Following the assassination of Hachalu Hundessa, the country mainly Oromia, Harari, Addis Ababa and Dire Dawa City Administrations saw fatal violence for days starting from June 30. The violence in the country has highly affected the sample taking of COVID 19 tests. To control the outbreak and spread of the pandemic the government has banned public gathering and declared wearing face masks as mandatory but the majority of the protesters show up without considering the pandemic. According to the Ministry of Health data the samples that were taken for tests were highly affected. Tigistu Adamu (MD) is a medical doctor advisor at the Ministry of Health. He talked to Capital how his Ministry is trying to boost COVID 19 tests and how recent events affected their work. Excerpts;
Capital: How did the recent incident affect the activity of Ministry of Health on responding to the pandemic?
Tigistu Adamu: The incident has come up with a lot of effect to the response of the pandemic. One of the challenges were, the incident has reduced the samples taken for COVID 19 tests. Primarily it was related with logistics. It was difficult to send our staff to contacts and in the society to collect samples. The number of samples we took was reduced by 30 percent in average. During that time we took an average of 5000 samples. The highest number taken after the incident was 4,000 samples that was on Thursday July 9, 2020, even if it is higher than it was lower than before. The ministry has been planning to conduct 15,000 tests daily. Now we are reaching to 7,000 tests.
Usually the highest sample is taken from Addis Ababa and Oromia although the unrest was in these areas. Such kind of incidents affects the overall activities not only the health sector but other activities.
Capital: Does the Ministry have a guideline or protocol to continue the response to the pandemic if such kind of incidents happen in the country?
Tigistu: Yes we do have. While the politics is one issue when there is a pandemic there may be a lot of other subjects that can rise an unrest in a country. It could be political, social, economic or logistics. However it is difficult to predict when. In such times we cannot operate as normal therefore we have plan which can fit with the crises and crises management.
For example if the worst case scenario happens in one region and our limited mobility may upsets people and create grievances and unrest in the region, though to control such kinds of happenings the government has declared state of emergency and form a COVID 19 response team from the beginning of the outbreak. The Ethiopian Public Health Institute mainly run such kind of health crises response not only for covid. In such times this helps to work strongly with the security apparatus although some incidents may go out of control.
Capital: Have you identified hotspot areas based on the situations? And what will be the next step?
Tigistu: Usually hotspot areas are identified and determined based on positivity test result. We do the pandemic investigation based on population density, movement in the area, housing, socio economic status and other basic needs such as electricity, water and so on.
By taking this in to account previously we have prepared a map, for example in Addis Ketema, Liedeta and Gulele sub cities the positivity rate has been over lapping and were identified as a hot spot.
As in the previous we will do same researches, identify places were lots of protesters came from and were gathered. We get the information from security offices. Currently in collaboration with the national COVID 19 response team and security offices the Ministry is working to identify hot spot areas to control the spread of the virus. After mapping we will focus on the areas as a target, we will increase the sample test in the areas.
Currently the thing what is worrying us is most of the protesters were young and from regional areas. The thing here is that if they get infected in the protest they can transmit to their parents or other elders. Which is as we all see the virus can develop serious illness on old people and people with pre existing medical condition more than others. So currently we are talking with the Oromia Health Bureau and actively working to educate the people and focus on the areas on sampling.
Capital: How are you going to cope with it if the number goes to the worst case scenario?
Tigistu: It is like an evolution. In the first time we all have been working if the cases has shown symptoms, if they were in simple or high risk. They stay at the mandatory isolation centers. However from time to time if the numbers continue to increase it would be expensive to take care all the cases in governmental centers. Thou we have prepared a directive that if the case is in a mild situation and can be deemed to qualify for self-isolation at his home without infecting others they can do that.
This can help us to give space for the governmental isolation centers and the staff. But this is if the number of cases continues as it is now.
But if the number continues to increase and become beyond our control we will do as the other world does. So we will divide the cases based on their illness situation.
Capital: Besides COVID 19 there are a lot of diseaseas that are breaking out, such as measles in which the Ministry has started giving a vaccine, how does the Ministry managed it with its limited human resources?
Tigistu: It is known that there is a shortage of human resources. The World Health Organization suggests in minimum 4.5 health care workers’s for 10,000 people but in our context 1.2 health care workers is for 10,000 people. There is a big difference but we cannot sit just because there is a shortage when other situations happen in this time we are adjusting our staff and our resources by identifying places which will be affected and are in good condition.
We Move staffers from hospitals and clinics. Always when you start focusing on one thing there are always things that would be affected. So to minimize this we are deploying volunteers on hospitals and clinics.