Surinam is the smallest South American state and was a colony of the Netherlands until its independence in 1975. Concerns about the coronavirus pandemic in the country rapidly increased after March 4, when five infections were diagnosed in Saint-Laurent – a border town of neighboring French Guiana. The first case of SARS-CoV-2 in Surinam was identified on March 13, and concerned a person who had returned from the Netherlands shortly before.
The first infection led to the closure of Surinamese borders to all non-essential travel via land, water, or air. Only repatriation flights are still transporting Surinamese citizens who were stranded abroad. These returnees subsequently go into government ordered quarantine. At the time of writing (April 13), the country had ten confirmed, six recovered, and one deceased COVID-19 case. The latter person passed away on April 3 after a period of hospital quarantine. Thus far, 43 persons are in self-quarantine (under government supervision), and 54 persons in government appointed locations. After the first SARS-CoV-2 infection in Surinam on March 13, the Surinamese Minister of Health visited Cuba to ask for medical support. After successfully mobilizing 50 Cuban healthcare workers, the Minister returned home and went into mandatory quarantine.
To minimize the risk of a local outbreak, schools were closed starting March 16, and almost all public transport was shut down, as well as transport to rural areas in Surinam. On March 18, the President gave a televised speech and presented the virus as “a national matter.” Gatherings of more than ten people were prohibited. At that time, 53 persons were self-quarantined. Whereas citizens were initially urged to distance themselves from each other, the President announced a lockdown during a second speech on national television on March 29. Thereof, citizens were no longer allowed to engage in public between 8.00 PM and 6.00 AM. The President considered declaring a state of emergency in the border areas if citizens did not act according to the public engagement rule. Thus far, this has not been introduced.
A few topics stand out in the Surinamese approach in response to COVID-19. First, precautions were quickly taken by the Ministry of Health to prevent the virus from entering the country, such as the installment of ten body temperature scanners at the national airport for travelers from abroad on March 4, and travel bans from March 14. The Surinam Chinese United Association (SCUA) recommended Chinese citizens to avoid travelling between China and Surinam, especially from contaminated areas on January 31. Several shops were closed voluntary, afraid of being infected from customers. Preparing for the worse, the Pan-American Health Organization (PAHO) supported the Ministry of Health through the realization of a so-called National Public Health Response team mid-January, on which virologists and government officials are represented. This expert-informed way of responding resulted in action plans in which steps are described on how to handle when a suspected case enters the country from a high-risk area, predominantly from China. Surinam and China have grown strong ties over the last decade, and the Chinese population in Surinam has steadily grown.
Despite the relatively few COVID-19 infections thus far, there are already shortages in personal protective equipment (PPE) and medical devices for healthcare professionals as in many other countries. Recently (April 9), the Association of Pharmacists released an alarming message, claiming that there is an insufficient stock of medicines, recognized as a critical weakness of the Surinamese healthcare system. To illustrate, PAHO described Surinam (and a number of other countries in the region) as ‘risk countries’ in responding to the pandemic because of such weaknesses, among others (i.e. approximately only 30 ICU beds and ventilators). As a result, Surinam is anticipated to face difficulties in detecting and controlling the virus at an early stage, a situation that has been acknowledged by the Surinam government.
There has, however, been some confusion about the number of infections, after online messages suggested that two people were infected and held in quarantine in the academic hospital on February 5. The Minister replied that such messages (‘fake news’) could harm Surinam as well as other countries in tackling the pandemic. Although government officials and representatives of the response team publicly said that they cannot guarantee full control over the outbreak, there seems indeed to be transparent communication through various news outlets. For example, a website (https://covid-19.sr/) was launched to inform citizens on a daily basis on COVID-19 developments.
Reflecting on the Surinamese response to COVID-19, the steady low number of cases for almost a week seems to be a positive sign that no major outbreak will occur in the upcoming weeks; but there is no guarantee. The low number of cases might indicate that the strategy of responding immediately in tackling the outbreak has worked out well. However, it is too early to judge the impact of the measures taken. Critics point out that the fragile state of healthcare in Surinam, with a lack of ICU and testing capacity, shortages in medicines and medical equipment, severely limits the extent to which the State will be able to respond to a sudden increase in infections. Dependence on other countries and institutions has arisen for financial resources, medical equipment and workforce.
While the resilience of the Surinamese healthcare system is debatable, the President guaranteed – during one of his television speeches – care, sufficient nutrition and order in society during the pandemic. Yet, at the same time an economic crisis unfolds. Therefore, the current situation is described by citizens as a ‘double’ crisis. Due to malpractice at the Central Bank of Surinam in January, the value of the Surinamese dollar spiraled downwards, resulting in increasing prices (from 10% up to a shocking 200%) in supermarkets and other shops. The double crisis, and fear of a local epidemic, led to long queues for cash registers soon after the first COVID-19 case was reported. Whilst the economy is slowly grinding to a halt, new questions emerge on how the measures taken will affect the already fragile economic state of the country (with approximal 600.000 inhabitants), and especially the viability of small businesses. Moreover, to what extent is Surinam able to cope with the existing weaknesses in the healthcare system if the number of cases increases? Although no government decisions on potential postponement of the scheduled national elections (May 25) have been made, it is certain that vast challenges lie ahead for Surinam as this double crisis unfolds.