On 7 May, the Belgium-based transnational think-tank  the International Crisis Group (ICG) published their report entitled “The Covid-19 Challenge in Post-Soviet Breakaway Stetelets” which covered the Covid-19 situation in the separatists regions of Abkhazia, Crimea, Donbas, Nagorno-Karabakh, Transistrinia and  Tskhinvali (South Ossetia). 

The report outlined that “all six statelets have reported comparatively few COVID-19 infections, although these numbers probably reflect limited testing and tightly controlled information.” It further emphasized that the de-facto authorities in these regions “have been slow to take measures to prevent the virus’ spread, despite the risks they face with ageing populations that are particularly vulnerable, as well as outdated, often Soviet-era infrastructure and weak health systems and that their contested status complicates or blocks international aid.” 

Nagorno-Karabakh

The report outlined that years of conflict have eroded Nagorno-Karabakh’s medical infrastructure. While Armenia and some ethnic Armenian diaspora organisations have provided basic medical supplies, medical staff often lack know-how. The knowledge gap exists in part because Nagorno-Karabakh’s unrecognised status precludes citizens from travelling abroad for training and professional conferences. The situation is particularly dire outside of Stepanakert/Khakendi, where even basic equipment and emergency vehicles are outdated and in short supply.  Moreover, although Yerevan has provided COVID-19 test kits, the local laboratory is unable to assess the results, so samples must travel to Armenia.

Because Nagorno-Karabakh is considered Azerbaijani territory under international law, international organisations require Baku’s permission to operate there. Without Azerbaijan’s sanction, no UN agency, including the WHO, has access to the entity. The International Committee of the Red Cross (ICRC) is the only international organisation providing support to the region. It is distributing cash grants to the elderly, tablets to local youth for online education, and masks, gloves, gowns and sanitisers to local hospitals, orphanages and detention centres, as well as the region’s lone nursing home. However, the ICRC’s geographical reach is limited, and it can operate only in the territory demarcated by the Soviet-era boundaries of the Nagorno-Karabakh Autonomous Oblast. It has no access to settlements in the adjacent territories, which is home to almost 17,000 people and where the region’s first seven COVID-19 cases were identified.

The report further emphasized that at the last meeting between the Armenian and Azerbaijani Foreign Ministers, Zohrab Mnatsakanyan and Elmar Mammadyarov, which took place on 21 April, the readiness of all parties to organise support for the entity “without regard to political boundaries” and with the hope that doing so “will bring a creative and constructive impetus to the peace process” was affirmed. However, this has not turned into concrete action so far. In the meantime, diplomats have developed several ideas focused on delivering aid. One option is to deliver it via Armenian authorities, though Baku would have to approve such an arrangement, and has yet to do so. As an alternative, a diplomat offered to arrange a telephone connection between the WHO and Stepanakert to track the situation and potentially provide online training for health care workers.

Abkhazia and Tskhinvali

The report outlined that the two Georgian breakaway regions have responded differently to the pandemic. In Tskhinvali, whereas of 6 May three cases have been reported so far, authorities prohibited movement from or to government-controlled Georgia in February 2020, arguing that this step was necessary to prevent the virus from spreading. By contrast, Abkhazia, where three COVID-19 cases have been registered, has taken Tbilisi up on its promise to work together. Although regular traffic has ceased across two crossing points between Georgia and this breakaway region, to date eleven people have been allowed to leave Abkhazia to visit Georgian hospitals. 

The report emphasized that from all of the 6 analyzed separatist regions, Tskhinvali was arguably at the biggest risk because of its significant elderly population and underequipped hospitals. Russia, which provides a majority of the region’s needs, stopped most exports of medical supplies in early March. Moreover, many of the region’s medical professionals have had no training for years, lacking even the know-how to operate the 26 ventilators delivered from Russia.

The ICRC is the only international organisation operating in Tskhinvali. It has provided supplies to the local jail and plans to deliver food to elderly residents, including in remote villages. While the organisation says it is prepared to step up operations, it lacks medical staff on the ground to assess local health needs.  When the WHO sought to send an assessment team to the region in mid-March, de facto authorities refused to admit the specialists unless they entered through Russia rather than Georgia. 

The situation in Abkhazia is better, although it still presents vulnerabilities. Local officials said their greatest challenge was discouraging locals from holding large funerals. After almost a month of curfew, the de facto authorities started easing movement restrictions and allowed the reopening of markets in major towns as of 20 April. Abkhazia’s de facto authorities reached out for outside help in early March.  In response, the UN Development Programme (UNDP) delivered over 12,000 packages of basic medical supplies and sanitisers purchased with U.S. and EU financial support; Russia supplied some 500 COVID-19 test kits and sent soldiers to support disinfection of public places; and international NGOs with local offices in Abkhazia offered vehicles for emergency care and equipment to disinfect public transport.  Facilitated by the UNDP, WHO specialists carried out a needs assessment in Sukhumi.

As a means to overcome the situation the ICG suggested that the de-facto Tskhinvali authorities should facilitate efforts by others to help, physically or virtually. Most immediately, they should find a way to enable the dispatch of a WHO assessment mission. For its part, Georgia should seek to engage with the de facto leadership of Abkhazia to cooperate on ways to support economic recovery, including through trade across the line of separation. It might also consider continuing to support the flow of aid even once the immediate crisis passes, as Abkhazia’s dependence on tourism bodes ill for a rapid recovery.