“Sauti”

African immigrants have been uniquely affected by the coronavirus crisis. There is a need for researchers, health care providers and the health care system to understand their experiences and develop culturally and linguistically appropriate interventions. Sauti, was conducted to document the challenges that African immigrants in New England are facing related to COVID-19. We also captured ways they are coping and being supported through their challenges during the COVID-19 pandemic.

We engaged 103 African immigrants from across the New England region in sharing their experiences using photovoice, a participatory research method that asks individuals to represent their lives, points of view, and experiences using photos and narratives. The visual images and accompanying stories are the tools used to promote action and change.

In each state, participants gathered photostories. Through a participatory data analysis process with participants and regional partners, 9 themes (34 photostories) were identified highlighting challenges African immigrants face during the pandemic across New England, and 7 themes (24 photostories) were defined focusing on strategies participants used to cope with the pandemic.

Loneliness and Isolation

People experienced loneliness and isolation during lockdown when required to stay at home and adhere to social distancing guidelines. There was a loss of connection with friends, family members and the community. There was a feeling of being like a prisoner at home.

Restrictive Movement

Stay-at-home orders required non-essential places to close. People were unable to remain active and engaged in their community. This included not going to places, such as faith institutions, where people typically receive trusted information.

Life Changes, New Normal

The new public health guidelines impacted every aspect of life and people had to adjust to wearing masks in public and getting tested regularly. There was often a shortage of food, PPEs and other supplies.

Experiencing Loss

People experienced immense loss, in the US and their home country, as a result of the pandemic – financial, family, lifestyle, and community. Friends and family died because of COVID-19. There was financial loss due to getting laid off, furloughed or not being able to find a job. People were not able to connect at social gatherings, such as church service, weddings, picnics, and outings. In addition, there was a burden knowing that family in their home country did not have the same resources.

Systems Challenges: Healthcare, Emergency Response, Food Supply

The public health and  healthcare systems had gaps in their response to COVID-19 specifically for refugees. Because hospitals and clinics were overwhelmed with COVID-19 patients, people could not get appointments for non-COVID-19 related health issues. In addition, there wasn’t an adequate emergency response in the community. This caused shortages of food and supplies. The mandate to wear masks made it challenging for people who are deaf and hard of hearing to communicate because they were unable to reads lips in order to converse with others.

Fear of the Unknown

There wasn’t clear information begin released from the government. No definite answers related to transmission, the period of infection, the outcome of getting COVID-19, and if a vaccine will curtail the disease. People also feared others in the community thinking they had COVID-19.

Difficulties for Our Children

Children faced many challenges related to using virtual platforms for remote learning. This included technical issues and difficulty paying attention. In addition, some families did not have the technology or parents were unable to support the children because of their limited computer literacy. Overall, children lost socializing with friends. Specifically younger children were not able to learn critical social skills, such as “sharing is caring” and playing nice with others.

Parental Stress

Parents were dealing with a lot of stress due to children schooling at home. It was challenging to support their kids while also working. Parents feared that their children would be left behind.

Coping with Illness During the Pandemic

Families had a difficult time dealing with children and loved ones who tested positive for COVID-19. Parents were scared to take their children to the emergency room. Family members were unsure about how to support and take care of their loved ones that needed to be quarantined.

Have Hope and Stay Positive

People were encouraged to stay positive during the pandemic and to persevere through the challenges. There was hope for better days ahead, including a cure being developed and people will eventually feel relief and feel free to move around.

Government Guidelines and Assistance

To keep their community and family safe, people adhered to the public health guidelines determined by Center for Disease Control and Prevention (CDC) and each state. People acknowledge comfort in having control to keep themselves safe and well (e.g. washing hands). In addition, people were waiting on financial aid from the government to support their families and anticipating the approval of a vaccine.

Exercising

People exercised safely as a way to keep physically and emotionally healthy. It served as a coping strategy to mitigate the stress caused by the epidemic and not being able to see family and friends.

Traditional and Home Remedies

People used traditional and home remedies for prevention and when providers said to stay home after they tested positive for COVID-19. Remedies were made from perfumed woods, garlic, fruits, herbs,  and honey. Some were made into a drink or used in a steam. They were used to boost the immunity against the virus and cure symptoms caused by COVID-19. In some communities, it was believed that certain remedies have biomedical properties for a cure for the virus, e.g. medicine developed in Madagascar.

Communications and Information Gathering

Social media platforms help family and community members to stay connected. Platforms include: WhatsApp, Zoom, and Facebook and television news. At times, virtual support groups were created to support people having a difficult time. There was also a need to have information provided about COVID-19, including prevention and vaccine development in different languages.

Faith

People held on to their spirtual practices and belief in God who protects them from diseases, including COVID-19. Many faith organizations started virtual services and prayer lines. This helped them face the losses caused by the pandemic.

Maintaining Connections to Family, Friends and Information

Comfort, care, and support came from family, friends, and neighbors. It was important for people to stay connected. Family members, in the US and at home, were able to spend more time together because they were required to stay-at-home. For family and friends who did not stay in the same house, using virtual platforms like WhatsApp, Zoom, and Facebook helped them stay in contact. In addition, people stayed connected to their spiritual family and online platforms to receive accurate information and services.