Excellencies, ladies and gentlemen. UHC political declaration marks one of the most ambitious gatherings on health. I am happy to share the perspective of the International Federation of Red Cross and Red Crescent Societies on this important topic. Through our experience reaching 1 billion people with health services during COVID-19, I can tell you that a primary health care approach is the only way we stand a chance to achieve universal health coverage and to ensure no one is left behind, both in times of crisis and stability. Resilient health systems focused on primary health care (PHC) with enough trained health workers, data capacity, and well-functioning basic services are better prepared to prevent and respond to health emergencies. Health emergencies often differ from other emergencies in their complexities, their scope, durations, and in response approach. Here are the shifts needed to embed the PHC during health emergencies, this comes from the IFRC study on recent COVID19 pandemic: First and foremost: trust. Governments must do the groundwork to build trust with the public before health emergencies - people won’t use even the best health systems if they don’t trust them. How do we do this? -Proximity: People trust people they know, such as community members. -Education: People trust what they understand, via health literacy programmes. -Listening: People trust those who listen to them and act on their concerns, such as trained community engagement specialists who gather feedback and analyse it. -Access to services: People trust those who address their needs, including their basic health and social protection needs. -Ownership: People trust measures they feel ownership of and are consulted on. Second is equity. Do not exclude anyone. Equity is fundamental element of embedding PHC during emergencies. Migrants, refugees and other disadvantaged communities are the worst impacted by health emergencies. We need to address formal and informal barriers to access to health and other essential services, including stigma and discrimination. Data driven decision making significantly helps to ensure inclusion. Embedding a PHC approach requires integrating health information systems to facilitate real time data sharing and evidence-based decision making. Finally, local action. Strong Community Health Systems that combine the power of communities and technologies: We must prioritize health systems strengthening at the community level, with a well-resourced and protected community health workforce to match. To do this, a much greater portion of existing health financing needs to go to the local level. Universal health Coverage plans must be tailored to the communities they serve by putting them at the center of policy design. It is groundbreaking that governments have committed in paragraph 104 of the declaration to involve local communities in the design of universal health coverage plans, and to find ways of enhancing participatory and inclusive approaches to health governance. Excellencies, humanitarian needs are only growing, and global health is at a crossroads: without systemic change, we will only achieve health for some, and not health for all. Strong governance and leadership are expected of all of us. In the decades since the Alma-Ata Declaration, the international community has focused more on diseases rather than on individuals, and on treatment rather than on prevention. We can’t continue down the same path and expect a different result. Today must represent a shift towards a community-driven, primary health care-first model to global health systems. Thank you.

Our Resilient and Empowered African Community Health (REACH) initiative, in partnership with Africa CDC, aims to improve the health of communities across Africa by scaling upeffective, people-centred and integrated community health workforces and systems.

While Thai culture is relatively open in terms of gender identity, transgender people in Thailand continue to face discrimination and exclusion in many aspects of life. Health care is no exception. “The topic of gender diversity isn’t widely discussed [in Thailand]”, says Piglet, a transgender woman who lives in Bangkok. “Sometimes I’m not able to talk to anyone about it because it makes me feel nervous”. Piglet (not her real name) is a client at the Thai Red Cross Anonymous Clinic, a health centre in the heart of Bangkok designed to help people get health services without fear of being identified or of feeling stigmatized because of her gender or sexual identity. Understanding the challenges The goal is to create an environment where transgender individuals can openly discuss hormone treatment, sexual orientation, and other related issues with healthcare providers who understand their needs and what they are going through. Because transgender people often confront discrimination or a lack of understanding of the unique health needs, they often experience physical, mental and emotional stress when seeking out care. This is especially true during public health emergencies such as the COVID-19 pandemic, according to recent health studies. In some circumstances, this anxiety may prevent people from getting care or lead them to avoid seeking care. The Thai Red Cross Society has long been dedicated to reaching out to marginalized communities, including transgender people and men who have sex with men, in their efforts to combat HIV and other sexually transmitted diseases. Services for optimal health The Anonymous Clinic offers a wide range of services, including counselling, testing for HIV and other sexually transmitted diseases, hormone monitoring, gender-affirming hormone therapy, neovagina examination, anal cancer screening, and Hepatitis A/B vaccination. “The main mission of the Thai Red Cross AIDS Research Centre (Anonymous Clinic) is to provide effective prevention measures, widely known as PreP (pre-exposure prophylaxis), and PEP (post-exposure prophylaxis)”, explains Chanin Suksom, a psychologist at the Anonymous Clinic. “The health services we provide represent an equal opportunity to everyone at a very low cost”. While the clinic was initially established in response to the HIV/AIDS epidemic, it now plays a critical role in providing gender-affirming services and improving the overall well-being of transgender individuals. “During the past year, we assisted approximately 360 transgender clients, from which over 200 of them accessed services for free”, says Suksom. By offering a comprehensive range of services and fostering a safe and inclusive environment, the Anonymous Clinic empowers transgender individuals to take control of their health and well-being. “People who have come to the clinic for the first time are usually reluctant to talk about their stories. So, we ask informal open-ended questions”, explains Naiyapak Chaipun, a counsellor at the Anonymous Clinic who is herself transgender. “We sometimes chat in a very casual way. We encourage them to take things step by step without forcing them”, she says. For people like Piglet, the Anonymous Clinic has become a safe haven, where people can learn how to better take care of themselves. “I brought my friends to the Anonymous Clinic because they feel shy, and it reminds me of my own experience when I felt frustrated and didn’t know where to go”, she describes. “I think the Anonymous Clinic is a great place for transgender people to access health services. A place where we can love ourselves and where we can learn how to keep ourselves healthy in the long run”. -- This story was produced and originally published by the Red Cross Red Crescent Magazine. To learn about the Magazine, and to read more stories like this,click here.

Bending over her traditional clay cookstove, 38-year-old Lucky Mazangesure stirs the simmering ingredients in a small saucepan: fried-green bananas in stew of tomatoes and onions. As the fire crackles, the scent of woodsmoke mixes with the savory-sweet aroma of the saucy, steaming treat. “Trust me,” she says, “after eating this banana dish you won’t be able to stop.” She can’t resist a quick taste – just to make sure it’s coming out the way it should. “I really love cooking,” she says. “I like tasting the food while cooking. It makes me happy and it keeps my stomach full.” Then she checks on some simmering beans and starts preparing another local delicacy: pumpkin porridge with roasted peanuts, which will be complimented by cooked spinach and broccoli. This diverse meal does a lot more than keep her full, she adds. It gives her body the vitamins, minerals, proteins and carbohyrdates she needs to keep herself and her infant, nursing child healthy. Like many new mothers here in Chibuwe, in southeastern Zimbabwe, Lucky is able to prepare these well-balanced meals thanks to a garden at the Chibuwe Health Clinic, which is tended largely by pregnant woman and new mothers who visit the clinic for pre-natal and post-partum care. The garden got started several years ago as part of a larger initiative by the British Red Cross and the Zimbabwe Red Cross to set up gardens for expecting and new mothers at hospitals and local health clinics, where health workers were witnessing worsening nutrition levels among women and young children. In a region hard hit by drought, windstorms, cyclones and flash floods, many legumes, fruits and root crops that are rich in vitamins, proteins and minerals are hard to get. Infant malnutrition here has been on the rise in recent years, with some estimates suggesting that roughly one-third of children under 5 are malnourished. Covid-19 has only aggravated the situation by disrupting regional and local food distribution systems. “It’s hard for expecting mothers in this community to get a decent meal,” says Robert Magweva, a nurse at the Chibuwe Health Clinic, adding that too often, people must rely only on sadza [sorghum], a carbohydrate, and a limited range of leafy vegetables. “It’s a major challenge to have a well-balanced diet here. So the vegetables that are grown in the clinic garden help them to get a well-balanced meal.” As a mark of the programme’s success, most of these gardens are now sustained entirely by the clinics, hospitals and the communities around them, with support of local agriculture experts and local Zimbabwe Red Cross volunteers. Better farming for a changing climate Still, growing one’s own food in this environment is not easy. The climate has generally gotten hotter and drier, with dry spells punctuated by intense storms and winds, and unpredictable rains. Scorching heat evaporates water quickly and can easily whither young seedlings. “At this clinic garden, we were taught smart agriculture techniques as a way of combating the effects that climate change was having on our harvest,” says Beauty Manyazda, another new mother who works regularly at the Chibuwe Clinic garden. “We learnt techniques such as conservation farming and mulching.” Conservation farming is an approach that aims to improve soil moisture and health by minimising the intensive tilling and plowing associated with large-scale crop production. Mulching is one very common conservation technique in which straw, leaves or other organic matter is laid down on the soil between the crops. This keeps moisture from evaporating, while discouraging weeds and providing nutrients to the soil as the mulch decays. Such techniques are increasingly critical as climate change makes farming more difficult. “Our rainfall patterns have changed over the years,” explains Lucky. “We used to get rain in October, when we would sow the seeds for our crops. Now, we get rains in January. So the seeds we put in the ground get damaged waiting for the rainfall.” Meanwhile, storms, droughts and heatwaves have become more and more intense, says Lucky. “Temperatures have continued to rise and this has resulted in regular, violent winds,” she notes. “These winds have destroyed our homes. We also get floods which also contribute to the destruction.” Amid these challenges, the garden provides also provides other nourishing ingredients: the joy and satisfaction of being able to work and provide sustenance while also being among plants, close the soil with other women at her side. “I love gardening,” says Lucky, her baby tied to her back, fast asleep as she picks a handful of chard. “The green nature of the garden warms my heart. With the garden, I know my family will always have a home-grown, nutritious meal.” -- This story was produced and originally published by the Red Cross Red Crescent Magazine. To learn about the Magazine, and to read more stories like this, click here.

Port Vila, 31 March 2023 – There are grave concerns over the increase in Leptospirosis cases, a bacterial disease, one month on from the double category 4 cyclones in Vanuatu. The country has reported 19 new cases of Leptospirosis and three deaths since the cyclone passed. The majority of cases have been in Santo and Efate islands, with a few cases in Malekula, Pentecost, Malo and Erromango. Vanuatu Red Cross is working in coordination with authorities to curb the situation with health awareness in communities across the six provinces. Vanuatu Red Cross Secretary General, Dickinson Tevi said: "It is usually in the aftermath of any cyclone that we see an increase in diseases such as Leptospirosis. Flooded waters have contaminated water sources, animals have been affected, and people who are in contact with these animals and infected water sources, usually get it." "Our volunteers are raising awareness on these issues, including to watch out for symptoms, when they visit the communities with relief distributions. Teams are also raising awareness on other diseases such as typhoid and dengue fever which are also common in the aftermath of a cyclone. They are advising communities to practice safe hygiene and to boil all drinking water. Cleaning their surroundings is also important to prevent dengue fever." Vanuatu Red Cross has so far reached over 9,000 people with immediate relief assistance. Over 1,000 shelter toolkits, 2,500 tarpaulins, 1,600 mosquito nets, 800 hygiene kits, 250 dignity kits which includes sanitary hygiene items for women and girls, and 1,400 jerry cans for storing water have been distributed to severely affected communities. The International Federation of Red Cross Red Crescent Societies (IFRC) continue to work with Vanuatu Red Cross and partners to provide essential support to the teams on the ground. Emergency funds totalling 799,389 Swiss Francs has been released to support Vanuatu Red Cross with their operations over the next six months – until September, 2023. Head of the IFRC Pacific Office, Katie Greenwood, said: "We continue to provide critical support to Vanuatu Red Cross and the affected communities. Families are slowly picking up the pieces and the Red Cross is right there assisting them get back on their feet.” “In the coming weeks and months, we will focus on early recovery efforts in the form of water source rehabilitation through rainwater harvesting and restoring livelihoods through cash voucher assistance.” For more information, contact: In Suva: Soneel Ram, +679 998 3688, [email protected]

Malawi, 25 January 2023—Malawi is currently facing its worst cholera outbreak in two decades, with over 29,000 cases reported and more than 900 people dead. The Malawi Red Cross, in partnership with the International Federation of Red Cross and Red Crescent Societies (IFRC) and in-country partners—Danish Red Cross-led consortium and Swiss Red Cross—is scaling up its cholera response to assist over two million people. Since the first recorded case in February 2022, cases have continued to spread, with all 29 districts affected. Cholera is now putting over 10 million people at risk, including more than five million children. “Malawi Red Cross Society is committed to continue supporting the Government of Malawi in responding to the cholera outbreak and other health emergencies. We are grateful to the IFRC and other Movement partners for continued finance and technical assistance to the MRCS Cholera response plan,” said McBain Kanongodza, Secretary General for the Malawi Red Cross Society. According to the Malawi Ministry of Health’s cholera update on 22 January 2023, over 29,364 cases and 960 fatalities were reported, leaving the fatality rate at 3.27 per cent, which is considerably higher than the acceptable rate of less than 1 per cent set by WHO. The Malawi Red Cross Society (MRCS) is already providing lifesaving treatment at the community level by administering Oral Rehydration Therapy. Volunteers ensure that water supplies are safe and that sanitation facilities are working. They also go door-to-door to raise awareness on preventing the disease from spreading. With the rainy season underway, it is crucial that people take precautions to protect themselves and their families. “We have been monitoring the developments on the ground since the first cases, and we are deeply concerned that this outbreak has taken a foothold in every corner of Malawi. We need to support the joint efforts of the MOH and Malawi Red Cross in their response to this devastating situation. As the outbreak worsens, partnerships are crucial to ensure lives are saved,” said John Roche, Head of IFRC’s Delegation for Malawi, Zambia and Zimbabwe. The IFRC and its membership are launching an Emergency Appeal seeking 5.2 million Swiss francs, which will help the Malawi Red Cross reach a further 1,385,391 people in need of assistance. Malawi Red Cross and its partners with the IFRC aim to target 15 affected districts, with the core objectives being to prevent and control the spread of the outbreak, reduce morbidity and mortality due to cholera and improve the availability of safe water and sanitation facilities, through continued support to communities and district health offices. For more information, please contact: In Lilongwe: Felix Washon, +265 999 95 57 21, [email protected] In Harare: Ella Mcsharry, +263 78 689 3350, [email protected] In Nairobi: Euloge Ishimwe, +254 731 688 613, [email protected] In Geneva: Marie Claudet, +1 202 999 8689, [email protected]

Combining both learning and entertainment, mobile cinema has, over the years, become a prominent way of engaging remote communities around the world on a wide range of important topics—everything from how to stay healthy, to how to prepare for disasters. Each mobile cinema kit contains a projection screen and tripod, laptop, microphones and speakers and a generator so they can still run even in the face of power cuts. Since receiving the kits, the Cameroon Red Cross has been using mobile cinema to share life-saving messages about COVID-19, cholera, and any others relevant topics, which will help people to prepare and stay safe. All in an exciting and effective way, and within a community’s own environment. "Mobile cinema allows us to provide the right information that communities need in the fight against epidemics and disasters of all forms. This fun and useful tool is undoubtedly allowing us to improve our humanitarian response across the country,” Cécile Akamé President of the Cameroon Red Cross Mobile cinema screenings aren’t just about sitting back and watching. They’re also a great way to engage communities through question-and-answer sessions and to gather people’s valuable feedback. Each screening is facilitated by Cameroonian Red Cross volunteers—many of whom were recently trained in communication, community engagement and feedback collection. Listening to people’s questions, concerns, thoughts and fears helps volunteers to understand communities’ needs better, and tailor their work accordingly. Marlyse, a 15-year-old student in the southern city of Kribi who attended a recent screening, said: “This is the first time I have taken part in this type of activity and I have learned a lot. We watched a video on COVID-19 and this reinforced our knowledge on preventive measures. Also the talk with the people from the Red Cross helped us to know more about the vaccine.” Marlyse Mobile Cinema attendee in Kribi You can watch the video Marlyse refers to below (in French): At the IFRC, we know that epidemics begin and end in communities. And that with the right information and support, everyone can play an important role in detecting diseases, responding effectively, and preparing for future health risks. Take Mr Biyong, for example, a community leader in Kribi who is excited about the Cameroonian Red Cross project and the potential of mobile cinema: "We are currently experiencing a cholera epidemic in our community and in the whole region. I think this tool is very timely! Through the broadcasting of the video on cholera, the modes of transmission and how to prevent this disease, my community members were able to see with their own eyes what we try to explain to them every day. This is really a tool that will help stop the spread of the disease.” Mr Biyong Kribi Community Leader Together, the IFRC and Cameroonian Red Cross hope to expand mobile cinema screenings across the country in the coming months, listening to and learning from the people we support as we go. “In addition to things like food, water and shelter, we know that information is, in itself, aid. The IFRC is working hard to help National Societies like the Cameroonian Red Cross take ownership of the opportunities and benefits of this exciting mobile cinema approach to making communities more resilient,” ​​​​​​ Thierry Balloy IFRC Head of Country Cluster Delegation for Central Africa -- This work in Cameroon is part of the IFRC’s multi-country Community Epidemic and Pandemic Preparedness Programme (CP3), funded by USAID. Click here to learn more about the project and our work in this area. And if you enjoyed this story, you may also be interested in our new case studies showing how Red Cross and Red Crescent Societies have helped prepare communities for, and protect them from, COVID-19.

The IFRC network provides strong advocacy, prevention, treatment and care services for people who use drugs. Our aim is to help National Societies better support people with drug disorders, with a focus on harm reduction and tackling stigma and social exclusion.

Beirut, 16 December 2021 – Red Cross and Red Crescent National Societies are reaching more than 1.5 million migrants, refugees and internally displaced people (IDPs) in the Middle East and North Africa, yet the number of people on the move left without essential support is colossal, a report by the International Federation of Red Cross and Red Crescent Societies (IFRC) has found. Ahead of International Migrants Day on 18 December, the IFRC is calling for a stronger commitment to support people on the move during their journey, not only once they have managed to reach their planned destination – if they ever do. Fabrizio Anzolini, Migration Regional Advisor for IFRC MENA, said: “Countless migrants face inhumane conditions along their way, including violence, lack of food, shelter and access to health services. Climate change and conflicts are only expected to accelerate the number of people migrating out of the region in the coming months and years. We need to act right now on the routes and advocating for durable solutions.” The region, with more than 40 million migrants and 14 million internally displaced people, has some of the world’s longest protracted conflicts, combined with frequent natural disasters, man-made crises and the ongoing COVID-19 pandemic. Regional hotspots include the population movement from Afghanistan to Iran, the migration flows from Morocco, Tunisia and Libya to Europe, the extensive number of internally displaced persons in Syria, as well as the route from the Horn of Africa to Yemen, the Kingdom of Saudi Arabia and other Gulf states. Rania Ahmed, IFRC MENA Deputy Regional Director, said: “Red Cross and Red Crescent Societies are reaching more than 1.5 million migrants and displaced people in the Middle East and North Africa, but it is not enough. We need bigger investment and greater long-term commitment to address their plight. We need to mobilize all efforts and resources to ensure people on the move receive humanitarian assistance and protection. Migrants and displaced populations are intensely vulnerable and must be included in COVID-19 prevention, response, and recovery plans. We urge governments to ensure that people on the move have equal access to vaccinations, health care and basic services.” With the engagement of the IFRC, Red Cross and Red Crescent Societies in the MENA region are on the frontline attempting to cover the enormous gap between people’s needs and the support that is available for them. Red Cross and Red Crescent teams provide multidisciplinary assistance, including health services, livelihood support, protection for children and victims of violence, mental health, and psychosocial support, as well as cash assistance. These support services are also widely available to host communities, leaving no one behind. Red Cross and Red Crescent Societies remain committed to continue responding to the needs of migrants and displaced people as well as advocating for the support that they need at country, regional and global levels through evidence-based humanitarian diplomacy. However, their continued activities are hampered by shrinking funding. In addition, access to migrants is often limited, especially in conflict zones and due to restrictions put in place to curb the COVID-19 pandemic. You can access the full report here: MENA Red Cross and Red Crescent Activities on Migration and Displacement – Snapshot 2021. The survey includes responses from twelve Red Cross and Red Crescent Societies in the Middle East and North Africa. For more information or to arrange an interview, contact: In Geneva: Rana Sidani Cassou, +41 766715751 / +33 675945515, [email protected] In Beirut: Jani Savolainen, +961 70372812 / +358 504667831, [email protected]

Community-level health volunteers and activities are vital to addressing the most pressing global health risks. Governments and international partners must provide greater funding and recognition for the role of community level health volunteers and interventions.

The IFRC and our member National Societies are training community-based health workers and volunteers to deliveressential community healthservices. In doing so, we’re addressing the global shortage of health care workers and contributing to the sustainable development goals (SDGs) and universal health coverage (UHC) agenda.

Everyone, everywhere has the right to good health. Within their communities, our millions of Red Cross and Red Crescent volunteers are working hard to promote good health, prevent disease, and reduce suffering.

Geneva, 16 July 2021–The InternationalFederation ofRed CrossandRedCrescent Societies (IFRC)warnsthatthe global vaccination rate must increaserapidlyand protection measures upheld,if we are to win the race againstmoretransmissible, and potentially more deadly,variants. At least three quarters of people in most countries want to be vaccinated worldwide, in the face of emerging new variants, according to new survey data.1However, despite lofty rhetoric about global solidarity,there is a deadly gap in the global plan to equitably distribute COVID-19 vaccines.Only around a quarter of the world’s population have received at least one dose of the vaccine.This number drops dramatically in low-income countries, whereonly 1% of people have received one dose.2And some countries are yet tostart mass vaccination campaigns. JaganChapagain, Secretary General of the IFRC, said: “To world leaders we say, it is time to pull out all the stops to boost vaccine production. This includes atemporary waiver on intellectualproperty, as well asthesharing of knowledge and technologybetweencountries.Vaccine equity is key to reducing the likelihood of variants and saving lives by limiting the spread of the virus. This is the only way we can truly end this pandemic. “The IFRC is already playing its part to get vaccines into the arms of the most vulnerable, but in some countries, vaccination campaigns have hardly started. Our data shows that people want to be vaccinated, but production and vaccine dose sharing needs to happen much faster if we want vaccination to outpace the variants.” The global number of new cases reported last week (5-11 July 2021) was nearlythreemillion, a 10% increase as compared to the previous week3.This comes asthemore transmissible Delta variant has been identified as the dominant variant in several countries across the globe, many of which have been hard hit in the latestpeaks.* As cases continue to rise in several parts of the world, the IFRC sends a strong reminder that, in the short term,the best methods ofcurbing transmissionsremain the same as they have been since the outset, even as restrictions ease in several countries. Emanuele Capobianco, IFRC Director of Health and Care, who has led theorganization’sglobalhealth responsesince the start of the pandemic, said: “We are facing adéjá-vu situation.Unless action is taken to curbtransmissionand boost equitable vaccine distribution,werisk going back to square one.This virus has not taken a break, and neither should we. As global solutions are sought, we urgently remind that we are all part of the solution. Get a vaccine, if you have access to one, continue to wear your mask, keep physical distance, and meet outdoors or in well ventilated spaces. “The uncontrolled circulation of the virus will significantly increase the risk of emergence of new and more aggressive variants. This is a deadly risk for everyone in the world, including people already vaccinated. The only way to reduce this risk is tomaintainpublic health measures and increase vaccination coverage everywhere in the world.” The IFRC and National Red Cross and Red Crescent Societies are already on the ground,facilitating the deliveryof vaccinesto overlooked and vulnerable communities around the globe.They relentlessly continueto treat, care for, and support hundreds of millions of people, as they have done since the start of this crisis. The Colombian Red Crosshas supported the vaccination of highly vulnerable and indigenous populations in the Amazon, whileChilean Red Cross is supporting the vaccination of migrants. The Red Cross Society of Seychelles has supported the vaccination of 83% of the country’s vaccinated population,while the Comoros Red Crescent is helping to identify and support the most vulnerable, elderly people, who want to be vaccinated. ThePakistan Red Crescent operates the only non-government facility designated as a Mass Vaccination Centreand in Bangladesh, theBangladesh Red Crescent Society has supported the vaccination of over 50%of the country’s vaccinated population. The Italian Red Cross is runningmultiplevaccination centresinthe country,andthe French Red Cross has supported theimmunisation ofaround 1.5million peopleso far, including through mobile teams thatvaccinate vulnerablepeople athome. The Lebanese Red Cross runs Lebanon’s largest vaccination centre,with thecapacity to vaccinate up to 5,000 people per dayandtheTunisian Red Crescent has supported the reception and care of more than 80,000 people receiving their vaccination. MrChapagainemphasized thatthough these are some of the hardest days the world has ever faced, we areallin this together: “We have seen how all parts of society have come together to protect each other during this crisis. We must not give up on this now. Millions of Red CrossandRed Crescent volunteers have stood side by side with their communities toprovidelifesaving supportandequitableaccess to a vaccine. We have been there since thebeginning,andwewill continue to be for as long as we are needed.” The IFRC will host a live Q&A with Emanuele Capobianco, IFRC Director of Health and Care onTwitter at 15:00 Geneva time. Notes to editors *In Tunisia more than 7,500 casesare being reporteddaily,almostfourtimes higher than a month ago. A significant increase in cases has also been reported in Libya, Iran and Iraq, a trend that the IFRC is concerned could spark a domino effectin the region. Indonesia is the newepicentrein Asia, with 54,517 recorded cases, which is a 565% increase. Across Europe,caseshave been steadily increasing over the past month, with sharp rises reported in the last two weeks(30% and 20%, respectively) including new variants.Worrying spikes of cases and deaths have been reported in many countries, but the situation is particularly concerning in Eastern Europe, SouthCaucasusand Central Asia as health systems in those areas are often fragile and most of the people haven’t yet been vaccinated. Africa has recorded a 43% week-on-week rise in COVID-19 deaths.Southern Africaisreporting concerning numbers of new cases with health systems stretched to capacity and decreased oxygen supply.The majority ofnew cases are nowsequenced as the Delta variant. All countries of major concern have reported less than 5% of their population receiving at least one vaccine dose. TheAmericas region continues to report the highest incidence of cases and deaths globally, with Cuba and Colombia reporting the highest relative number of new cases in the last week. [1] The RCCE Collective Service is an initiative led by IFRC, GOARN, UNICEF and WHO https://www.rcce-collective.net/resource/data-synthesis-public-perceptions-of-the-covid-19-vaccinations-june-2021/ [1] https://ourworldindata.org/covid-vaccinations [1] COVID-19 Weekly Epidemiological Update - WHO For more informationor to arrange an interview, contact: In Geneva: AnnVaessen, +41 79 405 77 50,[email protected] Tommaso Della Longa, +41 79 708 43 67,[email protected] About IFRC TheIFRC is the world’s largest humanitarian network, comprising 192 National Red Cross and Red Crescent Societies working to save lives and promote dignity around the world. www.ifrc.org - Facebook - Twitter - YouTube

On the 4th of August, a massive explosion occurred in the port area of Beirut, capital of Lebanon, injuring more than 6500 people and affecting the lives of hundreds of thousands. Four months later, a lot has been done but the work is far from finished. Secretary-General of the Lebanese Red Cross (LRC), Georges Kettaneh, what are the needs of the affected people four months after the explosions? People need three things: cash, health services and reconstruction of their houses. We are supporting with the minor repairs and providing cash assistance to the families assessed to be in the most vulnerable situation. We continue the lead in the ambulance services and blood transfusions. We are active in primary health care services, providing mental health support, restoring family links and dead body management. We are also responding to the COVID-19 pandemic in many ways. How was the situation when the explosion happened on the 4th of August? We had, and still have, an emergency contingency plan to manage unset emergencies. But the Beirut Port explosion was something we had not prepared for or even imagined in our wildest risk assessment exercises. We acknowledge that the humanitarian needs were too big for us to manage completely. In 2 minutes, the blast caused devastation beyond imagination. People lost their lives, homes, loved ones. When we went to the streets to assess the needs, we found bodies of people laying on the ground. We started our needs assessment as soon as possible to have the data that helped us to set priorities. Many people left their houses that were destroyed so we could not reach them. Now, they are coming back to us asking to be included. We had to evacuate people affected by COVID-19 and other patients from the destroyed hospitals to the ones that remained functional, either in Beirut or outside the capital. How is the mental health of the Lebanese Red Cross staff and volunteers? We Lebanese often like to project a positive image about ourselves pretending that we are doing fine. But in reality, we have been shaken to the bones. Our volunteers and staff need psychological support as all Lebanese people do. Personally, I went through many challenging situations throughout my 20-year career as a humanitarian. During the war in Lebanon, I evacuated 21 bodies in 1986 in an explosion in Northern Beirut. I was kidnapped many times. I was under fire from snipers several times. All of this affected me for sure. But the Beirut explosion has been by far the most difficult thing to witness. When the blast took place, people called me on my mobile screaming that they were injured pleading me to evacuate them. We mobilized all the ambulances and volunteers we could, even the retired ones. Some of the ambulances were not able to reach people because the roads were blocked by the rubble. Paramedics were hearing injured screaming under the rubble of their houses but they were not able to reach them. As a humanitarian, this is your scariest nightmare.This affected me a lot. Some of my acquaintances and friends died. We all need mental health support in this situation, and the Lebanese Red Cross is doing as much as possible to provide it to everyone willing to receive it. What have you learned from the explosion and the response operation? The explosions were a force majeure. We were not prepared for such a thing. We didn’t envisage an explosion in the port. We were fully stretched by the COVID-19 as well as in providing first-aid, COVID-19 awareness and responding otherwise to the demonstrations in various parts of the country. No matter how overwhelmed we might be, we should always be prepared for the worse. Another learning we got when we started to distribute relief item boxes. At first, we had 400 boxes but only 100 people showed up at the collection points. The community members that were affected by the blast, did not come to the street to receive the relief items they urgently needed. Culturally, coming to the public for the aid was hard for them. We realized we need to adjust our approach to fit the sensitivities of the community. We decided to distribute the relief items from door-to-door even if it meant more work for us. Then, people were very happy to receive the aid as their dignity was intact. Does the Lebanese Red Cross have enough resources to help the people in need? We have gotten enough donations to provide cash assistance for 10,000 families. We are providing 300 US dollars per month to the most vulnerable affected families to cover their basic needs. You can read more about the cash assistance on the Lebanese Red Cross website. The demand would go beyond the 10,000 families but we don’t have resources for more. We are thankful for all the donations and support we have received from IFRC, ICRC and Partnering National Societies as well as other partners. We have worked together as one in the response to the explosion. From the Lebanese diaspora and companies, we have received more than 20 million USD as they regarded us as a neutral and trusted organization. What comes to the economic crisis in Lebanon, we don’t have enough for responding to that in long term. For example, we need to provide livelihood support and shelter for the people, including the Syrian refugees. In this situation, being transparent and accountable is crucial. Therefore, we have hired an international audit company to monitor our performance and to be as transparent as possible. Key figures 3,741 Individuals treated & transported by ambulance 14,499 individuals received primary health support 13,895 blood units distributed to hospitals 22,001 households with 110,005 individuals received food parcels & hygiene kits 49,127 door-to-door household assessments completed 6,019 individuals affected by COVID-19 transported 16,437 individuals received psycho-social support 9,744 vulnerable families received cash assistance Appeal Update The Lebanese Red Cross launched an appeal for 19 million USD to continue providing emergency medical services and relief operations during the first three months. IFRC, in support of LRC plan, has appealed for 20 million Swiss francs (21.8 million US dollars) to scale up health, shelter and livelihood support over the coming 24 months. Read more on the Lebanon Red Cross website. Media contacts: In Beirut: Rana Sidani Cassou, +961 71802779, [email protected]

Each nurse and midwife who joined the Red Cross and Red Crescent Movement has a different story, but they share a common passion: to care for those in need. “I have a big heart that prompts me to engage in humanitarian work in all sectors, whether in times of peace, war, or natural disasters,” said Etidal Abdo Nasser Al-Qabati, a Yemeni nurse and midwife who has specialized in practical nursing and midwifery for three years and studied for four years to become a paramedic. The World Health Organization (WHO) has designated 2020 as the “International Year of the Nurse and the Midwife,” in honor of the 200th anniversary of Florence Nightingale’s birth. This year, according to WHO, the world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030. ‘’I started to volunteer for humanitarian work, with the Yemeni Red Crescent, in 1973, and fell in love with nursing and helping others,’’ said Etidal, who is known as ‘Mama Etidal.’ “My biggest pain is knowing that we can conduct rescue missions but lack the necessary resources.” Etidal started as a @YemenCrescent volunteer, now she is a professional nurse and midwife: “My long experience and big heart prompt me to humanitarian work.” She is the one who protects the dignity of mothers and women during the most difficult times. #YearOfTheNurseAndMidwife pic.twitter.com/5pnQXElVtf — IFRC Middle East and North Africa (@IFRC_MENA) November 6, 2020 Lebanese midwife Pascale Rizk, joined the International Committee of the Red Cross in 2017 and chose this profession ‘’because it is amongst the most noble professions in the world”. ‘’The relationship that the certified midwife builds with the couple is outstandingly beautiful. Indeed, she witnesses the couple’s greatest moment of joy. And the most sacred event of their lifetime, i.e. the arrival of their newborn.’’ According to Pascale, midwifery and nursing are misperceived by society. ‘’Honestly, when people used to ask me what I did for a living, I would answer by saying ‘a certified midwife,’ and the first response that I would get was: ‘Oh, so you’re a doula?’ People don’t realize that certified midwives are one of the pillars of the medical sector. ‘’ Nurses and midwives play a vital role in providing health services and are often the first and only points of care in their communities. Nurses in the Red Cross and Red Crescent Movement have long been at the frontlines, in war, natural disasters and in combating major diseases like Ebola, SARS, coronaviruses and lately COVID-19, often putting their lives at risk. "The core of our work is saving other people's lives," says Pascale, a #midwife at @ICRC_lb.#Midwives reduce suffering and protect the dignity of mothers and women during the most difficult times: war, disasters and disease outbreaks such as COVID-19.#YearOfTheNurseAndMidwife pic.twitter.com/DH7Gelr6FC — IFRC Middle East and North Africa (@IFRC_MENA) November 8, 2020 Muhsin Ghalib, an Iraqi Red Crescent nursing officer, has chosen the nursing profession because it is a vocation that helps preserve human rights. Ghalib narrates an unforgettable experience where he witnessed the death of a young man who was helping his father at the hospital. “I can never forget this experience, because the father was the one who was sick, but ended up staying alive. Whereas his son, who was perfectly healthy, passed away just like that.’’ Today, health care workers need #solidarity, not #stigma. Thank them and show them your support every day. By doing this, you help yourself and others to stay safe. Think what would happen if we don’t have enough #nurses and #midwives#YearOfTheNurseAndMidwife @iraqircs pic.twitter.com/EDsgGKU364 — IFRC Middle East and North Africa (@IFRC_MENA) November 5, 2020 It is pivotal to create and respect a humanitarian space in order to allow Red Cross and Red Crescent volunteers and health workers to care for people in need and alleviate human suffering among the most vulnerable and hardest-to-reach communities. Health workers who dedicate themselves to saving lives deserve society’s respect. They must not be prevented from reaching those in need. Nurses and midwives have devoted their lives to saving and caring for others. In return, we should protect, respect, recognize and give thanks nurses, midwives and all health workers at all times. Elias from @YemenCrescent was granted a #FlorenceNightingale medal – the highest award one can get in #HealthCareSector.#Midwives and #nurses are needed today more than ever before, and they must be appreciated by everyone. Thank you for what you do! #YearOfTheNurseAndMidwife pic.twitter.com/jUHiflcwj7 — IFRC Middle East and North Africa (@IFRC_MENA) November 4, 2020

By Olivia Acosta Maximiliano is 24 years old, a senior nursing student at the Argentine Red Cross Superior Institute in Salta, a province located in the northwest of Argentina that borders Bolivia, Chile and Paraguay. He is also responsible for the humanitarian camp of the Argentine Red Cross in Salta, where he and his colleagues support 800 indigenous families of Wichis, Toba and Chorote ethnicities every day. The project started at the beginning of the year due to the declaration of an emergency following the death of 10 indigenous children from malnutrition and lack of access to water. According to Maximiliano, "it was at this time when the Argentine Red Cross decided to implement a humanitarian camp to provide health care, food and drinking water to indigenous families affected by malnutrition and drought, and to support the development of their capacities". The camp is located in the heart of the communities, in the middle of nowhere, and through its 10 tanks and a water treatment plant it is able to provide between 45,000 and 60,000 liters of water daily to the indigenous families of the area. Survival in Salta is very difficult, the temperature can reach 45º, the area is very arid and deserted. "Access to the communities is very complicated, there are no roads, we had to create them ourselves in order to be able to get there with our vehicles and bring water every two or three days. The children are waiting for us very excited, with the little cups ready... I have learned to value water very much, you realize how important it is when you don’t have it. Since we brought them the water, we have managed to reduce diarrhea and improve the children's size, because before they took water from contaminated rivers, putting their health at risk." Given the scarcity of medical care in the area, the camp also has a first aid tent and a mobile team to be able to move patients from the most remote villages. All camp volunteers are trained in first aid and provide support to families with a protection, gender and inclusion perspective. When COVID-19 arrived in the area, Maximiliano thought that if there were a high number of infections, the pandemic could wreak havoc, because it would be very difficult to control it. Indigenous families are very vulnerable and their houses, which are barely 8 square meters, with mud walls and plastic roofs, are home to families of more than 8 people, in conditions of great poverty and overcrowding. "The first thing I thought was: how are we going to teach them to wash their hands to avoid infection, if they barely have water?" With the arrival of the pandemic, the volunteers of the camp had to work to adapt to the isolated conditions and decided to increase the distribution of drinking water, with the intention of generating more hygienic habits in the families. Besides that, they started to collaborate with the San Victoria Hospital in the "Plan Detectar". Their work consists of visiting the communities to evaluate symptoms and respiratory problems, with the objective of verifying the need for PCR tests if the established criteria are met. For severe cases they coordinate the transfer to the hospital and for mild ones, they follow up on their health status at home and distribute masks and hygienic disinfection kits. According to Maximiliano, "the use of masks has been complicated for them, because they had never worn any before. We had to hold workshops and give guidelines through community radio to advise, for example, to avoid crowds. Now, almost 75% wear masks and follow the prevention measures, which has been a success and has compensated for all the effort. So far, we have had 18 positive cases and 16 are already recovered," he says proudly. According to Maximiliano, these are nomadic communities that are deeply rooted in their culture, religion, and language, and it is not easy to establish relationships. "I have been in the camp for 250 days and now everyone knows us, several volunteers are learning their language, some even speak it already, and wichi language is very complicated! For the children of the indigenous families, the camp is a fun place with trailers, motorcycles, lights, vehicles... they find it very appealing and love to come visit us". Now begins the second stage of the project for the development of these communities and improvement of their quality of life, through a plan of crops and gardens, training in the use of recycling, waste collection, construction and access to latrines, among others. "Sometimes we get frustrated when we think about all the work we have ahead of us to support the development of these communities, we feel like ants, but then I always think: if we weren't here, how would they be now? And then I see the progress we made together with the families, I realize the great value we bring and how important it is for the communities," concludes Maximiliano. Since the beginning of the pandemic, the Argentine Red Cross has been developing articulated actions to support the response to COVID-19 with the aim of reducing infections, alleviating the suffering of affected people and their families, and contributing to reduce the impact of the emergency in the country. Since the beginning of the pandemic, the volunteers of the Argentine Red Cross have carried out more than 9,500 social and health actions in response to the emergency.

Randa El Ozeir: The Iraqi Red Crescent Society (IRCS) has gathered its efforts to fight COVID-19, and launched “Your Doctor” program to guide, sensitize, and refer people to the relevant health services depending on their situation. In our conversation with the President of the IRCS, Dr. Yaseen Abbas, we talked about how Iraqis are dealing with the pandemic, which hasn’t changed much of their behavior and social culture although it caused them to lose their livelihood and revealed the depth of the economic and social crisis inflicting on the country. Dr. Abbas stressed the need to strengthen Disaster Risk Reduction and Management to protect the population and keep and attract the local and foreign investments. Why the situation in Iraq regarding COVID-19 hasn’t improved despite all the adopted measures? Any measure taken during a pandemic wouldn’t succeed if citizens do not cooperate or understand its importance. Since the beginning, it was obvious that the adopted measures focused on the health side without looking into the reality of livelihood. In the first phase, a curfew has been imposed in Iraq. And this simply meant livelihood interruption for citizens who earn their living from daily jobs. I don’t think citizens would respect such a curfew as it affects their livelihood and their families’ and would find breaking this ban as their only option. The second and more important point in my opinion is the physical distancing during social event. The social celebrations didn’t stop at all, namely “Majalid Al-Aza’a” (Mourning Gatherings). It is an occasion where come together the parents, relatives, friends, locals, and everyone who had known the deceased. They crowd in pavilions, mosques, and halls for three days as per the customs in Iraq. Social distancing was not practiced as well as the physical distancing in such occasions. Shaking hands, and even hugging, continued. Besides, visits during the curfew did not ease if not increased due to work suspension, and the chances upped for everyone to stay late and meet in the morning, at noon, and at night. Do you find that learning and education factor in helping with the awareness about the seriousness of COVID-19? And how do you deal with people who believe only in our written fate? Learning plays a crucial and direct role in the process of accepting and perceiving information. But nowadays, we notice a lot of confusion circulating through the social media. Unfortunately, part of the confusion is coming from highly educated people. There is been a talk lately, about the concept of “COVID-19 fatigue” as a widespread phenomenon among people, the youth in particular. Does this apply to Iraq or specific parts of it? Yes, it does apply to Iraq, and I suspect it to be a human nature regardless of the country. The latest measures in Iraq reflect this fatigue, which is noticed through the complete opening of institutions. All restaurants, coffee shops, and public shops are open in a manifestation of COVID-19 fatigue. Prior to COVID-19, Iraq was still struggling with social, economic, and political crisis. How the unfavourable impact of the virus reflected in the whole situation of the country? As a result of COVID-19, many jobs discontinued in Iraq. For instance, the hospitality and restaurant sector almost stopped altogether. It employed huge numbers of citizens and affected other related sectors, which was a direct reason for too many to lose their livings, especially those who bank on daily jobs with no protection or insurance. The other factor is the falling of oil prices, which directly affected many businesses linked to official spending, such as construction, business related to public firms, buying from the markets, and the salary of some public employees or the people who do daily work with the government. The government was in a tight spot to secure the permanent employees’ salaries, which led to harming some of those who earn a daily living. “Your Doctor” for Help and Guidance Are there any particular initiatives you like to highlight or believe they played, or could play, a positive role in protecting the population? In the extensive awareness program the IRCS adopted since the end of last January, the Society launched “Your Doctor” project due to the many confusing opinions circulating about COVID-19. We gave the phone numbers of numerous doctors to guide, at certain hours, those who are suspected of being infected or who are actually infected. Our doctors receive a high volume of calls and refer the caller to the best way of consulting health institutions when his situation worsens and encourage him not to ignore the approved health guidelines in Iraq, as well as these of World Health Organization. We asked the government to adopt the concept of “Disaster Risk Reduction.” The world and the investors evaluate the countries’ situation by their capacity and resilience at times of disasters whether it be natural or man-made. The risks of investment and building projects in a country are assessed by its capacity to deal with all kinds of disasters. A lack of such plans raises the risk level in investment for both local and foreign investors. Iraq suffered an unrest due to the living conditions that affected the stability of political situation. There were demonstrations and strikes that might have coincided with what happened in Lebanon. Then later came the COVID-19 pandemic. We all need to understand that “Disaster Risk Reduction” is not a luxury, but a necessity and foundation for any development process to achieve progress and stability. The International Red Cross and Red Crescent Movement, and notably the National Societies, and the IFRC are involved in directing the government’s focus to prepare emergency plans. To this date, many governments haven’t done that. This is a real problem, as we may find ourselves facing other disasters without any fending governmental plans, the way it happened with COVID-19. Thus, we see the amplified effect in our countries where the most vulnerable groups in society are to bear it. There’s no doubt that the virus is present among the healthcare workers on the frontline, and the volunteers and staff of the IRCS are no exception. What measures are in place to curb the spread of cases, and how do you deal with the infection cases within the Society? From the beginning, we realized that our affiliates should follow three simple steps: cleaning the hands, wearing a mask, and social distancing. So we have made clear decisions to reduce the number of people in the offices, limit the numbers within the field teams, and in a clear educational method, stress on the importance of taking the obligatory steps to keep the hands clean and put on the mask. We succeeded to a great extent in preventing the infections inside and through our activities and in our institutions. But this did not spare our staff and volunteers from getting infected by their social interactions, in one way or another, with their families and other members of society. There have been cases, but I believe that 99 percent, if not 100 percent, of them came from outside the Iraq Red Crescent National Society. Are you still capable of providing the Society’s regular services on a daily basis (for instance, the ambulatory services, the psycho-social support, etc…) although COVID-19 has been on the top priority of the service list? The psycho-social support is currently a continuing service, namely for the patients, their families, the medical and health cadres who have started to suffer from exhaustion and anxiety too. We offer the First Aid now through our ambulances, but with lower frequency compared to previous times. In fact, I think that as IRCS, we should do business as usual, but gradually and with safe coexistence with people. What does it mean for you, personally, to be the IRCS president in the time of COVID-19? What are the most difficult challenges you have to face? As a president of the IRCS in such circumstances and in a country where human suffering is diverse and abundant, it means one thing: keep trying to be innovative in all means. We shouldn’t follow the traditional ways, as we have to be creative in order to deliver our response to the amounting humanitarian needs deriving from COVID-19 and from other issues. And this is the primary challenge. Thank God we haven’t stopped providing our services to the community and were able, despite the regular life disruption for a period of time, to conduct our activities according to population’s needs emerging from the pandemic. As IRCS, I believe we navigated lots of phases in fulfilling our humanitarian goals, as well as answering people’s requirements. Among other challenges is maintaining the National Society’s regular activities, effectiveness, and staff performance. I mean here particularly its the staff who have been working every day, day and night, without interruption in spite of the difficult circumstances that we went through.

We are on the verge of wiping out polio again in the Philippines, a battle many of us have been waging for decades. Growing up with neighbors and schoolmates who wore leg braces for limbs withered from polio, I didn't realize that polio was an ancient scourge that globally maimed or killed tens of thousands of people every year. My first job as an assistant to the Philippines Health Secretary 30 years ago gave me the privilege to work on eliminating the wild poliovirus that was living in nine million Filipino children when then Health Secretary Juan Flavier launched an immunization campaign called "Oplan Alis Disis" -- Remove Sickness -- that was based on a simple strategy: mobilize the 3 "M"s: mayors, midwives, and the media. Calling for a "Ceasefire for Children," the Philippines established local "peace zones" in areas of best by armed conflict. There we were able to deliver polio drops and other lifesaving vaccinations against measles, diphtheria, pertussis, tetanus, and Vitamin A -- regardless of religion, socio-economic status, or political affiliation. In response, mothers, fathers, and grandparents brought nine million children -- some dressed in their Sunday best -- to receive vital polio drops at health centers adorned with balloons, bands, and freebies as if for a fiesta. It took ten years of consistent routine vaccination, interspersed with national immunization days and the constant education of families in health centers, to the point of eradicating polio. By the time I became Undersecretary of Health in 1998 and by 2000, the Philippines was declared "polio-free." Yet polio is back. Today, I am seeing Red Cross volunteers and staff wearing face masks and shields standing alongside government health teams as they scour the densely populated slums of Metro Manila, going door to door to administer polio vaccine drops. After almost 20 years being polio-free, the virus has returned. The COVID-19 crisis has only made it more difficult for health workers. Today stands as one of the most dangerous periods in decades, with thousands of children not receiving vital polio vaccinations because of the lockdown. There are other problems too. Some Red Cross vaccination teams are welcomed with smiles, with families grateful that they do not have to bring their children to a health facility where they are afraid of contracting the COVID-19 virus. But for many other families, the fear of contracting COVID-19 is so great that they refuse to open their doors, speaking only through their windows. We must not allow COVID-19 to block out the message that the Philippines government has embarked on a new effort to halt the spread of polio. Take the example of Mary Rose Amauin, who refused to talk to Red Cross volunteers at first when they knocked on her door in August and her husband claimed their child had already been vaccinated. Patiently the Red Cross volunteers urged Mary Rose to reconsider. After all her questions were answered, Mary Rose eventually allowed her 10-months-old baby, Bianca to receive the drops, apologizing that she was more cautious as times are tough because of COVID-19. For Philippine Red Cross volunteer Merlita Daygo, patience and kindness have helped her convince other hesitant parents like Mary Rose to allow their children to be vaccinated. She knows that taking the time to clearly explain the purpose of the vaccine will help save children's lives. Without a house-to-house vaccination campaign, many children would miss their polio vaccination. As part of the preparation for the mass polio vaccination, volunteers and staff undergo training on how to handle refusals and how to keep everyone safe. Another volunteer vaccinator Mary Grace Kafilas told me how sad she feels when parents decline the polio vaccine. On the first day of a recent vaccination push in Rizal, seven parents refused the vaccination. What hurts so much is that it's such a simple, easy measure to prevent a life-threatening virus I am encouraged by parents whose children have contracted polio and who now strongly advise and encourage other parents to take immunization seriously. Polio infections have occurred for thousands of years and was portrayed in ancient Egyptian paintings and carvings. But it was only in the 1940s and 1950s that polio epidemics infected more than half a million people around the world every year, inflicting a lifetime of paralysis, and in some cases death. As we celebrate the great success of the eradication of the wild poliovirus in Africa, we must remember that national immunization days and the strengthening of routine vaccinations through grassroots mother and child health programs played a critical role in ridding an entire continent of this terrible disease. As the global race for a COVID-19 vaccine heats up, we must also remember that today millions of children in the Philippines also need lifesaving polio drops to address its re-emergence. In the middle of the worst pandemic in 100 years, let's make sure we take the last steps. This article first appeared in the Nikkei Asian Review

Johannesburg/Geneva, 7 August 2020 – A senior Red Cross official has warned that South Africa needed to learn lessons from the country’s fight against HIV/AIDS to help curb the rise in the number of people testing positive for COVID-19, as the number crossed the half a million mark on 1 August 2020. South Africa is the worst affected nation on the African continent, and currently has the fifth highest number of people testing positive worldwide, after the United States, Brazil, India and Russia. Dr Michael Charles, the Head of the Southern Africa Country Cluster office of the International Federation of Red Cross and Red Crescent Societies (IFRC), said: “This is a time to look back and look at the experiences of the past. South Africa was really the epicentre for HIV/AIDS, and we learnt so much from it. Yes it took a while before we could get it up and running in terms of our prevention methods, in terms of stigma, and these are the examples and the lessons learnt that we can bring to the fight against COVID.” South Africa’s first COVID-19 case was confirmed on 5 March 2020. When the cases doubled every two days in the following three weeks, the country imposed an early lockdown, slowing the transmission. However, following the decision to ease the lockdown in July, the country has seen an exponential rise in cases, causing worldwide concern as it rapidly rose up the ranks of the world’s COVID-19 tally. As of yesterday (5 August), South Africa had reported almost 530,000 confirmed COVID-19 cases and almost 10,000 deaths. Last week, a record 572 deaths were recorded in the previous 24 hours. These figures have confounded analysts who cannot explain the high rise in numbers but relatively low numbers in death. South Africa has a far lower death toll than other countries that have fewer confirmed cases, for example the UK. Masks are still mandatory, strict government guidelines have been issued for hygiene practices on public transport like taxis, social distancing is promoted in all public spaces, bars and shebeens (informal drinking spots in townships) remain closed and gatherings like funerals prohibit more than 50 people at a time. Despite these measures, however, many South Africans within and outside the hotspots flout government prescriptions, with community feedback indicating that many believe the virus not to be real or not likely to affect them. Stigma is an ongoing challenge, with humanitarian actors quoting behaviour similar to that seen during the AIDS pandemic, when people would rather not test, than know they have COVID-19 and be stigmatised or ostracised. The IFRC’s Dr Charles said: “It is really our responsibility to stop stigmatising people who have COVID, stop harassing people within the communities because of COVID, and it’s time for us to get together and fight the cause together. It is only then that we can say that we are winning the fight. At the moment unfortunately we are not winning it because our numbers are going up and up but am sure that once we change our attitude, once we bring the lessons learnt from the past, that is when we will start to see the numbers go down.” Since the outbreak of COVID-19, the South African Red Cross has partnered with the Department of Health to support in screening, testing and contact tracing in key hotspot areas. Ongoing parallel hygiene promotion and behavior change messaging accompany all Red Cross activities to increase health awareness among the general public and targeted communities. Media Communication and Risk Communication and Community Engagement (RCCE) activities have been rolled out to the affected and non-affected communities by Red Cross volunteers. During lockdown, the Red Cross has been providing food to homeless people and other highly affected groups, with a focus on people living in informal settlements.

By Fernando Gandarillas. Cristian is a volunteer of the Chilean Red Cross and a specialist in psychosocial support. Along with other medical and psychological volunteers, he has been providing psychosocial support since April to passengers on domestic flights. So far, nearly 1,000 people have been reached in 15 trips, thanks to a partnership with the private company in Chile. "The combination of a pandemic and air travel can be intimidating for a person. People get very nervous", Cristian said. He is in the aisle, talking to passengers and giving them psychosocial support. As he finishes his talk, another volunteer waves at him from the other side of the aisle, so that he moves closer to an older woman who is in a state of panic. Minutes earlier, the Red Cross medical volunteers were giving practical demonstrations on the use of masks and proper hand washing, when one of them noticed the woman had injuries on her hands, and was very stressed. He waited for Cristian to finish talking and called for his attention. Cristian starts talking to the woman to create trust. She says she is returning to Santiago de Chile after attending a family wake in Iquique. During the last few days, she had washed her hands with chlorine, mistakenly believing that this would stop COVID-19. She tells Cristian how petrified she is of catching COVID-19 on the plane and bringing the virus home. It's 10 pm and the flight is about to arrive in Santiago. Cristian moves away from the woman and they both take their seat to prepare for landing. It has been a long day for the volunteers. At 6 am they were already at the Arturo Merino Benitez Airport in Santiago to provide support to the crew and passengers who were travelling on the outbound flight from the capital to Iquique. "People who leave the capital for different regions usually present significant levels of anxiety. However, those who travel from small cities or towns in the country to Santiago are the ones who face higher levels of fear, because they know that the capital is where the greatest concentration of cases are. Many of these people need to travel to the capital because they have to undergo health treatment," Cristian says. Chile is one of the countries in the region most impacted by COVID-19. To respond to the pandemic, the Chilean Red Cross has been working to raise public awareness of disease prevention, providing psychosocial support, and delivering personal protection equipment to various cities throughout the country. To strengthen this work, actions have been coordinated with the private sector. The support that volunteers provide on commercial flights within Chile is part of these coordinated efforts to stop the spread of the virus. The plane lands and Cristian, together with his colleagues, waits for all the passengers to leave. "I learned a lot about prevention measures on this flight, and above all I felt support. I loved the emotional release techniques they taught us," said one of the passengers. Before getting off the plane, the Red Cross volunteers hold a small meeting to listen to the flight captain and crew's observations. "As soon as we get into the plane, they welcome us and make us feel part of their team," Cristian says. Satisfied of providing help in the fight against the pandemic, Cristian crosses the runway to go to airport control. "Personally, I think this is a way of fulfilling our humanitarian mission. And for me it's a way to thank life.”

As the Pacific Islands battle to keep Covid-19 out, and continues to reel from the aftermath of the Tropical Cyclone Harold, they are fighting another battle; Dengue Fever. More than 4,000 cases of dengue fever have been reported in both Fiji and the Marshall Islands, but several more islands are at risk. There are now 700 confirmed cases of dengue fever in areas of Fiji that were most affected by Tropical Cyclone Harold. The majority of new cases are children under the age of 18. As of 12 May, the Marshall Islands has reported more than 3,388 cases of dengue-like illness, of which more than 1,576 have been laboratory confirmed. Dr. Dewindra Widiamurti, Red Cross Pacific Health Manager, says: “In Fiji, the destruction by the cyclone resulted in water sources being contaminated, and increased challenges with wastewater removal. People who lost their homes are now living in evacuation centres, where social distancing is difficult, if not impossible, potentially making it easier for mosquitos to spread the virus.” This situation is coupled with a shortage of safe water, which increases the health risks to displaced people, not only from dengue fever but also from other waterborne and mosquito-spread diseases. If COVID-19 entered these evacuation centres, it could also create an increased risk of spread, as lack of hygiene also facilitates the transmission of COVID-19. Following the first confirmed COVID-19 case in Fiji, the Government responded immediately by isolating the person and carrying out thorough contact tracing, as well as tightening its national and international travel. Although Fiji has not reported a new COVID-19 case since 20 April 2020, the Government is advising the community to remain vigilant and international travel restriction continues. Tropical Cyclone Harold hit the country in early April, at the same time as the COVID-19 response was rolling out. The dengue outbreak has further complicated the health situation. TheMarshall Islands dengue feveroutbreak began in July 2019 and is considered the worst outbreak in the country’s history. Dr Widiamurti says: “We hope the outbreak is declining, as dengue fever is unpleasant and possibly life threatening. Two people have died of the fever since the outbreak started. We are concerned that COVID-19 might become a double burden to the affected communities. Hygiene advice, shared by the Red Cross volunteers is vital in the effort to prevent the spread of these diseases and limit mosquito breeding sites and the risk of being bitten.” Since the outbreak was first reported, the Marshall Islands Red Cross Society has been actively visiting villages and communities to build awareness and promote measures to reduce the risk of mosquito bite. The Fiji Red Cross have now also mobilised trained volunteers to conduct health education and hygiene promotion. They visit villages throughout the high-risk areas to build awareness and knowledge, simultaneously sharing COVID-19 hygiene precaution measures. Since the outbreak was first reported, The Marshall Islands Red Cross has been actively visiting villages and communities to build awareness and promote measures to reduce the risk of mosquito bite. The Fiji Red Cross have now also mobilized trained volunteers to conduct health education and hygiene promotion. They visit villages throughout the high-risk areas to build awareness and knowledge, simultaneously sharing COVID-19 hygiene precaution measures.

“Medicine has been my passion since I was in high school” says Damarys Solano on the phone, while she's preparing to go out. Today she'll be giving medical attention at a shelter in Tumbes, where many migrants are following the mandatory isolation given in Peru due to the emergency of COVID-19. Damarys was born in Tumbes, a city in the north of Peru, next to the frontier with Ecuador, and since she was very young she realized that there were many people with limitations to access to health services, and she wanted to do something about it, that is why she decided to study medicine. She completed her university studies in Cuba, and while at university she took part of the Student Health Brigade, to help people that didn't have easy access to the health system. And that passion continues with her today. Dr. Solano works at the International Federation of Red Cross and Red Crescent Societies (IFRC) since September 2018, at the Red Cross Care Center at the Binational Border Assistance Center (CEBAF), in the border with Ecuador, placed in response to the increase in the number of migrants entering the country. “The needs of migrants were increasing constantly, I had to think daily about what methods to use to not only alleviate their pain with medication, but also the emotional aspect, because sometimes just listening to them would take away their pain. For them, doing their journey by foot was very difficult, but they have been brave”, remark Dr. Solano, for whom helping anyone in need, regardless their nationality, race, religion, social condition or political beliefs, is one of the principles of her work, a principle she shares with IFRC and is one of the reasons why she decided to work here. She remembers in a bittersweet way the different people she has seen through CEBAF, such as elderly patients who had made their journey on foot hoping to meet their family in Peru, or mothers who were traveling alone and that have gave birth shortly before, in one of the transit countries. “The Red Cross principle of humanity is something that you live and apply in the day-to-day work, with your patients. That makes a big difference.”, adds Damarys. The migratory context changed over time, although migrants continued to enter trough CEBAF, the number of people who stayed in Tumbes city increased. The Care Center at CEBAF wasn't enough to meet the health needs of the vulnerable population, and this is how the Community Health Campaigns began to be implemented. Damarys remembers with great satisfaction the active participation of the population, both migrant and local, at the health campaigns which brought medical attention to more than 650 patients. Today, in the context of COVID-19, many of the migrants who were waiting for a response at CEBAF have been transferred to shelters. That doesn't mean that Damarys rests; she, along with the rest of the team, continue to work, visiting the shelters, providing health care and treatment, ensuring that the patients are well, and monitoring their situation. “I feel that all this experience has reinforced my feelings for medicine, since sometimes you think that you sit at a desk prescribing recipes to those in pain, and is not only that; is to relieve with the art of healing those who need us. To value life and to give them hope that not all is lost”, concludes Damarys.

In the courtyard of a health centre in Managua, Nicaragua, a mother and daughter share a supportive smile. Their expressions convey joy and confidence. They have just shared with us a story of survival and empowerment. Having had a very hard personal experience with dengue fever, both are now community volunteers in a Nicaraguan Red Cross vector control operation. In 2019, the Central American region suffered the most extensive dengue epidemic of the decade. More than one million people have been affected by the outbreak, with the highest numbers of cases reported in Honduras and Nicaragua. The Red Cross is working in these two countries, as well as in Costa Rica, El Salvador and Guatemala, to empower local communities to cope with both the current crisis and possible future outbreaks. With the support of the International Federation of the Red Cross and Red Crescent (IFRC), National Societies are working alongside communities in the most affected areas to equip them with the information and materials necessary to control and mitigate the effects of the current outbreak, and prevent future ones. This community-based approach is known as Community-Based Epidemiological Surveillance (CBES), and has been used in the region before with positive results in other epidemic crises, such as zika in 2016. This strategy allows community members themselves to identify risks in their environment and take action to eliminate or mitigate them, empowering them to become active agents of change. The first step of CBES is to identify social leaders who, working together with National Societies, organize community groups. Once these groups are formed, the Red Cross provides them with information on the outbreak so that they can identify warning signs and know what referral routes to health care are available if a potential dengue case is identified, as well as what hygiene and sanitation measures should be taken to prevent and mitigate outbreaks. Based on this information, communities create risk maps and plans to implement preventive and mitigation measures. The final step of CBES is the implementation of these plans through breeding site identification and elimination campaigns, home visits in which they replicate the information learned about dengue prevention, and outreach activities in schools. A life-changing disease At a recent activity with community volunteers in Managua, Karen Rodriguez, a Nicaraguan Red Cross volunteer, shared her experience with dengue fever. Her daughter, Jade Gámez, had suffered from dengue three times, at the age of 11, 12 and 13. The last of those times, Jade had been diagnosed with severe dengue, and the girl suffered kidney and liver damage as well as a preinfarction. Children under the age of 15 are a particularly vulnerable group. In August 2019, 66% of the deaths reported in Honduras as part of the current outbreak were under 15 years of age, and in Guatemala, 52% of the severe dengue cases reported were also in this age group. Having survived such a serious illness, mother and daughter are now volunteers with the Nicaraguan Red Cross. As part of the current operation, their work consists on replicating the information received among their neighbors, as well as carrying out clean-up campaigns to eliminate breeding grounds in their community. "We both do the same thing - when one can't go to the clean-up activities, the other one goes," says Karen. For them, this is an opportunity to help their neighbors avoid going through the same experience they went through years ago. "Now that I am supporting the Red Cross and I can help people, I feel calm, I feel happy," says Karen. "More than anything, so that people don’t go through the same experience I went through," adds Jade. Dengue fever outbreaks are cyclical and peaks occur around the world every year during rainy seasons, with extensive epidemics occurring at a frequency of every four to five years. In 2019, the World Health Organization recognized dengue as one of the top ten threats to global health, with an estimated 40% of the world’s population currently at risk. Epidemics can have a devastating effect on the most vulnerable groups, such as children. That is why it is important for National Societies to work on advocacy and capacity building to continue to empower communities in preparing for and responding to dengue and other vector-borne diseases such as zika and chikungunya.

“You doh ever want to become the latest victim of Zika, Guillain Barre Syndrome, dengue or chikungunya, so cover up, take some time and do some clean up.” Catchy, melodic and accompanied by the sweet sounds of steelpan it sounds like the beginnings of an interesting calypso but a conversation with the singer reveals that it is much more than that. It is a jingle, it is a plea to the listener, most importantly it is a lesson to be heeded. Ajamu is a name with African/Nigerian origins that means ‘a man that fights for what he wants’, therefore it should come as no surprise that Edson Mitchell, better known as Ajamu, fought for his life. The nine-time Calypso King of Grenada was one of the persons infected with the Zika Virus who subsequently developed Guillain Barre Syndrome. According to The Mayo Clinic, “Guillain-Barre (gee-YAH-buh-RAY) syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms. These sensations can quickly spread, eventually paralyzing your whole body.” The Mayo Clinic further states that “the exact cause of Guillain-Barre syndrome is unknown. But it is often preceded by an infectious illness. There's no known cure. Most people recover from Guillain-Barre syndrome, though some may experience lingering effects from it, such as weakness, numbness or fatigue.” August 16th, 2017 is a date Ajamu will never forget as it was when he fell ill but to tell the truth he had been feeling unwell long before that. Plagued daily by extraordinary headaches since March or April, he simply took medication and thought little of it. Scheduled to perform in Toronto in mid-August he booked a flight to Canada. The day of the flight he woke early, as most travellers do, but paid no mind to the strange sensation in his hands. It was a sign of things to come, however, as he found himself in the airport in his home slippers, an unusual mistake that should have indicated that something was wrong, but he just laughed off the wardrobe fail. It was during the flight when he experienced what he described as” the worst headache of my life” that he made the decision to see a doctor. By that time it was too late, when the plane landed he had to be hospitalised as his legs would no longer support his body. This first hospitalisation was followed by two more stints as he was released despite having really high blood pressure. It was his wife Lucy who came to Toronto and took him back to their home in Virginia, even though it was deemed risky for him to fly. After two days and a battery of tests Ajamu finally had his diagnosis. It was Guillain Barre Syndrome. This was a disease about which he had never heard so it was his daughter, a Nurse, who did some research and educated him. Almost two years later he still gets emotional while talking about it because there was one particularly difficult night where he essentially gave up. He is of the firm belief that he would not be here today if not for the grace of God and the support of his ‘biggest blessing’, Lucy. Ajamu has regained his mobility fully however he is experiencing the lingering effects. He is easily fatigued and his is memory and eyesight never really returned to their previous states. He also notes his smile is not the same. The good news is that his greatest fear did not come to pass and he has the use of his hands as all his fine motor skills have returned. In fact his band members say that he is a better musician now than he was before. It may sound strange to some but for this sound engineer and self-taught musician, life in a wheelchair would have been preferable to life without the ability to play music. He professed, “I don’t know what my life would be if I wasn’t able to play music again”. Even though he is now back on his beloved instruments he isn’t 100% recovered as he expected to be by now. Cold temperatures affect him so he has to take this into consideration now when scheduling his performances. Acceding to a request to sing a jingle for the Grenada Red Cross to help in the fight against the Aedes Egypti mosquito was no hardship for him, as, making music is what he does. That he would take it a step further and shoot a video to raise awareness, (his suggestion) about the required behaviour change is somewhat surprising. “My greatest love is for God and humanity. God is humanity,” is the rationale he proffers. If one were to look at humanity through a Red Cross lens his motivation aligns perfectly with the first fundamental principle. That he would not wish his experience on his worst enemy and would do anything to prevent it from happening to anybody else reflects a desire to prevent and alleviate human suffering as well as protect life and health. Ajamu’s perspective on his experience is one that harkens back to a saying by his grandmother that goes, ‘better to light a candle than cuss the darkness.’ Instead of bemoaning the cards he was dealt he chooses to spread a message. He believes it is his responsibility to educate people, that this is his purpose, the reason that he is still here. The Caribbean Public Health Agency (CARPHA) predicts that the Caribbean will see a return of dengue, which is also spread by the Aedes Egypti mosquito, in the near future and Erin Law, Global Zika Advisor, explains that these diseases, Zika, dengue and chikungunya, are “expected to be cyclical, that it is expected that there will be an outbreak again”, therefore we must be prepared. Ajamu hopes that if people can learn one thing from his experience it would be to not to take anything for granted because life is very fragile. He would encourage Grenadians and persons from the Caribbean to minimise opportunities for the mosquito to breed even though “mosquitos and humans have to co-exist”, he says with a smile. Watch the video here.