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'We’re standing on the edge of a precipice' - Exclusive report from British woman on South Sudan's frontline

A UN official has warned that if coronavirus hits South Sudan, with its non-existent healthcare system, the consequences will be disastrous. British NGO worker Jenny Davies is working with Mission Aviation Fellowship (MAF) in the world's third most dangerous nation. She gives this first-hand account of how both the charity and the nation are bracing themselves for the pandemic to hit

As news of Coronavirus has spread across the world I find myself anxiously scrolling through newsfeeds just like everyone else. I know that this isn’t healthy. It's needlessly feeding my anxiety when there's nothing I can do. But perhaps its wise to stay informed.

From the window opposite my desk at the MAF office near Juba’s International Airport, life goes on as normal. Traffic is flowing across the busy junction opposite in the usual chaotic manner. Covid-19 is far away.  

I arrived in Juba seven weeks ago and joined the MAF South Sudan Covid-19 meeting in my second week at work. At the first meeting someone produced the Programme Security and Contingency Plan. The hefty document landed on the table with a thud. There are pages and pages of well-thought-out scenarios, risk assessments and checklists, covering every eventuality - except a pandemic.

Colleagues from the Netherlands, Australia and South Africa reflect on the situation unfolding in their home nations. It still seems quite remote to us here - although discussions are coloured by concern for the welfare of family and friends back home. Most countries are taking measures to limit social contact, and some, such as Italy and Spain have locked down completely.  

There are still no cases here in Juba. Life goes on as it has always done. People come to work, chat and share food over lunch and our flights take-off and land. All the while newsfeeds continue to pump out updates. Italy is suffering terribly and Spain is following suit. My communications with my sister in Mallorca, usually sporadic, are more frequent now I know that she’s stuck indoors. It's good to hear her voice.

At work we write emails to advise staff to stock up on food, stop shaking hands and notify us of any underlying health conditions. The concept of social distance has not yet entered common parlance and we all wonder how people will react when the inevitable government advice is issued and how it will filter down. Most people in South Sudan can't afford the luxury of stockpiling food in comfortable homes. We offer staff loans so they can stock up on basics before shortages bite and the price rises kick in. 

Colleagues ask politely after my family in the UK as the situation across Europe becomes more serious. I think of my parents, on the cusp of their 70s, and a number of medically fragile friends. I read articles about herd immunity which make me angry. I try to check my attitude and acknowledge that everyone’s doing their best. 

In the office we review health insurance policies and reflect on the sobering inadequacies of the country’s healthcare system. The rest of the world is counting their ventilators, an easy task in South Sudan - because there are none. We discuss two types of med-evac flights, the ones we might fly for our partners in remote communities and the international transfers we might need ourselves (someone is tasked with checking if these will still be available).

At the same time, it’s business as usual. At morning devotions colleagues request prayer for sick children and ailing mothers. South Sudanese colleagues share news of family tragedies and concerns for intercommunal violence in the areas where they’re from. We’re all reminded that there are more immediate concerns, and today already has enough trouble of its own.

When Covid-19 arrives in nearby Kenya and Uganda, conversations change. A friend drops in to discuss the ultimatum she's been given by her organisation. She either leaves in two days when her country closes its borders, or she’s here in Juba for the duration.

We make posters telling passengers to wash their hands and comply with our security staff as they measure the temperatures of everyone entering the building. We replace the posters with official government ones as soon as they are available.

The logistics team stock up on hand sanitizer, managing to obtain a supply at hugely inflated prices, aware that nobody knows how long this will last and how much we’ll eventually need. Washing hands seems such a trivial defence, soap such an unlikely weapon in a country where crises are usually fought with guns.

At the airport, the likely entry point for the virus (and its cure), our dispatch staff wear masks and gloves. There are long discussions about whether this is a pointless waste of time. Stocks are running low in the country and need to be preserved for those who really need them. Later there is a discussion on a social media platform about getting reusable ones made by locally by tailors. A partner organisation is looking for enough for 850 clinic workers.

An offer of help is made by MAF to the government to help by flying test kits, samples, emergency assessment and response teams. When the Governments High Level Task Force on Covid-19 make a public announcement later that day, MAF gets a mention. In the next sentence the spokesman announces the closure of borders to all international flights and passenger transport. MAF has already taken steps to reduce flying while allowing urgent charters and emergency flights to continue.

In some ways restrictions makes things easier. Decisions have been taken out of our hands. In other ways they’re a reminder of what’s at stake. Speculation that the hot climate might somehow slow the virus’s spread has yet to be proven. Our African neighbours are weeks behind the European countries now grinding to halt with increasingly strict lockdowns in an attempt to halt the spread. It feels more and more like we’re standing on the edge of a precipice. Nobody’s looking down.

A national colleague asks pointedly, ‘when’ I will return to the UK? I shrug in reply, but I know what he means. In every crisis the foreign workers are the first ones to go. But this crisis is different. Covid-19 is everywhere. South Sudan relies on the healthcare and basic services that humanitarian organisations provide. MAF has an important role to play. I can't leave.

We keep a mental tally of how people are behaving, whether habits are changing and if rules are being enforced. South Sudanese colleagues complain of raising market prices, restaurant closures and the commute to work. The ‘boda boda’ motorbikes which are the arteries of this burgeoning city, have become casualties of social distancing rules. Drivers usually carry 2-3 passengers. Now they carry one. Transport has become even more expensive and scarce.  

My driving license comes through in the midst of it all and I nervously head out onto the streets in one of the company’s 4x4s. Compared to my little run-around in the UK, it feels like I’m driving a tank. It’s a right-hand drive, so occasionally my colleague grabs the gearstick as I mistakenly grapple with the window leaver. I’m thankful the roads are quieter than usual – but sad if I think about why.

A few days later my work visa arrives and I can finally join flights - just as demand for our services is drying up. My first flight has been arranged to bring a missionary back to Juba so they can catch an international flight mandated by their embassy due to Covid-19. It ends up being cancelled.

In the afternoon we receive a last minute request for the emergency evacuation of a medical team. Rumours had reached them of an impending attack in the area. Nearby gunshots that morning were enough for their NGO to pull the plug and get them on the next plane out. They are disappointed not to be able to continue with their work.

The month tips into April and there are still no cases in South Sudan. Of 18 cases tested so far – all have come back negative. But day by day the reach of Covid-19 is getting wider. On a map of Africa, South Sudan is now the largest patch of Covid-free territory on the continent apart from the tiny mountain Kingdom of Lesotho, and island nations of Sao Tome and Principe and the Comoros.

Isolation has become a byword for community lockdown over the past six weeks. But there are still places of real physical isolation where basic healthcare isn’t available, let alone respirators and critical life support. As the dry season drags on, a good proportion of people in South Sudan will struggle to get enough to eat, whether Covid-19 arrives or not. Hungry people struggle to fight off disease. As the shadow of the pandemic looms, it’s time to acknowledge that malnutrition, dirty water and the cramped living conditions are underlying health conditions too.

Jenny Davies is a British NGO worker serving with Mission Aviation Fellowship (MAF) – the world’s largest humanitarian airline – in Juba, South Sudan. A Comms Officer previously from Kent, Jenny has been in her role for just seven weeks, living in the world’s third-most dangerous country. While many foreign aid workers evacuate, Jenny and her MAF colleagues sit tight, waiting for the virus to hit so they can see how best to serve. With the first confirmed case in Juba on Sunday 5 April, it is not a matter of if, but when. 

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