Prevention of COVID-19 in Internally Displaced Persons Camps in War-Torn North Kivu, Democratic Republic of the Congo: A Mixed-Methods Study

Kasereka M. Claude; Muyisa Sahika Serge; Kahindo Kahatane Alexis; Michael T. Hawkes

doi:10.9745/GHSP-D-20-00272

Key Findings

Congolese internally displaced persons (IDPs) had high awareness and fear of COVID-19, but low specific knowledge.
IDPs face major barriers to implementing COVID-19 prevention measures: crowded shelters, frequent movements in and out of the camp for work, and lack of soap for hand hygiene.
IDPs’ desire for peace and to return to their native homes, where COVID-19 precautions could be feasibly implemented, overshadowed their enthusiasm for other control measures such as a vaccine.

Key Implications

Donors and policy makers should consider providing consumables, such as soap for hand hygiene and face masks, to implement COVID-19 precautions.
The national government or international aid agencies should consider providing individual family dwellings (e.g., tarpaulin tents) to allow IDPs to practice physical distancing.
National and international governments should take serious measures to restore peace to the area by controlling armed conflict. A safe return to their homes would allow IDPs to practice COVID-19 prevention without external aid.

ABSTRACT

Background:

The coronavirus disease (COVID-19) pandemic poses a grave threat to refugees and internally displaced persons (IDPs). We examined knowledge, attitudes, and practices with respect to COVID-19 prevention among IDPs in war-torn Eastern Democratic Republic of the Congo (DRC).

Methods:

Mixed-methods study with qualitative (focus group discussions, [FGDs]) and quantitative (52-item survey questionnaire) data collection and synthesis.

Results:

FGDs (N=23) and survey questionnaires (N=164 IDPs; N=143 comparison group) were conducted in May 2020. FGD participants provided narratives of violence that they had fled. IDPs were statistically more likely to have larger household size, experience more extreme poverty, have lower educational attainment, and have less access to information through media and internet versus the comparison group (P<.05 for the comparison group). IDPs had a high level of awareness (99%) and fear (98%) of COVID-19, but lower specific knowledge (15% sufficient knowledge versus 30% among the comparison group, P<.0001), a difference which remained significant in a multivariable model adjusting for confounding. IDPs faced major barriers to implementing COVID-19 prevention measures. Physical distancing was impossible for IDPs in crowded shelters, and 70% reported coming in close contact with someone other than a family member within the past 24 hours (versus 56% of the comparison group, P=.014). Frequent movements in and out of the camp for subsistence left IDPs vulnerable to the introduction of COVID-19: 61% left the camp on a daily basis and 65% had received a visitor in the past month. Despite acceptance of hand hygiene for prevention, 92% lacked soap (versus 65% of the comparison group, P<.0001). IDPs’ desire for peace and to return to their native homes, where COVID-19 precautions could be feasibly implemented, overshadowed their perceived benefits of measures such as a COVID-19 vaccine.

Conclusions:

These findings provide empiric evidence supporting the vulnerability of IDPs to COVID-19 and call for action to protect neglected displaced populations.

Received: June 21, 2020.
Accepted: September 18, 2020.
Published: December 23, 2020.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-20-00272

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