COVID-19

April 13, 2020

No Protection for the Elderly amid Covid-19 Pandemic

By Geoffrey Kamadi

Agnes Kariuki, team leader of the Kibera Day Care for the Elderly, demonstrates how hand washing should be done. The organisation donates foodstuff to the elderly in the slums. Photo| GEOFFREY KAMADI.

There were only 687 individuals aged 100 years and above in Kenya, according to the census conducted in 2019. This figure is included in the 400,000 persons aged over 80 years– or 0.0085% of the country’s total population of 47 million people.

This is the age range in which the fatality rate of Covid-19 rises sevenfold to 15%, according to data based on 44,000 Covid-19 cases in China. What this means is that the highly virulent disease could decimate this tiny population in no time, should the country experience the scourge to a fraction of a degree of what is taking place in some of the developed countries.

No Legislation

This is especially the case given that what would have militated against the pandemic, such as a robust health infrastructure, is either woefully inadequate or non-existent at all.

Even so, the old population has been finding itself more and more on the fringes of society. It is fast becoming a marginalized group in Kenya.

Yet, unlike other vulnerable categories such as orphaned children, women, people living with disabilities, indigenous communities and the youth, this segment of the society is not protected by law.

Attempts in the past to come up with strategies and policies to this end, both at national and regional levels, have been half-hearted at best and yielded zero results at worst.

For example, a bill known as the Care and Protection of Older Members of Society Bill, has never moved past its second reading in Kenya’s parliament. In other words, no policy, legislation or strategy exists that would otherwise safeguard the rights and welfare of the elderly in the country.

In addition, only two member states of the African Union (AU) – Benin and Lesotho – have signed and ratified the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Older Persons. The Protocol was adopted in 2016.

Erastus Maina (L), the Kenya Country Programme Coordinator, HelpAge International with Mr. Kinuthia Wamwangi, HelpAge International Ambassador for older people in Kenya. The international NGO has come up with guidelines to help old people protect themselves against the pandemic. Photo| GEOFFREY KAMADI.

At least 15 AU countries need to be signatories as well as ratify the Protocol, for it to become part and parcel of the laws of individual member states. This apparent hesitancy by African countries is viewed by many as unhelpful in terms of advancing old people’s welfare.

No Safety Nets

At another level, the extended family unit which provided protection and a sense of security to its elderly members in African societies, is being eroded – if not already.

Along with this erosion is the chipping away of the elevated and esteemed status aged people once enjoyed in Africa. They were cherished and revered. This is no longer necessarily the case.

The economic realities of the day have compelled the young members of the community to move out looking for work in big cities and towns. This in turn has undermined the once-secure and cohesive family bonds.

The old are therefore left behind in their rural settings, with no one to look after them. Some instances actually demand that they take care of their grandchildren, even as their parents are working in urban centres.

Old people feel discriminated against. They cannot find jobs, making it difficult for them to earn a living. Antipathy against them is turning into hatred, something which has been exacerbated by the Covid-19 pandemic.

It is high time this segment of society, which in many ways is a treasure to have, be enshrined in legislation. This is the only way that their welfare, which includes the right to health can be protected.

April 3, 2020

Behind the Curve – Lessons for Africa from Europe’s Late COVID-19 Response

By Geoffrey Kamadi

Before boarding a matatu ( a common public transportation in Kenya), the passenger’s hands have to be sanitized. Photo|GEOFFREY KAMADI.

People in Africa are aghast at the grim corona virus situation unfolding in Europe and America. If the health systems of the so-called First World cannot sustain the strain visited upon them by the COVID-19 global pandemic, what then for the rickety infrastructure in Africa?

“If what is happening in Europe were to take place here,” said one pub patron in earnest, a few days before the 7pm-5am curfew was enforced “we will all be dead,” adding in an attempt at dry humour, “at least my favourite drink will be in here,” motioning at- and rubbing his belly with the palm of his hand.

But it might already be taking place, for all we know. Kenya’s Health Cabinet Secretary, Mr. Mutahi Kagwe came out on April 2nd, warning Kenyans to brace themselves for the worst, after the country’s recorded cases climbed to 110 with three deaths.

No wonder, the apprehension is all too palpable. And so is the frustration borne out of a lockdown meant to stem the spread of the deadly disease, but has since paralyzed the nation.

However, it ought not be this way, not least given that the continent had ample time to learn. It also had the opportunity to prepare for what could otherwise degenerate quickly into a catastrophe of unimaginable proportions. Scientists agree.

What to Do?

This may seem obvious to say but unfortunately many European countries in particular have been really behind the curve on this

Professor Kevin Marsh

First and foremost, the number of transmission taking place on the continent need to be known, according to Professor Kevin Marsh, Senior Advisor at the African Academy of Sciences.

“This may seem obvious to say but unfortunately many European countries in particular have been really behind the curve on this,” said Marsh, during a webinar hosted by the AAS last week, looking at the research and development opportunities on the continent that the COVID-19 presented.

Many people are skeptical about the low COVID-19 figures reported on the continent. They suspect that the lack of testing could be a factor.

However, the Kenya Medical Research Institute (KEMRI) has begun testing for SARS-COV2, the virus that causes the COVID-19 respiratory disease. Even so, they are using manual testing at the moment.

“Very shortly, high throughput assays will come into use, with a capacity of thousands of tests,” KEMRI assured the public via twitter. These tests, the Institute explained further, can provide at least 12,000 test results a day.

Surveillance

The Nairobi City Water & Sewerage Company is installing hand washing points in public areas like the markets. Photo|GEOFFREY KAMADI.

Surveillance of cases is another important step to be taken according to Marsh. He stresses the need for rapid, planned surveillance, ideally with shared agreed protocol so that they can be comparable.

One model is to have population surveys based around areas of known cases and then to have them conducted in controlled areas.

The reason for this is “that if, maybe, there are more transmissions than we are aware of, it may be that there is little transmission,” he said, before emphasizing, “whichever the case, it is essential we know this now.”

Investigators have been accused in the past for not sharing their findings with colleagues. This should not be the case at this time, given the magnitude of the problem we are facing. The urgency of the situation demands the sharing of data, which will assist in coming up with models, to help combat it more effectively.

“I think all the data needs to be made available in real time, so that different modeling can be taken,” urged Marsh.

Large Trials

At another level, the setting up of large and pragmatic trials, both for treatment and potential prevention will go a long way, which will look at drugs, vaccines and other interventions.

And, in the wake of the emergency situation that the COVID-19 now presents, ethical reviews should take a much shorter time than is usually case. These reviews take weeks and months on the continent.

One way of doing this, suggests Marsh, is to establish a credible, full time expert group drawn from across the continent and beyond. The decisions of this group would be acceptable by other ethical committees.

With a weak healthcare infrastructure that can ill withstand the COVID-19 onslaught ravaging parts of the First World, Africa cannot afford to sit back and wait. Action is needed and needed fast.