COVID-19 in the Central African Republic: Respecting Barriers Measures in a Multi-Crisis Context

Located in the centre of the African continent, the Central African Republic (CAR), like other countries in the sub-region, has not been spared from the COVID-19 pandemic. A country struggling with many social, political, economic and, above all, security challenges since the coup of 24 March 2013, the CAR did not need another crisis on its already long list of problems. Alas, the virus is indiscriminate.

A new crisis
The first imported COVID-19 case (from Italy) in CAR dates from 14 March 2020. However, by 6 July, the country already had 4009 confirmed cases, including 948 recovered patients and 51 deaths (including 43 in non-hospital settings) (Ministry of Health data). So, how is the population of around 5 million inhabitants experiencing this new crisis? What are the effects of the pandemic on the daily life of Central Africans? Gleaned data can help us take a look at this situation that we can now call a multi-crisis.

Border closures and barrier measures
Faced with the fear that the pandemic is spreading throughout the  world and confronted with a failing (arguably non-existent) healthcare system, CAR authorities imposed restrictive measures early on in order to limit the spread of the illness at a local level, but also to stop imported cases: border closures (with the exception of the Bangui-Bouar-Garoua-Mboulaye line, almost the only artery supplying the country with finished products), closure of places of worship, schools and universities, night clubs and dance halls, a ban on groups of more than 15 people, a ban on handshakes and embraces, systematic hand washing at the entrance to public buildings, restrictions on population movements to the hinterland, etc. These barrier measures taken for 15-day periods have been constantly renewed and reinforced as the pandemic spreads. According to the latest news, the country has now enforced the compulsory wearing of masks in public spaces. So, how is the population reacting to these new measures and how are they coping with another crisis?

Precarious economic situation
In recent years, the CAR has experienced a security crisis (with at least 14 active armed groups) that has weakened almost all socio, health and administrative structures: there has been a destruction of healthcare, education, administrative and economic structures in the capital Bangui as well as in the provinces. A simple example is the lack of beds in hospitals, which forces health authorities to (as far as is possible) care for patients at home; hence the high number of deaths in an extra-hospital environment. Given its precarious economic situation and the high rate of unemployment and underemployment, the people of the Central African Republic live mostly from the informal economy, from resourcefulness, and hand to mouth. This situation makes compliance with the rules almost illusory.

Mainly Christian (80%), the Central African population frequently defers to God when faced with difficulties. However, people also retain traditional practices. Since the last crises, the country has experienced a clear rise in rumors and misinformation, reinforced by a high rate of illiteracy (nearly six out of 10 Central African 10-year-olds cannot read or write). On the other hand, the country has one of the youngest populations on the continent: the average age in the Central African Republic is 22 years, according to data from the last population census in 2003. Unfortunately, this young population could also be one of the weakest in terms of immunity given the growing malnutrition. While this youthfulness may be an advantage, it is clearly problematic in view of the increase in asymptomatic cases of the virus.

Football and funerals
As this dark configuration shows, some Central Africans are reluctant to respect the barrier measures taken by the government to slow down the spread of the pandemic. Some describe COVID-19 as a ‘white man’s disease’ or a ‘divine punishment against sinners’. Despite the incessant exhortations to respect the instructions via radio and television announcements, and from the mobile telephone companies (SMS and audio messages), some inhabitants of Bangui appear insensitive: gatherings are common, e.g. for football matches in quartiers, even though this is prohibited); funerals (also prohibited are organised with great fanfare and without regard to social distancing; handshakes are rife, and drinking places that officially remain closed operate behind closed doors.

Denial of the pandemic
In the provinces, small churches continue to operate ‘as usual’. In Bangui, some people go so far as to describe the figures presented by the government as fanciful and intended to attract funding for the purpose of embezzlement. Even the first official deaths have failed to dispel these beliefs, to the point that the body of the first deceased person from COVID-19 was snatched from Central African Red Cross agents and forcibly taken by his parents back to their neighbourhood, where they organised a ‘traditional’ funeral. The deceased’s parents rejected the official version that led to the death, favouring other explanations, such as metamorphosis or meningitis, forgetting that people with a medical history (diabetes, heart problems, etc.) are the most exposed.

In the environs of the town of Bossangoa (north-west centre of CAR), some people refuse to take part in awareness-raising sessions (of less than 15 people) organised by NGOs, just because they reject the imposition of the barrier measures. They say that “it is frowned upon to greet someone without shaking their hand. It is to show hostility.” In other places like Batangafo (north centre of CAR), where insecurity is increasing, people seem to deny the very existence of the pandemic. If the churches and schools are closed, here, the mosques and Koranic schools remain functional. Even in Bangui, in the Muslim quarter of PK5, the mosques were opened during Ramadan, in defiance of the government restrictions.

Cost of living increases
On the economic front, the closing of the borders has caused the prices of basic necessities to soar, thus increasing the cost of living. Consequently, people ignore the barrier measures in the markets, instead taking advantage of the situation to make more profits or to earn more to meet the high cost of living. Customers, too, seem to show little respect for the barrier measures. Here, everyday survival seems to take precedence over the pandemic. This is being exacerbated by some law enforcement officials being among the first to violate the new rules, including frequenting alcohol drinking places.

Opening of places of worship
Recently, in a bid to help the population ‘get used to the virus’, the government has eased the barrier measures by authorising the opening of places of worship and bars (except dance halls and nightclubs), but it remains compulsory to respect social distancing, the installation of hand washing devices at the entrance to these places, and the compulsory wearing of masks. The first Sunday,  14 June, following the easing of these measures saw churches crowded with people without masks or social distancing. Many say that “the wearing of masks is a satanic sign,”, or, “we cannot go to God with our mouths covered.”. Meanwhile, the number of new cases continues to increase, and the dilemma about reopening schools and universities remains difficult to solve in a country without infrastructure and with a plethora of students and only a limited number of qualified teachers.

Prioritise survival
Despite the swift introduction of barrier measures to stop the spread of the COVID-19 pandemic, Central Africans appear to remain resistant. Many continue to dispute the official figures. This can be partly explained by the difficult socio-economic situation in the country, and the priority being survival and tradition (including monotheistic beliefs and ancestral practices). This is far from encouraging in terms of compliance with the measures aimed at blocking the spread of COVID-19 in the Central African Republic. Today, only a handful of people systematically observe these measures. Meanwhile, the shortage of drinking water in some parts of the country frustrates the practice of even simple gestures such as hand washing.

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Photo credits
Top photo: the city centre of Bangui (source: Wikimedia Commons). All other photos by the author.