The death of a 60-year-old man in Dire Dawa Dil Chora Referral Hospital on June 17 has left many hospital staff in a state of fear. The patient was first admitted to the hospital after exhibiting headaches and chest infection, according to a primary care physician. “Then came a fever and a dry cough. A few days later, the oxygen saturation level dropped,” the physician says. He did the test for COVID -19 and the test came back positive ten days after his hospitalization, and he passed away a day later. After word spread in the hospital, staff who were looking after the deceased and other patients who shared a room with him were seized with apprehension. The physician who worked in emergency rooms said that they were worried more so because the management of the hospital had not taken the initiative to test the staff who were at risk and accordingly place them into quarantine. “It was like nothing had happened. They didn’t say anything. The hospital was not closed for cleaning.” Certain of the doctors had thus to take the initiative to give their samples for testing, he said. (All of them have since tested negative.)
From cleaning staff to doctors and nurses, hospital workers report exasperating failures by management to notify them of potential exposure to patients known to be infected with COVID-19 or co-workers. Those working in institutions not dedicated to Covid-19 patients say that the nature of the job made keeping a distance from patients difficult. In the case of Dire Dawa, doctors at Dil Chora say the regional government is directing its focus towards Sabian Hospital, a center dedicated to treating the virus.
The outbursts of Ethiopian doctors against the unpreparedness of the health system in the face of the Covid-19 epidemic and the risks they run at the hospitals are being increasingly voiced on state and private media since May. They took on an alarmist tone when the official case tally began to rise sharply this month. With 75 fatalities and nearly 4, 848 cases of contamination as of June 23, according to official figures, the country is still relatively spared compared with the U.S and Europe, but it now records hundreds of infections every day, including the record high cases of 399 on 20 June. Officials say there is significant community transmission of the virus in the country and the geographical spread is increasing, reaching new areas in the rural part of the country. According to some estimates, a total of 200 health workers in the country have tested positive for the coronavirus.
Hospitals across the country say they are running out of the masks, gowns, protective suits, goggles, and sanitizer that they need to protect staff against the coronavirus. With a shortage of personal protective equipment and testing and delays in tests, many health officers feel they are abandoned and left to their own devices.
The government says it is following up to provide the best possible care and sending supplies like masks, gloves and surgical gowns from the donations by China’s Jack Ma Foundation to hospitals in need. “In the past 100 days, 17, 435 treatment and isolation beds were prepared and more than 4500 additional health workers were hired and 12,000 volunteers mobilized,” Director of Public Relations & Communication of Ministry of Health, Tegegne Regassa said in a press briefing on Tuesday. 513 million birr worth personal protective equipment (PPE) and medical equipment were distributed throughout the country, he added. But some medical professions say it fell far short of what was needed. UN Office for the Coordination of Humanitarian Affairs in its latest report wrote that inadequately equipped quarantine centers and distant test labs remain obstacles in the COVID-19 coordination and response. “Some quarantine centers have been reported to lack access to water, food, PPE and electricity. COVID-19-related awareness raising, and capacity building have also been limited. With the rapid increase in confirmed cases, health facilities are reportedly overstretched, while quarantine centers are full or nearing their full capacity,” the report reads.
The safety protocols for those hospitals dedicated to COVID are better but at other regular hospitals and emergency rooms, the situation is worrying. Dr. Chernet Tegegn from Yekatit 12 Hospital in Addis Ababa complained in an interview with the state-owned Addis Zemen how health workers are being rendered vulnerable to Covid-19 and a lack of vital equipment is becoming their real concern. He lamented how most physicians are treating both regular as well as COVID-19 patients unprotected. Doctors at Tikur Anbesa have also recently told parliamentarians that they are receiving less attention from the government, preventing them from delivering healthcare services to patients.
Ministry of Health officials have been conducting a meeting and dialogue with health care workers in different parts of the country. In a recent meeting led by state minister of health, Dereje Duguma in Dire Dawa, promises were made with regards to PPE and reserving quarantine facilities units to health care workers. To complaints of bosses asking doctors and nurses to work without PPE when treating patients, the Communication Director of the Ministry said that is not right and it should be corrected.
With the number of confirmed cases growing by the day, a continued quarantine response would quickly leave the health care system short-staffed and overwhelmed. The situation has prompted the government to amend the state of emergency regulations, including shortening a mandatory 14-day quarantine of arrivals from abroad. “Individuals suspected for COVID-19 or who tested positive with mild or no symptoms will be asked to self isolate at home if they have the resources, the support, are willing and fulfill the criteria,” Minister of Health Lia Tadesse announced on Friday.
