As two confirmed cases have appeared in the city, officials and residents have begun to brace for the possibility of a widespread outbreak.

There is growing anxiety in Dire Dawa, Ethiopia’s third-largest city after the city saw its first two confirmed cases. There is a scene of eerie silence unfolding. “This virus came to town and frightened everyone,” lamented Lidetu Alemu, who owns a souk on Feres magalaa. He fears that a local outbreak could be devastating.

A challenge for the health system

Health practitioners described a growing concern about the illness and how a serious outbreak could quickly overwhelm the local health system. Poor sanitation facilities, limited access to health-care services mean the infectious disease is already a major problem. The International WHO Readiness Assessment checklist by nine Ethiopian regions describes Dire Dawa as having a limited capacity of preparedness for the pandemic with an overall score of 62 percent, slightly better score than Gambella and Gumuz regions but lower than other regions in the country. The autonomous city administration does not possess enough critical care beds and ventilators. There is a worry that too so few people were currently being tested, leaving an incomplete picture of how widespread the pandemic, a scenario similar in the whole of the country. So far Ethiopia had administered only 1,386 tests. The country has focused on physical distancing policies to contain the virus but has resisted some of the tough measures and nationwide lockdown put in place in many countries, while two deaths have been recorded in the country.

Details about the town’s first coronavirus case

In Dire Dawa, it all started with the arrival of a 42-year-old man, Testi Yisehak from Australia who has been confirmed to be the city’s’ first coronavirus case. He came to Dire Dawa for a wedding ceremony, traveling through Addis Ababa. His fiancée, 33, lived here. Upon arriving at the airport, he telephoned his brother, Adil Yisehak who took him to a family home, a family friend told Ethiopia Observer. «On the sixth day of his arrival, he started feeling run down and he headed to a local clinic. He was told that he was suffering from insomnia and went back home. But his symptoms worsened within three days. It was only when he announced that he came from abroad that his blood sample was taken and sent to Addis Ababa. A few days later, the result came positive for COVID-19 on March 31,” the family friend explains. The patient was in the city for almost two weeks before isolated. He is being treated at a hospital in the city and he is well recovering, he said.

Town residents raise questions, such as how contagious the patient was from the very start his arrival, and how many of the people he came in contact with were tracked. On April 2, the patient’s fiancée tested positive. In Dire Dawa, the city of around 300, 000, thirty-six people were quarantined at the Ethio-Djibouti Railway Hospital, more commonly referred to as Ferensay Hospital, following exposure to the subject and his fiancée. So far 13 people were tested and four of them, including the brother Adil Yisehak, were found not to have the virus. The other results are still pending, according to officials.

“We are not having as much testing as we would like to, but we’re hopeful,” the newly assigned Dire Dawa Administrative Regional Health Bureau head Lemlem Bezabih said Monday.

The nearby Haramaya University has acquired a testing lab and it would start to administer tests in a few day’s time, she said. “Increasing the number of tests would help both for medical treatment and also to immediately move those people into isolation, identify their close contacts,” Lemlem said.

“The number will continue to rise.”

The Regional Health Bureau head warned that the number of infections will continue to rise during the next two weeks. “Increases are to be expected at this stage as more tests and results become available,” she said.  

People are being advised to protect against the virus’s spread with actions like washing their hands and covering their mouth and nose when coughing and maintaining physical distance. Efforts to persuade people to adhere to those safety guidelines and maintain physical distancing have not always proven successful. Keeping a safe distance from one’s neighbors and friends is not a common practice in Dire Dawa where people drink coffee together, sit for a Khat chewing ceremony for longer hours. “People are fearful and nervous. They are concerned about their health but are not necessarily taking the precaution,” Mezgebu Leulkal, a town resident says. “People continue getting together and gatherings as usual,”  says Mezegebu who delivered a one-story house for use by people who have to go into quarantine.

Another resident says the group khat chewing ceremony has reduced by seventy percent but there are still pockets of people doing it here and there.

A coronavirus task force

Dire Dawa had established a coronavirus task force, comprising members from various government bodies to lead the prevention measures. The task force has begun converting schools, and hotels into isolation wards to deal with an anticipated outbreak. Robel Getachew, the taskforce’s logistic head says 464 places in four high schools have been set up in addition to already designated treatment centers in the town’s three major hospitals. According to Robel, the facilities are being equipped with vital medical equipment and beds. “But there are some challenges as some people are protesting about the coronavirus isolation centers becoming too close to their residential houses, Robel says. “We are trying to convince them that if we have to contain the virus, we need to isolate people in those centers, and we are succeeding in most cases,” he says. Community figures and businesspeople have come together to try to support those with no income and so far 15 million Ethiopian birr was collected, he said.

Health professionals in Dire Dawa say they are doing their best to implement systems for handling new coronavirus cases but they fear how the health systems would cope with an outbreak of the virus.

On April 6, an activist in Dire Dawa calls for respecting physical distance to prevent further spread of the coronavirus. Courtesy of Dire Dawa Mass Media Enterprise.

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