Working with IOM as a health and data consultant in response and preparedness for COVID-19 in Tanzania
By Blick Nuwe
Image 1. Discussion with a security personnel on one unofficial PoE in Kigoma Region
As a data management consultant in the field, it is both challenging and fascinating to work in emergencies. At the start of March 2020, I started to work as a health and data consultant with the International Organisation for Migration (IOM) Tanzania. My main terms of reference include: working with the mission’s Program Coordinator to establish a National Technical Working Group to map and define existing migration data sources across the various line ministries in Tanzania, spearheading the mission’s migration and health data-related activities, and strengthening the government’s understanding of the migration dynamics and the relevant migration indicators across all the different government agencies.
On 11 March 2020, the World Health Organization (WHO) declared the Coronavirus Disease 2019 (COVID-19) a pandemic. This situation has since changed the course of my work and general operations in the IOM Mission in Tanzania. My current activities are now mainly focusing on a capacity needs assessment for all points of entry concerning preparedness for the COVID-19 pandemic.
Image 2. Meeting with health Port officials for an assessment at Kigoma Port in Kigoma District
As of 28 April 2020, the WHO reports that there have been 300 confirmed cases of COVID-19, including ten deaths, in the United Republic of Tanzania. As a response to the COVID-19 pandemic, most East African countries imposed travel and border restrictions in March 2020, with the Tanzanian authorities suspending all international flights from 12 April 2020.
Since 12 April 2020, international movements have been restricted, with the authorities allowing cargo movement to continue operating normally. However, with the country’s porous borders, cross-border communities continue to move in and out of the country using unofficial Points of Entry.
The Tanzanian government has not imposed strict social distancing and self-isolation policies such as a total lockdown as has been with its neighboring countries such as Uganda, and Rwanda.
IOM is designated as a pillar lead on the Points of Entry, and the organization is currently working with different partners including the WHO, and the Ministry of Health in Tanzania to prepare and respond to the COVID-19 outbreak, with operational and technical support. IOM’s focus is on strengthening the capacity of frontline health staff, migration officers, and other agencies in order to detect, respond to, and manage suspected cases through active surveillance at the Points of Entry.
I am currently focusing on conducting preparedness and capacity needs assessment in all official and non-official Points of Entry areas in Kigoma and Kagera regions, with a focus on the Ebola Virus Disease (EVD) and COVID-19. My main activities include guiding the mission on the most appropriate assessment methodologies, design of the assessment’s checklists, data analysis, interacting with the relevant authorities, field visits to official and unofficial Points of Entry and producing a report with key recommendations for interventions to IOM and other United Nations (UN) Partners in Tanzania and the region.
Image 3. Taking GPS Coordinates with the assessment team at Kilelema Informal PoE (A porous border with Burundi)
Since 20 March 2020, I have been able to visit several points of entry and health care facilities bordering the Democratic Republic of Congo, Burundi, Rwanda, and Uganda. Key areas of this health assessment include collecting geo-coordinates of both formal and informal points of entry and assessing the infrastructural status of these units, volumes of the migration flow, presence of medical personnel, activities being conducted by officials at the border points. I have also been assessing the COVID-19 border screening operations in terms of the communications procedures in place in case of any positive case(s), the capacity of screeners, screening equipment, personnel protective equipment, implementation of the National COVID-19 Contingency Plan at a lower local governance level, infection prevention, and control measures, isolation centres or temporary holding facilities for suspected cases at Points of Entry, case management, and referral mechanisms.
Image 4. An isolation facility at Kibirizi Port (used to manage temporally suspected cases after health screening at PoE)
The health preparedness assessment I am involved in also seeks to collect field data on restrictions across different points of entry and use its findings to inform the IOM’s monitoring and mapping of people’s movements within and across borders.
I usually start my day at 6:30 A.M, since most Points of Entry are far away from towns with poor accessibility. With my assessment colleagues, we engage with different officials at the district level and local councils for guidance and collect information on both formal and informal points of entry and how the current movement restrictions have affected cross border communities and other migrants. Assessment findings are now being used to inform IOM and other UN partners’ programming; including the distribution of personnel protective equipment to the point of entry officials, planning for stocking and management of isolation centres in border communities, and the provision of other medical consumables necessary to address the gaps identified in border communities among other interventions.
Risk communication and community engagement strategies have been designed based on our findings, plus a preliminary report with crucial recommendations guiding IOM’s programming and partner agencies with a focus on how COVID-19 interventions can plan for and include the mobile populations. These rapid response actions have been undertaken to help halt the spread of COVID-19 while simultaneously facilitating the strengthening of the health system in rural border communities.
Image 5. Assessment at Pembe Port In Zanzibar
In relation to COVID-19 response and preparedness, other IOM Tanzania areas of intervention include (i) assisting points of entry to set up or enhance hand-washing facilities, (ii) capacity-building for government staff on disease surveillance, (iii) supporting the Ministry of Health with case management, (iv) improvement of displacement sites to ensure site safety, hygiene, and that livelihoods are sustained; and (v) dissemination of information on how to stay healthy, specifically targeting migrants, refugees, and displaced persons.
Finally, population mobility data is a crucial determinant to plan and include vulnerable groups of people, including all migrants that have been affected by the closure of borders and addressing unintended effects on cross-border communities. As an individual with interests in development research and data, it has been very captivating and rewarding for me to see how data is being used in COVID-19 preparedness and response by different UN agencies.
Image 6. Crossing with a ferry to Rubengelera Point of Entry