Stigma harming Somalia's efforts to stop COVID-19

MOGADISHU, Somalia - The stigma around COVID-19 is stopping Somalis from seeking medical treatment and thwarting efforts in Somalia to stop the spread of the virus, including track and trace.

In CARE-supported health centers in Somalia/Somaliland, the number of people seeking consultations for communicable diseases has fallen by more than a quarter [26 percent] since the first case of COVID-19 was recorded, with fear of stigma for having the virus being a major factor.

"Our teams are seeing people who have tested positive running away from their homes out of fear of being stigmatized by the community," said Abdinur Elmi, CARE Somalia/Somaliland's Emergency Director.

"We are deeply worried that whole communities can get infected if we don't address the stigma, which is being fuelled by cultural and religious beliefs," he said.

Somalia's health system is already at breaking point following decades of instability caused by conflict, neglect, and climate shocks. The country ranks 194th out of 195 on the Global Health Security Index, and according to a study by US-think tank The Rand Corporation, is the country most vulnerable to the spread of infectious diseases and most unequipped to deal with a pandemic. Somalia has confirmed 3,119 COVID-19 cases and 93 deaths.

Humanitarian organizations and partners are racing to try to support the Somali health system and stop the spread of COVID-19. But stigma is making people avoid treatment.

"I've heard of patients who've disappeared from their communities after testing positive and many others who are now afraid of visiting health centers because they fear being shunned if they test positive. In turn, this has made contact tracing nearly impossible," said Amran Shire, CARE Somalia/Somaliland's Humanitarian Program Manager.

People suspected or known to have COVID-19 have reported being cut off by the community, of being unable to access essential services such as water, food, and health care, and of having no support.

Amina, aged 21 and from Hargeisa, lost her mother and sister to COVID-19. She and her brother tested positive for the virus.

"I felt isolated and even after recovering, the whole community avoided me and I had to stay indoors all the time," she said.

"I felt everyone was blaming our family for bringing this virus to the community. It was and still is a difficult time for me. I even struggled to find a nurse to tell me how to take care of myself and I wish this virus had not come to my family."

CARE Somalia/Somaliland's COVID-19 awareness-raising campaign aims to reach more than 2 million people through text messages, radio and TV talk shows. CARE is also giving people hygiene and sanitation supplies and providing health centers with hand-washing facilities.

"Through our programs, we have started raising awareness about the detrimental effects of stigma in the communities we work in. We are calling on Somali communities to unite and collectively fight stigma to beat COVID-19," said Elmi.

CARE has been providing emergency relief and lifesaving assistance to the Somali people since 1981. Our main program activities since then have included projects in emergency response, cash programming, water and sanitation, resilience and disaster risk reduction, sustainable pastoralist activities, civil society and media development, small-scale enterprise development, primary school education, teacher training, adult literacy, and vocational training. We work in partnership with Somali and international aid agencies, civil society leaders, and local authorities. CARE Somalia/Somaliland has a large footprint across the country and is operational in the regions of Puntland, Somaliland, and South-Central Somalia.

Somalia ranks 194th out of 195 on the Global Health Security Index (behind North Korea and in front of Equatorial Guinea).

Somalia only has 2 health care workers per 100,000 people, far less than the WHO's global standard for health care workers is 25 per 100,000 people.

With only 15 ICU beds for a population of more than 15 million, Somalia is listed among the least prepared countries in the world to detect and report epidemics, or to execute a rapid response that might stop diseases spreading.

A global study by The Rand Corporation, a US think-tank based in California, found that Somalia was the least equipped country to cope with coronavirus