Rwanda is now enduring a week in a total lockdown after the government imposed the move to mitigate the likely, unbearable consequences of the now global pandemic; COVID-19.
Kigali reported its first case of Coronavirus on March 14th and within a week, on 21st March, the country was already in a total lockdown, becoming the first country on the continent to impose such high-level restrictive measures despite relatively fewer numbers of patients, who were just 17 when the lockdown was signed into action by the Office of the Prime Minister.
The typical quick reaction of the government to control the virus came as a surprise to many, considering that the country had had only 17 confirmed cases imported from abroad, with no death nor internal contagions. This is different to countries like Nigeria which registered its first case back on 28 February but has yet to impose a total national lockdown despite registering a number of deaths.
However, to those familiar with the context in which Rwandan government run its business, it is not difficult to figure out why the country took sweeping measures so early.
Long before even the virus entered Africa, Rwanda was already testing its arrivals at Kigali International Airport. The case involving testing kits also resulted in the sacking of the former Minister of Health, after it emerged that she lied the Office of the President on number of available testing kits of the Coronavirus.
Moreover, two chambers in most of the hospitals across the country were reserved to provide emergency care to anyone who would show symptoms of the deadly virus, with the country’s high-level laboratory able to correctly detect the virus – a vital component in the overall fight against the pandemic. The government, it seemed, was one step ahead of virus and it can be argued that when the virus first reported in the country, there was already a plan that was in place to be launched when required.
For instance, when 11 cases reported, the government slightly restricted the movements and gatherings across the country. It seemed like the measures were thought even before the virus erupted, and we are going to look at why the government acted so quickly.
Lessons well learnt.
Rwanda was among the first countries to report the virus in the East African region. However, the virus entered Rwanda after months of sweeping Asia, Europe and America. This gave the government a good opportunity to learn and assess different methods that were being employed to tackle the virus from different global regions.
In a televised interview right after Rwanda reported its first case, new Minister of Health, Dr. Daniel Ngamije, clarified that the government was monitoring and learning how the global communities were responding to the virus. He literally mentioned two different methods that were being implemented by both Eastern Asia and Europe. It was so early to predict anything but it was all clear; the government was learning.
After the virus ravaged China, its origin center and first epicenter, it was impossible to stop its spread to other countries, starting with close neighbors. Countries like Singapore, South Korea, Taiwan, Japan, Vietnam, France and the United States were among the first to report cases of COVID-19 disease, which result from Coronavirus attack.
The eruption of Covid-19 quickly spread throughout countries closer to China because of two big reasons. First is the timing. It was mid-December last year when Coronavirus first become public, this is a specific period in which traffic between China and countries with closer cultural links celebrate their specific Chinese New Year. It’s a holiday period and so traffic between China and its neighbors is very high since most Chinese tend to go home for vacation and vice-verse.
Second is the nature of the virus. Coronavirus is highly hideous and could not necessarily be detected despite residing in human body for days. It takes about 14 days to correctly detect it but before, an infected person might be living normally with no symptoms. This is why the virus was able to spread worldwide. In the meantime, the infected will be infecting others
unintentionally. So even if countries like Singapore, Taiwan and South Korea started testing so early, it was impossible to prevent infected people from entering because some would show zero symptoms at the check point, only to feel unwell after days. That was before quarantine technique was launched.
The hideous nature of the virus is one of the reasons it quickly spread worldwide in a blink of an eye. And this is how Rwanda contradicted it too.
So, Thailand, a country whose tourism sector depends heavily on Chinese, was the first to report the first case of Covid-19 outside China. It was a matter of time before countries like Japan confirmed its first cases. United States, France, Nepal, Australia, Malaysia, Singapore, South Korea, Vietnam and Taiwan were to follow shortly afterwards.
This virus was completely new, which made it harder for researchers and scientists to figure out preventive measures, but ultimately, countries had to set up strategies to tackle it, since it was evident that the virus has already spread to four different continents within a few weeks.
How countries would react at that point, towards the end of January throughout to mid-February, was going to be vital at the moment.
The situation, in fact, looks differently according to the methods each country applied, especially those which reported their first cases at the breakthrough of the virus. Eastern Asia countries are deservingly praised for their productive efforts to counter the virus while Europe and USA are struggling to keep up with its tenacity. It suggests how the first few days, not weeks, were very vital in the fight against the new enemy.
Let’s take an example of Italy, for instance. The country reported its first case ten days after Singapore but its response was so timid, with no clear plans of either testing or social distance of people. Like most of European countries, Italy downplayed the magnitude of the virus and didn’t take any gamble which would hurt its already weakened economy. Measures like restriction of movements were ineffective, social distancing was a horrible idea that Italians and Europeans didn’t even want to contemplate on.
Meanwhile, the virus was spreading to unprecedent level that were never anticipated and it reached at the point of no return, where it was impossible to undo the terrible effects that were coming. So many people were already ill, so many of them critically, few beds were available and the lockdown was going to limit the future damages but not what were in making for previous days.
It reached ‘unthinkable point’ where Italian hospitals were no longer able to serve extraordinarily high demands of patients, and some patients were left to die by doctors in order to save those with higher chance of surviving – those who would consume fewer expenses in terms time and equipment to recover. The chaos prevented patients of other critical illness to seek their regular hospital assistance, and some died at home. It is a disaster Italians have rarely seen before in their majestic country.
On the other hand, Singapore reacted as quickly as possible to contain the virus. The city state immediately restricted travels with China so early that Chinese government was angered by the decision, dubbing it ‘exaggeration’ at that time.
In addition, Singapore traced all citizens who contacted everyone who had been infected. This came after it was emerged that testing materials might not correctly detect everyone who has contracted the virus at the testing time. The tracking reached an epic level to the extent 100 people had been in communication with Singapore’s health authorities before being diagnosed with the disease.
Taiwan was doing enough on its side. The island started regular tests for all China arrivals in December, the time when very few information about the virus were available even to World Health Organization (WHO). That resulted in early detection and early follow up, which highly restricted the spread of the virus. At the moment, Taiwan is less affected by the virus than most of other developed countries.
South Korea becomes the first country to launch mass testing throughout the country. Restrictions and lockdown also came exactly at the right time when it was actually possible to downplay the damage of the virus. South Korea was the most risked nation to be hit hard by the virus because of a huge surge of cases that were recorded in the first few days, but their immediate approach really saved them time and kept the virus under control.
Authorities of Eastern Asia countries were very active despite uncertainties that surrounded first days of Coronavirus outbreak. In fact, it was a gamble-like choice. With fewer information about the tenacity of the virus and its overall impact, it was not easily understood why restrictive measures that would destroy economy were needed at that time. If the virus was weak and yet economies were scrambled in a bid to deter it, then the decision would be harshly criticized.
Another option was to try to tackle the roaming virus and so when it reaches its pick, it will only cause limited damages since its early responses would contain its intensity at a certain level. This later method is what Eastern Asia applied while Europe, whose economy is struggling, and USA applied the first option mostly in a bid to conserve their economies but also because they actually had fewer information on severity of the virus, which has just erupted for first time ever.
Eastern Asia countries took no gamble because of their experience with diseases like Coronavirus. Their advanced economies and technologies were a huge advantage but not the only game changer as Europe, the most hit continent, is also a major superpower economically.
Instead, experts have accused European authorities to be so timid and to portray a certain level of arrogance in their response to the virus. As mentioned, Europe received the virus as early as Asia. But their approach was slow, mute and less effective.
European approach failed because of two main reasons. First, as we have mentioned, any response was a gambling play at certain level. The disease was entirely new and very few information was available. So, imposing harsher policies like locking down cities with no backing information about the intensity of the virus would have attracted criticism. With political uncertainties mostly because of the firm rise of far-right movements, miscalculation and baseless panicking of governments would no doubt have unprecedent consequences in decisive periods like elections.
Secondly, Europe has always survived recent big epidemics. The outrageous Ebola in West Africa in 2014 didn’t cross Mediterranean Sea to Europe. The same as other epidemics like swine Flu, SARS, MERS and Zika – all have stayed in the places of origin without crossing to Europe. It was hard then, in that blindfold observation, to predict that Coronavirus was going to break the record, given that it was very much undermined during its first sweeping days and it was commonly thought that it would be contained in Wuhan, its epicenter area, let alone cracking China as whole. So dramatic measures which would shake weakened economies of European countries wouldn’t at any point be welcomed.
Their gamble didn’t prove to be true though, and nevertheless, Europe, unlike Eastern Asia, is paying such a huge and long-term price to the situation which was entirely stoppable, should measures been set in place at the right time.
And so, Rwanda was learning throughout, and it is obvious now that the pandemic has reached its territory. As mentioned above, Rwanda failed to eradicate COVID-19 from entering its territory, but the response to control its spread were as quick as it would have been suggested.
It should be noted that Rwanda has managed to stop the last Ebola epidemic which ravaged Republic Democratic of Congo as of last year. The epidemic almost reached Goma, seven kilometers from Rwanda’s boarder, but never entered the country’s territory, which was such a huge success.
But Coronavirus was so different, especially in its ability to hide and continues to be deadly simultaneously. And so, the virus would enter the country but it wouldn’t be allowed any further.
Rwandan government notably chose the Asian method in its efforts to fight against Coronavirus. “The quick response method” has proved to be very successful in terms of limiting the spread of the virus, which will limit the economic damages in turn.
For instance, discussions and public campaigns started even when there were no confirmed cases in Rwanda. As the cases lose, so did strategies to halt out-of-control spread. At 11th case, gatherings and movements were slightly restricted.
When the number of patients reached 17, the government established a total lockdown. At time, there was no internal confirmed case, which implies that all cases were imported. Foreigners also dominated a number of cases.
The early lockdown clearly was backed by the deployment of security organs like Police and its partners.
For Rwandan context, whose cases were still limited and very well quarantined, early shutdown of the country matches its capabilities and reflects its quick response. We have to consider that Rwanda lacks innovation, financial muscles and enough treatment units that would be inevitably needed in case of out of control outbreak and the lockdown was used more like protective measure rather than preventive mechanism. This is unlike Europe; whose countries imposed a lockdown after already being a step behind in the control of the pandemic.
Avoiding additional pressure on the overwhelmed health system.
Rwanda’s public health system is among the most reliable in Sub-Sahara Africa but that doesn’t erase the fact that it is still growing and still behind the world’s standard in some aspects. Rwandans’ life expectance is about 69 years, one of the best ratios in Sub-Sahara Africa and infant mortality rates are low, at 27 per 1000 children. However, there are a couple of other concerning indicators, like a number of doctors and specialists, available infrastructures and availability of emergence budget. All those components, among others, should complement each other to fight the pandemic, should it erupt, and it is alarming that Rwanda hasn’t yet established unshakable abilities in those aspects.
In fact, the country has one doctor per 8,919 people, while WHO recommends one doctor per 1,000 people – a demand even the richer countries struggle to keep with. There was one ambulance per 48,747 people and one health center per 23,847 with 21,826 hospital beds according to Ministry of Health’s Rwanda Master Facility List, 2018.
It was reported on social media that the country counts only 39 beds in Intensive Care Unit (ICU), which reflects that Rwanda would really struggle to keep up with high number of patients who would inevitably need Intensive Care services.
So, with such fragile public health system, it would be a disaster if a pandemic of the COVId-19 caliber spread, as the current state of our growing heath system wouldn’t cope. Just imagine if Italy, the 8th strongest economy in the world, with one of the best advanced health system (Life expectance is 80 years for men and 85 years for women – the fifth best ratio in the world) struggles to manage high number of patients and actually let some to die in favor of those who would easily survive, what would happen to a developing country like Rwanda which still builds all aspects of life after just 26 years since Genocide against Tutsi ravished everything?
This is why in a recent warning blog by International Monetary Fund (IMF), they advised Africa and other developing countries to do every possible thing to stop the pandemic from spreading, because the readiness of their health systems to deal with aggressive pandemic like Coronavirus are very limited in many forms – personnel, financial, infrastructure and more.
And again, it tells a lot to hear that the idea to postpone Tokyo Olympic games which were scheduled to take place in Japan this coming summer, was revitalized by the fact that African countries were quickly submerging big number of patients of Covid-19.
So, the Rwandan government looked far and basically assessed its honest ability to contain and treat Covid-19 pandemic. The answer was very clear; the health system would not manage an outbreak like Covid-19 should it get out of control, and so imposing protective, quick response (total lockdown in this form) in order to save an already overwhelmed health system was the best answer.
Limiting Economic Impacts.
Rwanda’s possible option to prevent its economy from sinking was to prevent Coronavirus from prevailing. As argued before, the country already has very limited abilities to cope with out-of-control pandemic, so should Coronavirus penetrate further, the chance to revamp its impacts on the economy would be very difficult.
It would cost more to treat high number of patients, and even more to buy equipment and set up affiliating infrastructures to facilitate fewer doctors to treat the infected. The economy would also stagnant for long time, affecting tax collection and investments. Tourism, which is very important in the balance of the economy’s foreign money exchange would be hit further if Rwanda would still be fighting the virus while the world’s economy resolute.
In its recent analysis on the effects of Coronavirus, IMF has made it clear that Sub-Sahara countries will be hit the most by the consequences of the virus. The article by Karen Ongley and Abebe Aemro Selassie published on 25th this month, states that in recent global recessions, Africa was less hit because its financial systems were not swiftly intersected with global systems but now the situation has literally changed.
Of course, it is now a fact that global recession, which was in postponement mood after years of making, will inevitably happen. The article explains that Africa will be hard hit by the global recession, additional to its economical struggles, because “Many countries in Sub-Sahara Africa have limited room in their budgets to increase spending. They also rely more on global capital markets”.
So, the early lockdown demonstrates how much Rwandan government understands this simple fact – that the best way to prevent its economy from sinking was to mitigate the spread of Coronavirus even if it required temporally lockdown as a small sacrifice, which is a better choice than what would follow should the situation escalate.
The importance to protect its economy was strengthened by the expected uncertainties that will ravage the world after the pandemic. In fact, IMF has declared global demands to fall, despite recent assurance of G20 countries to spend about $5trillion in the rescue of global economy. This is a sharp slap to Rwanda’s export, which is mostly constituted by coffee, tea and minerals.
On tourism side, the pandemic has already costed around $8million from conferences and meetings that were canceled or postponed because of the outbreak. This has already started to impact employees in hospitality sector, which already employees around 142,000 workers including casual workers. Hotels and lodges have lost more than Rwf13 billion since the situation of the virus escalated in the last two months.
Rwanda will also pay through the dramatic reduction of tourism revenue. Virunga National Park, which shelters rare mountain gorillas has already been closed for tourists and researchers. The park singlehandedly presented $19million in the government’s coffins last year.
With fewer dollars from fewer exports and tourists, and fewer taxes as businesses are collapsing, the impacts of Coronavirus will be mirrored through the ability of the country to continue its ongoing and upcoming massive projects. The most notable one is the construction of Bugesera International airport. The $1.3 billion joint venture between Rwanda and Qatar is scheduled to be completed by 2022 but with uncertainties that will follow Coronavirus outbreak, it can be questioned if this massive project won’t be affected.
Rwanda is also planning to build a multibillion rail gauge in partnership with Tanzania. This project is among the most priority given its expected impacts on economy but it can be affected if the consequences of the pandemic are severe. Rwanda needs to pay $1.3 billion share of the $2.3 billion of total costs.
The government’s spending bills are also in constant hike, as the country is running around the clock to implement all 2024 objectives that are designed in what is known as National Strategies Transformation (NST1). Some of massive projects include distribution of electricity to all Rwandans, from 53% who are currently on national grid line. Poverty will be completely eradicated while agricultural products will be doubled with 1.5 million jobs created. 3000km of feeder roads and 800 km of national asphalt roads will be built. There are other projects and IMF has suggested the cost of this NST1 initiative is $39.2 billion in which governments and private sector will share. 59.41% will be government’s share.
To achieve this massive initiative, the IMF review report of the government’s progress reads “The main objective in this respect is to avoid assuming further financial risks on the government balance sheet”.
It’s inevitable however that this ongoing pandemic hasn’t yet affected the government’s resources given the current global circumstances, though at a very small scale which will mount depending on how long the pandemic will last.
So, with a lot of expenses in place and many projects underway, there is no room for Rwanda to welcome any distraction of high caliber like Covid-19. That’s why a sacrifice of two weeks lockdown was issued in order to stabilize the economy and to enable activities to resume when things click again.
Meanwhile, the coincidence of the lockdown at moment when the global economy is stagnant anyway, can be viewed positively as it will be an advantageous chance to catch up quickly with other economies when the world re-bounce, presumably later this summer.
The cultural aspects.
Rwanda, as most of other African countries, is such a very cultural country. Traditional beliefs still play a big role in our daily life, and one of the cultural components that is still vibrant is togetherness. Rwandans like to comfort each other. Meanwhile, one of the quickest ways to spread Coronavirus is through direct contact. For Rwandans, it was always going to be difficult to practice social distance and avoiding frequent handshaking. In this form, the lockdown is a rescue.
You will also have to mind that Rwanda is one of the most densely populated country in the world. There are more than 12 million population on km2 26,338; which translates to 479.5 people per square meter (the 14th most populated non-island nation worldwide). It is such a huge number which stimulates more contact, both voluntarily or not. In such case, the government’s surest way to separate people is only going to put them into lockdown, because social distance would be hardly understood based on that togetherness culture and small area which prompt frequent contacts.
All in all, the government was aware of the situation and understood its role from the first minute. It assessed its abilities and recognized when and how to react. The lockdown, from many angles, looked to have been the best, non-gambling solution the government should have taken in order to limit inevitable consequences of Coronavirus. It is a sacrifice, because the economy is destabilized and jobs have vanished. But we have to understand that the move is saving lives and that economy should have deteriorated even further should pandemic got out of hands.
We have also to credit the government of Rwanda for its fitting solutions as it looks like despite surging numbers, Coronavirus pandemic is very much under control in Rwanda, unlike some African countries which are struggling with everything. More than 1,200 people who have been in direct contacts with the 60 confirmed cases have been tracked and early quarantine technique has enabled health authorities to keep an eye on the suspected cases, which facilitated their work as some patients developed symptoms while they haven’t yet been let out in public, it is a such an incredible work and the hope is that in few days, first COVID-19 patients will be discharged from Kinyinya hospital where they are receiving special treatments. .
The government is also continuing its distribution of food and other hygiene necessities to the needy population around the country, in order to help the vulnerable stay health as the lockdown is ongoing.
Meanwhile, the world has succumbed to the deadly virus. More than 683,000 people have been infected with more than 32,000 fatalities in 199 countries and territories. Africa has registered around 4,000 cases so far with South Africa leading cases with more than 1,170.
By Emmanuel NDAHAYO
The Express News