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Namibia: ‘Health System Was Never Built for This’

SHELLEYGAN PETERSEN, ARLANA SHIKONGO and CHARMAINE NGATJIHEUE

AS the number of new coronavirus infections and deaths in the country increases on a daily basis, hospitals have been forced to leave some rooms empty because of the shortage of oxygen.

Some doctors have predicted that the situation could get worse in the coming weeks.

On Wednesday, The Namibian visited the Covid-19 intensive care unit (ICU) at Windhoek Central Hospital and found that a room which can accommodate at least four patients was empty because of the lack of oxygen the hospital is experiencing.

Health executive director Ben Nangombe earlier this week said oxygen tanks were recently installed at Katutura Intermediate Hospital, while other hospitals like Windhoek Central Hospital had to continue relying on oxygen cylinders.

As of Wednesday, the health ministry had reported that 400 Covid-19 patients were hospitalised, 84 of whome were in the intensive care unit and 56 in high care.

“The health system was never built for this,” Nangombe said.

Health and social services minister Kalumbi Shangula on Wednesday said the hospital has 72 high-care and 22 ICU beds.

The Namibian found that the hospital’s capacity is 17, however, only 11 patients can currently be accommodated due to the shortage of oxygen.

Oxygen cylinders that were in the room were empty.

Shangula yesterday admitted that the oxygen situation is concerning.

He said it not only affects Namibia, adding that the ministry is working with private suppliers.

Due to demand, however, private suppliers’ capacity had also been affected.

“We are facing a challenge but we have spoken to our suppliers and we are waiting on them. The demand for oxygen is too much but let’s not focus on the oxygen but on the causes leading to the need,” he stressed.

He reiterated that Namibians should focus on preventing the spread of the virus by adhering to set regulations.

“There are things we can control […] Let’s not over-burden the health system,” he said.

Knowledge Katti, whose company, Intaka Technology Namibia, has been supplying hospitals countrywide with oxygen since 2011, earlier this week said 34 gas generating systems from Intaka in Namibia are generating oxygen at full capacity as per their legal agreements.

“However, the supply of medical oxygen systems includes back-up cylinders that are supplied by Air Liquide and Afrox,” he said in a Facebook post.

Responding to questions, Nangombe previously said a technical team had explained to him that the demand placed on the oxygen system would impact on the pressure of the available oxygen and possibly the purity of the oxygen supplied.

“Systems were installed according to specifications of demand at that point in time, it was seen prudent to have bulk oxygen like what is seen at Katutura,” he said.

He said the high demand for oxygen is also affecting the quality of available oxygen.

‘ON THE BRINK OF COLLAPSE’

Windhoek-based infectious disease specialist Gordon Cupido said Namibia’s capacity to expand its healthcare system to accommodate more ICU beds and have more oxygen available is limited.

In an interview on The Namibian’s health talk show, ‘Heartbeat’, on Wednesday, Cupido described the situation as being ‘on the brink of collapse’.

“On the ground in Windhoek, as well as in many other towns, we find that patients are arriving at clinics, at hospitals – public and private – and are told that there are simply no beds for them.

“So our health system is now being saturated with Covid patients. Our capacity to expand is limited and, essentially, our facilities are overrun. Our health system is probably on the brink of collapse,” he said.

Asked whether Namibia’s measures to recall doctors and nurses and temporarily set up additional infrastructure to accommodate the influx of Covid patients was enough, Cupido said ‘no’.

“I’d say this for the following reasons: patients are not being admitted to oxygen-providing beds to the extent that they require. Our ICUs are full.

“Our oxygen supply is strained and even patients who are on oxygen in hospital are often not receiving adequate oxygen because the supply is not sufficient,” he said.

According to Cupido, the situation looks bleak as things will possibly take a turn for the worse in the next week or two.

“We are still on the ascending limb of the pandemic curve, which means everyone who has been infected in the past week or two weeks will still come into the hospitals in the next week or two.

“So, where we are now is better than where we are going to be in two weeks,” he detailed.

Namibian-born infectious disease specialist and internal medicine doctor Izona Bock echoed Cupido’s sentiments.

She said Namibia has the second highest daily Covid-19 cases per 100 000 in Africa, after Seychelles.

Furthermore, Namibia also has the second highest Covid-19 death rate per 100 000 in Africa, after Tunisia, Bock said.

“The numbers … We see those deaths coming right after the infections. So the number of deaths are going to continue going up and we have to do something now,” she said.

Bock, who is currently working in the Phoenix Metro Area in Arizona State, United States, said very few countries have the health infrastructure to deal with this kind of surge in Covid-19 cases.

“It makes it much more dangerous to get Covid.

“People say to me, there’s a 2% death rate, so there’s only a 2% chance that I’m going to die if I get Covid. But when you’re thinking that kind of thing, are you considering there’s no bed for you in the hospital, there’s no oxygen for you in the hospital?” she stressed.

Furthermore, Bock detailed that these pressures also affect the quality of treatment.

“You have to consider this: if there’s no one there to catch you, what’s going to happen? You can expand the beds, but where do you get the doctors? Where do you get the nurses?

“As somebody who has been very overwhelmed when we had these surges in Arizona, you cannot provide the highest quality of care that you would normally provide,” she said.

Medical front line workers have in recent weeks described the situation in both public and private hospitals as dire, stressing that the shortage of these essentials has thrown a wrench in patient care.

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