Opinion: A reminder during COVID-19 — Africa is not a monolith

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A medical worker in full protective gear walks out of the emergency ward at a hospital in Mogadishu, Somalia. Photo by: AMISOM Photo / Steven Candia / CC0

COVID-19 exposes our collective blind spots to problems that preceded its contagion. Food insecurity, already strained health systems, and high burdens of preexisting communicable and noncommunicable disease have been highlighted as factors that will exacerbate the spread of this inexorable disease.

Prior to the pandemic, significant progress had been made toward addressing some of these factors that place many countries and their citizens at increased vulnerability for the disease. However, positive gains in infectious disease prevention and surveillance may be stalled, and lockdown measures will have unintended and undesirable economic consequences.

None of these vulnerabilities are unique to low- middle-income countries, or LMICs; they are ubiquitous and we need to address them as such. There is a disproportionate focus on these factors by North Americans and Western Europeans who mischaracterize them as the plight of Africa — and Africa alone. This is careless and misguided on their part, because in doing so it leaves them underprepared to address their own systemic vulnerabilities that result in the same tragedies they hypothesize and predict elsewhere.

Many editorials and think pieces about Africa have been criticized for not including specificity and nuance. For example, after reading a recently published Bloomberg piece with the evocative title “Covid-19 Threatens to Starve Africa,” I took umbrage with the exclusive focus on Africa, because food insecurity has been described by the World Food Programme’s executive director as a looming hunger pandemic that will affect the global community. And health system failures and underpreparedness are as much a problem in African countries as they are in the U.S.

Additionally, Africa is not a monolith where challenges in one country apply to the dozens of others on the continent. No one country is the same, and no one health system is equally strained as another. “As it expands on the continent, Covid-19 will put further stress on already strained health systems”, the Bloomberg author wrote. But which health systems? The piece does not specify, nor does it delineate which countries are being referred to. It is a sweeping generalization about a whole continent that continues to metastasize.

There are notable strengths in Africa that differ by country and are often overlooked. Rwanda has the continent’s most innovative and sought-after health system, providing near-universal coverage. From prior experience with disease outbreaks and epidemics, Uganda has had in place many of the requisite measures needed to detect, prevent, and trace the coronavirus. South Africa has the continent’s best public health system, in which many internationally regarded clinicians work to provide the best possible care to their patients. Innovations in Senegal put it on track to develop $1 diagnostic kits to identify the virus.

However, we don’t read or hear about these strengths as much as we hear about the perennial inadequacy of Africa and her countries. Moreover, the challenges facing the health systems of African nations are not the same, but the manner in which they are covered makes this erroneous assumption.

We tell a single story about Africa — one of uncontrolled disease, poverty, and a complete lack of academic, intellectual, and professional know-how. This is the “danger of a single story,” as writer Chimamanda Ngozi Adichie has explained. We create a myopic and distorted lens through which to view Africa and its countries. Though the continent has shown its comparable abilities to approach the pandemic, people continue to underestimate the inherent capacity that African countries have to adapt, develop, and succeed.

In Africa, we have a breadth and depth of knowledge, expertise, and human capital, highlighting that there is much more to our story than the exclusive focus on poverty, disease, and resource limitations. Even if we were to exclusively focus on these substantial problems facing African countries — their health systems, their economies, and their human development indexes — we would be remiss to not juxtapose those with the historical legacies of colonization from which their contemporary issues originated.

Despite their share of problems, African countries have shown that they are not inept, lacking leadership, or faced with dead bodies in the streets, as philanthropist Melinda Gates predicted. Rwanda, leveraging the strengths of its health system, was swift in implementing a nationwide government response. In South Africa, the response was incredibly efficient during the weekslong lockdown. In Uganda, continued partnerships and its strengths are keeping citizens safe and healthy during this pandemic.

These successes coexist with their myriad challenges, and they make balancing the many competing interests difficult. However, these are not unique to African LMICs; they can be found in high-income countries as well. In the U.K., swaths of vulnerable groups are faced with job losses, hunger, and the exacerbation of preexisting medical and mental health problems.

In the U.S. — currently the epicenter of the pandemic — unemployment is at a historic high, hunger is worsening, and it is here where bodies decompose in the streets, not Africa.

This is not a competition, however. There is no winner in a pandemic, and there are immeasurable losses — both tangible and abstract.

People continue to underestimate the inherent capacity that African countries have to adapt, develop, and succeed.

Indeed, countries in Africa may be more vulnerable to suffering these losses, but it would be ignorant, if not unfair, to mischaracterize the African story as one of gross incapability to recognize these risks and be spurred to action. Overcrowding, the inability to socially isolate, and the desperate need to work despite the risks are not uncommon problems in the U.S. Though food insecurity, poverty, and resource limitation have been the common story of LMICs, these socioeconomic problems are clearly shared across human development indexes.

Academics from North America and Western Europe have an incredible ability to be incisive, impartial, measured, and nuanced when critiquing their own countries or those similar to them. Why can the same not be done when they talk and write about African countries? Progress has been made, but it seems that amid the “infodemic” and race to publish papers, editorials, and opinion pieces, we have largely regressed to unproductive tropes. The language and vocabulary we use, and the manner in which we use it, matters.

Too often, people from Africa have to first push back on the narrative of their continent, followed by that of their country, and then they must only speak to the points of interest because if they don’t do it, no one will. Africa is not a homogenous community, and there are differences between African countries and within them — significant layers and complexities that distinguish one nation from another.

But academia fails to recognize this. Africans must not be the only ones who can produce and publish works that speak to these similarities and obvious differences. It is time that North American and European academia recognizes this and ascribes to Africa and her countries the same level of granularity, nuance, and specificity that it gives itself and its countries.

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About the author

  • Hloni Bookholane

    Hloni Bookholane is a medical doctor from South Africa, a Fulbright scholar, and currently enrolled in the Master of Public Health program at the Johns Hopkins Bloomberg School of Public Health.