In a country where pneumonia, malaria and TB are much bigger
killers, doctors say ‘resource-intensive’ Covid-19 is diverting precious
resources
A Covid patient is transferred from Tengandogo University hospital's ICU. Photograph: Amanda Coakley
When stocks of medical equipment in the general ward of Tengandogo University hospital in Ouagadougou ran low as resources flowed to the coronavirus unit, medical staff bought the essentials themselves.
Blood pressure monitors, glucose monitors and oximeters were
needed. Even the ink in the printers had to be replaced.
The hospital closed to non-Covid patients during Burkina
Faso’s first wave in March but reopened in July to treat the numerous other
illnesses that affect the population of approximately 20 million people.
Without any emergency budget for resources, doctors faced a challenge.
“The pandemic has had a big impact on resources, especially
things like oxygen that are needed for coronavirus treatment,” Dr Lassina Séré,
a senior practitioner, told the Guardian. “In terms of equipment, some things
that the hospital used to be able to pay for are no longer covered by the
budget because it’s all been used on Covid, so what the doctors have done is
start initiatives to buy what’s needed ourselves.”
Tengandogo is one of Burkina Faso’s leading health
institutions. A sprawling blush pink complex, it’s eerily quiet. There is no
buzz of machines or the drone of a hospital intercom. It’s a private facility
that treats the country’s most critical patients, but since March it has
treated people with coronavirus without charge.
Before the pandemic this landlocked country had a shortage
of specialist staff, especially in rural areas where the quality of care is
considerably lower. Poor salaries coupled with growing
insecurity in the north and east due to militant violence have
led many young professionals to leave, and deterred others from coming. In Tengandogo,
the staff are overworked, and when some have had to self-isolate, it has been a
struggle.
A small clinic in Gampela village on the outskirts of Ouagadougou. Photograph: Sam Mednick/AP
“We had to create a new Covid area in the hospital. We couldn’t hire new personnel, so we had to take from the regular staff, which means there are shortages on the other services,” says Dr Moussa Kabré, head of the general ward. The slight 41-year-old is exhausted, and says recent months have been among the most challenging of his career.
Respiratory diseases such as pneumonia are the leading cause
of death in Burkina Faso. Dr Christian Jules Wenl Minoungou, head of
respiratory medicine at Tengandogo, has struggled to access resources. One
patient under his care, 23-year-old Philomon, has been in the general ward for
two months with an undisclosed respiratory disease. His body has wasted away
and speaking has become uncomfortable. On the floor next to him sits his tired
mother, Delphin. “My only hope is for my son to get better and recover,” she
says.
“There are only 30 lung specialists in this country,” says
Minoungou. “Pneumonia is the first cause of death here and if you don’t act
quickly the situation deteriorates. We need more resources to deal with it.
People are always coming in from the countryside in an advanced condition
because they are unable to get care there.”
The director of Tengandogo, Ferdinand Tiendrébéogo, agrees:
“When you look at the figures, coronavirus is not a priority. It’s very small
compared to, say, malaria. That said, you do need to keep an eye on Covid
because you never know what can happen with it, but overall it’s been a very
resource-intensive disease for this hospital.”
Crossing the threshold into the ICU at Tengandogo, the quiet
is replaced by the steady beat of heart monitors. A handful of nurses care for
four Covid patients and the 12 other patients who are at the other end of the
ward. Some of the staff are in full PPE, others wear only mask and gloves. In
the corner by the door is a pile of discarded garments.
Head ICU nurse Ally Ouattara. Photograph: Amanda Coakley
Ally Ouattara, the unit’s head nurse, is six hours into his
shift. The smile behind his mask reaches his eyes and he stands out in brightly
patterned scrubs. He carefully recounts the details of each of his Covid
patients. Two men in their 60s with underlying health conditions. A middle-aged
woman with a history of TB. The fourth, Ismail, 50, is being moved to the
recovery ward after eight days. It’s a moment of celebration for the staff in a
ward where the Covid survival rate is 50%.
According to the Africa Centres for Disease Control
and Prevention, there have been 11,847 lab-confirmed cases of
Covid-19 in Burkina Faso and 139 deaths. The true figure is thought to be
higher as testing is limited to about 2,000 rapid tests a day.
Track and trace is nonexistent and daily life for millions of people continues as normal despite some earlier restrictions. Since late November the Burkinabé have seen a second wave that led to a spike in admissions and renewed fears that hospitals could be overrun. Dr Brice Wilfried, the director of Corus, Burkina Faso’s health emergencies organisation, says the second spike is in decline, after a fall in cases over the past two weeks.
Getting the Covid message across in Ouagadougou, Burkina Faso. Photograph: Legnan Koula/EPA
Dr Jerry-Jonas Mbasha, health cluster coordinator for the World
Health Organization in Burkina Faso, says: “We need to understand the fragility
of the health system here before Covid-19 and what’s happened over the last
year is a significant amount of extra stress. There already was a strategy to
identify specific respiratory diseases across the country and what we did to
ensure that continued to function was integrate Covid testing into that
structure and that’s been quite effective.”
For Séré, Covid is more of an economic problem than a health
emergency. “It’s changed our access to resources and the attention it’s getting
here is disproportionate compared to the impact,” he says.
Like his colleagues, he believes that quality care has to
continue for all patients even if it means financing it from their own pockets.
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