International Development Committee Response


Humanitarian Crises Monitoring: Impact of COVID-19

Current Situation and Immediate Risks and Threats

Iraq, Mali, Syria, and Yemen


Executive Summary


1)      Answering the International Development Committee’s request, we submit this brief to help inform the UK government’s understanding and possible international response to the impacts of COVID-19, particularly in fragile settings and on vulnerable populations. Our response is organised into country profiles presenting current responses to and impacts of COVID-19 in-country, as well as the emerging risks of the pandemic to ongoing conflicts and humanitarian crises. We profile four country contexts in which we are delivering development programming for HMG. In compiling this information, we have conducted key informant interviews with our own programme staff and consultants, NGOs, and local civil society organisations.


2)      Country Situation Assessments:



Introduction to Chemonics International


3)      Founded in 1975, Chemonics is an international development consulting firm working in more than 84 countries. We have a global workforce of approximately 5,500 specialists collaborating across 12 different sectoral practices and are currently implementing UK government-funded development programmes in multiple states with protracted and ongoing humanitarian crises.





Current State of COVID-19 Response


4)      As of April 17, the country has confirmed 1,434 cases of COVID-19, including 80 fatalities. Despite sharing an extensive border (with more than 12 border crossings) with Iran, an early epicentre of the pandemic in the Middle East, containment measures against the virus were slow to roll out in late February and early March. Ongoing government decentralisation has led to unclear roles and difficulty in coordinating response efforts across the federal, provincial, and local levels on the implementation of curfews, social-distancing policies, and testing and treatment protocols. A nationwide curfew was ordered on 17 March, but has been only partially and inconsistently enforced.


5)      To date, Iraq has relied predominantly on individuals to self-present if they are experiencing symptoms. Community-based testing has only begun in recent weeks in suspected hotspots. As a result, it is probable that the number of confirmed cases vastly underestimates the number of actual cases in the country. Baghdad has provided instructions on testing and treatment to all 18 provinces, but only five provinces have advanced testing capacity. Samples from the remaining 13 provinces are sent to Baghdad. Iraq’s health system has suffered from decades of underfunding, damage from war, poor management, corruption, and reduced human resources capacity from the emigration of doctors and other trained medical professionals.


6)      Government responses are often viewed by citizens with scepticism, which has created a breeding ground for the spread of misinformation and a fundamental lack of understanding in many communities of how the disease spreads and how it is combated. For example, Kirkuk’s health department announced on the morning of 14 April, that the province is completely free of the virus. Inconsistent messaging like this fuels doubt and distrust. In formerly ISIS-controlled communities, radios and televisions in many households were destroyed to prevent contact with information from the outside world. Many of these communities still rely heavily on word of mouth for dissemination of information.


Impact of COVID-19 on Ongoing Conflicts/Humanitarian Crises.


7)      Iraq has been in a state of heightened political crisis and unrest in recent months due to the fallout of the Iran/US political tensions and escalations, mass protests against the post-war political system, and political stalemate in appointing/agreeing on a new prime minister and government.


8)      Due to corruption, mismanagement, and militarization across the country, there was already significant distrust of public health institutions prior to the emergence of COVID-19. Furthermore, the same security forces that violently cracked down on recent protests are the same ones now at the centre of enforcing Iraq’s COVID-19 response, resulting in heightened mistrust of government information and action against COVID-19. Families are reluctant to turn over sick family members to hospitals perceived to be corrupt or untrustworthy.


9)      Although the recent protests and demonstrations have been suspended due to the COVID-19 outbreak, the pause could allow demonstrators to reorganize and to push for further concessions when the health crisis subsides. Finally, many individuals are dependent on daily wages from public-sector employment and governmental support. Growing economic hardship from lost wages coupled with the general sense of disorder and distrust in the government may provide an opportunity for ISIS or other extremist groups and non-state actors to regain support in some areas.


Broader Impact of COVID-19.


10)  Oil extraction and exportation is the main economic activity in Iraq, responsible for 90 percent of the government budget and 60 percent of GDP. The collapse of oil prices due to massive loss in global demand and the Saudi-Russian price war has already cut monthly revenues in half. Coupled with the shutdown of the private sector economy, this has left many people without an income or a state-sponsored financial safety net.


11)  Traditional gender norms and practices in Iraq often relegate women to the role of primary caretaker, placing a disproportionate caregiving burden on women and girls and preventing them from being able to properly quarantine. Local customs that discourage male and female interactions are also creating difficulties for women and girls in receiving testing for the virus. School closures will also leave girls at a higher risk of long-term education disruptions, and when compounded with economic hardship, may result in increased instances of early child marriage. Instances of gender-based violence are on the rise and expected to grow as the hardship persists.





Current State of COVID-19 Response.


12)  As of 17 April, the country has confirmed 171 cases of COVID-19, including 13 fatalities. Most cases are centralised around the capital Bamako with additional cases in the regions of Kayes, Koulikoro, and Mopti.


13)  The Malian government has implemented multiple measures to curb the spread of the disease and mitigate its impact. This includes broad social distancing measures like closing schools and universities, closing public spaces and businesses, introducing a curfew, and limiting the hours businesses and markets can remain open. To spread the word about these measures, the government has relied on more traditional channels of communications, such as local humourists, who relay information to the public through comedic sketches and shows, and religious leaders.


14)  Beyond prevention, the government has taken certain measures to proactively mitigate the social and economic impacts on the local population. The government has lowered the tax on basic goods, such as rice and milk, and set up a fund to distribute 56,000 tons of grains and 16,000 tons of livestock feed to vulnerable populations impacted by COVID-19. The government has also eliminated VAT on essential items like electricity and water for the months of April, May, and June, and has promised a tax rebate to the private sector on a case-by-case basis. The government has recently mobilised security and defence forces to monitor public areas and enforce curfews in crowded areas. Influential members of government including the president and prime minister have renounced between one to three months of their salaries to contribute towards the government’s response to COVID-19. The government has promised to take additional steps to reallocate the budget to direct funds towards responding to the pandemic.


15)  While the government and civil society are doing what they can to dispel misinformation and inform the public through the media and other public campaigns, some religious leaders have refused to close mosques and are continuing with services. These religious leaders hold significant sway among the general public and set the tone for others to follow. As proof, weddings and baptisms are continuing in Bamako and other localities, despite the ban on public gatherings.


Impact of COVID-19 on Ongoing Conflicts/Humanitarian Crises.


16)  The COVID-19 health crisis has diverted attention from ongoing peace and reconciliation efforts and the governments attempt to combat terrorism. Local media has shifted its coverage from peace and reconciliation activities to focus on the government’s response to the disease. Prior to the emergence of COVID-19, the country was already facing a health crisis fuelled by natural disasters and internal conflict.


17)  As a result of internal conflict and general insecurity, close to 1 million people in Mali have been affected and forced to flee violence. As of January 2020, estimates put the number of internally displaced people (IDPs) in Mali at 207,751, with 54 percent women and 53 percent under the age of 18. Their displacement leaves them disadvantaged in many ways. The majority of IDPs and refugees live in incredibly crowded settlements, which makes social distancing particularly challenging. Should they contract the virus, these populations often lack access to the necessary healthcare infrastructure required for treatment. Limited access to information, misinformation, mistrust of authorities, the absence of communication networks, and language barriers can also prevent accurate and far-reaching messaging.


Broader Impact of COVID-19.


18)  COVID-19 is having far reaching impacts on the Malian economy. The sectors most severely affected by closures and social distancing measures include the service industry (catering and hotels), petty trade, manufacturing, and transport. These are also the driving forces for the country’s economy and job creation. Many small and medium enterprises, another major driver for employment in Mali, threaten to close.


19)  Measures put in place by the government to respond to the crisis have significantly strained the government’s financial resources. In a public notice on 6 April, the government noted the impact of COVID-19 on the country’s macroeconomic outlook for 2020. According to the government’s own analysis, the economic and financial consequence of the spread of the disease, will likely result in a budgetary deficit and loss of assets in the treasury. In the first quarter of 2020, a deficit of US$309.7 million (182.2 billion FCFA) is expected as a result of tax revisions and loss of collections from imports.




Current State of COVID-19 Response.


20)  As of 10 April, 19 cases of COVID-19 have been confirmed in Syria, including two fatalities. While much of Syria remains in relative isolation from the rest of the world due to the ongoing conflict, the whole of Syria has seen a growing number of confirmed cases. Due to a general lack of infrastructure, disruptions in the supply of medical equipment and testing kits, and a limited number of facilities capable of processing tests, there has been a delay in the declaration of confirmed cases, and the number of cases is likely undercounted.


21)  In Syria, various authorities in the different regions have thus far applied different procedures and timelines to slow the spread of the disease and prepare for outbreaks. In general, the whole of Syria has adopted broad social distancing measures, including imposing curfews, suspending classes in schools and universities, closing mosques, and limiting transport between governorates.


22)  While information and news regarding the disease was slow to spread to the general public, efforts to slow the spread of the disease in Syria have caused almost as much concern as the disease itself. In some cases, curfews and lockdown measures have forced new gatherings and shortages as people gather to wait for bread at distribution points. Many Syrians fear the impact that social distancing measures will have on their livelihoods and the economy, which was already struggling to recover from years of conflict. In many cases, Syrians throughout the country have had no choice but to ignore some of the social distancing measures in order to provide necessities for their families. For many throughout the country, COVID-19 seems a distant threat, as more urgent priorities such as identifying shelter, food, and water remain a daily challenge.


Impact of COVID-19 on Ongoing Conflicts/Humanitarian Crises.


23)  The Syrian war has just entered its tenth year. As a direct result of the conflict, Syria’s healthcare system has been significantly weakened. Idlib in northwest Syria and the SDF-controlled areas in the northeast are the most vulnerable regions. In Idlib, daily bombing and shelling have put more than 80 hospitals out of service since the start of the year. The facilities that remain have little of the equipment required to treat patients, such as ventilators, or to protect healthcare workers from infection. Additionally, ongoing attacks on health facilities, in addition to the harsh economic situation, has forced many medical staff in the country to flee, leaving these facilities severely understaffed and under-resourced.


24)  IDPs and refugees remain the most vulnerable. More than 5.6 million people have fled Syria since 2011, and more than 6.5 million remain displaced inside the country. Humanitarian groups fear catastrophic consequences if COVID-19 spreads in overcrowded camps for the displaced in opposition-held areas in northwest Syria. In Idlib alone, more than 1 million people reside in overcrowded and unhygienic camps where it is very challenging to impose social distancing measures. Ongoing attacks on water pump stations make maintaining proper hygiene and basic measures like handwashing particularly challenging.


Broader Impact of COVID-19.


25)  As a result of the closure of borders and disruptions in food supply chains, prices of basic goods have increased, and some areas have experienced shortages. The value of the Syrian pound, last trading at 500 to the dollar in January, reached a record low of 1,360 to the dollar in late March contributing to inflation and the soaring cost of basic goods. The price of bread has increased by 30 per cent, and prices of vegetables and eggs have gone up by between 40 and 75 per cent. In some areas, price increases for food, fuel, and transport sparked protests.


26)  Women and youth have been significantly impacted by the response to COVID-19. Traditionally responsible for securing basic goods for their households, women are forced to secure the family needs in a very harsh social, economic, and security environment. In some cases, women are forced to wait in long queues where social distancing is not an option to obtain basic goods like bread. As a result of the economic downturn caused by the pandemic, youth, in particular, have suffered from the loss of jobs, and the closing of schools has disrupted education.




Current State of COVID-19 Response.


27)  As of 17 April, the country has confirmed one case of COVID-19 and no fatalities. Through the continuing humanitarian crisis, Yemen is facing a complex response effort with severe access restrictions, along with an increase in political tensions. More than 3.5 million people have been displaced since the start of the conflict including more than 40,000 people displaced countrywide in the first week of March alone. As a result, containment measures have been inconsistent and difficult to implement.


28)  Since the beginning of April, the World Health Organization, working with the Yemen Ministry of Health, have established three facilities in Sana’a, Aden, and Mukalla which now have the capacity to administer multiple tests using throat or nasal samples from patients. The United Nations Office for the Coordination of Humanitarian Affairs is working with the Ministry of Health and directly coordinating the overall humanitarian response effort alongside 121 humanitarian partners. The International Organization for Migration is leading the coordination towards migration and IDP movements.


29)                                                                                                                                                                                                                                                                     The government has implemented restrictions in the south, suspending all commercial flights, and ordering of the closure of schools. In northern Yemen, Houthi authorities have closed land borders with government-controlled areas. In addition to closing schools, they have suspended all incoming flights, including humanitarian services. The last UN flight arrived on 16 March. Coordination and scale-up of priority response interventions remain constrained under the current conflict escalation with more than a third of the Yemeni population living in overcrowded camps and informal settlements with limited access to basic sanitation.


Impact of COVID-19 on Ongoing Conflicts/Humanitarian Crises.


30)  The ongoing conflict and humanitarian crisis will make it difficult to control the spread of COVID-19 throughout the country. Overcrowded and sub-standard living conditions pose a challenge to enforcing social distancing and wider public health measures. This will disproportionately impact displaced populations and those living in camps or overcrowded urban settlements. The conflict has largely decimated the country’s infrastructure and reduced the number of operational medical facilities. More than half of all medical centres no longer have working general practitioners, and there are an estimated 10 health care workers per 10,000 people (against the global standard of 41 per 10,000 people).


31)  Obtaining accurate infection information and tracking data is also a critical challenge amidst the ongoing humanitarian crisis with vulnerable communities and displaced populations facing restricted access to medical support and wider aid services.


Broader Impact of COVID-19.


32)  COVID-19 presents a significant risk to Yemen, given the lack of healthcare infrastructure, government capacity to respond to the health crisis, and coordination challenges among the many humanitarian and government actors.


33)  The WHO along with the Ministry of Public Health, in both Ansarullah and government-controlled areas, have looked to build on the emergency teams first established during the latest cholera outbreak. There are currently 333 teams, one team per district, each consisting of three to five members. Those teams will need specific training on how to respond along with the medical equipment and PPE to work effectively across affected communities.


34)  At present, Yemen is particularly reliant on imports for up to 90 percent of basic goods. Border closures and travel restrictions have significantly impacted the supply of basic goods into the country. Remittances from workers overseas make up another important financial safety net for Yemeni families, often serving as a key source of income. The global spread of COVID-19 has seriously impacted the livelihood of Yemeni migrant workers overseas, significantly reducing the flow of remittances into the country.

              IRAQ, MALI, SYRIA, AND YEMEN              5