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75-year-old woman dies of COVID-19 in Ekit

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CHAPTER One of Tanzania’s experience with the COVID-19 pandemic came to an end in late April. The second half of that month had seen the number of confirmed cases rise to 480, up sharply from the 32 in mid-month. As I wrote at the time, the chance for early containment looked like it had already passed us by.

  President John Magufuli had opted not to listen to the global scientific advice. Instead, he had put his trust – and the lives of millions – in the hands of God. And in some odd (and potentially dangerous) “scientific” thinking of his own. And in the belief, shared by some experts, that locking down cities such as Dar es Salaam might do more harm than good.

That was Chapter One. Chapter Two is now being written. And it is being written in the dark.

Are cases really much higher or…lower?

We no longer have any reliable estimates of the number of cases or deaths from COVID-19. According to the African Centres for Disease Control and Prevention, Tanzania has conducted just 652 tests (as of 7 May). This compares to over 26,000 tests conducted in Kenya and nearly 45,000 in Uganda. Tanzania’s number is so low it almost defies belief. Have more tests been done but the results not released? Or is this the true figure, in which case is it the result of staggering incompetence or shocking indifference to the potential suffering of millions?

  For some years now, statistics and the media have been a highly charged political battleground in Tanzania. Controlling the narrative means silencing facts that contradict the official line. Someone suggests economic growth may not be as strong as the government claims? Charge them with sedition. Someone publishes data showing political leaders are not as popular as they once were? Strip them of their passport.

The COVID-19 numbers are no different. The government is giving updates only every week or so, and sometimes the new data doesn’t even include basic figures such as the number of new cases and deaths. In such a vacuum, widespread reports of night-time burials and people dying with coronavirus-like symptoms take on more than anecdotal credibility. Many understandably question whether the true number of cases and deaths is substantially higher than the official figures.

  On the other hand, even President Magufuli seems to distrust the official numbers – though in the opposite direction. In a speech on 3 May, he accused unnamed imperialist foreign powers of sabotaging the national response by providing ineffective testing kits or buying off laboratory employees. He said he had sent “samples” from a pawpaw and goat for testing, with some producing positive results. Heads rolled at the national health laboratory.

  In the same speech, the president also suggested international media organisations – the BBC was not named, but the implication was clear – have been deliberately spreading scare stories to undermine Tanzania while ignoring the extent of the outbreak in their home countries. He called this “another form of warfare”. (Incidentally, he had previously wondered aloud whether masks and disinfectant sprays might have been deliberately contaminated with the coronavirus.)

  In short, nobody believes the official figures and nobody know how many cases we have. That ship has sailed. Local community transmission has been going on for weeks. We have no meaningful lockdown. And the process of testing, contact tracing and isolation can no longer cope. The true numbers could be anywhere between one thousand and one hundred thousand. Even within the Ministry of Health, in quiet corridors well away from both political bosses and media scrutiny, nobody really knows.

Four pillars of Magufuli’s approach

What else can we say about Chapter Two?

Well, the president has continued to infuse the national response with his own personal style. His pronouncements are watched keenly by the nation and followed closely by public servants. And those statements appear to be informed more by his own personal worldview than any input from scientists.

  If the first strand of Magufuli’s approach is a tight control of information, the second is an emphasis on religious faith. Having previously argued the virus could not survive in the body of Jesus, the president again called for religious services to continue on 3 May. He concluded: “My fellow Tanzanians, stand firm. We have already won this war. God cannot abandon us, and our God loves us always.”

  The third element of the president’s approach is to put a premium on the avoidance of fear. “Fear is a very bad thing,” he said. “There might well already be people in this situation who have been killed by fear. Let us put an end to fear. Let us defeat fear.” This is the logic that saw him criticise international media and young people online for scaremongering.

  There is some truth in this perspective. Fear and stress bring genuine dangers. But the argument has limits. The point at which fear-avoidance means the government reports only on recoveries but not new cases or deaths, insists religious services should continue despite the risks of transmission, and asserts that God will protect us, it starts to look more like denial. And with potentially devastating consequences.

  The fourth strand of Magufuli’s approach is a determination to keep the country and its economy going. Schools and universities have closed, sporting events remain suspended, and people are being encouraged to main distance from others and wear masks when out in public. But the president has strongly resisted calls to introduce any tighter lockdown measures. Instead, he has emphasised the importance of working hard, keeping the economy going strong, and maintaining a healthy supply of food and other goods.   This all adds up to something very different to the responses seen in other countries. Every context is different, of course, and the president has rightly warned against a copy-and-paste approach. But is Tanzania really so different? It is facing the same virus that has caused havoc and heartache elsewhere, and epidemiologists’ advice to Tanzania must surely be similar to that being offered in Kenya, Uganda and elsewhere.

  Turning bullets into water

Only time will tell whether Magufuli’s gamble pays off. But we should be in no doubt that it is a huge gamble. The stakes are the lives and livelihoods of millions of Tanzanians. Two lessons from history illustrate this particularly keenly.

  The first is the 1918 Spanish Flu. This pandemic hit Tanganyika hard and came hot on the heels of the First World War, which itself had had a devastating impact. There are no exact figures – sound familiar? – but it is estimated that half the country of 4.2 million people was infected and over 5% (over 200,000 people) died. At the same time in Zanzibar, authorities introduced stringent quarantine measures that limited the impact considerably.

  The second may be even more relevant. In 1905, Kinjeketile Ngwale (also known as Bokero) persuaded his followers in southern parts of the country that a certain “medicine” – a mix of water, castor oil and millet seeds – would turn German bullets into water. Maybe he truly believed this. Maybe it was an attempt to inspire confidence and overcome fear. Either way, the gamble failed. The Maji-Maji Rebellion against German rule was a disaster.

  Once again, nobody knows the true death toll, but it is likely that tens thousands of soldiers were killed and as many as 250,000 civilians died of hunger. Kinjeketile was arrested and hanged in 1905, but the fighting continued. Later that year, Ngoni soldiers retreating from battle are reported to have thrown away their war medicine as they cried out “the maji is a lie!”

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