On the 21st of March, the Angolan government announced its first two confirmed cases of COVID-19. As of July 24th, the country has reported 851 cases and 33 deaths. I spoke with the Angolan branch of Population Services International (PSI), a global health NGO, and my interviews with 3 of their team were foundational for the research for this article. Anya Federova, the Country Representative of Angola, reported that the government had responded “quickly and effectively” to control the spread of the pandemic. Strict lockdown measures were put in place in Luanda almost immediately. Currently, the country has moved from a State of Emergency to a State of Calamity, and restrictions have been lifted in 16 of the 18 Angolan provinces. However, due to a recent spike in cases, lockdown restrictions in Luanda and neighbouring province Kwanza-Norte have been extended until August 9th, and only essential service providers, humanitarian workers and people seeking medical assistance are allowed to cross Luanda’s borders. The rest of the country is reopening shops, hotels and factories. At the moment, rural areas have been largely untouched by the pandemic, though it is unclear whether this will remain the case.
The Government has run a widespread campaign to disseminate information on COVID-19, prioritising messaging on social distancing and hand-washing through the radio in local languages, social media posts and the distribution of materials like flyers and posters. In a country where there has been pervasive underdevelopment in rural areas and a centralisation of resources and power in Luanda, the fact that the Government reached out to even the most rural areas with this messaging is an example of the effective and novel efforts made to combat the spread of the virus. There has also been widespread use of masks, which were made compulsory in April, and the rapid opening of a field hospital to respond to new cases. However, government messaging has been very general and has not targeted specific focus groups.
A UNDP report projecting the potential socio-economic impacts of COVID-19 in Angola from April states that ‘the pandemic is expected to create a tremendous challenge for the most vulnerable groups and the weak social services’. Economically, the pandemic will have a disastrous impact on both the livelihoods and social protections available to vulnerable groups. After years of state corruption and fund mismanagement, state services are already extremely limited, and the current global oil crash will hit this fuel-dependent country hard. Oil exports account for 90% of Angola’s GDP, and in 2015, a much less severe global oil price crash forced the government to slash spending by 53%, and health and sanitation budgets were cut by 70%. The situation for many Angolans was already severe, as about 40% of the population lives below the poverty line and over 50% does not have access to public healthcare.
More than 72% of the population rely on the informal sector, and according to the Centre for Strategic and International Studies (CSIS), over the past few months “the absence of a robust social safety net has left many of these families in dire straits, and nongovernmental organizations are unable to help due to state-of-emergency restrictions.” It is widely acknowledged that economic crises impact upon women’s rights. As UN Women noted, when women live in poverty, their rights are not protected and they have far fewer resources to gain autonomy, cope with food insecurity, gain access to healthcare and education, their voices are marginalised. The Government has made some specific measures to assist women whose work has been impacted by the lockdown, but these only reach women employed in the formal sector. Pregnant women and women with children under 12 years old in their care, alongside those over 60 years of age and people with underlying health conditions, have been classed as vulnerable, and during the State of Emergency period, they were protected by special duties of care. Mothers of children under 12 years of age are guaranteed their full salary and protected from the risk of redundancy if they choose to “work from home” rather than returning to the office.
Research is lacking, but, as seen globally, domestic violence cases have likely increased during the pandemic as lockdown restrictions have made it more difficult for women to report cases of Gender-Based Violence (GBV). However, PSI reported that COVID-19 has exposed the persistently high rates of GBV, with Federova saying GBV is “already bad” in the country. At both a cultural and institutional level, there are barriers preventing people from reporting cases of GBV. Though domestic violence was outlawed in 2011, there is still much to address before women can feel safe within their own homes. For example, according to Anya Federova, the procedure for reporting rape is complex. Though there are other forms of violence being committed against women, and rape is one of the most extreme, Ms Federova concentrated on this issue in our interview. Reports of rape made to healthcare authorities, for example in public hospitals, are not recorded as crimes, and legally, women must go to the specifically assigned service run by the police. According to Eva Fidel and Suse Emiliano, also of PSI Angola, because the majority of police officers are men, the patriarchal and cultural gendered hierarchy that allows for GBV against women to be so pervasive in Angolan society also leads police forces to be extremely dismissive of the experience of victims. As Emiliano stated, “they intimidate women when they go to report their husbands, because most of the police officers [in Angola] are men, and men are most of the time the ones who commit domestic violence against their families”.
Outside of the law, there are many social and cultural biases that Angolan women face. Women are encouraged not to report their family members for Intimate Partner Violence and domestic abuse. According to Eva Fidel, there is constant messaging that women “should just be quiet to make their husbands happy”. The view that domestic abuse is a private concern, a “family problem”, and that outsiders should not interfere is pervasive in Angolan communities. Women themselves are often co-opted into this mentality through years of social conditioning and it is not rare to find older women within families, such as aunties and grandmothers, teaching young girls that they will not find a good husband or have a happy home if they “do not learn to be quiet”. Fidel stated that this is taught “in such a normalised way that is directly and indirectly communicated to you while you are being raised by people that you recognise as your role models for the future. So, you learn how to accept things that are not acceptable”. There is a normalisation of many abusive behaviours by men towards women at every level of Angolan society, and women tend not to validate these as disrespectful or abusive, which leads to mass underreporting. A CMI report from 2016 found that even health care professionals’ attitudes to Intimate Partner Violence were “coloured by patriarchal norms about male superiority and women’s roles as mothers and spouses”. For women living in abject poverty, domestic violence has been found to be extremely normalised and not deemed to be a severe problem.
Though the Ministry of Health has done an excellent job in prioritising COVID-19 response, this has meant that access to other forms of healthcare has suffered. Firstly, the resources available to the Ministry of Health have been limited as half of the healthcare providers in Angola are over 50 and thus are staying at home. In the Ministry, Civil Servants were forced to take on extra roles to respond to the pandemic, essentially working 2 jobs in an already understaffed Ministry, which has made them overworked and overtired. These challenges impose on an already strained public healthcare system which lacks sufficiently trained professionals, medicine and infrastructure, and averages 2.1 physicians to every 10,000 civilians. Further cause for concern is that, out of fear of contracting COVID-19, many people are resisting going to the hospital to seek help for health issues until it is an absolute emergency. This, in turn, is taking its toll on hospital staff, who have to constantly remain in “emergency mode” with high-stress levels.
In our interview, Federova stated that the lockdown has impacted PSI’s work dramatically and that “family planning suffered” in Angola. PSI provides many Sexual and Reproductive Health (SRH) services in Luanda, including the provision of long-term contraceptive measures or HIV/AIDS treatment. Many clinics providing SRH services have had to close. PSI worked with 18 private facilities in Luanda, out of which 17 had to close during the lockdown. Of the 42 public health facilities that PSI worked with, only 2 continued supporting family planning services. Access to safe contraception, including the commonly-used oral contraceptive, is limited by pharmacy stock-outs which are not accessible to women due to lockdown measures. Though the provision of many family planning services has been limited, PSI Angola also reported that demand has decreased, specifically with regards to condom usage. In a digital advertising campaign, where PSI attempted to promote the use of condoms for safe sex, the team found many responses and comments from men who did not understand why they should need a condom to have sex with their wives. It has revealed the normality of extra-marital sex in Angola, as men publicly confirm their multiple partners. These limitations on contraceptive measures, combined with boredom, will likely lead to an increase in pregnancy rates for women which are already high at a rate of 5.54 children born per woman.
Unfortunately in Angola, there is very little research into women’s health or domestic abuse, and as coronavirus deepens the stigmas surrounding both, women will suffer. Unlike other countries in the region, such as Zimbabwe or South Africa, there is a lack of NGO or Civil Society presence to campaign for women’s issues in the country. This is largely a result of the mid-2000s oil boom that Angola experienced when it was classed as a middle-income economy, and the government resisted any international presence. Without adequate research or support for these issues, it will be very difficult for many women in Angola to manage the gendered consequences of COVID-19.
With many thanks to Anya Federova, Suse Emiliano and Eva Fidel of PSI Angola. For more information on their current work, see https://www.psi.org/2020/04/iptp-angola/