Somalia told to use debt relief to fix healthcare infrastructure

A doctor cares a patient who is infected with the COVID-19 in the Intensive Care Unit at Martini hospital in Mogadishu, Somalia, July 29, 2020.

MOGADISHU, Somalia - The federal republic of Somalia should use debt relief to fix the dilapidated healthcare infrastructure, a report compiled by Amnesty International suggests, as the country now struggles to contain the Covid-19 situation.

The report was titled “We Just Watched Covid-19 Patients Die” - Covid-19 Exposed Somalia’s Weak Healthcare System But Debt Relief Can Transform It, shows how Covid-19 has exposed a range of pre-existing weaknesses in Somalia’s healthcare system.

At least more than 40 individuals were interviewed, including 33 health and humanitarian workers, government officials, finance and debt relief experts, as well as analysis of government budgets and policies and feedback from Somalia’s Ministry of Finance.

The Somalia government’s response to the pandemic was wholly inadequate, the report notes, confirming fears that the actual number of infections and deaths could be more than what the department of health has been publishing.

The research finds that access to health facilities for Covid-19 patients has been severely limited with just one hospital in the capital Mogadishu managing all Covid-19-related cases across the south-central region during the first wave of infections.

“The Somalia government’s response to the pandemic was wholly inadequate - characterized by a dire lack of ventilators, severe shortages of oxygen and almost non-existent access to ambulance services, all of which are the result of years of neglect and failure to invest in healthcare,” said Deprose Muchena, Amnesty International’s Director for East and Southern Africa.

“Now that Somalia is eligible for debt relief, the authorities should ensure that a sufficient portion of the proceeds and future grants are used to significantly invest in improving healthcare provision, both in rural and urban areas.”

With a history of armed conflict and political instability as well as being one of the most heavily indebted countries in the world, Somalia trails others on many health indicators, including access to reproductive, maternal, and child healthcare. Child mortality is currently the highest in the world. In 2017, it had a ratio of one surgeon per 1,000,000 people. Only an estimated 15 percent of people have access to medical care in rural areas.

Analysis done by the Amnesty International of the country’s government budgets between 2017 and 2021 showed that the average budget allocated for health and health-related projects was only 2%. In the same period, the average budget allocated to the security sector, including to the ministries of defense and internal security, was 31 percent of the total government budget.

Officially, there have been 15,294 confirmed Covid-19 cases, and 798 confirmed deaths, but the actual figures are likely to be much higher given the limited testing capacity, and weaknesses in the reporting and registration of deaths.

This is confirmed by the country’s Chief Medical Officer Dr. Mohamed Mohamud Ali, who told Amnesty International that he believes the death toll from Covid-19 is far higher than estimated.

“Testing was very limited. Only those who managed to get to health facilities and were tested are included in the official government data. The figure is just the tip of the iceberg, many more were infected and died at home,” he said.

The medical staff Amnesty spoke to reveal how the country has struggled from day one with its healthcare response during the pandemic. One nurse told Amnesty International: “We scrambled at the beginning. Everything was a mess. We had nothing to treat patients with. There was no oxygen, no ICU beds, and on ventilators. We just watched patients die, it was really sad.”

A senior doctor said many Covid-19 positive patients also died because of insufficient oxygen supplies: “We had to use a single nasal oxygen cannula for multiple patients. There was a day we had four elderly men in one ward, they all needed oxygen, but they all died within 10 minutes. I can still remember their faces; I am sad we were unable to get oxygen to save their lives.”

Commenting on shortages experienced during the first few weeks of March 2020, a lab specialist with the Ministry of Health told Amnesty International: “We did not have any testing equipment for a few weeks... We were initially sending samples to Kenya for testing until we got the first PCR machine as a donation from the Chinese company Alibaba.”

GAROWE ONLINE