AFRICA BETWEEN CORONAVIRUS AND THE WEAK HEALTH SYSTEMS

           

             
                    Earlier this year, when the first reports of the Coronavirus started to come out of China, globale health officials said they were very worried about what would happen if COVID-19 started spreading in Africa, where many health systems are already struggling, well Africa now affected by the Coronavirus pandemic, so far the number of reported cases remains growing more than 1,400 confirmed cases of COVID-19 have been identified in 40 African countries that have so far spared from the Coronavirus outbreak, but in reality they are likely to be hit the hardest, according to recent assessment obviously brought to evolve, Uganda and Eritrea joined the list of African countries which announced last weekend their first confirmed cases, Tanzania, Ethiopia, Mauritius and Kenya have reported additional cases, from Burkina Faso in west to Mauritius in east cost, governments have banned public gatherings and closed schools, mosques, churches, restaurants and airports, Ethiopia has just announced closing its borders.
The World Health Organization (WHO) has expressed concern over the past few days about a surge in the pandemic on the African continent, whose health systems are woefully under-resourced, but the only reason that makes the Non Governmental Organization NGO worried is the pandemic is very difficult to fight on the spot. Regional experts say  a wide spread epidemic in Africa could cripple the continent's fragile health care systems and be devastating economically, it also could be difficult to contain while foreign donor nations that traditionally assist the continent in such crisis are overwhelmed with their own Coronavirus outbreaks, the head of WHO's Africa region, Dr Matshido Moeti said that most of cases have been imported from Europe and so far there is relatively limited community transmission of  the Coronavirus on the continent, although there may be some undetected infections, we don't think these are very large in number. Managing a major outbreak on the continent could be difficult, Moeti said and two of WHO's recommended interventions as social distancing and hand washing may not always be possible, sometimes families live in houses where you don't have a bedroom for every family member, quite a few people in the family have to site in the same space and sleep in the same space, in addition they may be in houses that do not have running water so the possibilities of hand washing in the ways that it's recommended with soap is a challenge under those circumstances.
Given Africa's close ties to China and the explosive outbreaks happening elsewhere in the world, researchers are questioning whether Africa is somehow less vulnerable to Coronavirus or if it's still just in an early phase of the epidemic, Moeti speculated that the low number of cases may be because the southern Hemisphere is just coming out of summer. Many of the largest outbreaks have been in regions where the weather is cooler, leading to speculation that the disease might begin to tail off with the arrival of summer, many experts have already cautioned against banking too much on the Coronavirus dying down over the Summer, in southern American countries there's also been spread but it has not been the same as we've seen in the Global North, so we are trying to understand if this could be related to temperature or to weather, we have a distinct flu season in the southern part of the continent and some Eastern African countries, we may from this infer that we should expect to see an increase in the rate of transmission of the Coronavirus, perhaps in a couple of months when the winter sets in the South.
Tom Achoki, who is studied health care in Africa extensively, says the medical systems have improved significantly in many countries since 2014 Ebola outbreak but still the health care systems are very weak, Achoki the Co-founder of Mass Sciences and a lecturer at the University of Pretoria, says by "very weak" he doesn't mean just a shortage of emergency room beds but they are dealing with access to things like disinfectant, there is a need to train workers on using masks and gowns to protect themselves when treating COVID-19 patients, he also points out that the data is still collected on paper forms rather than digitally in many African countries, so the transmission of data is not effective, this is an epidemic which is moving very quickly, he says improving information systems is something that needs to be addressed and could be hamper the ability of some countries to respond to this outbreak effectively. 

At the beginning of February only two countries in sub-Saharan Africa has the ability to test for Coronavirus which are Senegal and South Africa, the WHO has helped 43 more countries set up or augment their national laboratories so that they can also test this pathogen, however the capacity of those labs is low and the tests will have to be done in capital cities, but getting even a basic level of domestic testing capacity running could be crucial as borders close and international air transport grinds to halt, some countries currently have only few cases and screening is already underway.
Augustin Augier the General Director of Alima -an NGO that acts for health in 12 African countries- announced that there are more than 40 countries are able to do RT-PCR tests but in largely insufficient quantities these countries will need trained personnel, reagent stocks and machinery, however it's in this beginning of the epidemic that screening is essential. Isabelle Defourny, Director of Operations at Médecins sans Frontières, analyzes that we have understood that it's very useful to test widely to isolate patients and their contacts in this first phase but in the African countries in which we work, ministries tell us that they hold between 500 and 1,000 tests (in South Korea we did up to 20,000 tests a day). Now all countries affected are wrestling with these precious tests, these NGOs hope that the west may one day be useful for African countries when the wave has passed through Europe and the United States. A majority of these African countries will not have the means to contain the pandemic,"To reduce mortality in patients with Coronavirus, it is necessary to have access to respiratory assistance" emphasizes Augustin Augier, in these countries there is almost no capacity to provide them with the necessary care, in west Africa there are twenty times fewer hospital beds than in France, in addition, there are almost no follow up care services. As for respirators, they number in the tens for millions of people, in Nigeria there are only 250 resuscitation beds with mechanical respirators (France has 5,000) adds Isabelle, at least oxygen and protection (masks, gloves, glasses,gowns, etc...) are required for medical personnel, in all the hospitals in Africa there are protections but with Coronavirus, the consumption of masks is multiplied by 10 or 20, few hospitals have sufficient stock to meet this increase in needs, otherwise caregivers will fall ill and the healthcare system may be further paralyzed, in addition hospitals are already struggling and to multiple wars and violence, some African countries are already suffering with several deadly disease, health systems must manage all other pathologies like Malnutrition, Malaria, Measles, obstetric emergencies, said the Director of Alima, especially since the NGOs are finding it increasingly difficult to transport medicines, doctors, food, with air transport stopped in some countries and closing borders except for some negotiations about sending adequate material to certain countries.
Rwanda and Nigeria for example are beginning to put in place measures to isolate sick cases with financial assistance, what is not obvious everywhere because imposing total containment is impossible in economies where most people eat in the evening what they have earned during the day, they have no resources to survive, neither savings nor wealth. In France and the United States, the state is present with measures such as partial unemployment, work stoppages for childcare, a number of African countries are too poor to implement this state protection, this is why the NGO director calls for a great movement of international solidarity, the challenge is immense at a time when many Western countries are facing the greatest health crisis in a hundred years and the economic disaster promises to be major, the most important question is: Will European Union and the United States be willing to send masks, test kits, human and financial resources to support African countries?
It's necessary for some important reasons, first on a human and humanitarian level: we cannot accept that a continent collapse and that mortality explodes, furthermore if we cannot control the epidemic while it is circulating on a continent like Africa it will be reintroduced here, finally for a geopolitics reason the epidemic can contribute to the destabilization of certain regions, for example in the Sahel armed groups will not stop during the Coronavirus.