The threat of Covid-19 in Kenya: thoughts and worries, and the urgent need for social protection and safety nets plan
Author: James Wangu (LANDac and Utrecht University)
Date: 11 May 2020
For those of us born a few decades after the Second World War, the current novel coronavirus (Covid-19) crisis is unlike anything we have ever experienced in our lifetime. Since the outbreak of the virus in China late last year, Covid-19 has left a trail of suffering in all corners of the world.
About the author
James Wangu is a LANDac fellow and PhD Candidate, Department of Human Geography and Spatial Planning, Utrecht University. James’ research focuses on the contribution of inclusive agribusiness on local food security in Kenya.
According to the World Health Organization, as of May 6, 2020, at least 3.5 million people have been infected, in over 185 countries and territories, causing more than 196,000 (7%) deaths. In terms of the infection cases and number of deaths, wealthy countries, especially the United States of America (US), Italy and Spain, have been hit the hardest. The high death toll in countries such as the Netherlands – that are considered to have a highly efficient healthcare system (universal healthcare), makes the pandemic even more worrying. Besides the mounting deaths, the severe and infectious nature of Covid-19 has put enormous pressure on healthcare systems in terms of available space and treatment facilities – ventilators for patients and personal protection equipment for the health workers. In addition, the measures taken by governments to stop the virus from spreading are having devastating economic implications. In this blog, I will share some of my thoughts and worries that have emerged from the threatening situation in Kenya, my home country.
Kenya, like most developing countries in Africa, has so far recorded considerably few infection cases and deaths in comparison with developed nations. Nevertheless, over the last week, the country has seen the numbers quickly go up with an increase in community transmission in densely populated neighborhoods such as in Eastleigh, Nairobi. As of May 6, 2020, there were 582 confirmed positive cases in Kenya, including 26 deaths and 190 recovered cases. To better comprehend the economic impact of COVID-19 in Kenya, the current situation and ongoing government efforts to contain the disease and address the economic fallout needs to be reviewed in the context of responses elsewhere in the world.
Besides basic hygienic measures in the communities, testing is touted to be among the first line of defense against the virus. The total number of tests conducted by May 6, 2020 were 27,370. This present barely 1% of the Kenya’s a total population of over 47 million people. Until late last week (week of April 27, 2020), the government adopted contact tracing approach to trace suspected infection cases. With increased cases and confirmed community transmission, the government has increased public testing facilities and is encouraging everyone in the transmission hotspot areas to get tested. But until May 6, 2020, the suspected cases were put under forced quarantine for 14 days and the patient was responsible for covering the costs of staying in the facility and the tests (at least Ksh. 2000 ≈ €20/night). Due to low turnout for testing out of the fear of forced quarantine and costs, the government has reversed to free testing and quarantine in public facilities. While the Kenyan government has made some notable efforts with the testing, the total number of those tested remain low, especially now that the country is experiencing community transmission. Widespread testing is likely to remain a challenge in Kenya and other developing countries, given the high cost and competition with wealthy nations for the testing resources, as reported by the New York Times.
“Covid-19 aside, most Kenyans are low-income earners, who can barely afford regular treatment.”
A second challenge is the small number of available hospital beds. Despite being the fastest growing economy in East Africa, Kenya has only 518 beds for critical care. This is a negligible proportion to the country’s total population, and most of them are located in urban healthcare facilities that may not be easily reachable for people in remote rural areas due to poor infrastructure. When compared to the Netherlands (with at least 1900 intensive care beds and capacity to set up more), where nearly 5000 lives have been lost despite the country’s advanced healthcare and transport systems, this calls for major concern. Furthermore, unlike in the Netherlands where healthcare access is universal, the ability of most Kenyan to secure treatment is another area of concern. Since most people do not have access to health insurance, accessing Covid-19 related medical services will be a challenge. A large part of the few Kenyans that had health insurance lost the cover upon losing their jobs, which is a rampant occurrence presently following lockdown and other measures the government has put in place. Those who work in the informal sector or run businesses that have closed, the loss of income means they are unable to pay for their treatment.
Third, the current crisis will increase inequality. Some people have argued that Covid-19 is an equalizer in the sense that both the rich and the poor are getting sick, and that due to travel ban and high treatment demand for residence in foreign countries, even the wealthy Kenyans would have to get their medical help within the country. This argument is particularly targeted to politician who rarely invest in the local healthcare system, but instead travel abroad to Europe, South Africa and India for treatment when they get sick. The current situation forces them to get their treatment in the local hospital. I am afraid that in the event of an increase in patients, the wealthy Kenyan citizens are still likely to get priority for treatment due to their resources and better connections. This has been the case in, for example, the US, where it has been reported that the disease is disproportionately impacting poor, highlighting the effect of socio-economic inequality on the disease’s impact in the society.
“In the event of an economic crash, there will be emergence of ‘silent killers’.”
Fourth, while not downplaying Covid-19 impact on the loss of lives, it is argued that economic fallout from the disease will be worse, especially due to the ongoing social distancing measures. Could the lockdown cure be worse than the disease in developing countries? Probably not, in that in the event of an economic crash, there will be emergence of ‘silent killers’ such as malnutrition, diarrhea and infant mortality. Many are already struggling to make ends meet as a result of unemployment or pay cuts, closure of businesses, etc. The lockdown in Nairobi, Mombasa, and Kilifi and Kwale counties, the most extreme measure so far, was accompanied by a restriction in movement of ‘some’ goods and people in and out of these regions, that for many functions as business hubs. There is a high chance that food and other essential products will start to become unavailable or grow more expensive if such measures persist.
To help governments address the economic implications of Covid-19, the International Labour Organization (ILO) has proposed measures to protect the economy and employment that include, for example: extensive social protection, short-time work, paid leave and tax relief for micro, small and medium-sized enterprises. Other efforts relate to fiscal and monetary policy such as lending and financial support for specific sectors. Western countries in Europe and Northern America have already taken up these measures. The Netherlands, for instance, proposed a stimulus package to support the business community by injecting between 10 and 20 billion euros over the course of the next three months. The Dutch government is also keen to work with municipalities to reduce local tax burdens that companies face, and to make sure that local arts and culture organizations are still able to survive, particularly because of the national ban on public gatherings. There are also discussions on compensation to cafes, restaurants and travel sectors. In the US, the Senate passed US$2/€1.8 trillion package aimed at aiding businesses, workers and the healthcare system affected by the pandemic.
In Kenya, the government has announced a Kshs. 40 billion (€349 million) package, as well as support to the poor and vulnerable families, income tax and credit relief, and lowering of VAT and corporate tax for those still employed and running businesses respectively. The specifics on the relief package i.e. to whom, when and how with respect to the poor and vulnerable remain unsubstantiated. While welcome, these responses will not be nearly enough to mitigate the economic effects and prevent millions of people ending up in poverty. Unlike in the western nations, where governments have set aside billions of euros and trillions of dollars to bail out their economies and avoid job losses and business closures, Kenya does not have such plan in place for the working community. Those of us in the working class without a job who can no longer meet our basic needs in the current crisis, are forced to rely on our social networks that are heavily stressed presently. And that is if we are lucky to have them.
Lastly, in addition to the direct economic implications, Covid-19 crisis is also having indirect impacts that will have far reaching consequences. Particularly critical is the indefinite closure of land registries. It has been argued that such a move does not only affect transaction and circulation of millions of money, but according to Fridah Githuku, the director of GROOTS Kenya and LANDac fellow, with a lot of land transactions that are still pending, this leaves many people’s access to land in a vulnerable position. Elsewhere, Kenya being largely an agricultural economy, the decline in trade of agricultural products due to Covid-19 infection mitigation measures in the country and abroad, is having a profound impact on land-based investments and ultimately agricultural-based livelihoods and food security.
In sum, the Covid-19 scenario in Kenya highlights a significant inadequacy of our country to address its taxpayers needs and to safeguard people’s welfare in times of crisis. When we get through the pandemic, it will be high time to put up strong policies in place, like building a strong social protection and safety nets plan that is now saving lives in countries like the Netherlands.