Senegal’s health system put to the test
By Marta Driessen, EUAV in Communication in Senegal.
Translated by Elena Varela.
After living in Senegal for a year, I started cooperating with the NGO Médicos del Mundo, through the EU Aid Volunteer Programme (EUAV) organised by the European Union, 3 months ago.
The idea that Covid-19 would not pose a real threat to the African continent for reasons of temperature and youth of its population has resulted in nothing more than wishful thinking. The pandemic has already reached all 54 African nations, claiming 2,300 lives to this day.
Senegal, faced with a slow but steady trickle of infections, quickly imposed firm preventive measures. Weeks ahead of the first new coronavirus related death, the state of health alarm was declared: mobility among the various regions within the country was interrupted and a curfew was imposed as well as the closure of markets, places of worship and schools.
In addition, a widespread operation to track, isolate, and treat infected people was activated. Despite transmission within the community growing on a daily basis, the death toll from the virus in Senegal is unusually low: 27 deaths since the beginning of the crisis. President Macky Sall showed himself as a strong leader with clear views – so much so that he is being criticised for not having the same reaction when facing other more recurring epidemics such as malaria or tuberculosis.
Inevitably, the global economic crisis – to which Senegal is especially sensitive – and the aforementioned preventive measures have dealt a painful blow to the Senegalese economy. There is no doubt that its unprecedented growth will grind to a sudden halt; the period is already being referred to as the “lost triennium”. It is a sad paradox that the lack of an economic development that was never inclusive anyway is going to hit the most vulnerable sections of the population harder. Millions of jobs, both in the formal and informal sectors, have vanished into thin air as a result of the sudden stop of the economy. Meanwhile, the price of basic necessities continues to increase.
Confinement in Senegal: is the cure worse than the disease?
Confinement, seen in Europe as a necessary inconvenience, is a luxury that most within the Senegalese society cannot afford. A significant portion of the population lives in densely populated urban areas with communal access to running water and sanitation facilities. This is the reason why quarantine would not necessarily mean isolation and social distancing. In addition, with millions of people struggling to make ends meet – 96.4% of the jobs in Senegal belong to the informal sector -, locking themselves up at home is simply not an option. Many face a terrible dilemma: either starve or risk exposure to COVID-19.
Maimouna, the head of a family, owns a small informal restaurant located in one of the beach areas of Dakar. For security reasons, it has remained closed since the state of health alarm was first established in the country. “These past two months without an income have been very tough. We remain standing thanks to the mutual support from the neighbourhood and family”. She assured me that he will return to work when Ramadan finishes at the end of May. “We cannot go on like this”.
A prolonged quarantine with its socioeconomic consequences would sink food security levels, the country’s enrolment rate or the fight against preventable diseases among other development indicators. In the medium to long term, this would lead to the increase of other causes of mortality, probably in much greater rates than COVID-19 itself. Following this logic, and even though the curve of infection rate is becoming dangerously exponential, on 11 May the government announced the relaxation of the restrictive anti-COVID measures. “We must learn to live with the virus” is the principle guiding government’s actions these days.
The healthcare system on the brink of the abyss
Despite an understandable rush to reactivate the economy and avoid a catastrophe, the scientific community, civil society associations and some religious communities have spoken out against a return to normality. The Senegalese health system, underfunded for decades, would quickly collapse if COVID-19 began to wreak havoc.
Before the health crisis, the country had 80 ventilators for a population of 16 million people. The end of confinement brings an added concern: that the virus ends up spreading throughout Senegal, reaching even isolated rural areas. With the exception of the Dakar region, none of the regions in a country which stretches out thousands of square kilometres in length have more than two hospitals. Four of those regions have none. Finally, the structural lack of health workers, added to the shortage of personal protective equipment, would cause a serious crisis in terms of human resources. The health system cannot afford a massive rate of infection among its workers, whose numbers are already insufficient.
The NGO Médicos del Mundo, present in Senegal since 2003, has been heavily involved in the fight against the new coronavirus from the beginning. We work towards three objectives: to promote responsible social distancing behaviours, to strengthen the public health system so that it can face the epidemic and to help protect health workers.
On a medical level, we work with all kinds of health structures from hospitals to small health stations. Always coordinating with the authorities, Médicos del Mundo offers support in terms of supplying protective equipment as well as training health workers so that they can manage positive cases without putting themselves in danger.
As we all know by now, the fight against coronavirus is a collective responsibility the entire population must get involved in. With the help of radio broadcasts, posters and training sessions on the virus for influential community actors – religious as well as opinion leaders – Médicos del Mundo contributes by raising awareness of the disease in the country. This is the scope of my contribution as the person in charge of Communication and Social Change. I am very happy and grateful for being able to lend a hand and, even if my abilities are not directly related to the field of medicine, help cushion the blow of COVID-19 in Senegal.