Rwanda's Aggressive Approach to Covid Wins Plaudits—and Warnings

Rwanda's Aggressive Approach to Covid Wins Plaudits—and Warnings

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Drones mounted with megaphones buzz above Rwanda’s streets and villages, reminding pedestrians to social distance. In one clinic, sleek white robots chastise people for not wearing masks. Health workers in protective clothing take test samples from drivers at traffic intersections.

The tiny central African nation of Rwanda is implementing one of the continent’s most aggressive—and technologically sophisticated—strategies to contain the coronavirus.

One of the first African countries to detect an outbreak in March, Rwanda has since registered 4,800 cases and 29 deaths.

It is one of only 11 countries world-wide—and the only one in Africa—that the European Union considers a safe travel destination, although the U.S. Centers for Disease Control and Prevention warns against nonessential travel to the country. Some tourists, drawn to trekking tours to see Rwanda’s mountain gorillas and the country’s national parks, have trickled back.

International health agencies and public-health experts have held up Rwanda—the most densely populated nation on the African mainland, where 13 million people live in an area roughly the size of Maryland—as a poster child for how to tackle the coronavirus on the continent.

But its strategy, built on a tightly enforced lockdown and other restrictions that have led to the arrests of more than 70,000 people for coronavirus-related infractions, has alarmed human-rights advocates, who say some of the measures are overly aggressive and have led to abuse and violence of those detained. The police have said equipment being used to enforce public-health measures will later be used to maintain public order and control borders.

Rwanda has just one doctor for every 10,000 people, compared with 26 in the U.S., according to World Health Organization data, and more than half of its population lives in poverty. But the country started screening travelers for the coronavirus in January and was the first nation in Africa to impose a total lockdown in March that also shut the country’s borders.

A Rwandan police drone fitted with a megaphone flying in a Kigali neighborhood to enforce a coronavirus lockdown in April.



Photo:

Jean Bizimana/Reuters

Today, with large parts of the economy open again, more than 10,000 field workers visit homes, villages and towns to conduct contact tracing, submitting daily reports to the government. Coronavirus-prevention guidelines are blared through loudspeakers fitted on drones that hover above congested suburbs in the capital, Kigali.

At intersections, health workers take samples from drivers, who are chosen at random and whose permission is required. The samples are sent to government labs, with results usually delivered within 24 hours. Those who test positive are traced and ordered to stay in a government-run Covid-19 clinic. Their contacts must quarantine.

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The government has banned public gatherings of more than five people, and drones record images in cities and remote areas to report to police any infractions. In one well-publicized example, a Kigali pastor who had received a permit to attend a radio talk show was spotted—and quickly arrested—trying to go to church to organize a church service, which she hadn’t received a permit to do, according to police.

The government is using technology to minimize contact between patients and health workers. In several public hospitals, human-size robots, made by Belgium’s ZoraBots, relay messages about patients’ conditions to doctors, taking their temperature, delivering messages and detecting if patients aren’t wearing masks. They can also deliver medicine and food.

The government has hired 60 drones owned by San Francisco-based Zipline Inc. to transport protective gear and Covid-19 test samples, as well as to ferry intravenous fluids to and from hospitals.

People arrested for breaking Covid-19 health measures such as mask-wearing are taken to stadiums and other public places to hear public-health messages, such as the Nyamirambo stadium in Kigali.



Photo:

Agence France-Presse/Getty Images

Rwanda has conducted some 37,000 tests per one million people, the third-highest number of tests in Africa after South Africa and Mauritius. That is fewer than in the U.S., which has undertaken a little more than 300,000 per million, but it is triple the rate in Mexico. The country, which acquired tests and personal-protective equipment both on its own and from foreign donors, has now donated coronavirus-testing equipment and sent experts to train laboratory technicians in the crisis-stricken Central African Republic.

Rwanda’s approach contrasts with those of other African nations, where a surge in coronavirus has caused chaotic scenes and overwhelmed creaking health-care systems and fragile economies. In Nigeria, doctors have gone on strike demanding better pay and protective clothing. In Ivory Coast, protesters destroyed a coronavirus testing center. South Africa saw infections explode after a strict lockdown was eased in July.

“Rwanda has set the standard,” said

Dr. Diafuka Saila-Ngita

, a professor of infectious diseases at Tufts University in Massachusetts. “It’s a model of what other low-income nations should do to respond better to health emergencies.”

But rights groups and opposition activists say Rwanda’s aggressive approach has come at a cost.

Travel between Kigali and provinces has been banned since March, leaving one of the city’s busiest bus parks with much less traffic.



Photo:

Jacques NKINZINGABO for The Wall Street Journal

Human-rights groups say the government has stretched the boundaries of the law in arresting 70,000 people for coronavirus-related infractions such as violating night curfews, failing to wear masks or breaching social-distancing rules.

Failure to wear a mask normally carries a $26 fine on the first offense, but those violating the guidelines more than twice can be jailed for up to one year.

Many of those arrested have been detained in sports stadiums, where they have spent nights listening to public-health messages over loudspeakers and under the watch of armed guards, activists say. Some have reported being beaten or raped while detained, according to Human Rights Watch.

Authorities provide little or no legal justification for the arrests and release most people after a few days, say human-rights groups.

Journalists and opposition activists have been detained for attempting to chronicle alleged police beatings, according to Human Rights Watch.

President

Paul Kagame

, a former guerrilla fighter who has been in power since the 1994 genocide, has defended his security forces’ response.

DJ Z sells music and films to travelers at the bus park. His business has been hurt by the lockdown.



Photo:

Jacques NKINZINGABO for The Wall Street Journal

“You don’t spend nights in the stadiums because someone wants to hurt you,” he said earlier this month. “It’s to remind you that by disregarding Covid-19 preventive guidelines, you are putting your own lives and the lives of others at risk.”

Police have denied allegations of abuse during the enforcement of the measures, but the Defense Ministry has said it is investigating some of its personnel over “criminal allegations.”

Activists say the draconian health measures are just one element of a broader effort by Mr. Kagame to achieve total control of the country. Last month, Rwandan authorities detained

Paul Rusesabagina

—a permanent U.S. resident whose role helping victims of the genocide inspired the Hollywood movie “Hotel Rwanda”—as he transited through Dubai Airport in what his family and lawyers described as a kidnapping.

Rwanda’s government says Mr. Rusesabagina, a Kagame critic, wasn’t kidnapped but was arrested on an international warrant. He has been charged with a raft of crimes, including terrorism, which he denies.

Dozens of the president’s political opponents live in exile, claiming their lives would be at risk if they were to return to Rwanda, while others have been killed or disappeared in recent years, according to rights groups. Mr. Kagame and his government have denied allegations that they have threatened dissidents or been involved in any deaths.

Rwanda’s police force says the technology deployed in the fight against coronavirus will boost its ability to maintain order and security beyond the pandemic.

“Policing is more efficient with technology,” said police spokesman

John Bosco Kabera

. “We are in a much better control of the situation than before.”

Write to Nicholas Bariyo at nicholas.bariyo@wsj.com

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