t care about government restrictions that we were to stay 1 meter apart,” he added.

Kongo’s family, including six children, was given a card. They received two packets of maize meal, cooking oil and cereals.

People in the crowd “could see those with cards getting food and this caused the stampede as they tried to force their way in,” Kongo said.

He described his business as a standstill as Kenyans are discouraged from going out.

“Before, I used to make (the equivalent of) $10 and now with the coronavirus restrictions I can barely make $5,” he said. “It’s becoming hard to ensure my family gets three meals a day. Yesterday they missed breakfast.”

With Friday’s donation, his family now has enough for three meals, he said: “We are thankful for the donation, but it will only last two days.”

He lamented that Kenya’s government appears to have no plan to feed him and millions more.

According to these articles, the Kenyan government is locking people up for one month against their will, without knowing if some are positive or not, are not giving them any support and making them pay for their stay and in crowded slum areas. Hundreds of thousands remain stuck without income or food and the authorities are not even ensuring that enough food is being given.

In Embu County, local leaders requested that President Kenyatta looks into finding appropriate local herbal medicines to treat corona and not wait for the west to develop a cure or a vaccine.

‘“Kenya has some world-class laboratories and if the president can sanction experts to seek a herbal cure with consultation with elders, maybe we could get the cure for this pandemic”, local leader Ireri said. He added that since the times of yore, elders have been treating sicknesses of all kinds ranging from anthrax to leprosy using locally available herbs.

In fact, the Kenya Medical Research Institute (KEMRI), which is the largest government medical research body began as an organization looking into doing research into the use of traditional medicines and there is still a mandate to do more scientific exploration into herbal cures for a variety of illnesses.

So, as Kenya grapples with the crisis and follows the edicts from the WHO, the US Centres for Disease Control and other international bodies recommending a lockdown to deal with a crisis, the social and economic consequences are growing daily. Already, South Africa is having to go to the IMF and ask for a loan for up to 25 billion dollars. Kenya and other African countries are likely to have to do the same, if they keep their country closed for any length of time. Tanzania may avoid this by maintaining a more open approach, recognizing that the damage to the country from lockdown would be greater than that of COVID19. Given that Tanzania has only had 16 known deaths from COVID19 so far, it seems that they may have made the right decision.

 

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