TUNIS, Tunisia — In the grey drizzle of a wide street bustling with pedestrians and passing vehicles in Tunis’ distant suburb of Mhamdia, a small group of teenagers in blue uniforms stop to talk with locals every few steps. The teens are Tunisian Scouts and they are giving 60-second talks on personal safety measures — mask-wearing, physical distancing, handwashing — people can take to protect against COVID-19 infection. Some passersby stand and listen intently, nodding in agreement.
A few blocks away, a line of elder folk wearing masks is getting longer outside a municipal youth activities complex. The line is for people over the age of 60, all of whom are now eligible for the Pfizer COVID-19 vaccine in Tunisia. Inside, the Scouts walk down a line of patients in chairs, registering each person on an electronic tablet for the vaccination so they can be contacted for a second injection. Then they are called into the vaccination room to get their shot.
The Tunisian Scouts’ COVID-19 prevention activities are in collaboration with UNICEF, with the financial support of USAID. The Scouts are a national organization of volunteers, with members in all 24 of Tunisia’s provinces. A thousand of them have been trained to share health safety messaging just like this group is doing in Mhamdia.
Last year when the pandemic began to spread globally, Tunisia was a leader in North Africa in containing the coronavirus and keeping hospitalizations and deaths low. Now, there have been close to 325,000 COVID-19 infections and more than 11,000 deaths in the country. With cases on the rise and hospitals filling up, it’s more important than ever that UNICEF is joining Tunisians to fight the spread of COVID-19.
A thousand teenage volunteers have been trained to share COVID-19 health safety messaging in their communities
Wiem, 16, spoke to the Scouts as they roamed the main avenue of Mhamdia. “The more information you have, the more you’re able to beat coronavirus,” she said.
She plans to share the word on anti-COVID measures with her neighbors. “Anyone who has information like this has to share it. For example, if you run into someone wearing a mask beneath their nose, you have tell them to cover their nose too. When you go somewhere where there’s no media giving information on how to prevent infection, you have to tell people to wear masks and use hand gel.”
In the youth complex auditorium, one of the Scouts, 16-year-old Anes said he's proud of the volunteer work he's doing to stop the spread of COVID-19 in Tunisia.
Pointing to all of the elders seated around him and the health professionals shuttling in and out, he said, “In cooperation with the Tunisian Movement for Combatting Corona, we’re organizing the patients. We’re registering them and giving them vaccination numbers. After the vaccination we look after them for fifteen minutes to make sure they don’t have any adverse reactions. After three weeks, they are called using the information we collected for a second shot.”
As for raising awareness, Anes said that he sees change in the views of those he and the other Scouts speak to on the street. In their interventions in Tunisia’s neighborhoods, distributing flyers on anti-COVID measures, handing out masks, and explaining the novel coronavirus and its dangers, he sees children change the most.
“Some people are receptive to what we say. Some are not. But with children, after you talk to them once or twice, you find that they’re wearing their masks all the time and carrying disinfectant gel.”
Some people are receptive to what we say. Some are not. But with children, after you talk to them once or twice, you find that they're wearing their masks all the time and carrying disinfectant gel. — Anes, 16
Imen, 17, has been in the Scouts for three years. Like Anes, she has been out in the rain talking to people in the neighborhood about how to stop the spread of COVID-19, taking patients’ contact information in the vaccination hall and helping people move into the vaccination room.
Imen says that she fears for her health in school with coronavirus, because several of her teachers have gotten sick. Yet when asked about the fight against COVID-19 in Tunisia, despite the challenging odds, Imen is optimistic: “In my own neighborhood and in the places where we go out on awareness activities, I see that most people accept the information that we’re trying to pass to them. And when they get vaccinated, we’re reducing the number that can transmit the virus.
“We’re benefitting the community. The doctors here depend on us a lot. I think we’re making a difference.”
At the UNICEF Tunisia office in central Tunis, Marilena Viviani, UNICEF Country Representative for Tunisia, spoke about how COVID-19 has impacted Tunisian children and UNICEF’s response.
“It is true that the pandemic didn’t kill many children, and so far the virus has mostly affected elderly people. But the biggest impact has been on [their] socioeconomic situation — young children, school-age children and adolescents. There was a large impact on child poverty and on the ability of parents to provide for their children.”
Child poverty rates in Tunisia have risen sharply since the start of the pandemic
UNICEF studies show child poverty throughout Tunisia hovering around 25 percent — a major increase after more than a year of the pandemic.
The stress of mass unemployment, lack of safe spaces as schools closed to prevent the spread of the novel coronavirus, and uncertainty of the future during the pandemic has brought harm to children even at home. “In speaking to psychologists, we realized there was a lot of domestic violence against children during the lockdown,” said Viviani.
During Tunisia's first lockdown in March 2020, UNICEF responded by procuring equipment and supplies to help Tunisia’s Ministry of Health cope with the crisis. They made investments in communication and awareness-raising and trained the Scouts to lead community engagement campaigns.
In September 2020, UNICEF coordinated a communications campaign on COVID-19 awareness and hygiene measures for students and staff so that the Ministry of Education could safely reopen schools.
In September 2020, UNICEF provided a COVID-19 awareness campaign for students and staff so schools in Tunisia could safely reopen
UNICEF has also been working to build the Tunisian government’s capacity to respond to the crisis, advising the Ministries and Scouts on fighting child poverty, how to get kids back to school, and communication on COVID. “We provide health expertise, communication expertise and education planning, and we have an engineer for rehabilitation of schools. In all our work we are using local expertise,” said Viviani.
Viviani also pointed out that UNICEF is part of COVAX, the global alliance for procuring vaccines for developing countries. With what Viviani called the absolutely critical financial support of USAID, UNICEF is cooperating with the Tunisian government to obtain 20 percent of the needed vaccines for Tunisians.
In a room full of projector screens and tables piled high with health literature in a towering office building in Tunis, Professor Nissaf Bouafif Ben Alaya sits masked behind her desk. Ben Alaya is the General Director of the National Observatory for New and Emerging Diseases at Tunisia’s Ministry of Health. The Observatory is a critical institution in Tunisia, charged with making health measures recommendations to the government.
Very few children have died from COVID-19, said Ben Alaya, but there have been major psychosocial effects on children. “They used to do a lot of social activities, going to the movies, cultural events. But that is all restricted now. Now they’re [at home] on their computers, connected on social media, with real-life interactions minimized. This affects them — they need social interaction.”
The foremost challenge in managing the government’s pandemic response in Tunisia, Ben Alaya said, is encouraging people to stay vigilant. “After the first wave, we’ve experienced a long, drawn-out period where [Tunisians] have had to take health measures against COVID and can’t live their normal lives. This has caused pandemic fatigue,” she said, noting that some in Tunisia have begun to give up the health measures. “There has been a lot of misinformation around COVID-19. To keep citizens up to date with emerging scientific evidence was not easy.”
The #1 challenge in the fight to end the pandemic: encouraging people to stay vigilant
UNICEF has helped the Ministry of Health “strengthen our capacity in the field and identify our priority needs, collaborated with us to undertake community engagement” like the Scouts’ outreach efforts, “and helped us improve our communication strategy with tools to inform people,” like flyers, talks with community members and presentations to the public on the importance of vaccinations.
The message is getting through. Back in Mhamdia, in the youth center auditorium, 12-year-old Mariem said, “I used to be afraid of the vaccine.” But after talking to the Scouts, she’s learned a lot. “I have to wear my mask, wash my hands, and stay away from crowded places. And now I think I’ll get that vaccine. We need it to fight this pandemic.”
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Top photo: In Mhamdia, in the suburbs of Tunis, Tunisia, a group of UNICEF-trained Scouts talk to pedestrians about the risks of COVID-19 and share information about how to prevent infection. All Photos © Pau González for UNICEF USA