Update for the Week

This is the first time since I started this blog that I’ve managed to do (near) weekly updates. As I mentioned before, when something rather significant is going on it’s worthwhile. It allows one to stop and think about things in a way you might not ordinarily. It’s also a nice record of what was happening. It’s just that normally when something big is going on, I don’t have time to write about it. Self-isolation (or family isolation) in my case has not offered me the ample personal time that I’ve been hearing about from others. But, particularly on weekends, I can squeeze in some reading and writing.

Slowly the weeks tick by. In Kenya the rates of both infection and death still remain fairly linear, upwards but linear. We had anticipated that there might be a spike by now but, at least in what is being reported, the growth of the pandemic in the country so far seems rather stable. It’s difficult to interpret but I’m going to say at this point that the Ministry of Health has been doing a commendable job – possibly not getting the kudos from the public as it deserves. I may backtrack on that statement at a later day but that is the view for now.

In Somalia it’s more of an uphill battle. I’ve been conducting weekly calls with a small group of staff chosen by my HR Coordinator. It’s sort of a random group of 6-7 men and women from various levels in the organization, different group each week, and we have an informal conversation about how things are going, how they view the unfolding of the pandemic personally as well as professionally. It’s fascinating stuff and it’s one of my favorite calls of the week. So far people seem to be fairly frank in their insights and I get a much better idea as to what is happening on the ground. We’ve discussed the stigma of the virus. Their ability to conduct their lives and still do their jobs. Inflation. Isolation. Resourcefulness. One staff in Mogadishu talked about how in some ways it’s been a positive to work from home. Commuting is generally fraught with risk in normal times. You need to navigate military and militia checkpoints as you cross the city to get to the office. Anything can happen at these tense intersections. You could also end up in the wrong place at the wrong time when a targeted attack happens. Traffic is mayhem and you could end up in an accident. Now, he said, he doesn’t need to worry about all that. Reducing his potential exposure to the virus has reduced his exposure to some of the dangers of life in Mogadishu.

Unfortunately staff in all our locations continue to tell me that the virus has likely penetrated the far corners of the country. And people still aren’t taking it seriously. Significant numbers are not being reported because people are not able to be tested and many are in denial about the dangers. One woman talked about a prominent man in her town that exhibited all the symptoms and subsequently died. Other members of his family are now sick as well. However they all refuse to accept that it’s Covid-19. They continue to run errands in the community as normal. Now that we're in Ramadan, many people are gathering to socialize as they normally would. With no ability to test, it allows people to refuse to accept that the virus is in their town or, for some, that it even exists at all. The few flights that connected the area where this woman lives have been cancelled. It’s now only accessible by four-wheel drive vehicle. The virus apparently made it into the community either by one of these overloaded Land Cruisers or by someone who came in by airplane before flights were cancelled.

Regarding the stigma some are attaching to the virus, it’s a topic that has come up in each of these informal meetings with staff. It was also discussed in another meeting where someone shared the results of a survey they conducted in which many people in the country believe that the virus is God’s judgment on those who have not be faithful. They also point to the fact that infidels were responsible for bringing the virus to the country in the first place. This obviously makes someone think twice about coming forward with their sickness and getting tested.

There was also a recent article in the Washington Post that talked about extremist groups using the virus to advance their causes. Though they don’t mention Somalia, it seems to be related to what is happening in the country. Various flavors of rhetoric from extremists all over the world manifest in the same absence of common sense and disrespect for basic pandemic mitigation measures. It’s dangerous in that there have been calls to disregard government messaging on how to prevent the spread of the virus. Many unfortunately are buying into this. It’s interesting to see the similarities in the playbooks of both Islamist groups and the Far Right in the US and Europe. In the survey I mentioned, as one might expect, it tended to be people from poorer and more remote areas that were the most susceptible to such messaging. The rhetoric is intended to fuel anti-foreigner sentiment. And it could work, at least in the short term. I suspect, however, that as the number of infected grows, and the fact that the virus demonstrates that it is impervious to religious, race or ideological boundaries, it may make such beliefs less credible.

Not long ago we ventured out, something we rarely do nowadays. We went back to the forest with some friends, this time to visit the waterfall. We find that such outings are easier for the kids with short attention spans when we target a particular destination as opposed to just going for a walk for the sake of going for a walk.

stylish

It was good to be out in the fresh air. We’ve been pretty disciplined when it comes to self-isolation so being out, smelling the eucalyptus trees, spotting a dik dik, seeing friends (at a safe distance) was welcomed. Though the parking area was packed with vehicles, the forest is large enough that people seem to be able to keep a safe distance from each other when out on the trails. Even that the waterfall, where I assumed it might be crowded, there were few people and we didn’t have any trouble avoiding uncomfortable closeness.

The restaurant near the parking area is open for take-out only. I’m a big fan of the place and it’s in such a beautiful setting. We had the presence of mind to order food in advance and pick it up at the end of our walk. Good to support these businesses given that they must be suffering.

We saw an article yesterday that talked about all of the businesses in the US that are not likely to weather the pandemic – many of them well known and have been around for many years. I tend not to have a great deal of allegiance to US businesses generally speaking, partially due to the fact that I’ve lived outside the US for a quarter of a century. Moreover I think there may be a healthy culling that needs to take place anyway. There’s been such a glut of shopping centers, restaurants, etc. in many parts of the country (and here in Nairobi to be honest). It was unsustainable. Sadly, there will be some that I enjoy that will not survive. 

spending more time on the roof these days...

Humanitarian Response in a Time of Pandemic

As time moves forward, we can see some countries are on the downside of the pandemic arc. Some restrictions are being loosened and there is a small hint of normality returning. I hope this is an encouragement to countries, including Kenya and Somalia, that are still on the upside of the arc. I think it helps psychologically to actually see that there’s a possible end to the current situation. I mentioned it to my management team yesterday to encourage them to encourage their teams to enhance their respect for the protocols in place to stop the spread. From the sounds of it, people in Somalia aren’t being very diligent generally speaking. As I've mentioned before, there are unfortunately some good reasons for this (practical, economic, etc.). It doesn’t need to be perfect but it needs to be enough to prevent the virus from making its way through the country. Time will tell.

On the work side of things, rarely have I ever been this busy. I hear of people doing creative things with videos, Tik Tok, Twitter, YouTube, etc. I enjoy the creativity but I doubt that I will be able to tap into my own creative juices anytime soon.  It’s all hands on deck. Protecting staff. Pivoting towards response, given that our largest sector in Somalia is healthcare. We’re tapping into a considerable amount of experience from Ebola and our Congo response. Though Covid is not the same thing, the triage, isolation, etc. protocols are similar. Sort of gives us a head start in knowing how to prepare. Somalia’s caseload is still relatively small for now but that could change and we’ll need to be ready. 

A key source of frustration is the lack of protective equipment for staff who work in our clinics (caps, aprons, gowns, etc.). We've seen this in other countries and I think it's weighing heavily on my team. The problem is that with the shortages in such equipment worldwide, countries have instituted bans on exporting it. That means countries like Somalia are unable to import it. But lately I'm seeing that countries like China are starting to make some equipment available. Hopefully we can get a hold of it and it can make it here in time. 

One thing I didn’t anticipate is how much of my day I would spend on calls. It’s probably around 80%, sometimes going well into the evening (often to accommodate those who are in New York). At first I thought it might be part of the adjustment period and now I’m realizing this isn’t going away anytime soon.

As I look at my calendar of meetings over the past couple of weeks, I am noticing a pattern. Though many of these meetings are standard (even useful) meetings that existed pre-Covid, many are new. Online meetings have been the norm for me since I began working in Somalia in 2016, particularly given our structure. So that’s not new. I think what’s new is that some people who are accustomed to working in an office, mixing in travel every now and again, are struggling to feel useful. They may be working as hard, or harder, but they seem to be more concerned about the perception of their efforts. Sending the 11pm or 5am email isn’t enough to show the world how dedicated they are. As such they create meetings to show that they are being active and well and truly in charge of whatever they are supposed to be in charge of.

Admittedly, I’ve grown more and more cynical over the years. I watch the twenty- or thirty-something A-types throw themselves into humanitarian work – a burst of energy and new thinking that they feel is lacking in order to save the poor and the hungry. They spend countless hours on spreadsheets, graphs and tables that are intended to revolutionize how we do what we do. I question how much impact these efforts really have on the ground, though often they do influence leadership and some changes. I’ve lost count how many times we’ve made changes, only to change things back to the way they were to begin with. Sadly, change does not always imply progress.

I suppose that’s the nature of the beast. We go through this iterative process where, of the myriad of changes we make, some things actually stick and make things better. We just needed to weather the storm of a lot of nonsense to get us to that point. Little by little we end up moving in a positive direction. I guess my concern is that we wasted a lot of energy along the way.

A Month in Isolation

We’re coming to the end of a full month of self-isolation. Time flies when you’re having fun.

If I’m honest, it hasn’t been that bad. I miss the gym. I miss seeing friends. I miss coffee shops/restaurants. I’m not an extrovert so it hasn’t been as challenging for me as it is for others.

We’ve stepped out a few times for exercise (a run in the neighborhood or a walk or bike ride in the forest) and to pick up essential groceries. Otherwise, our lives have been confined to our building. I can run up and down the ten flights of stairs and go for a swim every couple of days. Priya and the girls have been doing these online instructor-supported workouts so thankfully we're all staying fit.

We heard that there was someone in the building that is positive with Covid-19. I don’t think it’s confirmed, however. We also saw an ambulance come in and out of the compound on a couple of occasions, which made us a bit suspicious. We do know that several families have been in full quarantine after travel and/or possible exposure. Even if there aren’t any cases in our compound, the government has confirmed that there are positive cases in our neighborhood. So it’s around us somewhere.

 We’re still reasonably impressed with the government response. They started slowly, like many governments, but they seem to be doing the right things. The day before yesterday the president announced a further lockdown on the city and other parts of the country. No vehicles coming in our out except approved cargo. The number of infections to date has climbed slowly but steadily to 158 as of yesterday. Obviously people are suspicious of the numbers but they seem to have been pretty transparent with the whole process of testing and doing contact tracing, including in our building. So who knows but as with other countries, you can run but you can’t hide. If you’re faking, it will show up at some point. 

Priya was sick over the weekend. As you might think, we were concerned since she’s not sick very often and she’s been the most exposed by going to the store every day or two to pick up groceries. But the symptoms weren’t consistent with what we know of Covid-19. Eventually she started feeling better and we’ve moved on. But every cough, sneeze or headache is suspicious nowadays.

This morning we’re hearing that a gaggle of Kenya MPs have come down with the virus - people who traveled and came back to the country with it. Supposedly some of them had a big party about a week and a half ago in a neighborhood adjacent to ours that pretty much infected all those who attended. I can anticipate the wry smiles throughout the populace as people will feel like the corrupt politicians are getting what’s coming to them. It does sound as though there has been some deadly irresponsible behavior. The sad part is that the people who work for those infected politicians are from the ‘hoods where hygiene and social distancing are far more challenging. It may well contribute to a spike in infections. This could get ugly.