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Algeria’s health system is on the brink of implosion, as coronavirus wave hits

By Rania Hamdi
Posted on Wednesday, 4 August 2021 07:53

An Algerian doctor in a hospital in Oran on 1 April 2021. Photo by Hamza Bouhara/ABACAPRESS.COM

The Algerian health system is currently overwhelmed and facing a worrying health situation, as the number of Covid infections is higher than ever. Health workers are calling for a “state of health emergency” to be declared.

“We are practicing medicine in near war-like conditions,” says a bitter nurse, who was waiting for the truck carrying oxygen to arrive in front of the gate of Mustapha-Bacha Hospital, the capital’s largest health facility, on 29 July.

She became more stressed with each passing minute as the prognosis of her relative, who was in intensive care, was life-threatening. All Algerian hospitals are experiencing an influx of patients that exceeds their capacity and are facing an oxygen shortage that has proved fatal to a large number of patients.

Paradoxical situation

On 28 July, the Mustapha-Bacha hospital, whose needs have increased sixfold during this third wave, experienced a particularly deadly oxygen shortage as 45 deaths were recorded in just a few hours, compared to the usual 10 to 15 deaths per day.

“We consume 10,000 litres every 16 hours,” says Professor Rachid Belhadj, head of the forensic medicine department and coordinator of medical and paramedical activities. He wants to see a road lane cleared for the supply trucks, which are often delayed by traffic jams.

This hospital’s storage capacity is around 20,000 litres, divided into two stainless steel tanks, to which are added around 100 shells with an average capacity of 180 litres. It is by far the country’s best-equipped hospital as other health structures still operate with simple oxygen bottles.

What is interesting is that the country has almost quadrupled its production in 2021, thereby bringing it to a total of 400 million litres of oxygen, according to Lotfi Benbahmed, minister of the pharmaceutical industry.

“It is not only a question of producing oxygen, but also of transporting it. In the future, we need to completely redesign our hospitals so that they are self-sufficient in oxygen,” says Lyes Merabet, president of the Syndicat National des Praticiens de la Santé Publique (National Union of Public Health Workers).

A grim record

Since the beginning of July, the number of infections has increased from 500 cases to more than 1,500 per day. More than 12,000 Covid patients are currently receiving treatment in the country’s various hospitals, the majority of whom are dependent on an oxygen supply. This is a record-breaking number that has not been observed since the beginning of the pandemic.

However, according to some health professionals, these unprecedented figures do not reflect the reality of the situation because they only take into account hospitalised patients or those who have taken PCR tests in public health structures, says Merabet.

“We probably have around 25,000 to 30,000 cases per day. This explains why hospitals are saturated because 1 to 3% of patients require hospitalisation and oxygen assistance,” says Professor Reda Djidjik, head of the immunology department at the Beni-Messous University Hospital.

The Delta variant, which is threatening the whole world with a fourth wave, predominates in Algeria at 71%, and will likely be responsible for 90% of contaminations by mid-August, warns the Pasteur Institute of Algeria. As of 20 June, it represented only 2.63% of the number of contagions.

The third wave was inevitable. The government failed to anticipate it by taking the necessary measures, starting with speeding up their vaccination campaign.

All the private analysis centres have been taken over by contact cases. The number of family clusters is exploding, due to the cramped conditions of homes in working-class neighbourhoods. “We carry out an average of 100 antigenic tests a day and as many PCR and serology tests,” says the analysis centre in the Sebala commune, which is now regularly frequented by an essentially young population from the early hours of the morning.

Faced with these alarming figures, Algeria’s President Abdelmadjid Tebboune decided belatedly – on 1 August – to tighten Covid restrictions in 35 wilayas (provinces) for a period of 10 days. The government has introduced the following measures to curb the pandemic’s momentum:

  • closing beaches, sports and leisure facilities;
  • limiting takeaway sales in cafés and restaurants;
  • suspending public transport at weekends;
  • imposing a curfew from 8pm.

All these measures have been described as a “first plan” and out of step with the current health situation, which is progressing “constantly and very seriously”, according to Bekkat Berkani, president of the Medical Council and a member of the national scientific committee tasked with monitoring the pandemic.

“A state of health emergency is necessary,” says Professor Belhadj, describing the epidemiological situation as “catastrophic.” This specialist, who is on the front lines fighting the pandemic, warns of the growing number of infections among medical staff and hospitals’ inability to take in cases that require oxygen.

According to Berkani: “The third wave was inevitable. The government failed to anticipate it by taking the necessary measures, starting with speeding up their vaccination campaign.”

The immunisation campaign was launched tentatively in January of this year, and at a slow pace as the government initially relied on the Covax programme, which was delayed in delivery. The campaign only really started in June. By mid-July, only 10% of the population had been vaccinated, according to the Insitute Pasteur of Algeria.

“It is currently necessary to vaccinate between 200,000 and 400,000 citizens per day. This is difficult to achieve from a practical point of view, as we do not have enough doses to vaccinate millions of Algerians,” says Professor Kamel Sanhadji, president of the Agence Nationale de Sécurité Sanitaire (National Agency of Health Security).

Many people gather in front of vaccination centres on a daily basis, which, paradoxically, may be contributing to the spread of the virus.

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