Response to the Coronavirus in Tanzania

In an effort to get ahead of the coronavirus curve in the Ayalagaya and Arri communities, we have been working hand in hand with the local government and medical leaders to assess the needs and fill the gaps to prepare the villages for Covid-19. We started our work on March 19, 2020, significantly before any major efforts by the Tanzanian government were implemented.

As of the end of June 2020, we continue to have not a single confirmed case of Covid-19 in Ayalagaya and Arri even though there are several confirmed cases and also a few deaths in the surrounding wards. We believe this is a direct result of the incredible preventive work Karimu executed with the local leadership and our staff.

Karimu worked specifically on three fronts jointly with the district and state governments and with the ward, village, and sub-village leadership across Arri and Ayalagaya:

1. Providing public awareness, education, and handwashing supplies

The Tanzanian government has worked to disseminate information on the transmission and prevention of Covid-19. However, a major challenge has been getting correct and timely information out to rural areas due to the absence of widespread media and a low literacy rate. Throughout April 2020, Karimu has:

• Organized a public awareness campaign - Funding of 4 motorbikes with speakers to drive everywhere in Arri and Ayalagaya while playing a recording from the government about COVID-19. These motorbikes visited every corner of the region at least 5 times in late March and early April to carry the message to even the most remote homes.

• Trained community leaders - Training covered coronavirus transmission, prevention, symptoms, and actions and effective handwashing practices. These individuals are highly respected and influential members of the communities and can lead changes in their communities. Karimu staff trained all chairs and executive officers of all 10 villages and 34 sub-villages, another 36 sub-village ambassadors, plus 52 midwives spanning Ayalagaya and Arri wards. In addition, all active savings groups have been contacted to discuss options to minimize transmission and economic risk. Finally, Karimu organized a WhatsApp group for ward teachers with smartphones (about a third of the 184 teachers) to disseminate as much information as possible and respond to their questions.

• Coordinated visits and donated soap to every household - In partnership with the village and sub-village leaders and ambassadors we conducted door to door visits with every household in Ayalagaya (2,366 households) and Arri (3,121) to educate them on COVID-19 and hand washing. Each household received Covid-19 and handwashing flyers in Swahili, and a very large bar of handwashing soap, enough to last a typical family one month. The ambassadors explained the content of each flyer and answered any questions that came up. Spot checks indicate that over 95% of households received soap and flyers and those who did not had been away from home. Ongoing followup should assure that we reach 100%. In total we distributed 19,000 copies of the COVID-19 flyers and 12,000 copies of the hand washing flyers including to each household, to government offices, and to clinics so people will receive the message through multiple channels to reinforce the importance.

2. Assisting area clinics and medical staff

Karimu worked with both the local and regional clinics to support preparations to meet the challenge of COVID-19. Fortunately, Karimu got started very early with the clinics and was able to purchase key supplies. But even in March 2020 shortages were appearing and our team had to improvise solutions. In April 2020 Karimu has:

• Trained medical staff - Karimu organized trainings for the head doctor and head nurse of all clinics in Ayalagaya (Dareda Kati Dispensary and Gajal Dispensary) and in Arri (Tsaayo, Dohom, and Managha Dispensaries and Maria Maculata health center). The training included 1) coronavirus and Covid-19 training 2) effective handwashing, and 3) patient in-take and triage procedures covering hygiene and protection, isolation of patients with highly contagious diseases, collecting vital signs, and flow of patients in the health facilities. The training was conducted via videoconference with medical experts from Brazil.

• Donated sanitation and intake supplies - Karimu donated 15 thermometers, 100 liters of alcohol, 39 buckets with faucet and stands for handwashing, 200 liters of liquid soap, 170 soap containers, 50 liters of hand sanitizer, 13 dispensers for hand sanitizers, 70 liters of bleach, mops, brooms and trash bags.

• Donated personal protective equipment - Karimu donated 105 boxes of medical gloves (50 pair/box), 60 boxes of masks (50 masks/box), 188 gowns for medical staff (sewn by local tailors), 180 self-made face protection shields (made by Karimu staff), 20 rubber boots and 20 elbow length gloves. Donations were made to both the local clinics and to the regional centers where testing and treatment of COVID-19 patients will occur.

• Accelerated new clinic opening - Karimu worked with the District Medical Officer to accelerate the planned opening of the Gajal Dispensary. Gajal´s sub-villages lie the farthest from the Dareda Kati Clinic, and villagers must walk up to six kilometers to get basic medical treatment. Originally scheduled for opening in September, this has been accelerated into May with Karimu completing the construction work and funding essential furniture and medical equipment. Meanwhile the government has hired the medical staff, delivered the medical supplies and medications, and secured the budget for the monthly operating costs.

3. Supporting Karimu’s local staff who are driving projects on the ground

Karimu’s local staff are key to the effective operation of Karimu all projects in the ward. Moreover, since starting the COVID-19 response project in mid March, they have worked tirelessly, seven days a week, and with urgency to do everything they can to prepare their community. A top Karimu priority is the safety of our staff.

• Trained of all Karimu employees on COVID-19 and handwashing

• Created new procedures and guidelines for safety - All Karimu employees and those on Karimu construction projects must limit the risk of exposure. Key procedures now include daily sanitation of the office, social distancing including at construction sites, rotational work schedules to limit the number of people in the office, and handwashing before entering the office.

• Defined preparation and procedures to limit Karimu operations - Once the virus reaches the region in which Karimu operates, all employees will be asked to shelter-at-home. Work will be limited to that which can be done online or over the phone. Employees have been advised to purchase extra food, extra telecommunication credits, take home protective gear for themselves and their families, and were given early salary payments.

4. Support the reopening of schools
The federal government of Tanzania required all schools to reopen on June 20. To help prevent infections, Karimu worked with all schools in Ayalgaya, Arri, and Dareda Mission Wards to protect their 12,128 students and 277 teachers and school staff. We donated the following items:

• 217 Big buckets for hand washing: one bucket for every classroom plus one bucket for the teachers’ office

• 217 stands for the buckets

• 255 half-meter bars of soap (1 bar for every 50 students)

• 295 liters of liquid soap (1L for every 50 students)

• 175 liters bleach (approximately 1L for every 100 students)

• 245 liters of spirit to clean every classroom daily

• 300 liters of hand sanitizer plus 277 ½ liter bottles (1 bottle for every teacher and staff).

• 344 poster sets for handwashing (how/when) to be hung up in every classroom or school office and each hand washing bucket or sink.

• 217 poster sets about respiratory illness to be hung up in every classroom and school office.

• Four training modules on
  Handwashing
  Covid-19 and respiratory illnesses
  Hygiene and proper use of toilets for boys
  Hygiene and proper use of toilets for boys.
  Commitment to train all students, teachers, and staff on the above 4 modules was a condition to
  receive Karimu’s donations.

• 12389 flyers on how to wear and make face masks for distribution (one per student and school staff).

• 12389 flyers on the how and when of handwashing (one per student and school staff).

• 12389 flyers on respiratory illness (one per student and school staff).

• 13589 flyers on how to treat a sick person at home (one per student and school staff and 1200 to be distributed at all clinics in the region).

Expected benefits:

• Reduced number of COVID-19 infections in the region

• Improved overall community health based on

• Critical handwashing intervention per WHO recommendations

• Critical patient intake procedures based on volunteer doctor on site needs assessment

• Early opening of Gajal clinic and better access to healthcare for that area

Cost:

$40,750

Learn more about Karimu Health Program .