Drawing on Ebola lessons to protect Tanzania camps from coronavirus

When an outbreak of Ebola stalked West Africa five years ago, Miata Tubee Johnson, a former refugee from Liberia and now a public health officer with UNHCR, the UN Refugee Agency, played a key role in reducing deaths in the community from the deadly virus that claimed more than 10,000 lives.

Now facing the spread of COVID-19, she is taking her knowledge of virus wars to protect thousands of highly vulnerable refugees living in camps in Tanzania.

"The last thing we want is for there to be an outbreak in the camp," says Miata, who spends her days between her office and three different refugee camps in Tanzania's Kigoma region.

More than three quarters of the world's 25.9 million refugees live in developing countries.

To prevent avoidable deaths and suffering, UNHCR, is prioritizing steps to curb potential COVID-19 outbreaks that would put extraordinary strain on already fragile local health-care services.

"The last thing we want is for there to be an outbreak in the camp."

With 245,000 refugees in Tanzania, Miata is working all hours to implement steps to prevent an outbreak in the camps and host communities that surround them.

First on her agenda is chairing a COVID-19 preparedness meeting with 20 staff from a number of organizations and the government, sitting at least one meter apart under a tree – social distancing in effect.

Next, she will hand over a much-needed digital X-ray machine recently procured with donor funding, to a nearby district hospital serving the host community. The machines are useful diagnostic tools for COVID-19, as they can detect lung damage.

"We are always working to build capacity in the local health facilities when we identify gaps. It is important for coexistence between refugees and host communities," adds Miata.

So far, there are no reported cases in Tanzania of the new coronavirus among refugees, most of whom are from Burundi and the Democratic Republic of the Congo.

• See also: Access to health services is key to halting COVID-19 and saving refugee lives

Part of Miata's focus is to ensure refugees are included in the national surveillance, preparedness and response activities. 

"If there are any cases of COVID-19 in the camp, they will be referred to government designated health facilities," she explains.

Having fled the civil war in Liberia as a child in 1991, Miata returned home with her family eight years later, went through school and graduated with a nursing degree. Two years later, she enrolled for a Master's in Public Health. She then applied for a job as a Public Health Associate with the UNHCR office in Liberia.

In 2014, one year into her new job, Liberia declared a state of emergency following the Ebola outbreak in the region. The small West African country was the hardest hit, recording 4,809 deaths before the outbreak was declared over in 2016.

Miata's job involved making sure refugees were well informed about how to prevent transmission of Ebola. She also worked with a team to convince governments to include refugees in the national Ebola prevention plan.

"My experience in Liberia actually prepared me for where I am today. I feel a sense of déjà vu," she says.

While COVID-19 has a different transmission and etiology to Ebola, Miata draws broadly on that experience to provide lifesaving public health messaging and call for the integration of refugees into the national coronavirus response.

"My experience in Liberia actually prepared me for where I am today."

The Tanzania refugee response is one of the least funded in the region, receiving only 25 per cent of the requested funding for 2019-2020. Basic services are severely over-stretched and unable to meet the needs of refugees.

• See also: Refugee nurse on the front line against coronavirus in Iran​

While she works in Tanzania, her family remains at home in Liberia. Her work is demanding but keeping in touch with her eight-year-old daughter keeps her going.

"Living away from home is the nature of our work as humanitarians but sometimes your child just needs your full attention as a mother," she says.

Miata, like many other humanitarian workers around the world is working through the global crisis to make sure refugees receive lifesaving assistance.

"I remember when we were in the refugee camp, I used to be happy when my parents would come from the food distribution point with food in their hands. I am playing that role now. Whether there will be a lock down or not, refugees should get what they need."

Additional reporting by Linda Muriuki in Nairobi, Kenya

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