A few women in hijabs stand close to each other talking at the Bole Preparatory School quarantine section.

A 31-year-old businessman and father of two arrived in Addis Abeba on March 24, 2020, a day after the mandatory quarantine for travellers was enforced by the government. The businessman travels to and from Dubai, where he buys electronic equipment like laptops and cell phones to resell in Ethiopia.

He and his friends who flew in with him from Dubai planned to stay at a friend's apartment for 14 days, since they were concerned about their families and did not want to put them at risk in case they had COVID-19.

Emirates Airlines informed him and his friends that their flight that was originally planned for March 31 had been rescheduled for the morning of March 24. They barely had time to pack their bags. The following day on March 25, Emirates, on orders from the United Arab Emirates government, grounded all its passenger flights to contain the spread of the virus.

"We heard that self-quarantine was possible in other countries, and we were planning to do that as we didn't want to put our families at risk," he said. "We didn't expect that they would be asking us to pay 56,875 Br a person to stay at Skylight Hotel. We refused, of course."

The process was shocking for many like him arriving in Ethiopia that day. The declaration form provided by Ethiopian Airlines stated a 1,750-dollar payment for staying at a designated hotel for the 14-day quarantine period.

A few hours of arguing later, they found another hotel for 40,000 Br. Finally, they were given Bole Preparatory School as an option. After almost six hours of back and forth at the Airport without any food or water, they were taken to the School.

The passengers, except for the few who had gone to the hotels, were told to get into a bus along with security, and they were dropped off at Bole Preparatory School.

"We arrived in the pitch-black compound past midnight. If there was a person with the virus in there, I don't see how the rest of us wouldn't have gotten it,” he said. “We shared a bus to get to the place and were staying with five other people in a room for the first night."

The businessman is among the 121 people staying at the Bole Preparatory School, one of the quarantine centres here in Addis Abeba.

Hotels have since been added to the list of options provided to travellers. Including the initially offered Skylight, Ghion, Azzeman, Saphire and Harambe hotels, there are now 23 hotels in the city with a capacity of 1,700 beds allocated for the purpose. As of April 5, nearly all of these beds were occupied.

Two mattresses and a classroom chair adorn one of the quarantine rooms at Bole Preparatory School, where 121 people were originally quarantined.

The government is working to get more beds secured and has negotiated prices with the hotels, according to Yakob Seman, director-general of medical services at the Ministry of Health.

Hotels are an expensive but comfortable option. One would be quarantined in a room with its own bathroom and dependable meal services. This is not the case for the remaining individuals quarantined in Bole Community School, Bole Preparatory School, Kokeb Atsbeha and the Goshu Wolde Health Centre in Arat Kilo.

Among these centres, there are close to 264 people who are being held, according to Melaku Seyoum, quarantine section team leader at the Emergency Operation Centre.

On the seventh or eighth day, the businessman and his friends were asked to move to a new centre, Addis Abeba Science & Technology University (AASTU) at Kilinto, after being told that it was a better prepared facility.

"We're not willing, because we didn't want to cram into another bus and expose ourselves again," he said. "We chose to stay here."

The University is the largest quarantine centre based on the number of people who are quarantined, and almost all of them are deported returnees from the Kingdom of Saudi Arabia (KSA), according to Melaku.

Deported returnees have been coming back from the KSA to Ethiopia since November 2017, a figure the International Organization for Migration (IOM) registers as close to 10,000 a month. Now, in the wake of COVID-19, they will be heading straight to the quarantine centres. Though there was a brief halt to the deportations due to the virus, it only lasted for 11 days.

As of Friday, April 10, close to 3,000 returnees were registered by the IOM in the AASTU campuses, according to Alemayehu Seifeselassie, a senior communications assistant at the IOM.

"We expect approximately 300 people to come in daily in the following days," he said.

Hurried efforts by the IOM, UN agencies and the government of Ethiopia to get basic materials prepared and operational at the AASTU have begun. This includes making basic materials, such as soap and wastebaskets, and more specific items, such as protective masks, available for both the returnees and the staff.

But it is not only resources for housing the returnees that are lacking. The returnees are also in need of medical care as most have been subjected to malnutrition and dehydration, while those who are victims of human trafficking have also experienced torture. Beyond providing adequate medical care, IOM is working on their registration and to find victims' families, especially for the close to 200 minors that are quarantined, according to a source inside the IOM.

There is close attention being paid to them as they have a lot of health problems. These are people that travelled for lengthy distances overseas looking for work, traversed deserts and were then imprisoned, so their health is already very precarious. The centre is also working on providing psycho-social support to help them recuperate, according to Melaku.

Currently, the AASTU campus has a little over 2,000 beds ready to house returnees. The Ethiopian Civil Service University and the different campuses of Addis Abeba University are also under preparation to house the rising number of people expected to go into quarantine. Though the quarantine centres in all the universities have one person per designated room and medical staff with an ambulance on stand-by 24 hours a day, the infrastructure has made sharing communal showers and toilets unavoidable.

"We need to prepare different rooms for those at higher risk of contracting the virus when there aren't enough facilities," advises Nuhamin Petros, a doctoral researcher at Karolinska Institue currently doing her PhD in epidemiology. "This means different rooms, bathrooms and eating areas should be set aside for those who are immunocompromised, people with underlying conditions and individuals who are above the age of 65," she added. "We're exposing high-risk individuals within the quarantined group by creating close contact with people who are asymptomatic or have mild symptoms."

The AASTU campus also houses an isolation centre designated for people with symptoms and travel history or who are known to have had contact with confirmed cases.

There are close to 2,000 beds overall for isolated patients in the city, and the number is expected to rise to 5,000 by May, according to Yakob. The beds that are ready for isolation are found in 10 health centres as well as in houses and buildings offered up by Good Samaritans in the city.

"The result from my test came yesterday as negative, but I don't know what I will do when we're told we can leave," the businessman from Dubai told Fortune.

"We share toilets and washrooms, and it's hard for me to believe that I'll be okay to go home to see my kids. Even the health professionals taking our temperatures rarely have masks and gloves."

There have been a total of 3,577 tests conducted in Ethiopia and 69 confirmed cases as of April 11, 2020. While 10 of the patients have recovered, three have passed away, and 54 are receiving treatment.

Lia Tadesse (MD), minister of Health, has been updating the country on the status of the virus, and that is also where those in quarantine are getting their information.

"We took the tests on April 7, exactly two weeks after arriving, and though we were told the results would be ready in 24 hours, we found out that only one had tested positive through social media. We are getting our results in rounds as well. Most of us here have gotten our results, but there're still some left. We don't have anyone to give us any information here, and we're left to speculate by ourselves," said the businessman. "It is very frustrating."

He stated that most are just as worried about what will also happen when they leave.

"It's not only the fear of having the disease but also contracting the virus while in quarantine. Among these, some already have psychological problems, and we need to be highly pro-active in interventions. We need to maintain continuity of care not just for the physical health and psychiatric state of the patients but for their families as well. Psycho-education on the virus along with psychological support programmes are essential," Nuhamin said.

There are close to 1,900 beds prepared for patients that have mild symptoms and do not require serious medical attention in Addis Abeba, and that number is said to account for 80pc of all confirmed cases, according to Yakob. The Millenium Hall, known for hosting the city's biggest concerts in better times, is being repurposed as one such facility.

The hospitals at Eka Kotebe, Saint Peter's, Saint Paul's and Silk Road can treat 1,200 patients with severe symptoms. Under the best case scenario, the estimates, according to the Medical Services is 1,473 beds will be needed for severe cases, and the centre is mobilising resources to fill this narrow gap.

Of the confirmed cases in Ethiopia, the two Japanese nationals have left the country. While people that require critical care account for less than five percent of all confirmed cases, it is still where the gap in healthcare is the widest. Eka Kotebe, Menelik, Saint Paul and Saint Peter Hospitals, all combined, can take only 76 patients. This is a far cry from the 553 beds the Centre estimates will be needed.

The human resources needed to serve in the treatment centres are estimated at 7,650 nurses, 2,997 general practitioners and 294 specialists, and the Ministry of Health has crafted a budget of 430 million dollars for the first phase of operations, which involves controlling the virus before it spreads into the community. This policy is modelled on the successful cases of China and Singapore This budget includes all costs related to COVID-19 quarantine, isolation and treatment, according to Yakob.

As for the quarantined in Bole Preparatory School, it has now become a waiting game for their release. As of Sunday, April 12, 2020, they have been there for 19 days.

"We want to get a certificate showing a negative result before we leave. We know there's a stigma associated, especially when you mention Dubai at the moment, so we're concerned about what the reception will be like when we go back out," he said. "If anything, it is us who have been tested that are actually more at risk by rejoining society."

UPDATE: Originally this article stated “The situation is worse in the quarantine centre in Addis Ababa Science & Technology University (AASTU) compound…” referring to the potential medical challenges because of the underlying health conditions of the deportees that are mostly hosted there. However, it has come to our attention that the report may be misunderstood to be referring to the physical infrastructure of the university. We regret that we did not use more explicit language to make the distinction. We would like to clarify to our esteemed readers that the physical infrastructure in AASTU is no worse than the other facilities mentioned in the story. We apologies for any inconvenience this might have caused.

PUBLISHED ON Apr 12,2020 [ VOL 21 , NO 1041]

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