A year in the fight against COVID-19 as the United Nations asserts the need to leave no one behind

The toll of the pandemic can be measured in numerous ways. Lives have been lost; jobs were eliminated, furloughed, or changed, and economies now devastated.

It has also highlighted the primal response for those of all ages, races, religions, sexes, and economic classes to ban together by following social distancing protocols, providing assistance to those in need, and checking on those who might be feeling alone. The United Nations Secretary-General, Antonio Guterres has numerously highlighted, “This is, above all, a human crisis that calls for solidarity.”

The United Nations Country Team (UNCT) has been working tirelessly this past year to provide as much support, to the Government of Belize (GOB) and those most at-risk, especially vulnerable populations/communities.

To assist, the United Nations (UN) launched a global inter-agency finance mechanism for low-and-middle-income programme countries like Belize in April 2020. The Multi-Partner Trust Fund (MPTF) provided much-needed support to the UNCT, which continue to work across all aspects of the COVID-19 response, including matters of health, education, risk communication, nutrition, food security, water sanitation, hygiene, adolescent health, child protection, ending gender-based violence, socioeconomic recovery, and many others.

UN agency-specific responses have included a variety of actions, that range in support capacities, including launching and re-allocating funds for support; procuring and repurposing essential equipment; supplying the most vulnerable with essential provisions and services; and aiding with guidance and communications.

As the first signs of the pandemic plagued the world, agencies began appealing, reallocating, and repurposing funds to respond to the COVID-19 pandemic. The Pan American Health Organization/World Health Organization (PAHO/WHO) appealed for funds in support of Caribbean countries, including Belize. It also initiated the strategic planning for the COVID-19 response with the UNCT, using the Strategic Prepared and Response Plan (SPRP) guide, to support vital preparedness, response, and recovery activities. Various agencies such as the United Nations High Commissioner for Refugees (UNHCR) re-allocated funds to directly support the COVID-19 response.

To name just a few, The United Nations Population Fund (UNFPA (United Nations Fund for Population)) reallocated USD $143,555 of its regular resource fund to support in 13 countries and 9 overseas territories, as well as allocated USD $70,000 to the Spotlight Initiative as a part of the COVID-19 response to Belize. The International Organization for Migration (IOM), through its Assisted Voluntary Program, contributed USD $95,000 to support stranded migrants in order to facilitate their return to their countries of origin. The United Nations Development Programme (UNDP) repurposed USD $75,000 for the provision of immediate drought and COVID-19 assistance for small farmers, which supports continuity of production systems to meet national food security objectives. Additionally, PAHO/WHO has also reoriented USD $550,000 of its ongoing EU funded Health Sector Support Program Belize, in order to enhance national laboratory network diagnostic capacity for early detection of COVID-19 for enhanced infection prevention and control, with a focus on medical waste management and improved integrated healthcare at the community level.

Without a doubt, one of the most urgent responses needed in the fight against COVID-19 was to guarantee that essential medical equipment was available to those working on the frontlines, ensuring that our populations had adequate access to health services while remaining safe. PAHO/WHO has procured various essential health care equipment such as reagents, swabs, canisters, shipping packages for shipment of samples, laboratory test kits, personal protective equipment (PPEs), probes, primers, and more. They are supporting the procurement of equipment and supplies for COVID-19 critical care management, including revising the guidelines on potential COVID-19 therapeutics, as well as guidelines for COVID-19 health facilities and joint assessments of the level of health facilities and isolation areas. PAHO/WHO has donated an estimated USD $187,000 in laboratory supplies and testing kits to facilitate the molecular detection of SARS-COV-2.

Additional support was provided to the Ministry of Health and Wellness (MOHW) by support through the capacity building of two laboratory technicians from the Central Medical Laboratory who were trained at the Institute of Epidemiological Diagnosis and Reference (InDRE) in Mexico City for the genomic detection of SARS-COV-2. The virtual training of MOHW personnel in the use of Go.Data to improve data collection, management, and analysis in Belize. The strengthening of surveillance capacity at the international airport, particularly to screen returning Belizean nationals and international tourists. Financial support to conduct a Field Epidemiology Training Program (FETP), in which nine public health officers were trained to support the ongoing COVID-19 response and the surveillance of other infectious diseases. And aid provided through strategies to decentralize and expand SARS-COV-2 testing to facilitate timely access to the test and rapid availability of the results for effective case management, which was supported through the donation of 105,000 antigen-based rapid diagnoses (Standard F and Standard Q SD Biosensor) along with seven units of SD Standard COVID-19 Antigen Control, and nine units of Rapid Diagnostic Test Analyzers, for an estimated USD $608,000.

COVID-19 surveillance is one of the most important pillars that allow for identification, isolation, and quarantine, as well as contact tracing and case management. Although there is currently no evidence of COVID-19 spreading from food or food packaging PAHO/WHO has supported the Food Safety Program of the MOHW through the procurement of testing kits for food sampling, which included a Supersnap Extra Sensitive ATP Test, LED Flashlights, PH Plastic Strips, etc. for a total of USD $24,040. Life-saving equipment such as ventilators, patient monitors, mobile x-ray machines, video laryngoscopes has continuously been donated to the COVID-19 critical care unit at KHMH (Karl Heusner Memorial Hospital) to strengthen its capacity to provide state-of-the-art medical treatment and care. Updated evidence-informed guidance on clinical care and therapeutics was provided, including protection of the health workforce. Additionally, in partnership with the MOHW and the Belize Medical and Dental Association, PAHO/WHO facilitated a series of Continuing Medical Education (CME) sessions on COVID-19 for awareness and capacity building.

Planning for a surge in cases, not only considers forecasting quarantine, isolation, and critical care beds, medicines, PPEs, laboratory tests, reagents, supplies, and human resources but also takes into account maintaining essential health services such as maternal and child health, immunization, noncommunicable diseases (NCD), HIV (Human Immunodeficiency Virus), tuberculosis (TB), sexual reproductive health (SRH), malaria and vector-borne diseases, among others. Integrated health services at the community level were enhanced through the training of two hundred and thirty community health workers, equipping them with basic health monitoring devices, first aid kits, and supplies.

To ensure access to essential quality and safe medicines, equipment, and supplies for both COVID and non-COVID responses; support was provided in terms of regulation, pharmacovigilance, and supply chain management in view of the global shortages and logistical challenges. PAHO/WHO and UNICEF assisted the MOHW in its comprehensive preparation for COVID-19 vaccine deployment, ranging from planning and coordination to cold chain and logistics, indemnity and regulations, prioritization of target populations, budgeting and resource mobilization, service delivery, risk communication, and demand generation, information and surveillance of adverse events following immunization, human resources, and capacity building, among others. Additionally, PAHO/WHO and UNHCR worked jointly to provide standardized medical supplies and equipment to the isolation units of the Western Regional Hospital and the Central Health Region, under the Multi-Partner Trust Fund (MPTF).

The United Nations Development Programme (UNDP) has supported the expansion of national testing capacities through the acquisition of testing swabs, CEPHEID testing kits, calibration kits, and the procurement of a COVID-19 module software update, all valued at USD $24,000. UNDP has also procured a ventilator at USD $25,000 in support of the national health system response and aided in repurposing two Gene Xpert diagnostic equipment at USD $40,000 to expand laboratory capability for test analysis that will decentralize lab works and increase efficiency in the purposing of tests. UNDP has supported the MOHW in the development and submission of a proposal valued USD $290,000 to the Global Fund COVID-19 Response Mechanism that includes mitigating COVID-19 impacts on HIV, TB, and Malaria programs through the procurement of medication, and facilitating access to different communities, whilst purchasing additional testing and collection kits to enhance the national capacity; as well as personal protective equipment (PPEs) for civil society.

Other agencies such as the United Nations Children’s Fund (UNICEF), supported in procuring personal protective equipment (PPE) to support 56 health centers throughout Belize. The UN Refugee Agency (UNHCR) supplied personal protective equipment (PPEs) to front-line healthcare workers within refugee communities located in the western health region of Belize. Additionally, other types of equipment such as pulse oximeters, an oxygen tank, and hospital beds were procured for the Valley of Peace Polyclinic. The World Food Programme (WFP) and the Caribbean Disaster Emergency Management Agency (CDEMA) have also led the process in building an Integrated Regional Logistics Hub (IRLH) in Barbados and are in the process of mobilizing resources to advance in this area of support to the region. The IRLH will serve the Caribbean in an emergency for the movement of vital relief items and house prepositioned logistics assets for a more rapid response. Resource mobilization efforts are also ongoing to establish air and sea bridges to facilitate the movement of essential supplies, vital personnel, and intra-regional movement of food and basic items.

Furthermore, the World Food Programme (WFP) established a Caribbean COVID-19 Logistics Cell (co-led by CDEMA) including PAHO, UNICEF, Multinational Caribbean Coordination Cell (NCCC), military members in the Caribbean, ECHO (European Community Humanitarian Aid Office), Global Affairs Canada,  UNOPS, IFRC (International Federation of Red Cross), and the French Red Cross (with more entities joining) to strengthen coordination and to gain an understanding of regional supply chain needs and potential common service support. A Caribbean COVID-19 Food Security and Livelihoods Impact Survey was undertaken by WFP with support from the Food and Agriculture Organization (FAO). The summary report found that COVID-19 has caused widespread disruption to livelihoods, with half of the respondents facing a change in income. Six hundred and forty-three Belizeans (63% female; 35% male; 2% “other”) completed the survey.

Overall, the pandemic has presented higher risks for the most vulnerable populations, hence agencies placed heavy focus, on ensuring they aid vulnerable population groups such as victims of gender-based violence, youth, women and pregnant women, persons with NCDs, rural communities, indigenous persons, persons with disabilities, refugees, migrants, and healthcare workers. The United Nations Development Programme (UNDP) has earmarked USD $30,000 in assistance for the National Women’s Commission (NWC) and the Belize Women’s Department for national programmes designed to identify, secure, and make operational alternative shelters and safe spaces for victims of Gender-Based Violence (GBV). Resources will also be applied to expand communication on the availability of support services for GBV victims as a national socio-economic assessment estimated at USD $25,000 has been commissioned. This complements ongoing national macro-economic studies being undertaken by the Government of Belize (GOB) as it focuses on vulnerable population groups inclusive of rural populations, those participating in the informal economies, the long-term unemployed, youth, and female-headed households, among others. This will provide greater insight into population vulnerability, with the hope of informing greater targeted actions for the response. Additionally, a total of USD $300,000 has also been earmarked by UNDP to support the strengthening of national structures and the enabling of the expansion of national safety nets/social protection systems. These funds support, in part, critical “surge” staffing needs within the Ministry of Human Development, Social Transformation, and Poverty Alleviation (MHDSTPA), as well as provides for the expansion of the National Electronic Case Management Platform (FAMCARE) which underlies National Food Assistance and BOOST programs.

The United Nations Population Fund (UNFPA) has developed a collective Caribbean Contingency Plan centered on identifying and rapidly addressing gaps in emergency service provisions for those who are at risk of or already experiencing gender-based violence (GBV). Key interventions are being supported through the Government of Belize (GOB) and civil society organizations, including the recruitment of a GBV in emergencies (GBViE) specialist; mapping of all GBV services; providing technical assistance for the strengthening or development of GBV referral pathways, providing technical and financial resources for the operationalization of tele-counseling, providing technical and financial resources for the establishment/scaling-up of hotlines, and providing technical and financial resources for the operationalization of temporary shelters.

UNICEF through the MOHW in collaboration with the Ministry of Education, Culture, Science and Technology, as well as the  MHDSTPA provided supplemented food for one thousand five hundred children, distributed hampers with hygiene supplies, school materials, food pantries as well as nutrition and hygiene communication materials. UNICEF and the MOHW also identified three hundred vulnerable pregnant women and children who received supplemented food and fresh fruit. Under the Water Sanitation and Hygiene (WASH) programme, UNICEF prepared hygiene packages with personal hygiene items such as toothbrushes, soap, diapers, Clorox, and rubbing alcohol which were sent to various schools. In addition, printed material, guidelines, and videos that stressed the importance of handwashing and other hygienic measures were widely distributed through appropriate channels, and IOM supported the MHDSTPA with six hundred hygiene kits. Support was also provided through the guidance and development of content for parents and caregivers to assist children studying at home, including psycho-social support and the development of special measures to ensure access to distance learning for the most vulnerable children. Communication materials and resources continue to be aired on local media television and radio stations for use and dissemination by the Ministry of Education and other partners.

Support is being provided to the Belize Police Department and Family Court to develop guidance for appropriate support to children as they interact with the child justice system during COVID-19. UNICEF is also working with the Belize Police Department and the Belize Defense Force to establish child-friendly spaces at two police stations to promote safe spaces for children to interact with law enforcement during and after COVID-19. UNICEF has been a large supporter in the response to violence against children. This has included providing guidance on Standard Operating Procedures (SOPs) for remote reporting, supplies for remote working and case management and response, as well as collaborating with the National Committee for Families and Children (NCFC) and the MHDSTPA to develop key messages for parents, especially directed towards those who will be burdened with additional care responsibilities, such as women and adolescent girls. These messages focus on violence prevention, positive discipline, reporting violence against children as well as domestic violence.

Despite the pandemic and the fear that was associated with COVID-19, efforts were made to encourage breastfeeding mothers to continue breastfeeding, and for pregnant women to initiate breastfeeding after delivery. During World Breastfeeding Week, in collaboration with the MOHW, breastfeeding promotion activities were implemented in all districts.  Posters promoting the importance of breastfeeding during the pandemic were developed and distributed countrywide. Additionally, considering the restriction of movement, psychiatric nurse practitioners and other nurses providing mental health care were provided with tablets that would allow them to follow up on their various patients. To protect frontline workers, personal protective equipment (PPEs) (gloves, gowns, goggles, face shields, e.g.) were donated to the MOHW, the Belize Red Cross, the Belize Defense Force, Customs Department, the Belize Coast Guard, and the Central Prison. Another vulnerable group was the persons living in long-term stay homes, including the elderly and children. Therefore, similar PPE items were donated for homes across the country. 

The United Nations Country Team (UNCT) has also been a valuable resource in providing guidance and communication development to various ministries and civil society organizations to mitigate against COVID-19 and its various impacts. PAHO/WHO participated in the National Task Force meetings and provided guidance to the Medical Response Sub-Committee which provided operational guidance to the MOHW and Risk Communication Sub-Committee. They also guided the development of COVID-19 Country Preparedness and Response Planning (CPRP) with the MOHW. This included working with the Policy, Planning, and Project Management Unit and the Statistical Institute of Belize on data simulation of COVID-19 outbreaks within Belize. The UNCT has continuously helped to develop and disseminate communication materials including posters, brochures, and public service announcements to promote COVID-19 awareness. Additionally, support was given for the development of a Risk Communication and Community Engagement Strategy (RCCE) with the MOHW. The 2020 RCCE strategy was developed and its objectives were to provide accurate, science-based information, recognizing the uncertainty and fluid nature of the situation with honesty and in alignment with international guidelines and directives from local health authorities while dispelling rumors and misinformation in order to help the public understand the risk of COVID-19, thus empowering them to reduce their exposure and protect their loved ones. 

The RCCE strategy focused on identifying target audiences, building key messages to be disseminated by posters, newspapers, radio, television, and social media. And generating messaging in various local languages on hand hygiene, use of masks, physical distancing, self-isolation, respiratory etiquette, modes of transmission, pregnancy and breastfeeding, hypertension, diabetes, stigma and discrimination, mental health, and alcohol abuse.

The United Nations Population Fund (UNFPA) Sub-Regional Office for the Caribbean has provided technical support and guidance in developing key messages and engages in the production and dissemination of messages aiming to prevent and address the secondary impact of the outbreak with the objective to minimize the human consequences for adolescents and youth, girls and women including pregnant women, LGBTQI and disabled persons, in line with UNFPA’s mandate, responsive, empathic, transparent and consistent messaging in local languages.

UNFPA has proactively shared relevant guidance and tools with government and civil society partners to ensure sexual and reproductive health and rights (SRHR) are prioritized to ensure appropriate and timely referrals to lifesaving SRH services. This includes support for the continued delivery of SRH information and counseling including for pregnant women via telephone and the delivery of commodities such as contraception.

The United Nations Development Programme (UNDP) has worked on enhancing civil society partner capacities to support health care in various communities. The United Nations Children’s Fund (UNICEF) created communication materials to promote healthy eating habits and safe breastfeeding according to PAHO-WHO COVID-19 guidelines, which were produced and disseminated on social media. And the United Nations High Commissioner for Refugees (UNHCR) assisted the MOHW with the reproduction of risk communication materials which were disseminated mostly within the western health region, where the concentration of refugees and other persons of interest are located.

Other agencies such as the International Organization for Migration (IOM) developed communication materials including flyers that stressed the importance of hygienic measures. As well, UN Women Multi-Country Office (MCO) provided communications support for the Belize National Gender Machinery (NGM) to develop two localized communications tools and hosted regular calls with NGM to ascertain needs as well as support sharing of better practices across NGMs in the region.

UNESCO has reacted to the unprecedented educational disruption in the Caribbean Small Island Developing States. In August 2020, UNESCO, together with Blackboard Academy, launched the Pilot Project 2020 "Professional Development for Teachers for Blended Learning and Online Strategies". The four-week online teachers training developed teaching capacity in the new learning reality of distance education due to COVID-19. The training focused on K-12, elementary and secondary levels with strategies for designing the online classroom. Whether teachers plan to use a blended classroom or a fully online one, this course supported them to ease the transition in creating an online class environment that meets the needs of both students and teachers. In addition, the initiative strengthened the teachers' ability to respond to the current crisis in the local environment and to strengthen the resilience of the sub-region's education systems to future shocks.

COVID-19 has also had significant impacts on workplaces, making occupational safety and health (OSH) a key component to building back better from the pandemic. Under the project “COVID-19 response to vulnerable populations and frontline workers in Belize”, the International Labour Organization (ILO) supported a national bipartite awareness campaign to help employers, workers, and the public create and maintain safe and healthy work environments in the context of the crisis. The six-week promotion, which launched in December 2020, was developed in collaboration with the Belize Chamber of Commerce and Industry (BCCI) and the National Trade Union Congress of Belize (NTUCB). Featuring the tagline “a safe and healthy workplace is a better workplace”, it included a series of nine television, radio, and print public service announcements (PSAs). Additionally, the campaign supported business continuity, resilience, and trust with clients. All materials were produced in English and Spanish to ensure a wide reach across the population. This was also made possible through funding from the Multi-Partner Trust Fund (UN MPTF).

During these challenging times, we have seen the very best from the United Nations Country Team and partners on the ground. While March 23rd marks the anniversary of Belize’s 1st presumptive positive COVID-19 case, we remain dedicated and steadfast in the COVID-19 Response and Recovery. As we celebrate World Health Day on April 7th under the theme “building a fairer, healthier world”, let us continue to follow our mitigation measures as we head together towards brighter days. That includes staying at home when you are sick, wearing a mask when among others, practicing social distancing and when eligible, receiving a COVID-19 vaccine.

Together, we will build back better, through a fairer, healthier world.