Moroto, a border district with no COVID-19 cases

UNICEF supporting social mobilisation campaigns and infection prevention and control interventions

By Alex Taremwa
water borne diseases, WASH, borehole, clean water, disease, cholera, unsafe water, health, hygiene, covid-19, covid19, coronavirus
UNICEF Uganda/2020/Taremwa
24 July 2020

According to Uganda Bureau of Statistics (UBOS), Moroto is one of the least populated districts in the country inhabited by slightly over 120,000 people. The district borders with Kenya in the North East and has been one of the districts that has had an extended ban on public transportation. 

While the district authorities and partners such as UNICEF and IntraHealth are running repeated social mobilisation campaigns to ensure compliance to global COVID-19 prevention measures, some residents in Moroto are still reluctant to adhere to Ministry of Health and World Health Organisation (WHO) Standard Operating Procedures (SOPs). 

It had to take a heavy deployment of the army to enforce compliance but in some places such as “Camp Swahili” in the outskirts of Moroto town, shops remained largely opened, masks are only worn when people are entering banking halls or when they see a police van approaching. 

“Our neighbours [Kenya] have some 14,700 COVID-19 cases but somehow my residents were dragging their feet. So, we agreed as a taskforce to step up the deployment. Now when you ask them, they say we have a government here. And there has been a lot of progress,”

the Resident District Commissioner, Locap Peterkhen said.

With support from UNICEF, there is a mandatory handwashing policy for all passengers entering Moroto town at Nadunget checkpoint that is secured by the Uganda Police Force. No one is allowed through whether in a private car, bus or taxi without washing their hands first and their temperature measured. 

This lacklustre attitude among the Karamojong should not be misconstrued to mean that the Moroto District COVID-19 taskforce is not doing a good job. The reverse is true. Moroto is the only border district that has not registered a single COVID-19 case since March. In his last address, H.E. President Museveni commended the district leaders for “organization.”

The district quarantine centre at Nadunget Secondary School has had 57 suspected cases since the lockdown started, most of these are Ugandans returning from Kenya via the Nakaabat border point but none of their results turned out positive for COVID-19. 
At the border point, the returnees are tested, and samples sent to the Uganda Virus Research Institute (UVRI) but none of the results have been positive.  

Lokong Zackary, 32, an enrolled nurse who runs the Nakaabat checkpoint explains the “strict policies” both locals and nationals must undergo before entering the country. 

“When they cross that point [points to the wooden boundary], they have to wash hands at the tank and sanitize. We take their temperatures and the community members are allowed to proceed while the returnees are kept here, their documents verified, and their samples taken. We then notify the district quarantine centre to send an ambulance and the suspect is taken to mandatory quarantine for 14 days as we await the results,” Lokong explained.
 
On a normal day, at least 30 people cross the Uganda-Kenya border, most from Lodwar, the nearest town on the Kenyan side. Lokong is assisted by Losike Paul Peter, a certified medical laboratory assistant. Together, they administer up to five COVID-19 tests a day. 

The COVID-19 test point at Nakaabat is very makeshift. All that meets the eye is a UNICEF tent in the middle of a shrub. On rainy days, Lokong and Losike must remain standing for long hours in order for them and the equipment not to soak. 

Other than the tent, UNICEF supplied them with a water tank, gumboots, goggles, sanitizers, liquid soap to keep them safe. 

At Kakingor Health Centre III – the medical command centre for the border point, UNICEF built an incinerator to destroy the used masks, medical gowns, gloves and their gear that medical workers use when testing COVID-19 suspect cases. The hospital In-Charge, Dr. Okiror Timothy said UNICEF supplies have enabled the hospital to develop capacity to absorb any pressures from the community and neighbouring Kenya. 

As precaution against COVID-19, the hospital has closed off all access routes to ensure that all visitors disinfect themselves and wash their hands before accessing the hospital. Other than the incinerator, UNICEF also built them male and female latrines with an “improvised” bathroom for mothers who have just given birth to bathe without bending their backs.

COVID-19 impact on the local community

The lock down has decimated livelihoods in Karamoja. With the gold mines sealed off by the army to curb infections and cattle markets closed, money is Karamoja is hard come by. This has increased street begging in Moroto and petty theft in local communities.

According to the Resident District Commissioner, Locap Peterkhen, the cases of domestic violence and Gender-Based Violence (GBV) have spiked since the lockdown. The COVID-19 task force has now approved a plan with UNICEF support to roll out phased home schooling but strictly following Ministry of Health and World Health Organizations guidelines of social distancing and handwashing.

“Through VSO, a local implementation partner, we have already got volunteer teachers and have also secured learning materials from the Ministry of Education and Sports. We think this approach will save children from some of the violence in their homes and salvage some good in what looks like a dead academic year,” Locap said.