I read with interest, Dr James Elima’s article in the Daily Monitor, June 8 on why ‘more oxygen, beds, and ventilators will not stop the Covid-19 pandemic.’ Dr Elima, the director of Gulu Regional Referral Hospital, is in a great place to make this claim.
Its main area of interest for me is his starting point, that in provision of healthcare services, ‘building more accident emergency units cannot stop accidents, building more theatres at health centre IVs, district hospitals, referral hospitals, and national referral hospitals cannot stop maternal deaths; and having more mental wards cannot stop mental health issues’.
As such, ‘producing more oxygen, having more beds in Intensive Care Units (ICUs) in all hospitals, and stuffing units with ventilators and personnel will not stop the Covid-19 pandemic because otherwise the developed world would have’.
Dr Elima is one of the few scientists to acknowledge that dealing with the pandemic will require more than just medical science and innovation. That our collective behaviour matters, perhaps more in terms of policy response.
Arguments such as those of Dr Elima with all its merits, further push the point that if we behaved, even without more oxygen, beds and ventilators and personnel in hospitals, we would have been saved.
The problem with positions that focus on one thing or the other is that they miss what is important. Behaviour change enabled by health communication is crucial but takes time and consistency. It can hardly be policed or beaten into shape.
More importantly, social behaviour change is not mutually exclusive of improving health infrastructure and some fair degree of readiness to deal with the casualties of a mysterious pandemic.
Much of the developed world that Dr Elima makes references, managed to save many of its citizen’s lives despite being at the centre of huge infections precisely because they had all round measures to handle the pandemic, they did not just lockdown.
They encouraged women with children to work from home and supported them with money in some cases equivalent to their salaries, they made testing for Covid-19 easy and available, some of their social sectors remained functional with even schools continuing.
They mixed viable socio-economic response with actions in health, never treating this as a typical health matter. They had reasonable support for citizens in distress. For that reason, they may have suffered, but they also averted catastrophe of great proportions.
There is never an easy solution or single magic bullet that deals with a health problem that largely entails behaviour. For instance, if we built more accident emergency units without ensuring our road infrastructure is designed to prevent reckless behaviour or left much of our roads to near non-existent status, no amount of megaphones urging the public to drive well would stop accidents or change behaviour conditioned by the state of roads.
The existence of the emergency unit is for purposes of saving lives, not stopping accidents, because that is what road design, safety campaigns, and traffic management is meant for. Health policy does not operate in isolation of other critical areas.
When Ugandans are concerned about the level of preparedness of our health actors, it should be taken in good faith and responded to rationally.
The problem with the current wave of Covid-19 is that many citizens feel that something went seriously wrong for us to wake up to the current numbers almost overnight. Now we are in panic, full of fear of death in large numbers, and possible mental and social breakdown. How we deal with that is now an issue of concerned, clear-headed leadership, not blame game.
Focused behaviour change communication should go hand in hand with provisioning for health services and an effective social and economic policy response. Lockdown without effective socio-economic measures will perhaps just drive most people mad.
A blame game is not going to help us. All actors should find ways to contribute to an effective response and continuous support of the population through the right type of communication and action that reassures the public.
In the absence of enough vaccines for all, sufficient stock of oxygen, beds and ventilators, we should focus on helping communities respond responsibly and cope with the current Covid-19 reality rather than panic.
Ms Maractho is the head and senior lecturer, Department of Journalism and Media Studies at UCU.