Similarly, when the Chinese e-commerce giant Alibaba’s founder Jack Ma offered to send hundreds of ventilators as well as hundreds of thousands of personal protective equipment (PPE) to 54 countries in Africa, most African leaders, such as Ethiopia’s Abiy Ahmed and Rwanda’s Paul Kagame, swiftly accepted the donation and expressed their gratitude.

The leaders of Eritrea, a country ranked 182/189 in the United Nations’s 2019 Human Development Index, however, surprisingly chose to reject the vital equipment Ma offered to send them. On April 5, the head of Economic Affairs for Eritrea’s ruling People’s Front for Democracy and Justice (PFDJ) party, Hagos “Kisha” Gebrehiwet, publicly confirmed that the Eritrean government rejected Ma’s donation. Talking as a guest speaker at the bi-weekly Hagerawi Nikhat (“national consciousness”) teleconference, an exclusive online seminar in which senior party officials get a chance to communicate with their cadres in the diaspora, the man in charge of Eritrea’s economy said the country does not want to become a “dumping site” for “unsolicited donations”. Accepting such offers would be against “the principled stance of the Eritrean government which advocates for self-reliance,” he added.

Within the very same online seminar, Gebrehiwet explained that the Eritrean leadership is now trying to buy the medical equipment needed to treat COVID-19 cases from the incredibly competitive Chinese market and arrange the shipment of these items to Eritrea on chartered planes.  

Of course, despite its rejection of foreign aid, the Eritrean government does not have the necessary funds to swiftly make such purchases. As a result, it turned to its own long-suffering citizens and launched aggressive fundraising campaigns to make them donate the little money they have to the state to help the efforts to combat the virus. Thanks to these aggressive campaigns, some of Eritrea’s most penurious citizens, including members of the national service, have already been coerced to make donations. It is not yet known, however, whether these donations proved sufficient for the country to buy everything it needs to contain the spread of the virus.

While the Eritrean government undoubtedly hindered the country’s ability to respond to this public health emergency by rejecting Ma’s generous donation, this was only one example demonstrating its tendency to value its own image and survival more than the wellbeing of its constituents, even during a pandemic.

While Eritrea is one of the most isolated countries in the world, it did not escape the pandemic. The first COVID-19 case in Eritrea was reported on March 21, and, as of April 28, there are 39 confirmed cases in the country, of which 19 have recovered according to the Ministry of Health. The country has been in a nation-wide lockdown to slow the transmission of the virus since April 1.

The pandemic has not yet reached its peak in Eritrea, but all signs indicate that the country is heading for catastrophe.

Eritrea’s healthcare system is not strong enough to handle a deadly and highly infectious disease like COVID-19. Even before the pandemic, the country’s healthcare facilities had been suffering from an acute shortage of supplies. At certain times, patients have even been asked to buy intravenous (IV) infusions from private pharmacies before being admitted to hospital. The Eritrean government closed all private clinics in 2009. In the second wave of state seizure that started in June 2019, it also took control of 29 Catholic hospitals, health centres and clinics. Meanwhile, the unfavourable working conditions pushed many Eritrean physicians to flee the country, causing major staff shortages in hospitals.

And lack of quality public healthcare is not the only reason why the coronavirus pandemic is likely to have catastrophic consequences for Eritrea.

Although many countries, including some developed nations, are suffering from a shortage of essential products as a result of the pandemic, the magnitude of the problem is double in the case of Eritrea where import and export businesses have been banned since 2003.

As, even during normal times, Eritreans can only buy rationed essential supplies that are on sale in the governing party’s stores, they could not stockpile to prepare for the lockdown. Moreover, even if the state miraculously managed to secure extra goods to put on sale, Eritreans would not be able to do any extra shopping as they are not allowed to withdraw more than $330 in any given month from their own savings. This, despiteEritrea being a complete cash economy. 

Since the mid-2000s, Eritrea’s President Isaias Afwerki has been spending most of his time supervising dam constructions. Yet the country’s major cities, including the capital, are still suffering from a chronic shortage of running water and electricity. In August 2018, the regime rounded up many water-tank truck owners. Many of them remain in prison. All water bottling companies were closed in June 2019. This makes it impossible for many Eritreans to follow the hygiene protocols necessary to curb the spread of the virus.

If not impossible, the regime has also made it very difficult forEritreans in diaspora to help their family members back home. Eritrean citizens living abroad are required to pay the so called “diaspora tax” first if they want to send goods to their home country. Wiring money back to Eritrea is also not easy for members of the diaspora, as they are forced to use an extremely deflated fixed currency rate imposed by the government to do so.

Eritreans are also suffering from a lack of political leadership during this difficult time. While the leaders of most countries are doing daily briefings to inform their citizens on the latest developments about the pandemic, President Isaias has not spoken to the Eritrean people or media for almost two months after giving an interview to the state-run media in mid-February, in which he did not even mention the growing threat posed by the new coronavirus. His prolonged absence from public life led to rumours that he is incapacitated or even dead. 

Inside sources told me the president was in the port-city of Massawa during his months of absence from public life, as he reportedly plans to relocate his temporary office to Gedem, near Massawa. Sources close to the matter also told me that it has been very difficult to get hold of him during this time. In an extremely centralised system, where senior state officials cannot make the smallest decision without the president’s approval, one can only imagine the damage caused by Afwerki’s absence during such a crucial time.

After his prolonged absence, on April 18, the president suddenly sent a five-minute recorded message to the Eritrean people from an unknown location. Afwerki only mentioned the pandemic in the introduction of his message and went on to tell his constituents that COVID-19 should not “derail the development programmes” his leadership has embarked on. The president’s message made it clear that the pandemic is just a secondary concern for the government. The Ministry of Information, however, only translated into English the short section of the message where the president mentioned the pandemic.

As it became clear that Eritrea is not going to be able to protect its citizens from COVID-19, rights groups, exiled scholars, and the UN’s Special Rapporteur on the situation of Human Rights in Eritrea, have called on the Eritrean government to release the tens of thousands of prisoners of conscience who have long been languishing in overcrowded and unsanitary prisons. Many also expressed concern about the thousands of students who are living in cramped conditions at the Sawa military training centre.

During his online seminar, Gebrehiwet also responded to these calls, brushing them off as “hypocritical”. Rather than offering an explanation as to how they are planning to stop the virus from spreading like wildfire in prisons and military schools, he claimed these would be the best places for anyone who needs to be in quarantine.

In response to the growing criticism of its COVID-19 response and concerns over the wellbeing of its citizens, the Eritrean government issued a statement on April 6, accusing the UNHRC of “harassment” and claiming that the state’s “enemies” are using the pandemic to push for regime change.

While the accusation that rights groups, media organisations and the UN itself are using the pandemic to push for regime change in Eritrea is clearly unfounded, there is a very real chance that this public health emergency is going to spell trouble for Eritrea’s authoritarian government.

History shows that public health crises such as pandemics, food shortages or extreme pollution harm all governments, but pose the most significant threat to authoritarian regimes. The 1973-1975 Ethiopian famine, for example, was the final trigger that ended Emperor Haile Selassie’s reign in the country. In Sudan, it was Omar al-Bashir’s repeated failure to handle such crises, such as the cholera outbreak of 2017 and the spike in the price of bread in 2018, that led to the demise of his 30-year regime.

The Eritrean government demonstrably failed to respond efficiently to the most significant public health threat the world has faced in a century. If it does not change its ways, accept the global community’s help and take action to save the lives of already-suffering Eritreans, it is unlikely to survive past this pandemic. 

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance. 

Home to some 26,000 people, including some 1,600 minors, Hitsats is one of four camps in the northern Tigray region hosting nearly 100,000 Eritrean refugees, according to the United Nations refugee agency (UNHCR).

Earlier this month, Ethiopia’s Agency for Refugee and Returnee Affairs (ARRA) announced to residents in Hitsats camp that the federal government had decided to relocate them to Mai Aini and Adi Harush camps, or offer them the possibility to live in towns. 

The plan has yet to be executed amid the coronavirus pandemic, but officials say preparations continue.

“We are ready to start the relocation at any time,” Eyob Awoke, deputy director general of ARRA, told Al Jazeera, noting that the declaration of a state of emergency last week due to the pandemic had forced authorities “to timely adapt the initial plan”.

“External factors are hampering us,” Eyob added, “but we can start with small numbers”.

“Hitsats refugees are suffering a lot from shortage of water, shelter and access to electricity,” Eyob said. “Merging of these camps is mainly required to ensure efficient and effective use of available resources.”

COVID-19 risk

The timeline and measures for the closure have not been shared with the UNHCR and other partners.

Yet, there are concerns that Mai Aini and Adi Harush camps are almost full and lack the infrastructure needed to cope with new arrivals, including sub-standard access to water.

In a statement sent to Al Jazeera on Friday, the UNHCR urged the government to put on hold any relocation effort, saying it risked making refugees vulnerable to COVID-19, the highly infectious respiratory disease caused by the new coronavirus.

“Any large-scale movement now will expose the refugees to risk of COVID-19 outbreak in camps”, the agency said.

ARRA assured that the transfer of the refugees would be carried out in a coordinated way. As of April 19, Ethiopia had 108 confirmed coronavirus cases, including three deaths.

In a letter sent to the UN at the end of March, refugees in Hitsats camp had also expressed deep concern about the prospect of the camp’s closure.

“We are in a deep fear, psychological stress and we need protection”, read the letter, which was seen by Al Jazeera.

“We feel threatened. They told us that if we decide to stay, we will lose any kind of support,” a refugee living in Hitsats camp told Al Jazeera.

Currently, only critical humanitarian and life-saving activities are running at the camp, as well as awareness-raising activities to prevent the spread of COVID-19. At the beginning of the month, the UNHCR and the World Food Programme reported that residents in Hitsats received a food ration for April.

Eritrean refugees are also allowed to live outside camps, but many do not want to leave Hitsats.

Other refugees eventually settle in the capital, Addis Ababa, but struggle to make a living and are highly dependent on external aid.

So far this year, ARRA has issued 5,000 official permits for refugees to live outside camps, according to the UNHCR, mainly for Eritreans in Hitsats and other camps in Tigray.

“In light of the current rush to close the camp, one is compelled to ponder whether the decision is more political as opposed to an operational one?” said Mehari Taddele Maru, a professor at the European University Institute.

The UNHCR, in its statement to Al Jazeera, said it could not speculate about the government’s rationale for closing the camp.

In a letter dated April 9, 2020 that was seen by Al Jazeera, ARRA communicated to all humanitarian partners that new arrivals from neighbouring Eritrea would no longer be offered “prima facie” refugee status, revisiting a longstanding policy of automatically granting all Eritrean asylum seekers the right to stay.

“We will have to narrow down the criteria for accepting Eritrean asylum claims, they have to demonstrate a personal fear of persecution based on political or religious action or association or military position”, Eyob said.

“Today, the situation is not like before, many people are coming to Ethiopia and going back to Eritrea.”

Ethiopian Prime Minister Abiy Ahmed sparked an historic rapprochement with Eritrea soon after taking office in April 2018, restoring ties that had been frozen since a 1998-2000 border war. His efforts in ending two decades of hostilities were cited by the Norwegian Nobel Committee as one of the main reasons for awarding Abiy the Nobel Peace Prize last year.

The rapprochement, however, has yet to lead to the full normalisation of the two neighbours’ ties, while activists’ hopes that the peace process would lead to major policy reforms within Eritrea have been largely dashed. The long-criticised universal conscription is still in place while crippling restrictions on press freedom and freedom of expression continue.

“We cannot return to Eritrea”, a refugee in Hitsats told Al Jazeera.

“For Eritreans, fleeing is one of the only real options to escape their government’s repression”, Laetitia Bader, a senior researcher for Human Rights Watch, said.

“Any policy shifts are definitely a risk to Eritreans’ right to asylum,” Bader said.