The loopholes in Covid-19 fight

Thursday March 19 2020
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Sanitising. Passengers wash their hands before boarding a bus to Kampala at Mbale Bus Park on Monday.

Whereas government vows that everything is in place to prevent and handle coronavirus in case of outbreak, a rapid assessment conducted by Daily Monitor discovered loopholes in the said preparedness.
This newspaper assessed the presence of, adherence and willingness to the use of sanitisers, handwashing cans in market places, points of entry into government offices, schools and other critical institutions.
We also assessed several data on the country public health.
We discovered that although people are well-informed about how deadly the virus is, have access to sanitisers or are capable of buying it, willingness to adhere to hygienic practices is remains utterly poor.

It is 12:45pm on a Monday afternoon. One of our investigators is at the Ministry of Energy and Mineral development premises adjacent to Kampala Road.
A transparent bottle of alcohol-based sanitiser is placed on the table at the entry point as a female security guard, looking composed, observes.
The investigator does the needful, puffs the water-alcohol mixture into his palms, rubs and goes in.
Predictably, one official, a tall and fat man of around 45 years, approaches the entry point, pays no attention to the disinfection kit and the security guard allows him to pass without telling him to sanitise.

Ministry of Education premises
The Education ministry decided to provide water containers with soap, instead of convenient sanitisers, for people to wash hands just at the entry point to the building.
Unsurprisingly, eight men and a lady walk past in a time lag of about five minutes. None but one gentleman gives a second thought to wash his hands.
According to a 2013 survey by National Hand Washing Campaign (NHWC), only 27 per cent of Ugandans wash hands after using a pit-latrine or toilet.
Hand-washing is the most effective way as it rids the hand of the coronavirus, among other germs, slowing down the spread of the virus, experts say.

Fate of rural people with coronavirus
Seventy six per cent of the population (approximately 31 million people), are living in rural areas, data from Uganda National Bureau of Statistics (UBOS) shows.
However, according to Uganda Demographic and Health Survey of 2016, only 44 per cent of households had soap and water at a place for hand-washing.
Still in the survey findings, 32 per cent had only water, and up to 21 percent had neither.

According to the Ministry of Water and Environment 2019 Sector Performance Report, only 36 per cent of rural inhabitants and 40 per cent of urban inhabitants have hand-washing facilities with soap and water at home.
With the biggest portion of the population (31 million people), living in rural areas, the statistics means that up to 20 million rural dwellers have no water and soap, the critical requirements in the Health ministry guidelines in preventing coronavirus.

The 2016 Demographic and Health Survey also shows that only eight per cent of Ugandan households have access to piped water.
Up to 92 per cent were getting water from wells and springs, that are characterised by contamination due to hardship in safeguarding from coming into contact with germs and other pollutants.
The survey showed that the rest were using water from their neighbours’ facilities, public taps and boreholes.

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Crowded Ugandans in homes
As a highly contagious disease, social distancing is being advised by governments in the affected countries.
The 2016/2017 National Housing Survey discovered that in Kampala, 71 per cent of households have only one room to sleep in, with an average of 2.6 people per room.
The fate of children in homes, where parents are supposed to self-isolate, remains to be explored too.

Healthcare facilities
A recent national assessment by researchers from Makerere University, discovered that the country had only 55 functional Intensive Care Unit (ICU) beds.
Coronavirus affects the lungs, causing enormous hardship in breathing, according to experts.
A small fraction of people who get CONVID-19 need hospital treatment, such as access to a respirator.
In the study dubbed “Assessment of the Current Capacity of Intensive Care Units in Uganda’’, researchers found that 80 per cent (10/12) of these functional ICUs are located in Kampala city.
Furthermore, the study led by Dr Patience Atumanya from Makerere University College of Health Sciences, indicates that up to 50 per cent of the functional ICU beds were in private hospitals.

The report further states that less than eight per cent of nurses in the ICUs had formal training to provide standard care.
“There were 171 ICU nurses, of whom 13 had formal training in critical care nursing,” the researchers stated in the report.
Some ICUs had only one nurse taking care of up to eight patients in critical condition.
Dr Diana Atwine, the Permanent Secretary in the Ministry of Health, had in reaction to this findings last month, said government was renovating ICUs in Lira and Gulu districts.
“We are equipping ICUs in the regional health facilities through a loan we are acquiring and direct injection from government,” Dr Atwine had told Daily Monitor in an interview.

“We have established a course at Mbarara University for training professionals in intensive care service provision. We shall be enrolling 400 nurses next year,” Ms Atwine said.
She also said there are specialists undergoing a Master’s-level training for the provision of intensive care services.
It remains to be witnessed whether government will rectify some of these critical needs to meet the urgency coronavirus brings.

The transport sector
A quick move through taxi and bus parks in the city shows massive unpreparedness despite the huge number of people they handle on daily basis.
On daily basis, more than 4,000 taxis enter the New Taxi Park in Kampala, according to its manager. However, no single bottle of sanitiser could be seen by this newspaper on Tuesday morning. Media reports show that taxi drivers in Kenya, even before the outbreak, were already using masks.
Mr Godfrey Walakira, the secretary of the park, said as management, they were at a loss on what to tell drivers to do.

“We know we need to provide disinfectants and check each passenger entering the parks and taxi but we lack the facilities,” he said.
An estimated 100,000 people board from this taxi park on a daily basis, according to information from management.
Mr Walakira said the park lacks a fence that would be useful to control entry and exit. He said their biggest worry is that government may halt their operations.
“We have loans in banks that we have to pay and families to take care of. We are just praying to God for help,” he said.

Mr Walakira said they are also engaging government officials to help provide disinfectants for the park.
“We have the human resource to put those sanitisers to use,” he said.
Mr Benjamin Agwa, a manager at Good Luck Bus Services, said they bought all the necessary materials to protect their staff and passengers from the virus.
“We shall be disinfecting the bus seats every morning and as each passenger enters, they will undergo mandatory disinfection,” he said.

The manager of Green Line Bus Services that operates between Kampala and Nairobi, said the company has already put sanitisers in their buses.
“Just like you find in other places, we have put sanitisers inside the bus so that as people enter, they can sanitise,” the company operations manager, who declined to reveal his name, said. However, there was no bus at the park at the time for this reporter to confirm the claim.

A check in to five other buses showed that no disinfectants were in place.
The airport taxi drivers were not any different. Although they recognised that the disease is dangerous, no driver was seen using sanitisers or masks.
“You know we need money to feed our families and besides, the virus does not kill Africans,” one taxi driver, who did not reveal his name, said. However, it should be known that the virus kills people of all races.

High risk
Most vulnerable groups. Coronavirus majorly kills elderly people. China data shows that among children aged 0-9 years, the death rate is 1 in 100,000.
However, in people of age bracket 65 years and above, the death rate is as high as 1 in 10 cases.
The 2018 data from UN population shows that two per cent (approximately 1 million) of Ugandans are elderly.
The other group of people at high risk are those who have weak immunity such as people living with HIV or having diabetes.
Around 1.4 million Ugandans have HIV, according to latest information from the Uganda Aids Commission.

editorial@ug.nationmedia.com

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