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New IRC report exposes double emergency of COVID-19 in humanitarian crises

Craig Zelizer

April 19, 2020

Crossposted from the IRC

New IRC report exposes double emergency of COVID-19 in humanitarian crises; reveals grave shortages of ventilators and ICU beds in fragile countries

New report by the International Rescue Committee (IRC) finds that fragile and conflict-affected countries face a double emergency: the arrival and impact of COVID-19, and the secondary humanitarian, economic and political havoc this outbreak will wreak

  • Report shows South Sudan only has four ventilators for the entire country; Northeast Syria has 11; Sierra Leone has 13; in Venezuela, 90% of hospitals lack critical supplies.
  • The IRC is working to mitigate the spread of coronavirus among the world’s most vulnerable populations and calls for more funding for NGOs working to combat the disease.

As COVID-19 continues to spread around the world and to conflict zones like South Sudan and Yemen and refugee camps like in Greece, the International Rescue Committee (IRC) has published a new report, “COVID-19 in humanitarian crises: a double emergency,” exposing the devastating impact of COVID-19 on fragile countries. The report raises the alarm not only on the lack of capacity of these health systems to handle the outbreak itself, but the significant and destabilizing impacts -- including escalation of conflict, political and economic instability -- the pandemic will provoke.

The four countries detailed in this report-- South Sudan, Syria, Venezuela and Yemen-- as well as large refugee camps-- show particular vulnerabilities to this pandemic [1]. While COVID-19 has already overwhelmed even the most advanced and prepared health systems in countries like the United States and United Kingdom, which measure ventilators, intensive care units and protective equipment in the thousands, these conflict-affected and fragile countries and many like them have close to none. Making up only 0.6% of world GDP, nearly half (46%) of the people in these four countries lack access to basic health services, while also facing acute shortages of supplies vital to fighting COVID-19. These fragile states are simply unable to deploy the strategies of wealthier countries against the virus, and will be severely affected by disruptions to humanitarian aid, risking an escalation of violence and economic and political instability:

  • In South Sudan, where less than half the country’s health facilities are functioning, there are 24 ICU beds and four ventilators. With life-saving humanitarian programs globally facing unprecedented disruption and suspension, countries like South Sudan which are already gripped by high levels of malnutrition may face famine.
  • Northeast Syria has only 28 ICU beds and 11 ventilators in the hospitals identified to quarantine and treat suspected COVID-19 cases. In Northwest Syria, and in Idlib in particular, there are only 105 ICU beds and only 30 adult ventilators; almost all are already in use [2]. Across Northern Syria, there were 85 attacks on health facilities last year alone by ongoing violence. The security and political vacuum the pandemic will create is likely to be exploited by actors involved in the Syrian conflict - including ISIS - to serve their interests.
  • In Yemen, the world’s largest humanitarian crisis, more than half of Yemen’s health facilities are no longer functioning and 18 million people do not have access to proper hygiene, water and sanitation. Parties agreed to a ceasefire to allow for a COVID-19 scale-up, only to violate it two days later. IRC has also warned about increases in other forms of violence against vulnerable groups worldwide, such as violence against women.
  • In Venezuela, where the crisis forced more than half of doctors to leave the country and 90% of hospitals face shortages of medicine and critical supplies, there are 84 ICU beds for a population of 32 million. With borders closed to Colombia, further economic turmoil not only threatens the lives of millions of Venezuelans, but further reductions to public services will only heighten political instability.
  • Other fragile countries facing grave ventilator and ICU bed shortages include:

- Burkina Faso - 11 ventilators for population of 20.9 million
- Sierra Leone - 13 ventilators for population of 7.9 million
- Central African Republic - 3 ventilators for population of 4.8 million [3]
- Somalia - 15 ICU beds for population of 15.8 million [4]

  • Meanwhile, camps in Syria, Greece and Bangladesh represent some of the most densely populated areas in the world -- up to 8.5 times more densely populated than the Diamond Princes cruise ship, where transmission of the virus was four times faster than in Wuhan, China [5]. In parts of Moria camp, Greece, over 1,300 people share one tap and over 200 share a latrine.

David Miliband, President and CEO of the International Rescue Committee, said: “The IRC’s analysis paints a dire picture: the scale, severity and speed of the outbreak will be magnified in fragile countries. The double crisis needs a double response. First, immediate activity to prevent the spread of the disease is imperative. Without handwashing facilities the disease takes root, and without effective triaging of people it runs rife. One need only glance at the shocking disparity in ventilator and ICU numbers in crisis-affected states to understand the very real threat this poses to life and limb. Now is the opportunity to take advantage of the short window of time in places like Yemen and Syria to forestall the disease running rampant.

“Second, the lesson of the crisis is that the weakest links in the global health chain are a threat to health everywhere. We cannot afford these weak links, and must strengthen the efforts in war-torn countries and communities to lift their life chances. This is why the IRC has launched a $30 million appeal for our global COVID 19 response- serving the most vulnerable and ensuring vulnerable groups like refugees are not left behind. The international community must equally ensure that underlying humanitarian vulnerabilities across these countries are not left to fester or to multiply. The call to abide by a global ceasefire launched by the UN Secretary General has never been more obvious. The global economic response, defined for instance by the G20, must cater to the needs of fragile and conflict-affected states. Should we fail, not only will the most vulnerable pay the price today for the inaction of the international community, the consequences will be felt across the globe for years, if not decades, to come.”

The IRC has launched a US $30 million appeal to help us mitigate the spread of coronavirus among the world’s most vulnerable populations. We are working across three key areas: to mitigate and respond to the spread of coronavirus within vulnerable communities, protect IRC staff, and ensure the continuation of our life-saving programming as much as possible across more than 40 countries worldwide.

Download the full report here.

Download images from the report here.

Download graphics of these statistics here.


[1] All stats as of April 8 unless otherwise specified.

[2] From Idlib Health Directorate as of March 28.

[3] As of March 31.

[4] As of March 31 and according to the WHO.

[5] Refugee camps are at particular risk due to overcrowding and paltry sanitary conditions: Bangaldesh’s Cox’s Bazar (40,000 per km2), Greece’s Moria camp (203,800 per km2), and Al Hol, Syria (37,570 per km2), all far exceed the density of the Diamond Princess cruise (24,400 per km2).

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