On April 19, a cargo plane from India landed at the airport in Kinshasa, the Congolese capital. The ship was carrying 1.9 million doses of the AstraZeneca vaccine, made by the powerful biotech company Serum Institute. Health officials noticed that part of the vials expired on June 23 and another on July 7. Despite the fact that only the capital has more than 17 million inhabitants, the local authorities considered themselves unable to manage such an amount within two months, so they kept 700,000 injectables and forwarded 1.2 million to the Republic Central African, a failed state lacking an effective Administration.
Carmen Terradillos, from Avila, coordinator of Doctors without Borders in the city of Bukavu, located 1,500 kilometers away, requested 200 of those vaccines for her team of professionals. The shipment arrived in May. “We had no problems with deadlines,” he recalls. The problem was another. “There was great mistrust among the health workers and we had to carry out a lot of awareness-raising work, explain what it prevents us from and how effective it is. In short, provide abundant information for them to accept.
This reluctance among health professionals is not exceptional, neither in the Congo nor in the entire sub-Saharan region. “It is a reflection of society,” he says. «The population dies as usual: malnutrition, diarrhea and other illnesses that are visible. The coronavirus is not present and is not given importance. Very few people are vaccinated ». The nurse believes that the cases are underestimated in a country with 94 million inhabitants, but that it reports less than 300 daily cases of covid-19. In any case, it maintains that its incidence is not appreciable.
Students from Madagascar hold a drink that the president assures that he fights the Covid. /
“They don’t see the need”
Vaccination in Africa is a complex matter. It is neither demanded nor could it be made available to the entire Congolese population, spread over a territory of more than 2.3 million square kilometers. “The drawbacks are diverse and enormous, and they have to do with transport, logistics or security,” says the nurse. “But the biggest obstacle is that people don’t see the need.”
Small island states, such as Seychelles or Mauritius, focused on tourism and with small and concentrated populations, have the best continental records. Rwanda, also small in size and with a free and easily accessible healthcare system, also ranks high.
On the Mediterranean shore, Morocco is an exception to precariousness. In addition to presenting high vaccination rates, it has already begun to apply the third dose and announces the introduction of the covid passport. Ambition also has financial incentives. Its ultimate aim is to become a platform for the process throughout the continent, through the installation of factories thanks to agreements with Russia and China, among other allies.
Tunisia is the dark side. The expansion of the Delta variant caused the collapse of health institutions and high mortality in summer. The street protests due to the lack of response from the Administration led to the coup of President Kaïs Saied and the end of his acclaimed democratic spring.
The sub-Saharan region is the one that accumulates the greatest delays and the global average of the continent does not exceed 7% with the double guideline. The causes cover a wide range. “In Congo it is only recommended for health workers and people with chronic treatments and those over 55, who represent a tiny minority.” The mandatory use of the mask is a cry in the desert. “In Bukavu nobody wears it,” recognizes Terradillos. “It is something difficult to demand in a place where eating every day is a luxury.”
In his opinion, sending more vaccines is meaningless. “This is nonsense if it is not accompanied by more promotion and mechanisms to facilitate supply and distribution,” he says. “The work of the Global Access Fund for Covid-19 Vaccines (Covax) does not come to fruition without tools that facilitate distribution,” a workhorse in settings lacking a modern communications network. “In this country, a trip with medicines can require the use of a motorcycle, canoe and walking for several hours before reaching the village, that the peasants have not traveled to their distant orchards and that they want to participate,” he explains. “But everything is even more complicated in remote places where there are no security conditions.”
A major challenge
The situation is very complex. Terradillos is committed to training community leaders or improving detection. In this context, getting 40% of the planet’s population vaccinated by March, as intended, seems very complicated, in his experience. “Let’s not forget that, in addition, there are states that suffer from serious armed conflicts and areas under rebel control to which no type of resource can be sent from the government area.”
Ómicron, the variant supposedly originated in South Africa, does not raise alarm in the heart of the continent. “The disease is associated with those foreigners who come to do business,” he alleges. “We take it there, they are not the one transporting it to Europe.” The reluctance to participate in the fight against the pandemic has other surprising repercussions. “We undertook a campaign to vaccinate against measles and the population was distrustful, they thought it was a ruse to surreptitiously introduce that of covid-19.” Denialist religious leaders and politicians like Malagasy President Andry Rajoelina, who patented a drink against the virus, also do not favor the adherence of a credulous population that often puts faith before science in the medical field.
A woman has just been immunized without getting out of the car in Pretoria, the most populous city in South Africa, where 24% of the population has already been vaccinated. /
Vaccinating in Congo is a major challenge. No more than 0.06% of its citizens have the complete guideline. The rates of Cameroon are much higher since they reach 2% of its inhabitants, although it is still a tiny percentage compared to the European average, estimated at 54%. Núria Pagespetit from Barcelona and her husband have lived in this country for 5 years, they have started a nursing school and are building a hospital in the port of Kribi with the support of the Spanish NGO Manos Unidas.
The focus on malaria
The arrival of the pandemic did not surprise them. They had enough rapid tests and vaccines were soon provided. “Four of the 26 teachers have used them,” he says. The refusal is well founded. “They say they have been waiting 40 years for the malaria vaccine to appear and that covid-19 arrives, and since it affects the whites and rich people, it comes out immediately. No, they are not going to put it on, they assure that it is a problem for the Europeans and that they use it ». Sinopharm and Pfizer preparations are available to the public, but hardly used. “At least 60,000 doses have been lost,” he laments.
Cameroon has resources against the coronavirus. An action protocol and a network of reference hospitals have been implemented in the fight against the disease. But the problems of its natives are other. “It is typhus, HIV, tuberculosis or malaria, which can affect four or five times a year and is the leading cause of death among children under five.”
There are no masks in Kribi. Life remains oblivious to the virus and its prophylaxis. Procedures such as confinement seem unfeasible when homes are tiny rooms without access to drinking water and sanitation. “Most of the people can’t even wash their hands. This is a rich country with poor citizens, but not miserable.
Screening at the local hospital reveals two or three positive cases out of 50 weekly tests. «It is usually done by those who need to travel and are asymptomatic. We advise them to stay home, but in the afternoon they are already in the market, always crowded.
What can be done in this situation? “Honestly, I think nothing,” confesses Núria Pagespetit, for whom, perhaps, the attitude of the locals would be different if the West had paid more attention and resources to the fight against malaria and other tropical diseases. “They say that we from the north have to learn to live with covid-19, the same as they have been doing since they are born, although, in their case, it is against a wide range of viruses.”
RETAIL
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A matter of priorities
Typhus, HIV, tuberculosis or malaria are the diseases that cause the most concern in the African population. The coronavirus, on the other hand, is a disease “of Westerners.” -
Wellness ‘islands’.
Small island states, such as Seychelles or Mauritius, focused on tourism and with concentrated populations are those that provide the best data in the fight against infection. -
7%
is the global mean with the double standard. The sub-Saharan region is the one that accumulates the most backwardness. Under minimum -
Face mask
Demanding that the population wear a mask when getting them to eat daily is already a challenge, it is very difficult
The peculiar South African case
South Africa, the first continental power, is not a homogeneous territory, but the juxtaposition of opposing realities. Possessing the greatest socioeconomic inequalities in the world, Western standards and marginalized situations typical of the sub-Saharan region coexist there. The response to the virus has also been different, although now the whole country faces the same problem: the appearance of Ómicron, the dangerous variant of Covid-19, has triggered infections from an average of 300 in November to more than 11,500 in November. December 2nd.
Unicef vaccination programs have created protocols that can now favor the weakest. “Child mortality has dropped by 60% in the last 30 years, although we have been in stagnation for three or four, aggravated by the outbreak of the pandemic,” says Blanca Carazo, head of Programs and Emergencies.
The industrial development of the southern cone has a positive impact where the greatest danger of infection has arisen. Moderna and BioNTech have partnered with the Biovac Institute of South Africa to produce vials in that country and use their distribution channels to reach the heart of the continent.
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