COVID-19 has reached the Middle East and Eurasia which are at high-risk for increased mortality from the disease. The population in these areas are ageing rapidly, face ongoing conflict and have huge displaced and refugee populations. Places like Syria have limited resources and medical infrastructure which will serve to make fighting COVID-19 all the harder.
We work in many countries in the Middle East and Eurasia, assisting with conflict affected older women, men and communities and improving social-economic prospects for refugees and their host communities. Our usual activities, such as meeting with older people in safe community centres, has had to be temporarily suspended to limit the spread of Covid-19.
We are working hard to prevent the spread of the disease by providing hygiene kits to at-risk older people alongside printed advice about how to stay safe from Covid-19. Additionally, all care visitors and staff have been asked to wear masks and use hand sanitizers before home-based care visits to minimise the risk of introducing Covid-19 to older people.
A combination of economic and political factors, such as the collapse of the Soviet Union, a devastating earthquake in the late ‘80s, and a war with neighboring Azerbaijan in the ‘90s, has left many Armenians struggling.
With nearly 12% of the population over 65-years-old (projected to increase to 19% by 2030) and a culture where care for older people is widely seen as a family responsibility there are few care institutions and home care providers for those without families to care for them. Life can be very challenging with very low pensions and high healthcare costs.
As coronavirus continues to spread we are working with Mission Armenia, an NGO, to help older people in Yerevan, Armenia’s capital and largest city and six RA regions: Gegharkunik, Kotayk. Ararat, Lori, Shirak and Syunik.
Mission Armenia has informed its staff and volunteers about coronavirus and how to prevent and protect from the virus. It has also provided PPE and disinfectant so that staff and volunteers can protect older people who need their help. In addition, all the premises and vehicles in use are being disinfected.
The charity is continuing to provide in-home care services for 4,000 older people and now needs to protect them from coronavirus in addition to their usual care needs. To help stop the spread of the virus to 500 older people receiving intensive care services, we will be purchasing and distributing masks, gloves, shoe covers, medical caps and coveralls. Additionally, hygiene kits including liquid soap and disinfectant will also be distributed. Transport will be organised to deliver these care services, PPE and hygiene packages.
Given the high-risk of COVID-19 to older people, it is also essential to raise their awareness on self-isolation and how to prevent catching the virus. 4,000 age friendly flyers are being created to inform on COVID-19 prevention, protection measures and provide emergency numbers for the COVID-19 response in Armenia. These will be distributed alongside food and hygiene packages. The staff members involved in the distribution will clearly explain the content of the flyers to the recipients. In addition, Mission Armenia will prepare posters that will be displayed in its social houses and the 24-hour care centre for the elderly.
Mission Armenia will also disseminate COVID-19 related age friendly information through two radio channels - “Radio Van” and “Radio Hay” with plans to broadcast the information five times a day for 60 days - 30 days through each channel. The information to be broadcasted and to be included in the flyers and posters will be elaborated taking into consideration HelpAge and WHO COVID-19 related materials.
Since the onset of the Syrian Crisis in March 2011, Jordan has shouldered the impact of a great influx of refugees, hosting the second highest share of refugees pro capita in the world with 755,050 refugees. Of the total number of registered refugees, 3.8% are older refugees aged 60+.
These refugees alongside vulnerable host communities face the continued threat of food insecurity, deterioration of living conditions and low incomes, exposure to protection risks and erosion of social cohesion.
Inadequate access to public infrastructure and services, including shelter, safe water, sanitation, education and healthcare, remains a major concern.
Coronavirus has added an immense level of pressure to this already critical situation.
A new three-month project to strengthen the COVID-19 emergency response for older men and women with and without disabilities is running in Jordan. Through this project, older men and women are protected by reducing their exposure to COVID-19 through age-inclusive preparedness, response and recovery.
An assessment of a sample of older people across six areas throughout Jordan showed that 58% of older men and women lack personal care & hygiene supplies, 41% lack food due to financial reasons, and 37% of the assessed sample lack necessary medication for their needs.
Based on this assessment, and the neglect and ageist attitudes towards older men and women in Jordan, it is essential that we directly support older men and women now, with emergency response funds and provide protection and basic needs.
Throughout the assessment, the stress levels, fear, and misinformation were noted, as well as the feeling of isolation due to the restriction of movement, and curfew, and ageist attitudes.
The project will run in Amman, Mafraq, Zarqa, and Tafileh and will see older people - both refugees and those from the host community- informed about coronavirus via an electronic campaign to ensure access to critical information on how to protect themselves from contracting COVID-19.
Additionally a “buddy system” will be set up where volunteers will phone older men and women and have conversations with them, identify any immediate needs, refer cases when required, and create a supportive environment where older men and women do not feel isolated and can have their immediate needs met.
Basic essentials will also be distributed to help meet needs at this difficult time. Two thousand five hundred older man and women are receiving hygiene kits– 500 to all older people in the 10 nursing homes in Jordan and 2000 to older people in Amman, Mafraq, Zarqa, and Tafileh.
To help the most vulnerable older men and women with and without disabilities, 200 individuals will also receive cash assistance to give them the means to purchase items and meet their basic needs.
This project will address the gaps in services regarding older men and women and highlight their needs.
Advocacy work will be throughout the duration of the project and beyond and will be shared with relevant organisations to help address older people’s needs in the future.
The first cases of coronavirus were reported in Kyrgyzstan in mid-March. Since then we have delayed elements of our projects in the country to limit the spread of the disease to older people and their families.
Older people in Kyrgyzstan are extremely vulnerable; pensions are insufficient and health services for older people are underfunded, leaving many older people enduring chronic diseases without adequate treatment. COVID-19 is a huge added weight on an already stretched healthcare system.
Staff from our project to prevent complications and treat those with diabetes have been regularly calling group leaders of 100 Older People’s Groups - volunteer led self-help groups, made up of mainly older women who work to resolve issues affecting vulnerable older people, and to increase their participation and integration into social life – who in turn regularly call members of their group to raise awareness on how to prevent catching coronavirus.
Patients with diabetes are also being contacted about possible complications that COVID-19 could present alongside their existing healthcare needs. Additionally, WhatsApp groups have been created for Older People’s Groups, these groups share information about diabetes and its complications.
Our project combatting gender-based violence in Kyrgyzstan is continuing to run by adapting to the new challenges that social distancing creates.
Clubs have been taken online to enable community discussion of gender-based violence and it’s prevention. There are different clubs focusing on specific audiences including males and in-laws.Psychologist provide stress coping techniques and there are themed discussions around subjects such as early/ forced marriages.
These online clubs also include sessions on COVID-19 risk awareness alongside health tips and how to harness new technology in these changing times.
We’ve been working in Moldova as part of our promoting healthy and active ageing project.
In order to protect the older people we work with, we are buying hygiene materials, including hand sanitizer, to help stop the spread of COVID-19. While we focus on this much of our other activity is temporarily postponed.
Older people are at a high risk of COVID-19 transmission in Gaza, an overcrowded and poor area with a weak medical health system. It is predicted that the number of infected people will increase in the Gaza Strip due to movements between Israel, Gaza and Egypt.
There is an urgent need for preventive measures to eliminate risk of older people getting infected.
Eighty percent of deaths from coronavirus are being recorded in the over-50 age group and according to the Palestinian Central Bureau of Statistics, 60,000 older citizens are estimated in the Gaza Strip.
Between 2009 and 2016 we supported the El-Wedad Society for Community Rehabilitation (WSCR) to found the Bait Jdoudna Club (Grandparents House Club) which provided psychological, social, cultural, physical therapy and health care services to the older people.
Now, four years on we are once again working with WSCR to help older people in Gaza throughout the coronavirus pandemic.
We have identified over 11,000 people most vulnerable to COVID-19 and as a part of our response we are working to help older people who do not receive a pension and are suffering from chronic diseases in the EL-shate'e Refugee area of Gaza City; one of the most densely populated areas in the Gaza Strip.
EL-shate'e is the third largest refugee camp in Gaza, and also the most crowded.
This hugely exasperates the vulnerability of older people to coronavirus especially given that there is an ongoing protracted crisis in Gaza; years of war has meant that Gaza’s health system has been devastated, with fewer than 100 ventilators to serve a population of around 2 million people.
The city does not have enough hospitals, ICU beds, or mechanical ventilators to deal with a large scale outbreak of COVID-19. Additionally, the dangerously steep decline in the quality of life as a result of the Israeli blockade has undermined basic hygiene, most evident in the shortage of water and sewage treatment facilities, which further hampers efforts to prevent the virus’s spread.
Our work to help prevent the spread of the virus includes:
- Printing and distributing 250 copies of guidance and advice on COVID-19 for older people to individuals while 50 copies are being sent to pharmacies, supermarkets and vegetable and fruit shops in highly populated areas. The guidance and advice will also be sent out by email, on social media and available on the WSCR website to reach as many older people and their families as possible.
- Three thousand people will be contacted by phone and sent awareness text messages and 2000 older people, including those with disabilities, have received calls as part of the “PSS system,” where volunteers call older men and women and have conversations with them, providing a supportive environment. Through this system, older people within Gaza's community will feel less isolated and have their immediate needs for information and COVID-19 protection met.
- Seventy community health workers will visit households to raise COVID-19 awareness amongst 5000 people in the targeted areas. During these visits, key messages will be communicated to increase preventative action and reduce the risk of a coronavirus outbreak within the community as possible.
- Distributing 250 hygiene kits which include hand sanitiser, alcohol-based soap, antimicrobial wipes, masks and gloves to older people and members of the Grandparents House Club and other high-risk individuals.
- Holding awareness sessions with older people led by WSCR staff along with a representative from Ministry of Healthwith on how older people can protect themselves and safely use the items included in the hygiene kits.
- A further 10,000 people will benefit from an additional 2,000 hygiene kits that will be distributed in the Gaza strip to households with older and at risk individuals
- Thirty doctors, nurses, health workers and outreach workers from WSCR will be trained on safety measures and supporting older people with COVID-19. This will be carried out through online training, on-the-job training and in targeted facilities. Additionally, PPE is being given to health workers, staff and volunteers for protection and to send a strong community message around COVID-19 prevention.
- Using radio slots providing guidance and advice specifically on how older people can protect themselves have been organised with two local radio stations (Gaza FM & El-Shaab radio) with two slots broadcasted a total of 100 times each, four times daily for 25 days. Older people in the Gaza Strip rely on radio as their main source of information, particularly as they have limited access to modern technologies.
- Through mass communication including radio and social media, we will reach 50,000 people on protection and prevention measures for coronavirus.
In Syria we are working with our partner, SEMA, to reduce the impact of COVID-19 on older people, who are most at risk, by ensuring that health facilities are prepared. The ongoing war has resulted in hundreds of thousands of people in North-Western Syria being forced to leave their homes this year alone. WHO considers the overall risk for Syria to be very high. Many people living in temporary shelters and inadequate conditions and health services are fragile and disrupted, inadequately prepared to detect or respond to the crisis.
WHO’s primary morbidity analysis shows that the mortality rate of those infected with COVID-19 increases with age, with those aged 70-80 having a 14% mortality rate. In addition, the 20% of the population affected by pandemic could need advanced healthcare. According to Idleb health directorate, North-Western Syria has a capacity of just 100 Intensive Care Unit beds while the population is reaching 3 million. There is an expectation that if COVID-19 spreads in this area then 100,000 people may need hospitalization and 10,000 of these may need the Intensive Care Unit.
If COVID-19 prevention measures and community awareness is carried out then it may increase the time it takes to reach the peak of infection, allowing more time to control the disease in such fragile health systems and help save lives.
Given the rapid spread of COVID-19 in neighbouring countries and the lack of public health facilities capable of detecting the virus, we have partnered with SEMA, an organisation which supports health facilities and mobile health units in Syria, to help them prepare for the virus and reduce its spread. Outreach workers in key areas and refugee camps will raise awareness of the virus and infection prevention, which may also help delay the peak of the infection so that health systems are better able to cope when it comes.
Programme activities include:
· Sterilisation of all health facilities
· Providing hygiene kits, gloves, masks and suits for healthcare staff
· Training staff on early detection of coronavirus and managing suspected cases
· Setting up additional medically equipped facilities to treat patients
· Community awareness-raising campaign in mosques, community centres etc
· Online awareness-raising campaign targeting health workers
· Supporting effective coordination with health authorities and other partners
We’ve been working in Ukraine to support conflict affected older women and men. These people are now at high risk to COVID-19 and we have taken new steps to help stop the spread of this sometimes fatal disease.
Ukraine saw its first case of coronavirus in early March and the cases have continued to rise each day since. Community safe spaces are temporarily closed and we have made changes to some of our existing programmes.
Three thousand medical masks and plastic boot covers have been secured and all care visitors and staff have been asked to wear PPE and use provided hand sanitizers before home based care visits to minimise the risk of introducing COVID-19 to older people. They have also been told to self-isolate, work from home or take sick leave if they feel unwell. To support this effort medical masks, gloves, plastic boot covers and hand sanitizers have all been provided to those in direct contact with older people.
Over 1,000 at-risk older people have received hygiene kits or hand sanitizers and our partner, HelpAge, has published and is distributing leaflets with key prevention messages on COVID-19 to 3000 older people. Relevant guides will also be available on the use and application of the medical masks, gloves and other materials to older people and their carers.
Home visits for 2000 housebound vulnerable older people, people with disabilities and their carers will be carried out to provide assistance to individuals who require direct support to reduce isolation, improve their psychosocial wellbeing and sense of safety and security. Community volunteers will also provide support for other needs including shopping for essential medicines.
Two thousand older people and people with disabilities will be provided with food packages, COVID-19 adapted Hygiene kits and COVID-19 information awareness materials and advice for their specific needs. Additionally, PPE Kits will be provided to possible COVID-19 patients with mild symptoms.
An estimated 80% of individuals who have been identified as needing support by way of food packages and/or hygiene packages have at least one family member. These family members will indirectly benefit from the information on how to combat COVID-19 as well as through the access to hygiene kits and food packages, helping to take the strain off household expenditure at this time.
Yemen’s health service has been crippled by nearly six years of war and already struggles to cope with outbreaks of disease, including malaria and cholera. There are high rates of poverty and malnutrition, with more than 13 million people there facing starvation each month. This and the high population density, limited water supply and lack of access to soap mean the area could easily become a hotspot for infections, and COVID-19 cases there are already multiplying fast. Only half the health service is functioning, with unhygienic and poorly maintained equipment, and the area is unlikely to be able to cope with a major COVID-19 outbreak. There is also a lack of access to information from trusted sources, particularly among older and disabled people, which means that they may not receive clear guidance on preventative measures they can take.
We are working with YFCA, a Yemen based organisation who has been active in the humanitarian response there, to support two centres which support older people with sight loss. They will distribute hygiene kits of soap, disinfectant, masks, gloves, and tissues to 160 older people with sight loss, many of whom also live with chronic diseases like hypertension and diabetes. YFCA will also hold awareness raising sessions for older people twice a week, ensuring that the information is accessible for those with sight loss, as well as providing cleaning supplies and training for staff at the centres for older people.
Older people in the poorest parts of the world affected by conflict or living in refugee camps need help urgently to survive the silent threat of COVID-19.