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COVID-19: Poorly-equipped hospitals are death traps

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THERE has been widespread concern over Zimbabwe’s lack of preparedness to contain coronavirus (COVID-19) — which has given even well-established economies across the world serious headaches — when it knocks on the country’s door having already penetrated a number of African countries including neighbouring South Africa and Zambia.

THERE has been widespread concern over Zimbabwe’s lack of preparedness to contain coronavirus (COVID-19) — which has given even well-established economies across the world serious headaches — when it knocks on the country’s door having already penetrated a number of African countries including neighbouring South Africa and Zambia.

BY PHILLIP CHIDAVAENZI

President Emmerson Mnangagwa was earlier this week forced to issue a statement in which he declared COVID-19 a national disaster after public pressure following his government’s apparent reluctance to be more aggressive in its preparations.

Mnangagwa on Tuesday announced several measures to control a possible outbreak, including banning gatherings of more than 100 people and postponing the Zimbabwe International Trade Fair, this year’s independence celebrations, but kept schools open.

He was, however, forced to make an about-turn when he said schools would now close on Tuesday after concern was raised over what seemed like ad hoc measures at a time some of the most hit countries have gone for complete lockdown.

“Following concerns from parents, as well as representations by the educational sector, government has decided that all schools and tertiary institutions (colleges, polytechnics and universities) will now close on Tuesday March 24, 2020, as a precaution against the outbreak and spread of coronavirus,” Mnangagwa said in a statement.

With the country’s public health system struggling following years of incapacitation against the backdrop of a massive economic meltdown, public health practitioner and Medical and Dental Private Practitioners’ Association of Zimbabwe interim president, Johannes Marisa, said poorly-equipped medical facilities could become “death grounds”.

“Health facilities can be death grounds or contamination centres if we are talking of contagious diseases. Highly transmissible viruses like COVID-19 can take advantage of poorly-capacitated surgeries, clinics or hospitals to ravage both patients, relatives and staff as it is common knowledge that whoever becomes sick from any ailment is rushed to medical centres for attention,” he said.

Marisa said the need for health institutions to be well-equipped with, among other things, adequate protective clothing, could not be over-emphasised.

“If extra care is not taken, medical staff can become the worst group of people to be affected and this will be a medical catastrophe in our country as the spread can be incendiary as most patients base their hopes on the medical staff,” he said.

Already, there have been reports that the country’s main isolation centre for COVID-19, Wilkins Hospital, has run out of protective clothing for staff received as part of a donation from the World Health Organisation two weeks ago.

Although Harare City Council health director Prosper Chonzi this week said training of staff at Wilkins Hospital to efficiently handle COVID-19 cases was “ongoing” the conduct of staff witnessed by this paper during a visit demonstrated a high level of ill-preparedness.

“We are doing refresher courses for those that have been trained to handle outbreaks and, also, we are training those that are comfortable, but have never handled outbreaks. We have also embarked on training of doctors, nurses, general hands,” he said.

Marisa emphasised the importance of effective training and the need for support for both public and private health facilities to be adequately equipped to deal with the cases.

“If government and the donor community can chip in with training and capacitation of all medical centres at the moment, the better. Basic protective clothing can be donated to all practitioners including sanitisers, masks, gloves. We are all fighting the same war, we have to win it,” he said.

A snap survey by NewsDay Weekender revealed that many public places and even shops had no sanitisers, a development that feeds into the general lackadaisical approach that has been adopted by government, including Mnangagwa who held a rally which was attended by thousands just a day after decreeing that there should be no public gatherings of over 100 people.

With millions of people exposed to infection should COVID-19 penetrate the country in places such as open markets, crowded high-density suburbs, supermarkets and even tollgates where physical money exchange hands, Zimbabwe is highly vulnerable.

With many of the high-density suburbs, as well as low-density residential areas, battling perennial water shortages, shutting the country’s points of entry such as borders and airports could be the only fool-proof defence mechanism, but the government does not appear keen on that option.

“Although it’s a good thing that schools have been closed, our society is set up in such a way that makes us naturally vulnerable because we are a crowded society. Our environment is already congested and business in the informal market relies on that congestion,” Marisa said.

“The fact that we have water challenges is also a big problem because again you find congestion at the boreholes.”

Early this week, South Africa indicated that it was closing 32 of its 72 border posts and banning travellers from countries with high infection rates of the virus such as Italy, Iran, South Korea, Spain, Germany, the United States, the United Kingdom and China.

Marisa said although medically, the best option for Zimbabwe was to close its borders so it could lock out COVID-19, the choice was not practicable.

“Medically, closing the borders is the best, but economically, it is not possible because we rely on imports. So, we can close out corona and then we will starve, so it is a question of weighing the risks against the benefits,” he said.

What is the way forward for Zimbabwe? “In short, the war against coronavirus in Zimbabwe can be won if both private and public practitioners team up against this scourge. Resources, training should be availed to all clinicians. Workshops should be urgently done to capacitate all practitioners,” Marisa said.

He said it was important to tighten the screening processes at the country’s entry points using qualified personnel.

Early this week, a British national who visited the Victoria Falls tested positive for COVID-19 upon arrival in the United Kingdom after having been treated for suspected malaria in the country.

Crisis in Zimbabwe Coalition spokesperson Marvellous Khumalo urged the government to quickly draft and implement a national plan on managing and mitigating the spread of COVID-19.

“While we commend the government for issuing a gazette on measures to contain COVID-19, developments in the country before and after these measures do not point to vigilance in insulating citizens against the coronavirus,” he said.

Khumalo said it was worrisome that measures to combat the spread of the virus appeared to be just suggestions and consequently ineffective as they did not cover areas where large numbers of people gathered including the Registrar-General’s Office, ports of entry, private companies and other workplaces.

“As there is no vaccine or specific treatment, the containment of the outbreak is based on a number of measures including identifying people who are sick, bringing them to healthcare centres, following up on contacts, preparing hospitals and clinics to manage a surge in patients, and training health workers,” he said.

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