Public health implication of displacement of Almajiri children in specific states of Northern Nigeria amidst COVID-19 pandemic

Background

The World Health Organisation, on the 11th March 2020, declared COVID-19 as a pandemic and a cause for global concern [1]. Before this declaration, Nigeria had the first case of COVID-19 and immediately activated the coronavirus emergency task force. However, as of 5th May 2020, Nigeria reported 2558 COVID-19 cases and 87 deaths. Nevertheless, there is a considerable concern whether the government is currently doing enough to contain the spread of the virus and create a safe environment for the people. Stand out among the lapses in the handling of the crisis stems from the ability to carry out tests. Nigeria, with a population of over 200 million, can barely carry out up to 1200 tests in a day [2].

Therefore, the issue of COVID-19 infection in Nigeria may increase geometrically if enough tracing and testing of suspected cases are lacking. Virtually, all states in Nigeria have reported cases of COVID-19. However, what is of real concern is the Almajiri children of Northern States in Nigeria. The Almajiris is a term commonly used for children who left their respective homes to study Islamic education in the northern part of Nigeria. Immediately, the government declared a nationwide lockdown; they were ordered to go home and were unable to move across states as a result of the lockdown.

Internally displaced persons are people or groups of people forced or obliged to flee or leave their homes or places of habitual residence, particularly as a result of or in order to avoid natural or human-made disasters, and who have not crossed an internationally recognised State border [3]. An estimate conducted in the 2008 school year in Kano metropolis found that metropolitan Kano alone had a total of 3703 Tsangaya/Almajiri schools, with approximately 1,560,611 learners spread across various levels in these schools [4]. Determining the impact of the displacement of the Almajiris on the health of the total population of Nigeria is vital for a wide range of estimation, to curtail the risk of spreading COVID-19 and provide timely intervention for the displaced. The airborne nature of COVID-19 makes it a risk factor for widespread diseases as non-infected people can get infected from droplets as a result of sneezing and coughing by those who are infected [5]. Consequently, the displacement of the Almajiris has raised public health concern that requires immediate intervention. Hence, this study is essential for scientific processes as it suggests possible public health consequences of displacement during a pandemic.

Affected area

The Northern part of Nigeria comprises of 19 states, and the people are commonly called Hausas. The education system, through the policy of the Universal Basic Education Commission (UBEC), encouraged Quran teaching in order to improve primary education in the region. A report by UNICEF 2014 reported that there are 9.5 million Almajiri children in Nigeria, making up 72 percent of the nation's out-of-school children [6]. Nigeria has between 13.2 million and 15 million out-of-school children, most of them in northern Nigeria.

Data

Limited available data was from various sources such as government documents, websites, and blogs for descriptive analysis purposes only. Information was searched from 1st March to 18th May, 2020 on the reported cases of COVID-19 among the Almajiri children and the repatriation action of various government bodies published in the above-listed sources.

Almajiri children population displacement

The classification of the Almajiri children as the displaced population first is based on the definition of the United Nations [3]. These groups of children are currently unwelcome at the place of their residences and thereby required to leave. Secondly, they are children and therefore are vulnerable. The ongoing global Pandemic induced the displacement of these children. Lastly, these groups of children are presently unsheltered, at the risk of starvation, and exposure to COVID-19. The total number of Almajiri children that have been displaced by COVID-19 pandemic is currently unknown. One of the most significant challenges is the repatriation of the Almajiris in their natural household or temporary homes. Another critical issue is the unaccounted children who have fled from different locations, thereby promoting public health crisis.

Displaced Almajiri children and reported cases of COVID-19

As of 18th May 2020, there is no central reporting system for the Almajiri children and no proper documentation. Reports and data on the displaced Almajiri children are scanty. However, we try to summarise and report, as per the available public data. Based on the data available online, Kano state had up to 178,000 Almajiri children ready to be returned to their families [7]. An estimate shows about 3452 of the children were repatriated to different states in two batches. Nasarawa state government reported that they had up to 23,500 displaced children as at 3rd May and were able to repatriate 1100 to various states [8]. Reports show that up to 11,700 Almajiri children were accounted for in Gombe state, of which 700 returned to various states [9].

The Federal Government of Nigeria issued a compulsory lockdown of the country to mitigate the spread of COVID-19. The lockdown left the population unprepared in terms of stocking up of house supplies. Closed businesses left workers in a state to cater for themselves financially, and the government did nothing in the form of palliative to support the population. Although the lockdown was to provide a lasting solution to eradicate COVID-19, the short-term effect was visible economically and worse on the vulnerable groups in the country. In a time of a pandemic such as this, the vulnerable groups should be protected at all costs. However, all the Quranic schools in Northern Nigeria could not shelter the Almajiri children and also do not device an achievable plan to return these children to their families. As a result, they were on the streets unsheltered.

Displacement in a time of COVID-19 pandemic is an extreme social problem and poses a health threat for affected children. In the absence of this current pandemic, the Almajiri children would be having their education and lives unaffected. However, having been displaced as a result of this pandemic, it is evident that the Almajiri children are unaccounted for, and there is no biometric data to support them. Consequently, they are potentially at risk of getting infected with COVID-19 because they are unsheltered and are migrating all over Nigeria. Similarly, they do not only pose a threat among themselves, but they also may potentially spread the virus to other people. Although they have gained substantial attention from the government and the media, less is discussed about the potentiality of a severe public health crisis.

COVID-19 pandemic is a public health problem. The ongoing displacement of the Almajiri children has the potential to create the COVID-19 explosion in Nigeria. Plans to repatriate the Almajiris children with their families at this time may not be the right measure to take. Considering the implication of interstate movement in the critical period of combating the virus, it becomes unsafe to carry out the repatriation plan. Notably, the unaccountability for all the Almajiri children that are scattered all over the Northern part of Nigeria is to be highlighted. The media reported a high rate of influx into states, where they can find shelter and food. These influxes create an avenue for the spread of COVID-19 in the population. Three possible scenarios could ensue if any of the Almajiri children are infected. The children may be symptomatic, pre-symptomatic, or asymptomatic. Therefore, there is an enormous risk in the release of Almajiri children into the population if they are asymptomatic.

The question remains whether the government had done enough in rounding up of all the Almajiri children that are currently displaced. Given that data are unavailable, controversies ensued about the acceptance of children repatriated from Nasarawa in states such as Taraba and Bauchi. Consequently, due to the mishandling of the Almajiri children, Kaduna state reported that up to 59 repatriated children were among the cases of COVID-19 [10]. In just 24 hours, further 16 were confirmed positive. In Gombe state, eight out of 48 Almajiri children tested positive for COVID-19 while seven out of 38 in Bauchi State also tested positive [11]. With evidence showing that some of the Almajiri children have tested COVID-19-positive, it becomes dangerous if they migrate across Nigeria. In this critical pandemic period, no clear plan is in place to track, camp, and put these children under quarantine. Instead, they are exposed to COVID-19 and thereby exposing others to the virus. This neglect is a clear violation of human rights. Although not substantiated, there are reports of sighting of the Almajiri children across states in Nigeria, and fewer tests carried out revealed that some tested positive for COVID-19. If there is no immediate solution, the rate of infection of COVID-19 will spiral beyond the control of the government.

Conclusion

The Nigeria government and various state governors face the problem of repatriating displaced Almajiri children in the period of COVID-19 pandemic. Then again, after repatriation, there is no evidence that these children will be resettled with their families. At this time, no one should be displaced or unsheltered, given the risk factor and contagious nature associated with COVID-19. As stated earlier, the plan to repatriate these children may not be the best course of action because it will increase the possibility of infecting people with the virus. A possible measure employable by the government is to round up all the Almajiri children in the states where they are and provide temporary camps. Providing a camp by the state governments will support head counting of the children for proper documentation. Providing camps for the Almajiri children, at the states where they currently are, will help the government in controlling the spread of COVID-19 among the children and to the general population. Camping measures mean that there will be a shelter for the children, provision of food and ultimately medical care. Medical care will be available for infected children or suspected cases if they finally tested positive.

Conclusively, the Almajiri children should receive care within the states they currently live in, and not be repatriated. Unresolved displacement of Almajiri children can only be a risk factor for the spread of COVID-19 and public health.

Ethical approval

No ethical approval was required for this paper. This paper explored only the data that was made available to the Nigerian public.

Funding

No funding was received for this paper.

Disclosure of interest

The author declares that he has no competing interest.