Concern's response to coronavirus: Our teams were on the ground

Many of the world's poorest communities depend on jobs like manual labour to make the income they need to survive but lockdown restrictions made this impossible, and families struggled to feed their children.

Given the impact of the disease on countries with strong health systems, Covid-19 posed an even larger threat to densely populated countries that were already struggling with the impact of conflict, climate change and hunger.

Our focus was on maintaining our current lifesaving programmes, where possible, as well as playing our part in raising awareness of the tools used to fight the spread of the infection and help with its wider impacts.

Here is a detailed breakdown of how we responded in each country.

On 16 March 2020, the Federal Ministry of Health of Somalia confirmed the first case of Covid-19 in the country’s capital, Mogadishu. Somalia has just one ICU bed per million people. We are taking all the necessary precautions to prevent the spread of Covid-19 to the communities we serve while ensuring the continuity of our lifesaving programmes. To do this, we are:

• Scaling up response and prevention measures at health facilities to ensure communities can continue to safely access life-saving nutrition support, including implementing social distancing measures, increasing handwashing stations, raising awareness on the importance of good hygiene and delivering handwashing demonstrations for staff and patients.
• Attempting to pre-position two months’ supply of life-saving therapeutic food, which will used for children suffering from life-threatening malnutrition.
• Continuing to carry out cash transfers to vulnerable households across Somalia to help people cope with the economic shocks expected as a result of the pandemic. 
• Implementing a number of specific Covid-19 responses in its educational activities, such as supporting the development of distance learning opportunities for children and the provision of WASH facilities and supplies and hygiene promotion work, ensuring that schools and children can remain safe and hygienic. 

We have worked with health centres to ensure fumigation is done, health workers are trained and that PPE is procured and distributed. In addition, hand-washing stations have been installed, soap has been provided, and the provision of water has been undertaken.

In Ethiopia, we have reviewed and adjusted all activities to avoid large gatherings, while also maintaining important food distribution and services to our outpatient therapeutic programmes. We are working to distribute soap and protective equipment for health staff, as well as setting up hand-washing stations. Finally, we are looking at measures that include emergency unrestricted cash assistance and phone counselling.

The importance of social distancing is being emphasised throughout our programme areas and amongst our staff. Our programmes are ensuring that the number of people attending clinics, training and food distributions at any one time are kept to a minimum and our teams use every opportunity to promote hand and respiratory hygiene.



To date we have:

• Provided over 1,200 hand-washing stations in key locations;
• Provided over 14,134 people with soap and sanitiser;
• Provided over 49,000 people with improved access to water as part of the Covid-19 response.
• Trained over 380 health care workers and 920 community health workers in Covid-19 prevention and response.
• Through posters and awareness campaigns, we have reached over 613,000 people with Covid-awareness messaging to ensure everyone is aware of the importance of prevention practices.

Concern is working with the Kenyan government in its response to Covid-19 by providing technical support through working groups and coordination meetings, but we are also responding by:

• Spreading Covid-19 messaging and promoting good hygiene practices across local radio.
• Giving cash assistance to urban households to cushion them against the economic impact of a Covid-19 shutdown.
• Working with a number of other organisations to promote awareness of social distancing and preparation for an emergency situation.

In Burundi, we are responding to Covid-19 by:

• Ensuring social distancing is undertaken for all our activities and that handwashing stations are available at all our sites.
• Training all staff on the risks, prevention, signs and symptoms of Covid-19.
• Adapting our health programme to incorporate Covid-19 community messaging materials and activities.
• Providing hygiene kits to facilitate proper handwashing.

In Rwanda, our team have developed strategies to support vulnerable communities through activities such as cash transfers, which will help to mitigate the economic impact of social distancing measures.

In DRC, we are adapting all our distribution activities in accordance with social distancing guidelines. However, we will continue cash transfer activities to help mitigate the economic impact of the virus. We are also adapting our health programme activities to include relevant hygiene activities and community messaging on infection control.

The arrival of Covid-19 in the Central African Republic (CAR) was expected to exacerbate the vulnerabilities of a population who are already coping with ongoing conflict, particularly in terms of access to good quality health services, adequate nutrition and livelihoods opportunities. As the hungriest country in the world, with one of the world’s weakest health systems, it was vital that we responded quickly and effectively. We immediately adapted two of our current projects and launched two new projects along the axis linking the capital Bangui to Douala in Cameroon - one of the areas most affected by the pandemic. 400,000 people across western CAR will benefit from this mobilisation.

We have also:

• Worked with 75 health centres to help train staff in Covid-19 infection control and response and have overseen the construction of 30 latrines and the rehabilitation of 20 water points for these health centres.
• Been involved in training hundreds of members of isolated communities to act as role models and motivate others to adopt good practices to reduce the risks of Covid transmission.
• Adapted our regular activities to align with social distancing guidelines.
• Produced radio messaging and other materials to promote vital messaging on reducing the spread of the virus.
• Distributed disinfection kits (chlorine, personal protection equipment) in health centres and ensuring handwashing stations in health centres and schools have soap.

In Niger, we are increasing all community awareness activities by sharing messages and advice to reduce the spread of Covid-19 over the radio. In addition, we are:

• Scaling up all community awareness activities by sharing messages and advice to reduce the spread of Covid-19 over the radio.
• Working with health authorities to further strengthen the capacity and preparation of 94 health centres in the Tahoua region of Niger and adopting community malnutrition services to Covid-19.
• Training community leaders and members to share information about the virus with the communities. 

Finally, we are setting up hand-washing stations in all of our community locations and particularly in health centres. Our education and livelihood activities have been adapted to incorporate social distancing guidelines. 

The first confirmed case of Covid-19 in Chad was announced on the 19 of March 2020.

Since then, we have implemented mass awareness campaigns to prevent and limit the spread of Covid-19 through a number of means including local radio. Recent assessments have shown that the levels of awareness regarding Covid-19 and its prevention are strong. These campaigns are continuing with the incorporation of new messages including stigmatisation and respecting preventative measures. We’re also providing practical assistance to prevent transmission, including strengthening access to protective equipment for health workers; rehabilitating boreholes to increase access to water for 5,000 households; and distributing water, sanitation and hygiene kits to 5,000 vulnerable households.

In Liberia, our team has been scaling down our general programme activities in line with government restrictions. The primary focus at present has been on preparing materials to raise awareness around social distancing and handwashing, including the production of radio jingles.

In Sierra Leone, we have introduced a range of activities under our programmes to help slow the spread of the virus, many of which are adapted from our response to the Ebola crisis in 2017. These include:

• Engaging with Traditional Healers to help spread important Covid-19 messaging and working with them to organise a ‘zone system’ in communities to ensure compliance with social distancing.
• Training Community Health Workers on Covid-19 messaging and infection control practices. 
• Producing educational materials on Covid-19 and broadcasting information through radios and loudspeaker vehicles.
• Installing handwashing points at 50 locations, including transport areas, petrol stations and markets. These handwashing stations include ‘veronica buckets’ (a big bucket with a lid and a tap) and stands for the bucket, hand soap, and large plastic water storage tanks.
• Supplying protective materials and manufacturing alcohol hand rub to distribute in 4 districts. 

We are also maintaining essential health services so people still receive treatment for non-Covid-19 related health issues. The prevalence of life-threatening illnesses, such as malaria, is only set to increase with the onset of the rainy season, which typically runs from May until October. A large part of our health response is to support those clinics so that they can remain operational and continue to treat such conditions during this pandemic. We’re supplying them with vital Infection Protection Control (IPC) materials – everything from chlorine to hand sanitiser – so that they can maintain a safe and sterile environment for both staff and patients.

Due to school closures, education activities have adapted to support the Ministry’s approved distance learning approach using a curriculum designed for use on the radio. We have also distributed radios and spare batteries to school children. 

In Sudan, our team has been scaling back regular programme activities in line with government social distancing restrictions and our health programme activities are currently being adapted to align with the national Covid-19 response strategy. We are:

• Adding additional handwashing stations and cleaning materials at health facilities.
• Distributing soap amongst the communities that we work with.
• Providing logistical support with hygiene materials and the awareness-raising campaign. 

Malawi’s population is particularly vulnerable to the effects of Covid-19, with just 25 intensive care unit beds and 20 ventilators in a country of more than 17 million people. As a result, our team has adapted our programme activities to reduce the size of meetings, keeping physical distance between the farmers we work with and introducing handwashing before and after trainings and seed fairs.

We are also responding by:

• Starting a new intervention supporting the Ministry of Health and doing community awareness in the high-density suburbs of Lilongwe where the effect of the virus will hit hardest.
• Distributing Personal Protective Equipment, where available, for health workers in both urban and rural areas, as well as training Community Health Workers on the risks and prevention of Covid-19.
• Providing cash transfers to support extremely poor households.
• Increasing our team capacity in the short-term to include a public health expert and a communications expert in order to respond more effectively to the demands of this crisis.

The outbreak of Covid-19 was predicted to affect Afghanistan significantly due to its weak health system, limited access to hygiene and sanitation facilities, and cramped living conditions in camps where people having fled conflict are currently living. We have been responding by:

• Installing hand-washing stations across its areas of intervention in Northern Afghanistan.
• Concern’s extensive network of community development facilitators conducted hygiene awareness campaigns specifically tailored to Covid-19.
• In coordination with community committees, Concern identified substandard water infrastructure, conducted repairs and identifies the best locations for hand-washing stations so that communities are better able to protect one another.
• All programmes have been adapted to take account of the risk of Covid-19 and to make use of Concern’s direct access in communities to raise awareness of the virus. For example, as part of its Education programme, Concern has distributed water tanks, soap, sanitiser and face masks to schools and has reached over 14,000 students with information on how they can protect themselves and their communities from Covid-19.

Where the government has imposed a nationwide shutdown in a bid to contain the virus, we have redesigned our nutrition services at the Rohingya camps near the village of Cox’s Bazar, where 855,000 refugees are living in close proximity to each other and in significant danger should Covid-19 enter the community.

 In addition to this, we are responding by:

• Ensuring the availability of a month’s supply of food to the Rohingya refugees. Having distributed a double ration of food prior to a period of shutdown, we have also prepositioned food stock in the camps that can be distributed by our volunteer network should the restrictions continue for a longer period.
• Providing gloves and masks to help prevent the spread of the virus whilst increasing awareness campaigns on hygiene promotion and infection control through one-to-one discussions in line with social distancing and demonstrations of how to use protective equipment.
• Distributing information leaflets about Covid-19 to communities outside of the Rohingya camps.

In Pakistan, under the Building Disaster Resilience Programme (BDRP), government health facilities and quarantine centres are being supported by the provision of:

• Hygiene and disinfection materials;
• Basic PPE;
• Installation of handwashing stations, water points, latrines, incinerators and solid waste management.

Similarly, the RAPID Programme is focused on improving preparedness and response capacity at the government and community level through its planned provision of:

• Essential supplies;
• Equipment;
• Disinfectants;
• Basic PPE and other essential measures;
• Installation of sanitation infrastructure in health facilities and provision of cash grants to the extremely poor and vulnerable households.

Training sessions are also planned for the front line staff in government health facilities, along with mass awareness at the community level.

The Democratic People's Republic of Korea (DPRK), remains officially Covid-free. However, due to its fragile health system we have been responding with key preventative measures in vulnerable communities where we work. Activities include:

• Hygiene messaging, such as promotion of hand-washing and provision of hygiene kits for those who lack basic facilities. Kits include items such as buckets, basins, soap, towels.
• We train caregivers in hygiene messaging to ensure a long-lasting impact.
• Concern also works with the most vulnerable to build more resilient livelihoods for those being affected by the broader socio-economic impact of the pandemic and restrictions of movement and trade.

In Iraq, years of war have taken a toll on its population and on governance, resulting in a limited capacity to rebuild the country. This is becoming even more challenging with the growing number of Covid-19 cases in Iraq – the Iraqi Ministry of Health confirmed over 535,000 cases as of November 23, 2020.

This emergency requires everyone to work together and highlights the vital role humanitarian agencies can play in supporting authorities to prevent the spread of the virus. Our work has focused specifically on:

• Supporting preventive measures for over 200,000 people living in camps in Northern Iraq.
• With support from the European Commission’s Humanitarian Aid and Civil Protection department (ECHO), we started a Covid-19 Hygiene Kit response, distributing bathing soap bars, detergent and sanitary pads to 84,500 individuals.
• Promoting Covid-19 prevention messaging through local partners.

The second wave of Covid-19 has now started, with an average of 1,800 new cases recorded per day. With little access to lifesaving health care and limited opportunities to practice adequate social distancing, refugees and migrant workers are at a heightened risk of contracting the virus. Our team is working to mitigate the impact of Covid-19 among Lebanon’s most vulnerable communities by: 

• Distributing hygiene kits to refugees and essential information on how to keep safe from the virus.
• Completing the rehabilitation of two isolation facilities for refugees that may be affected by Covid-19 in Akkar.
• Distributing emergency cash assistance to refugee households that have lost their source of income due to the pandemic.
• Undertaking awareness activities and hygiene kit distribution to refugee collective shelters.
• Rehabilitating a 50-room disused school to be used as an Isolation Facility.
• Ramping up remote case management.

As part of our ongoing Protection programme, our team has strengthened its remote case management work, which supports survivors of sexual and gender-based violence (SGBV), child protection, and intimate partner violence (IPV).

The number of deaths in Turkey has now passed 12,000 and our team is continuing to provide urgent protection support to vulnerable individuals.

We are responding to Covid-19 by:

• Providing urgent shelter support, cash support for food (in the form of shopping cards), basic household items (mattress, kitchen items etc.), and emergency transportation.
• Delivering online training sessions to caregivers of children on measures to take to prevent the spread of Covid-19.
• Distributing hygiene kits (comprised of soap, shampoo and anti-bacterial surface cleaners) supporting 52,600 vulnerable people to date.

The scale, severity and complexity of needs in Syria remain extensive with an estimated 11.7 million people in need, including thousands of people living in camps and informal settlements. These communities are especially vulnerable to Covid-19 because of crowded living conditions, inadequate shelter, limited access to water, handwashing facilities and soap, the prevalence of pre-existing medical conditions, with limited functioning health facilities. As a result, we are:

• Providing vouchers to vulnerable families which enable them to purchase both food and hygiene products from local vendors. Over 150,000 people are being supported in this way.
• Rapidly increasing hygiene kit distribution, which includes soap, dish washing gel, shampoo and laundry powder. So far, we have distributed almost 20,000 hygiene kits and food baskets to vulnerable people in camps, informal settlements, collective centres and urban areas.
• Providing extensive hygiene promotion campaigns based on World Health Organisation guidelines such as appropriate handing washing practices.
• Building handwashing facilities at health centres and planning to increase the number of water points to ensure Syrians, to the extent possible, meet social distancing guidelines
• Scaling up Infection, Prevention and Containment activities to successfully complete the rehabilitation of 25 health facilities. 

Already hit by a severe political and environmental crisis, Haiti is now facing another significant challenge with Covid-19. It will be particularly difficult in the slum areas of Port-of-Prince where we are currently implementing programmes.

Our team is committed to following Government recommendations such as social distancing and are working on adapting our programmes in Port-of-Prince in order to respond to the threat. Under our ‘Disaster Risks Reduction’ (DRR) programme, we have been putting in place important prevention measures such as social distancing messaging, hygiene kit distributions and water point and pump installations.

Our staff have been supplying cleaning soap and provided money and training for unemployed people to make their own soap to use and sell, which has been running successfully in Cite Soleil, Haiti’s largest slum. This helped the communities to get make an income from the soap making process, as well as getting access to protect themselves against Covid-19.

The coronavirus pandemic was a global crisis that required a global response. Concern has always been committed to a principle of leaving no one behind – and this has never been more relevant.