Staring at death: Inside Somalia's chaotic healthcare system as COVID-19 positive figures skyrocket

MOGADISHU, Somalia - A few months ago, Somalia had barely recorded a single COVID-19 case, not that there wasn't any, but because of the inability for the Horn of Africa nation to test several vulnerable people due to an almost dysfunctional healthcare system.

But using limited resources, coupled with help from international partners such as Turkey, United States, United Arab Emirates, and even the donations from individual entities such as Jack Ma, close to 1,400 people have since been tested.

Of this small figure, 873 people, which is almost 70 percent of total tests, have tested positive for the disease. Already, 39 have died while a small fraction, 75, has since recovered as of Tuesday according to the health department.

When comparing with neighbors, despite the high numbers of contracted victims, Somalia's testing capacity is below a threshold, something that exposes millions of vulnerable populations to imminent death.

Regional statistics indicate that both Kenya, Ethiopia, Uganda, Tanzania, Rwanda and Djibouti have tested slightly over 15,000 people. Until now, Djibouti has recorded the highest infections, 1200, but it has the fewest fatalities which now stand at two.

Kenya has 22 deaths from the 535 positive cases while Uganda seems to have fairly managed the pandemic, having not registered any single death. For Tanzania, it has been the question of the effectiveness of the test kits, which have been doubted by President Pombe Magufuli.

Somalia's struggles with COVID-19

With just a small number of tested individuals and high infection rates, the Horn of Africa nation is now staring at a major crisis, which could leave hundreds dead. The country has been struggling with the horrors of civil war and Al-Shabaab menace for decades now.

Last month, health minister Dr. Fawziya Abikar launched a call center; 449, whose intent is to have citizens reporting suspected cases for emergencies. The hotline service which was provided by Hormuud Telecom," she said, adding "would help us locate those in need".

Data accessed by Investigative Dossier, indicate that hundreds placed calls with some regarded as "nuisance" but there was a good number of those who sought medical advice. Some have since been evacuated for treatment.

Hodan District within Mogadishu according to the national data reported most symptoms. This is attributed to the large movements of people due to the presence of hotels and restaurants, local officials said.

Over 70 percent of these cases were reported in the larger Banadir region which hosts the capital, Mogadishu, while the rest have been registered in Somaliland, Puntland, and Jubaland.

The skyrocketing figure, doctors argue, "doesn’t reflect the spread of disease among wider society because those tested were specifically selected, and referred by doctors after showing symptoms". But the testing capacity is still limited due to inadequate equipment for testing.

Averagely, the country can only test between 70-80 people, a big contrast to neighbors who can manage mass testing. This, Rashid Abdi, a pundit on Horn of Africa affairs, says "it exposes thousands to death, it's unimaginable and completely heartbreaking".

Martini Hospital, the only known isolation and treatment facility for the victims, is completely overwhelmed due to its small capacity. Currently, reports indicate, the hospital gas only 76 beds with just 20 for ICU emergencies, another rejecting fact, which needs urgent attention.

Besides the small capacity, the facility suffers frequent power outages, although doctors insist that "we've not had deaths related to the interruption of power". FGS says there are plans to refurbish a second facility for Coronavirus patients.

Help from international partners

At Martini Hospital, sources intimate, of 28 doctors and several nurses stationed there, have since tested positive for COVID-19. Last week, the country lost one nurse to the deadly disease, further exposing the medics.

Exclusive reports revealed that 10 of the doctors who tested positive are attached to Erdogan Hospital, a Turkish run facility that has been serving as an annex of the main isolation center throughout the pandemic. Further, over 13 health officials have also been confirmed positive.

But despite the challenges, Turkey has come to the rescue of the impoverished nation, dispatching humanitarian aid over the weekend, to supplement medical supplies already donated by Jack Ma, the US and the United Arab Emirates.

Recep Tayyip Erdoğan, the President of the European nation, dispatched medical supplies, masks, PPEs, and ICU beds in a consignment that was transported in two places over the weekend. The consignment, he added, "will help our Somali brothers".

Terming the support generous, federal President Mohamed Abdullahi Farmajo said he had a "valuable" phone conversation with his Turkish counterpart. The donations would supplement the ailing health sector amid the pandemic, he added.

During Labour Day celebrations last week, Farmajo hailed the health workers for their "dedication" towards battling the pandemic, adding that their work is "fundamental" to the people of Somalia at this "troubling" moment.

"To all our Somali workers, more so our healthcare team on the frontline against COVID19 and every one of us who continues to sweat for Somalia, I salute you as I share my warmest congratulations on the occasion," he tweeted.

But to curb the further spread, the government has among others, suspended indefinitely both domestic and international flights, mass gatherings, and learning in various educational and religious centers.

At Mogadishu, a dusk-to-dawn curfew was imposed to combat the disease, but reports indicate it's "yet to serve it the purpose". Omar Filish, the port city's mayor, claimed last week that over 500 people were buried in the preceding two weeks, although he didn't directly relate them to COVID-19.

The economy has substantially diminished, Abdirahman Duale Beileh, the finance minister said, attributing the misfortune to reduced remittances from abroad. Hundreds of Somalis in the diaspora community are also said to have succumbed to the disease.

Apart from the inadequate health equipment and facilities, insecurity also remains an existential threat to Somalia's quest to combat the disease. Al-Shabaab has been waging deadly attacks against security forces and civilians, further sabotaging elaborate strategies to help the vulnerable population.

For instance, a plane carrying medical supplies was "downed" by an RBG on the outskirts of Bardale town, raising a question about the safety of aid workers. Six people aboard the aircraft died on spot, but investigations have been launched to establish the cause.

GAROWE ONLINE