“We first heard that the Americans were evacuating their citizens, then other countries followed suit – you watch your colleagues be evacuated and you feel helpless and abandoned.”Thomas Kanzira, Ugandan medical student in Wuhan
Quarantine and isolation are a common form of infectious disease control and can be used quite effectively to arrest the spread in the general population. Quarantine means, “…the restriction of activities and/or separation from others of suspect persons who are not ill …to prevent the possible spread of infection or contamination”
The situation of citizens of various nations trapped in Wuhan has highlighted the disparity in upholding the right to health of citizens, between developed nations and low- and middle-income countries (LMIC’s). While Australia, the United States and the European Union arranged evacuation for their citizens from Wuhan, many citizens of some African countries, such as Zimbabwe, Sudan, Uganda, Ghana, Kenya and Tanzania, to name a few, remain under quarantine in Wuhan. These citizens have been urged by their resource poor countries, to buckle down and ride out the quarantine, rather than return home to their loved ones. The governments’ decision is based on a utilitarian approach, that it is safer to keep the few in coronavirus hit Wuhan than to risk the spread of the virus in the general population in their home countries.
Arguably, refusal to evacuate citizens is a disproportionate response to the threat of the coronavirus and violates the human rights of citizens, including the right to health. Article 12 of the International Covenant on Civil and Political Rights guarantees freedom of movement and Article 13(2) of the Universal Declaration of Human Rights protects the right to return to one’s own country. Similarly, article 12(2) of the African Charter on Human and Peoples Rights guarantees the right of return, except in cases of public health considerations. However, in the present case public health grounds are not a valid reason to bar the African citizens in Wuhan from exercising their right to return to their countries because none of them have tested positive for the coronavirus. Rather, their continued stay in Wuhan, against their will, endangers their lives and increases their likelihood of infection, which is a violation of their right to health.
General Comment Number 14 on the Right to the Highest Attainable Standard of Health (GC 14) explains that any limitations to the right, should the least restrictive alternative, be of limited duration and subject to review. The continued forced stay in Wuhan of Africans is for an indefinite period with no possibility of review from their home countries. A more proportionate response which balances public health concerns and the human rights of the citizens is to bring the citizens back home and quarantine them for a 14 – 21-day period as other African countries have been doing. Egypt, for example, chartered a private plane with a medical team to evacuate its citizens, who were placed in 14-day quarantine under 24-hour medical supervision upon their return to Cairo.
Although countries such Kenya, South Africa and Ghana have been oscillating between evacuating their citizens and leaving them in Wuhan, nations such as Zimbabwe and Uganda for example have been adamant that they will not be evacuating any citizens. The blatant refusal to evacuate citizens who have repeatedly asked for such action is at best a dereliction of duty by the governments, and at worst a violation of international human rights law.
Firstly, governments are discriminating against and stigmatizing citizens in Wuhan by refusing to evacuate them back home. All human rights, including the right to health are underpinned by the principle of non-discrimination and equality. According to GC 14, “…health facilities, goods and services must be accessible to all, especially the most vulnerable or marginalized sections of the population, in law and in fact, without discrimination on any of the prohibited grounds.” Although GC 14 deals with accessibility within the jurisdiction, it is unfathomable that the states’ duty to protect their citizens enjoyment of human rights falls away simply because those individuals are in a different jurisdiction. States must take appropriate measures to protect the rights of citizens, particularly those who have been made vulnerable due to a major global health emergency such as the coronavirus outbreak. Reports from citizens from various African countries demonstrate a lack of adequate support during the quarantine – with threats of food and medicine shortages in Wuhan.
By abandoning their citizens on the grounds of protecting the larger population back home, the African states are discriminating against those they suspect could bring the coronavirus into their respective states, rather than honoring their obligation to protect those individuals’ right to the highest attainable standard of health, regardless of their health situation. WHO has already provided protocols that could be followed to ensure the virus does not spread once infected individuals returns home. All these countries have the obligation to render assistance as Egypt did, and make all efforts to ensure that health services are accessible to their citizens, and in this case, accessibility means providing evacuation from Wuhan for those that request such assistance.
Secondly, governments have the responsibility to provide humanitarian assistance in emergency situations. Citizens have complained directly to their governments of the potential food and medicine shortages while they are quarantined and isolated in Wuhan. The citizens and their families have appealed to be evacuated but most countries have argued they do not have the resources to evacuate them or the capacity to handle the quarantine of those potentially infected with the virus. However, countries which are unable to afford charter flights can engage more developed countries to seek the aid they need to assist their stranded citizenry, through international cooperation. For example, two Seychellois students were evacuated from Wuhan with the assistance of the French government. The Seychellois government noted that the two students who had requested evacuation, were initially quarantined in Marseille, France, before being returning home. Other Seychellois students preferred to remain in China as they felt safe where they were. Rwandese were also evacuated with the assistance of the French government and were similarly quarantined in France.
If each country is somehow unable to solicit international development assistance, the nations whose citizens are stranded can pool their resources to ensure all their citizens are evacuated. The African Union (AU) recently held a summit with the resource rich European Union in February 2020 and it is unclear whether they sought assistance to help with evacuation efforts. The AU has also not given clear details of the outcome of its discussions or plans regarding “…a common approach to receiving African students and citizens wishing to return from China”.
The Africa CDC provided training for health officials in Nairobi, Kenya and the Ministers of Health met with WHO, in Ethiopia, to discuss the outbreak. Understandably, African nations need to prepare their health systems for the eventual arrival of the coronavirus, but it does not justify abandoning their citizens. Instead of putting in place measures to evacuate Africans, the AU member states chose to issue a statement of solidarity with China and an expression of “…confidence in the ability of the Chinese authorities to deal with the challenges this epidemic poses…”
Source: Sarah Bosha
Update: South Africa evacuated 122 South Africans from Wuhan on 14 March.