Morocco – a model for managing the health crisis?

On the 5th May, at 10am, the Moroccan Health Minister announced one hundred new cases of Covid-19, bringing the number of confirmed infections to 5153. The kingdom mourns its 180 deaths while France grieves for its over 131,000 confirmed cases and 25,000 confirmed deaths recorded from the same date. What follows is Ap. D Connaissances’ exploration of Morocco’s model for managing this epidemic.

Morocco declared a state of public health emergency and enforced a lock-down at 6pm on Friday 20th March (five days after France), in order to contain the spread of Covid-19, and the country seems to stand out from others affected by Coronavirus – because Morocco has not visibly allowed itself to be overcome by the health crisis. And it makes an impression – on the international stage, but also on its own citizens. The country would have had time to prepare itself, to observe the response of its affected neighbours like France or, prior to that, Italy.

We should remember that Morocco is not a member of the European Union; closing its borders and controlling flights to and from the hardest-hit places is possible, or even easy (the country has fewer than ten international airports, and only one port that passengers can enter by). On this subject, the Moroccan news website Yabiladi (which draws its sources from the Moroccan Minister of Foreign Affairs) reported that on 3rd May, there were 387 deaths of Moroccans abroad following being ill with Coronavirus, in comparison with 174 recorded deaths in Morocco itself. Adjustments, strategies, and organisation: what are the factors that enabled this incredible resistance in the Kingdom of Morocco?

From an economic perspective, the country established an emergency fund of 10 billion Moroccan dirhams (€1 million/£830,000). The fund is financed by private businesses and individuals, but also by the king Mohammed VI himself. It is thanks in particular to this fund that the Kingdom was able to offer inexpensive masks to its citizens. Wearing a mask has been obligatory since 7th April, and each day, nearly 7 million masks are produced in the country. Businesses have transformed their activities to meet national demand. Sold at very low prices, sometimes even less than 1 dirham (1 Euro cent/less than 1 penny), masks are readily available in local grocery shops, as well in supermarkets and pharmacies.

Morocco was also one of the first countries to test the effects of the antimalarial drug chloroquine, the usage of which is heavily debated in France, on confirmed coronavirus cases. In April, Morocco authorised the use of chloroquine as a coronavirus treatment, by combining it with an antibiotic. In France, Professor Raoult, well-known infectious disease specialist, is one of the few to advocate for the effectiveness of the treatment of Covid-19 patients with chloroquine and azithromycin, as soon as the first symptoms of the virus appear. Can the difference in mortality rate in Moroccan territory compared with other affected countries (without forgetting Moroccan ex-patriots) perhaps be explained by the types of treatments being used? Is this a worthwhile initiative, a miracle product, or danger in liquid form? Note that if chloroquine seems to be effective in some cases, its most significant side effect can be bradycardia (very slow heartbeat). One of our sources, working in intensive care in a hospital in France, explains that in Lille for example, chloroquine is used in certain situations, but has not yet been subject to clinical trials. Its effectiveness has not been scientifically proven.

Military hangars in Morocco have been transformed into field hospitals. Military hospitals have themselves been requisitioned. The army has prepared for an eventual massive influx of patients. A major reorganisation can be observed within Moroccan hospitals, but not only this: the anaesthetist Dr Chafik El Kettani, speaking to the news outlet LCI, said that once the patients are clinically recovered, they have the choice between staying in hospital until they are biologically recovered, or to go to one of the ‘buffer’ facilities. These places, principally hotels, have been established to manage the movement of patients and ensure their well-being as much as possible. These spaces are disinfected several times a day, and patients are attended to by doctors who guarantee the monitoring of their recovery.

Beyond the purely technical and health-related provision that these structures provide (the decongestion of hospitals particularly), they also represent a support zone for those who have been ill – a transition before their return home. From a social perspective, Morocco has taken the right course of action here too: since the beginning, a strict quarantine and curfew were imposed by the government. The images of (totally) empty streets in different Moroccan towns inspire a certain admiration for the cooperation of Moroccan citizens. An individual walking around without a valid certification is not simply fined, but risks being immediately remanded in custody.

The area of education has not been pushed aside in the management of the crisis: distance learning courses have been arranged. Inequalities between students have also been taken into account, because certain lessons are even aired on a public television channel.

The countryside seems to have been spared by the epidemic, but the seemingly exemplary management of this health crisis has served to accentuate other inequalities in the most affected Moroccan towns – in particular, the struggles of the most vulnerable people, a real problem in lower-income neighbourhoods. Charities have thus been busy distributing food parcels to homes. The government, meanwhile, is paying a benefit of around 1000 dirhams (€100/£80) to undeclared workers.

According to the prince and political commentator Prince Moulay Hicham, the citizens of Morocco can be grateful for the management of ‘the health crisis, the lockdown measures, the quarantine, the funds and resources.’ Of course, the Prince is perhaps not entirely objective, because he is the first cousin of the King. Even so, it must be recognised that Morocco seems effectively to have known how to face the health, economic and social challenges linked to the coronavirus pandemic, and the figures support this.

If Morocco now fears a summer without tourists, this North African country has managed to establish its know-how, inspiring the admiration of the great powers who prefer to dance in the streets, go kayaking, drink bleach* or wait for herd immunity.

Health Minister Khalid Ait Tahib has nevertheless warned Moroccans to remain vigilant, as he maintains that ‘the epidemic could double in intensity.’

Clara Bousquet

Translated by Jenny Frost

*Drinking bleach is strongly discouraged by the editors of Ap. D Connaissances