In December 2019, I was seeing patients, living “my best life”, traveling around Tanzania with my family, making summer plans to travel to the U.S., and discussing possible “spring” travel plans. Meanwhile, COVID-19 cases were just starting to show up in China. I first heard about the then “Wuhan virus” around January. Initially I didn’t react much to it because I thought, like the H1N1, SARS, MERS, etc, it will most likely be contained in no time. I assumed that because of the current knowledge and expertise in the public health field, that there is no way it would get out of control. 

By the end of January, I started being a little more concerned. It is not difficult to picture the worst case scenario when living in the developing world with limited resources. Shortly after, I decided to start sharing information about it, including a video. Afterall, preventive medicine is why WAJAMAMA Wellness Center exists. Early on I decided that keeping our community as informed as possible is the best way to tackle this outbreak. I must admit, I was a little self-conscious about my posts because we didn’t know much about the virus and I wondered if I was being irrational and making a bigger deal about it than what was needed. I wondered, “am I just adding fuel to the fire”?

Fast forward to today; March 19th, 2020. Only a month and a half later, not only do we have our first confirmed COVID-19 case in Zanzibar, but it has affected hundreds of thousands of people and killed almost 8000 people around the world! It was declared a pandemic by the World Health Organization (WHO) on March 11th, 2020. Suddenly what we had been seeing on T.V. across the globe, seems to have arrived at our doorstep. Our travel plans we may have had, suddenly seem unlikely to be fulfilled. But now is not the time to wallow in the disappointment of potential personal and family inconveniences; we must come together in both small and large communities to play our part in combating this pandemic. I have put together this guide, to help communities stay calm and take all of the necessary precautions to limit transmission and help “flatten the curve”. I hope you find this helpful. 

Why It’s Important to “Flatten the Curve”

First of all, I would like to urge EVERYONE to take COVID-19 very seriously. This isn’t the seasonal flu or just a two weeks-long snowstorm. It’s also not a vacation. It has impacted so many lives globally, not only health-wise but also economically, and it will continue to pillage our communities if we do not act FAST. Here in the developing world, outbreaks will be exponentially more damaging, which means that we especially cannot afford to lose control. For those of you who have been in Zanzibar for a long time, I am sure you remember the impacts that outbreaks of malaria and cholera, for example, had on our community and our economy. 

I would like to also remind you that we are going into our monsoon season. The rains usually bring mosquitoes and thus malaria, dengue, and chikungunya, and occasionally we also see a surge in cholera and typhoid cases. The last thing we need during our rainy season, is a new respiratory virus that seems to get out of control everywhere it goes. Some may argue that most people with COVID-19 get mild to moderate illnesses and so it isn’t a big deal, and say we should therefore go on with our lives, and that all of this chaos is due to “media hype”. They are right in that MOST people who get the virus, do just fine, thankfully. Especially those who are young and healthy. So what’s the big deal, right? Well, because the small percentage of people who get the severe form of COVID-19, are those over the age of 60 and with underlying medical issues. This means our parents, grandparents, neighbors, friends, etc. This small percentage of people may seem like a tiny number, but almost 8000 families around the world (so far mostly in the developed world) lost their loved ones in the past few months. Additionally, the impact that COVID-19 can have on our economy as a whole will also be devastating. 

This could impact ALL of us in many ways, not only healthcare wise. And of course, as usual, the poor will suffer the most. Poor people most often don’t have the luxury of having savings while everything has to shut down for a long time. They are not able to stock up on food for months, and don’t have access to many other privileges some of us may have. Despite having only ONE confirmed case in Zanzibar thus far, the sooner we as individuals act, the sooner this will pass, and the sooner we can go back to our “normal” lives. I therefore urge you to STAY CALM and follow this guide. 

Surviving the COVID-19 Pandemic

  • DO NOT PANIC. Getting the “coronavirus” or COVID-19 is not the end of the world. Most people survive and do just fine. 
  • DO YOUR PART. This isn’t only the government’s fight. It is ALL of our fight. We all have to do our part in practicing proper hand hygiene, disinfecting, “coughing in our sleeves,” and social distancing. Social distancing does not mean hanging out at friends’ houses. It means trying your best to isolate yourself ONLY with your nuclear family, unless of course you are an essential personnel, or don’t have a choice. Stay home, as much as possible and avoid large gatherings. 
  • BOOST YOUR IMMUNITY. Use this time to get as healthy as possible. This means increasing your vitamin C intake (luckily we live on a tropical island with lots of fruits), eating healthy well-balanced meals, getting 8+ hours of sleep daily, staying fully hydrated with at least 8 glasses of water a day, getting 150-minutes of exercise per week, and taking many social media breaks. We all seem to be obsessively following up on COVID-19 news. While it is great to stay informed, it can be completely anxiety-provoking when you only read about all things corona, 24-hours a day. 
  • STAY HEALTHY. In addition to boosting your immune system, DO NOT forget our other longtime enemies — malaria, chikungunya, dengue, typhoid, and cholera. Use mosquito nets, spray, and repellent as needed, wash your hands frequently, and avoid eating uncooked veggies from street vendors and eating from unsanitary places. Also consider taking vitamin D supplements. 
  • DISCOURAGE TRAVELING. We are aware that some people feel safer in their home countries and so must make travel plans to return home to their families. This is understandable, although we do urge these travelers to take all of the necessary precautions during their journeys. We do, however, discourage people who do not have to travel to Zanzibar (or anywhere for that matter) from traveling. This isn’t the time to tour the world. Thankfully a lot of airlines are willing to make changes to tickets at no extra fees. Zanzibar will be MUCH nicer to travel to from June; when things would have calmed down, HOPEFULLY, with your help. Everyone should as much as possible stay where they are, unless of course, it is essential travel. 
  • STAY AT HOME. Just because you have respiratory symptoms, it does not mean that you have to run to the hospital or clinic. If you have mild or moderate respiratory symptoms, it is best to self isolate yourself and take care of your symptoms AT HOME. As  mentioned above, MOST people with COVID-19 fight it off with just supportive care – that is, hydration, vitamin C, and rest. If you have respiratory symptoms, assume you have it, and take all of the necessary precautions. IF you have a high fever and severe respiratory symptoms, however, please visit your nearest urgent care center or emergency department as soon as possible. We have to work hard to not overwhelm the hospital systems and health care workers who will be working extra hard for the next few weeks (or months). Should you need a remote consultation for mild or moderate symptoms, please schedule an appointment with WAJAMAMA Wellness Center’s Primary Care Provider. You may also want to consider having a fever reducer like acetaminophen, and a thermometer on hand.
  • CALL AHEAD. IF you must go into the hospital or clinic because of respiratory symptoms, a high fever, or if you know that you were exposed to COVID-19, please call the clinic or hospital ahead if possible to give them a heads up. While there and on your way there, put on a mask, hand sanitize frequently, and cover your sneeze and/or cough with a bent elbow or disposable tissue. 
  • HAND HYGIENE. Wash your hands with soap AND water for 20 seconds at a time and/or use hand sanitizer as much as possible! We do EVERYTHING with our hands and it is the most common way of transmitting viruses like SARS-Cov-2 (the virus that causes COVID-19). Get in touch with WAJAMAMA Wellness Center if you would like to schedule a hand hygiene and infection control workshop for your community! 
  • SOCIAL DISTANCING. Even though I have spoken about this above, I would like to mention this again. This is not the time for dinner or slumber parties. It is also not the time for playdates. It may be uncomfortable for a while BUT it would be even more uncomfortable if we exhaust all of our systems, medically and economically. IF you MUST take public transportation, assume someone in there has COVID-19 and take all necessary precautions. Try having exact change so that you don’t have to exchange money with people, put on a mask when in close quarters with others, practice proper hand hygiene, and try not touching any of your stuff  (including your cell phone) until AFTER you have washed your hands or hand sanitized. If you’re around someone with underlying medical issues or is older, please take all of the necessary precautions. IF you can work remotely, do so. If restaurants, supermarkets, and stores in general had been thinking about adding delivery services, this would be the perfect time to try this. It is our duty to protect the public, our loved ones, and our country! 
  • STAY CALM. Chill out. Take advantage of this time. Do some self reflection. Start a new show or book. Try new recipes. Enjoy your loved ones. And make lemonade with the lemons that the universe is currently serving us. 
  • BE KIND. This is a brand new experience for a lot of us. It is a new virus that we have very little information about. These are tough times for many and extremely anxiety-provoking. Let’s be calm, be kind, and respectful of one another. Let’s be supportive of our communities, the government, and all of those who are making sacrifices and are working tirelessly to get this outbreak under control. We are in this together.