the anguish of the staff of the Andohatapenaka University Hospital

© RFI/Sarah Tétaud
Madagascar, the Covid service of the “Manarapenitra” CHU in Andohatapenaka (January 2021). Caregivers point the finger at the recurring shortages of oxygen, which is vital for all Covid patients in respiratory distress.

In Madagascar, the number of Covid-19 contamination has quadrupled in the space of a week, according to the latest official weekly report released by the authorities on Sunday. Four of the country’s 22 regions have seen a sharp rise in cases, including Analamanga, where the capital is located.

What then in health centers? In Antananarivo, at the Andohatapenaka University Hospital, requisitioned to treat only patients with Covid-19 last July, the situation is overwhelming and the staff distraught.

from our correspondent in Antananarivo,

Four hospitals are in charge of welcoming coronavirus patients. At the Andohatapenaka University Hospital, the one that had been requisitioned to treat only patients with Covid-19 at the height of the pandemic last July, the situation is overwhelming. And the health personnel, distraught, even before the arrival of a second epidemic.

Defective infrastructure

We call it the hospital Manarapenitra, “The hospital up to standards”. It was inaugurated in 2014 by the current president. However, inside, the toilets no longer work, the taps are out of order. And the cans of chlorinated water for disinfecting your hands installed at the entrance to each department are desperately empty. As for the tiling, it is smashed: “it could not stand the incessant back and forth of carts loaded with oxygen bottles during the peak of the pandemic” explains the staff.

In the hospital laboratory, it is possible to do a PCR test free of charge. “Only, we say sorry, at the reception, you have to wait 14 days to get the results.” The sample is taken on site, but not the analysis. “Try to see in another hospital if the delays are shorter, or go directly to Pasteur”, then advises the agent behind his counter.

In the service that treats Covid patients, oxygen cylinders, all empty, lie in the corridors. Fourteen of the twenty beds were occupied at the beginning of the week, explains this doctor who requested anonymity.

« For two weeks, the number of Covid cases has continued to increase. Normally, the patient has to stay in the hospital for ten days for treatment. Except that we push people to go home very early, after five days, because there is a lack of beds. In fact, our capacity is limited… because the rooms are not decontaminated. »

In the fear of a second wave

“We know that something is in preparation and is going to fall on us but everyone closes their eyes. Nobody takes their responsibilities, entrusts us, bitter and worried, another doctor. The new variant, I think he’s already on the island. But we have had no awareness on how to treat this new strain. When we complain to our ministry, we are told that we must remain calm, that the political situation is too unstable. He reports, angry.

And his colleague, to add: ” if there is a second wave, we are not ready to face it. Due to a lack of equipment and due to problems with the infrastructure which has deteriorated following the previous peak. Right now, our big big problem is that we lack oxygen. We cannot manage the serious cases. »

Indeed, the oxygen generator has been out of order for two years. To repair it, 60 million ariary are needed (€ 13,000). During the epidemiological peak, donations of oxygen cylinders poured in to supply the hospital extractors. But today, this alternative is no longer viable because donations have been stopped. According to the nursing staff, the means are lacking to ensure a constant supply of oxygen. And unwanted power outages on site pose a real risk to patients placed under these oxygen extractors.

As for protective equipment, it is incomplete. Sufficient caps and masks are missing. Medicines – distributed free of charge to patients with Covid – remain available. However, neither the CVO nor the CVO +, the traditional Malagasy remedies so much praised by President Rajoelina “for their preventive and curative effects” are no longer offered to patients, confides the medical team.

But the staff have seen worse, so they bite the bullet. But until when ? Many interns, on the front line from the first hour to treat Covid patients, have to date still not received the risk premium of 200,000 ariary (43 €) per month promised by the government. “We sacrificed ourselves during the pandemic, we were at the bedside of the sick, without protection, night and day, and today, when we claim our due, we are made to understand that we are not yet PhD students and that if we open it too much, our career can come to a stop, ”deplore three interns from the department.

Faced with the increase in cases, Tuesday January 12 the Minister of Health warned in a filmed speech: “without respecting barrier gestures, the risk of returning to a re-containment is not excluded”, before announcing the reopening of a Covid reception center in the capital to examine and treat, if necessary, patients who show symptoms of the virus.

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