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Africa's ventilator dystopia, Ethiopia trains doctors on COVID-19 lifesavers


The effect of the COVID-19 pandemic on Africa is exacerbated by poor heath systems and ill-equipped facilities in most parts of the continent.

One medical equipment that has assumed star status in the wake of the current pandemic are ventilators. They are basically breathing machines that facilitates breathing in cases of respiratory failures. They buy time for especially chronic sufferers of the coronavirus as medics work on treatment.

The tallies of ventilators per most African nations is worrying low according to experts and officials. In Ethiopia, Africa’s second most populous country, doctors were recently given training on the use of ventilators in an Addis Ababa hospital.

The health professionals who received the private sector-led training are convinced that the device will make the difference between life and death when the time comes. Doctor Tihitina Legesse told the media: “I’ll be first in line on this. So I need to be trained in the use of this device.’‘

Ethiopia has over 100 million people, but only 54 respirators out of 450 available have been reserved for coronavirus patients. The Ministry of Health would like to acquire 1,500 more. The government has ordered a thousand devices from China. But global demand is strong. Addis Ababa will have to settle for 250 by April.

Rediet Libanos, another medic said: “In Italy, for example, they’re overwhelmed with patients, very sick patients. They are suffering from shortages of artificial ventilation and they have to decide who has priority. If things continue like this, if people don’t take it seriously, they’ll probably be overwhelmed.”

As of Friday April 3, Ethiopia has officially officially confirmed 35 coronavirus cases with two cases deemed serious.

– Global supplies scarce –

Ventilator shortages have been well-documented in Italy and New York, and health officials at the African Union stress that the problem is not unique to the continent. But African shortfalls could be especially acute — Europe and the United States are already scouring the world market for the precious machines.

The Norwegian Refugee Council reported this week there were just three ventilators in Central African Republic, a country of five million people.

The WHO is advising African countries to “start thinking about mobilising” additional ventilators, said Dr Mary Stephen, a technical officer for emergencies at the WHO’s regional office in Republic of Congo.

“We do not produce them in Africa, so countries need to start collaborating. Can we start talking with the private sector? Can we start talking to China?” Stephen said.

“These are actions that need to start happening before we get to that stage where we have a large number of cases.” Ethiopia’s experience shows that sourcing more ventilators is easier said than done.

The government has requested 1,000 ventilators from producers in China but has been told it won’t be able to get them all at once and may have to settle for 250 per month, Yakob said.

One procurement agent contracted by the government to find 200 ventilators, who spoke to AFP on condition of anonymity, said the process of fulfilling orders had been complicated by coronavirus-related flight restrictions and recent price hikes.

Ventilators once available for around $9,000 (8,300 euros) are going these days for more than $20,000, the agent said.

‘We’re definitely worried’

As Ethiopia’s COVID-19 case count slowly increases, officials are assessing how to make do with what they have.

In addition to 450 or so functional ventilators, the health ministry has tallied 197 non-functional ones, and it hopes to bring at least some of those back online, Yakob said.

Yet many ventilators in Ethiopia were donated, meaning health facilities do not have a direct line to manufacturers and struggle to find spare parts to maintain them.

“When you get something by donation, it will not have the right manual, you don’t have the right connection with the company, and skill transfer has not been done very well,” Yakob said.

The ventilator training held this week in Addis Ababa — organised by the American Medical Centre, a private clinic — is an attempt to make sure that whatever machines are available will be used properly, said Dr Nebiyou Asnake, the centre’s medical director.

The centre hopes to train 100 doctors on ventilation by the end of the month, Asnake said.

Since reporting its first COVID-19 case on March 13, Ethiopia has closed land borders and schools, freed thousands of prisoners to ease overcrowding, sprayed main streets in the capital with disinfectant, and discouraged large gatherings.

However Prime Minister Abiy Ahmed lamented this week that “social distancing” guidelines “aren’t being adhered to satisfactorily”.

“We’re definitely worried, but we’re trying our best,” said Dr Tihitina Negesse, who also took part in the training.

“We’re already seeing that in other countries, in Italy for example, they’re being overwhelmed with patients, severely ill patients. They’re having shortages of mechanical ventilators and they’re having to decide who to prioritise. If things continue like this, if people don’t take it seriously, then we’ll probably be overwhelmed.”


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