UNTIMELY VISITOR: CAN SOMALIA’S HEALTH CARE SYSTEM WITHSTAND COVID19 PANDEMIC EFFECTS?

Somalia is in a state of protracted military conflict; the central government lacks control over large parts of the country and is at odds with several of the regional governments. It faces widespread poverty and hunger, with a lack of capable health institutions leaving people vulnerable to an outbreak such as cholera, tuberculosis, diarrhea and coronavirus. Somalia’s healthcare infrastructure is weak; it ranks 194th out of 195 in the Global Health Security Index. The country has less than 20 ICU beds available. Somalia has dealt with drought, localized displacement, massive floods, and locust infestations in the past years, but the arrival of COVID-19 could push the country into another crisis.

Coronavirus (COVID-19) is a new virus to the world that was discovered in China’s Wuhan city in late December 2019. It causes respiratory illness in people and animals and can spread from person-to-person through sneezing and coughing droplets. This virus has signs and symptoms similar to the common cold but is dangerous, and if not reported early and managed by health workers, it can cause severe illnesses in humans and can lead to death. The symptoms of this disease include fever, cough and shortness of breath.

Somalia has confirmed the first imported case of the global coronavirus (COVID-19) pandemic on 16th March 2020. Since then, the total confirmed cases of COVID-19 as of 17th April 2020 is 116 positive cases and five fatalities, most of them locally transmitted cases. There are only two recovered cases in this period. Further spread of the virus could have a devastating impact in Somalia given the lack of capacity to prevent, detect and respond to such a pandemic. According to humanitarian agencies, less than twenty percent of health facilities have the required equipment and supplies to manage epidemics. A full-scale outbreak would also disrupt the ability of government and other agencies to respond to existing needs, thus compounding the situation. This pandemic of COVID-19 infects people of all ages. However, evidence to date suggests that two groups of people are at a higher risk of getting severe COVID-19 disease. These are older people (people over 60 years old); and those with underlying medical conditions (such as cardiovascular disease, diabetes, chronic respiratory disease, HIV/AIDs, and cancer).

The risk of severe disease gradually increases with age starting from around 40 years. Adults in this age range must protect themselves and in turn, protect others that may be more vulnerable.

COVID-19 Will Put Additional Pressure on Somalia’s Healthcare System

However, Somalia’s capacity to manage the COVID-19 public health threat is a cause for concern. Ministry of health suffers from a shortage of equipment, ICU and ventilator capacity, medicines, and qualified health workers in particular.

Internally Displaced People (IDPs) are at higher risk of contracting the virus simply because they live in confined environments, often in unhygienic and unsanitary conditions with little access to clean water.  People in the camps were already exposed to several other infectious diseases.

What makes matters even worse is the spread of misinformation on the pandemic. There’s a persistent narrative among the society that COVID-19 is a hoax engineered by the political elite to accumulate money from aid donors or that the disease does not kill practicing Muslims. And Last but not least, there is a cultural barrier stemming from Somalia’s culture of communal living a standard practice, in which extended (and usually numerous) family members live together in dense, overcrowded homes. The country has a history of a social culture where gatherings are frequent and visiting sick people is common and encouraged.

The road map to Somalia’s respond preparedness of COVID-19

Somalia is still at a very early stage of the spread. Despite the challenges, Somali authorities can manage the COVID-19 public health threat through leadership and governance. Also, Somalis need robust open communication and sensitization campaigns. In this regard, information posters about the danger of this pandemic and ways to prevent them like washing hands with soap and water, avoiding public places, practicing social distancing and using PPE (such as gloves, face masks) and avoiding touching face’s soft parts like the mouth, nose, and eyes should virally be preached among the Somali society. Voluntary self-isolation and forced quarantine for those who are feeling unwell can save a considerable number of the community from contracting the infection.

Valuable information for containing the virus should be widely distributed by giving clear guidelines to public markets and disinfecting the hands of the public transport passengers. Regular TV and radio programs should be broadcasted to sensitize the public further. Health equipment and advanced technology failed to save the developed nations from containing the spread of the virus. Still, somewhat they were helped much by ordinary measures that can be replicated by any other government regardless of their development and economic power. These measures, as discussed earlier include but not limited to; managing the public transmission of the virus through, lockdowns, curfews, social distancing, and restricting civil movements smartly and wisely because the virus does not move, but people drive it. Finally, it is quite clear that Somalia public health system cannot manage the containment of the epidemic, hence the need for social responsibility from the individual to community levels to help stop the spread of the virus.

 

Fartun Abdikadir Mohamed

Twitter: @FartunKashkaash

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