ReliefWeb

by Helen Guyatt

The World Health Organisation declared the COVID-19 outbreak to be a public health emergency of international concern on 30 January 2020 and recognised it as a pandemic on 11 March 2020. Following the first confirmed case in December 2019 in Wuhan the capital of China’s Hubei province, the number of cases and deaths have been slowly rising across the world.

Start Network members began to raise alerts to COVID-19 in Official Development Assistance (ODA) countries on 20 March, through the Start Network’s existing fund portfolio - Start Fund, Migration Emergency Response Fund (MERF) and Start Fund Bangladesh. Two weeks later, on 2 April Start Network launched Start Fund COVID-19 with a generous €1.5 million donation from the IKEA Foundation.

MITIGATING THE SPREAD IN CAMEROON

The first COVID-19 related alert came to the MERF, which focuses on new or emerging needs in the context of mixed migration in North, West, and Central Africa. On 20 March, an anticipation alert was raised to provide assistance in refugee camps in the Far North, East and Adamaoua regions of Cameroon to help mitigate the spread of COVID-19.

Three agencies were awarded 300,000 GBP to help improve health and hygiene practices for 140,000 refugees from Nigeria and the Central African Republic as well as neighbouring villages.

The number of COVID-19 cases in Cameroon has already increased significantly since the alert was activated, with 657 confirmed cases as of April 6, up from 54 cases on March 23.

LOCAL RESPONSES IN BANGLADESH

Our national fund, Start Fund Bangladesh, has raised and responded to three COVID-19 related alerts, providing a total of 565,000 GBP to support nine projects, all led by local NGOs (non-governmental organisations).

The first alert was raised on 27 March, to provide assistance to vulnerable people in the four districts of Naogaon, Panchagarh, Nilphamari and Thakurgaon in Northern Bangladesh. These were targeted as they had close to 2000 people already in quarantine. Three local NGOs submitted proposals, and one was awarded. Eco Social Development Organization (ESDO) received 102,000 GBP to reach more than 400,000 people with awareness-raising on the best hygiene practices for protecting against COVID-19, and hygiene kits to 4000 households.

Three days later on 30 March the next COVID-19 alert was raised. This again focused on the most at-risk districts in Bangladesh where there were high levels of home enforced quarantine for those returning from affected countries, and high levels of population movement both within and into the country. In these districts, poverty levels are high and the necessary health services and equipment are lacking, with some reports of doctors refusing to provide treatment in the absence of Personal Protection Equipment (PPE). In one of the districts, Rangamati, there was also a Measles epidemic. Seven projects were funded, most of which were less than 50,000 GBP as they focused on very localised geographical areas. The main activities are to provide PPE, community health activities and targeting households with hygiene kits and in some cash. Collectively, the proposals aim to reach more than two million people.

The third alert on COVID-19 was also received on 30 March, just an hour after the second alert. The local NGO Friendship was funded 107,000 GBP to strengthen health services and provide community awareness-raising and hygiene kits to the most vulnerable groups such as the elderly and those living in remote areas across fifteen different districts including Ukhiya and Kutubdia in Cox’s Bazaar. The target population is 300,000.

According to the alert note, before the lockdown in Bangladesh on the 26 March national newspapers reported that close to 11 million people in Dhaka left for their hometowns across the country, suggesting a worrying situation for transmission across the country in the coming weeks. The Government of Bangladesh has declared 1 Billion BDT (9.6 million GBP) to a COVID-19 fund, and 90 thousand tonnes of rice for the poor and extreme poor households, but the government work for hospitals and health care providers are so far only limited to Dhaka and some large cities. The support to local NGOs through the Start Fund Bangladesh will hopefully act as a stop-gap in these more remote areas until further funding arrives.

In the alert note for BO26, Friendship NGO stated: “This amount is far less than what is required but it is the critical amount needed before the sustained funding from traditional donors arrives which is assumed to be delayed for some time.”

COVID-19 ALERTS TO THE START FUND AROUND THE WORLD

ALBANIA

On 22 March, Islamic Relief, Save the Children and Catholic Relief Services alerted the Start Fund to a possible COVID-19 related crisis in Albania for 7,000 Roma people and new migrants from Greece who were seen as being particularly vulnerable and would benefit from the support of hygiene kits, cash and food deliveries. It was not activated, although the case for funding was clear because COVID-19 was a global pandemic there was some concern that it did not fit the Start Fund niche of focusing on small and medium emergencies.

AFGHANISTAN

A few days later on the 25 March, an anticipation alert was raised by Relief International, International Rescue Committee and World Vision in Afghanistan, to provide screening, treatment and protective equipment for health workers at five ‘highly-trafficked informal’ border crossings with Iran and Pakistan, used heavily by migrant workers, traders and truck drivers. It was not activated. Given that cases were already spread across Afghanistan, the decision group felt that a focus on borders only would have limited impact.

SIERRA LEONE

Then on 1 April, Catholic Relief Services and Save the Children alerted the Start Fund for support in informal settlements in Freetown, Sierra Leone. The request was generated following the release of Freetown City Councils COVID-19 Preparedness and Response Plan, and a related request for support from NGOs in its delivery. This anticipation alert received unanimous support from decision-makers, and £330,000 has been made available to provide WaSH activities and PPE to limit transmission of COVID-19.

The alert note for Start Fund alert ‘415 Sierra Leone, Anticipation COVID-19’ stated: “Now that a case is confirmed, the likelihood of an outbreak is imminent. While the national government is coordinating the country wide-response, the key stakeholders in the city must work together to meet the unique preparedness needs of Freetown beyond the national plan as fast as possible to ensure the outbreak is contained.”

WHY WE LAUNCHED THE NEW COVID-19 FUND

Reflecting on the activities suggested in the COVID-19 alerts, combined with learning from previous disease outbreaks, an unusual decision was then made to streamline anticipation and response alerts in the newly launched Start Fund COVID-19. Disease outbreaks lend themselves well to an approach that integrates both anticipation and response programming, as they require responding to existing cases and mitigating anticipated, with sensitisation and behaviour change support remaining critical throughout an outbreak.

Start Fund COVID-19 opened for alerts on Thursday 2 April 9am BST, and by Monday 6 April at 8am, it had received a total of 85 alerts from 69 ODA countries across five continents.

Alerts were raised in 29 countries across Africa, 21 countries in Asia, 11 countries in South America, 5 countries in Europe and three countries in North America. Five of these countries – Laos, Jordan, Armenia, Bosnia & Herzegovina and Venezuela - had never before had an alert raised through the Start Network funding mechanisms.

38 aid agencies around the world were involved in raising these alerts. Some alerts were raised by single members but most alerts were raised collectively with more than one agency. In 64% of the alerts, three or more agencies had worked together.

NO ONE SHOULD BE FORGOTTEN

Many of the countries targeted by our members do have COVID-19 plans and some funding in place, but this is primarily being directed at building up health care services, especially in the main cities, or providing support to formally registered households, so many gaps remain unmet.

In particular, our members identify a range of vulnerable and high-risk groups such as

• those on the move, refugees, internally displaced people (IDPs), and migrant workers returning home to their communities
• communities already suffering from drought and food security or living in unstable or conflict areas with fragile health systems
• the elderly, children, and neglected minority ethnic groups that often lack access to services and formal employment
• those living far from major cities and health facilities and also those living in densely populated urban areas or refugee camps where basic hygiene practices and facilities are lacking, and
• people are already suffering due to other diseases, poor nutrition and loss of livelihoods.

In addition to the provision of PPE, hygiene kits, handwashing stations, food and cash, some of the alerts focus on strengthening quarantine facilities and child protection services, supporting surveillance, and tracking and tracing schemes, and improving the healthcare messaging so that it explains more clearly what the risks are and dispels current myths around the disease.

The challenge now for the Start Network decision-making groups is to decide which of these 85 alerts to activate. Given that the current pot stands at 1.5 million GBP and many of the alerts proposed the threshold funding of 250,000 GBP, less than 10% can be activated.

Timeliness will be key in averting a disaster from COVID-19 and through the Start Fund, our members already have the experience and systems in place to act quickly. It is hoped that more donors will come forward to support the Start Network COVID-19 pot and help our members provide the assistance that is needed across these vulnerable communities.

Read more about Start Fund COVID-19