As Americans lament the social distancing measures in place to combat COVID-19, thousands of the world’s most vulnerable populations face an even greater challenge than closed nightclubs and toilet paper shortages. NPR reports that refugees and people in developing states with already fragile healthcare systems are at an increased risk of contracting the deadly disease.
Myanmar’s persecution of Rohingya Muslims has forced over a million refugees to flee into Bangladesh since the 1990s, more than half of which now living in Kutupalong, Cox’s Bazaar. According to UNHCR, the large size of this settlement draws “concerns over the lack of adequate water, shelter, and sanitation,” a situation that Asia Times describes as a “time bomb.” While Japan Times reports that the Kutupalong camp has no confirmed cases as of April 4, the refugee’s reliance on aid from Bangladeshi locals and international humanitarian workers leaves them at constant risk of exposure. Once a refugee contracts the disease, the close-quarters nature of the camp and the absence of adequate health infrastructure means the disease will spread like wildfire, quickly surpassing volunteers’ capacity to combat it.
The situation the Rohingya face in Bangladesh parallels the state of the Mae La refugee camp in Thailand during the 2009 H1N1 pandemic. The National Center for Biotechnology Information reports the Mae La camp, which housed only half the population density of Kutupalong, had five times the instances of influenza and influenza-associated pneumonia than the rest of Thailand. According to Asia News, Mae La refugees recovering from the effects of the pandemic subsequently suffered outbreaks of dengue and cholera. Reuters reported skyrocketing suicide rates in Mae La as the already vulnerable population continued to suffer.
Without greater access to health facilities and professionals, the Rohingya are bound to face the same fate as those living in Mae La a decade ago. However, refugees are far from the only at-risk group facing this pandemic.
Al Jazeera warns that developing nations with fragile healthcare systems may become hot spots for COVID-19. This is especially true in Nigeria, where population density limits civilians’ ability to self-isolate. While the number of COVID-19 patients soars to over 200, according to CNBC Africa, a deadly outbreak of Lassa fever is exhausting healthcare facilities across the country. According to Quartz Africa, Lassa fever, a disease comparable to Ebola, afflicted more Nigerians in the first two months of 2020 than in 2017 and 2018 combined. While the country has only suffered roughly 132 deaths, doctors believe the epidemic is far from over.
On top of Lassa fever and COVID-19, a third problem compounds Nigeria’s health crisis: access to working doctors. Healthcare professionals in the capital Abuja are now on strike, according to The New Humanitarian, asserting that they have not been paid in two months. Despite the rising need for them, doctors insist that they will not return to work until they receive all the back pay they are owed. Until the strike is over, the three million residents of Abuja are left to cope with these two diseases on their own.
Across the Atlantic, Haiti struggles to battle COVID-19 after years of natural disasters and cholera outbreaks, which devastate their sanitation and health facilities. In an interview with Press Herald, Haitian civilian Majorie Jean-Baptiste laments, “Coronavirus will kill like Cholera did. The country doesn’t have any resources to combat epidemic.”
While Haitian citizens anxiously wait to see if COVID-19 will be contained, the state faces a problem that may be more pressing than faltering hospital infrastructure: gang violence. The Guardian reports that gangs in Haiti take advantage of civil unrest for personal gain, kidnapping hospital administration and holding them for ransom, according to Reuters.
Although UN Secretary-General Antonio Guterres announced a $2 billion global humanitarian aid plan to help countries such as Haiti to combat COVID-19, Haitians remain skeptical. The National Review reports that the last time the UN sought to help Haiti, UN Peacekeepers sexually assaulted women, fathered children with girls as young as 11, and caused a cholera outbreak which infected over 80,000 Haitians.
The UN maintains that it seeks to help developing nations and will push for its plan to dispense aid. In a statement regarding its new humanitarian plan, the UN asserts that without significant aid, children in developing nations will be the “hidden victims” of this pandemic. While most COVID-19 related deaths occur in people over age 60 rather than adolescents, the UN contends that pandemic-driven school closures in developing nations put children at an increased risk of neglect, labor exploitation, and sexual abuse.
The UN Development Programme posits the economic losses caused by COVID-19 have the potential to impact education, human rights, and food security in many nations. While the media bombards citizens with information about infection rates and death tolls, people must look at who may be left behind. Aid packages proposed by the UN are a step toward lessening the impact of the pandemic, but if member states neglect to follow through, developing states and refugees will be left more vulnerable than ever before.