- Par Navin Singh Khadka
- Environmental Correspondent, BBC World Service
Many African countries are facing a “growing crisis” due to severe oxygen shortages leading to preventable deaths, international health agencies have warned.
A doctor in the semi-autonomous region of Puntland, Somalia, told the BBC that between five and ten of his Covid patients die almost every day from lack of oxygen.
“All of these deaths could be avoided if we had enough oxygen,” Dr Jama Abdi Mahamud said at the government-run Gardo General Hospital.
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There are no official figures showing an increase in preventable deaths, but many low-income countries are struggling to get oxygen amid rising coronavirus cases and limited or no access to coronavirus vaccines .
Every Breath Counts, a coalition of global health activists, says 18 low-income countries are currently facing or at risk of oxygen shortages, most of them in Africa.
“The leaders of the G20 World Health Summit did not mention oxygen at their meeting in May, but the G7 has now signaled that there will be financial support for oxygen,” said Leith Greenslade , coordinator of the coalition.
Jessica Winn, Pneumonia Support Hub Manager for Save the Children, says the need for oxygen in these countries is high and urgent.
“Now that a third wave of the pandemic has arrived in Africa, populations are again in danger. Since June 1, 2021, the oxygen needed to treat patients with Covid-19 in Zambia has increased fivefold to to reach 50,000 cubic meters, and by three to reach 12,000 cubic meters in the Democratic Republic of the Congo “.
“The demand for oxygen to treat patients with Covid-19 disease is increasing sharply in Zimbabwe.”
A study published in The Lancet last month suggests that more than half of Covid patients who died in 64 hospitals in 10 African countries have not received oxygen.
“No oxygen plants“
Dr Mahamud says that during the second wave in Somalia, up to 25 people died every day in his hospital due to lack of oxygen: “It is really stressful to work in these conditions.”
According to the World Health Organization (WHO), of the 14,823 cases of coronavirus confirmed in Somalia as of June 16, 775 people have died.
Health professionals say the real figure could be several times higher, as there is no proper reporting mechanism and many deaths occur in villages.
“There are around 750 hospitals and primary health centers in Somalia that urgently need more than 1,400 oxygen concentrators, but they have received less than 300,” said Dr Joseph Serike, senior technical specialist in health services with Save the Children in the capital, Mogadishu.
Government officials acknowledge that this is a growing challenge.
“No government-run hospital has oxygen facilities. Only three private hospitals in the capital, Mogadishu, have them,” said Dr Ubah Farah Ahmed, director of the family health department at the Somali Ministry of Health. .
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In neighboring Ethiopia, health officials said some public hospitals had oxygen factories but were overwhelmed as they now had to supply other hospitals.
“And because of the high production pressure, factories are breaking down, which exacerbates the shortage,” said Dr Menbeu Sultan, president of the Ethiopian Society of Emergency Medicine Professionals.
“The shortage is serious in remote and very poor places because they do not have their own production.”
“And trucks carrying oxygen cylinders have to travel hundreds of kilometers to reach these places and in some cases it is too late for patients who urgently need this gas.”
As of June 16, Ethiopia had 274,346 confirmed cases of Covid and 4,250 deaths.
During the last big wave, between April and May, Ethiopia needed around 15,000 oxygen cylinders per day, according to an oxygen needs tracker updated by Path, an international non-governmental organization. working in the health sector.
It says needs are now reduced to 1,200 bottles per day, but experts in the tracking tool said their calculations were based on reported Covid cases and most cases in the country were not. reported.
In DR Congo, demand fell from less than 500 bottles a day at the start of the month to nearly 2,000, according to the tracker.
A “blind spot”
Experts say many low-income African countries, like very poor countries elsewhere, do not have commercial oxygen production facilities, which could then potentially divert supplies to hospitals to help them in an emergency. .
As a result, very few hospitals can provide the high-flow oxygen that Covid patients need, according to health experts.
“Across our country, only one hospital has the capacity to treat more than 10 patients in need of high flow oxygen at a time and their Covid unit is usually full,” says Dr Sarah Wandia, who works at the hospital Maua Methodist in Kenya.
“We have lost two patients from our hospital who were waiting for a place in this unit.”
“Our hospital’s current oxygen plant has the capacity to produce 45 liters of oxygen while a Covid patient can use 15 liters of oxygen, leaving a precarious amount for treating premature babies, intubated patients in the operating theater and in the accident and emergency department. “
According to health experts, it took a year for the oxygen supply to be recognized as an essential drug in the overall strategy for treating Covid patients.
“The looming crisis has been a blind spot for the global health community for a year,” says Ms Greenslade of Every Breath Counts.
International funding agencies, like the Global Fund, say they have now made fast-start funding for oxygen available to some low-income countries, including The Gambia, Kenya, Malawi and Tanzania in Africa.
“With the help of donor agencies, we will soon be installing 10 oxygen plants in some public hospitals,” says Dr Ahmed from Somalia.