Tuesday, July 14, 2020

Corona virus – how bad can it turn out for Botswana

The World Health Organization (WHO) says the coronavirus outbreak that has swept from China to a number of countries in Asia, the Middle East, and Europe is not yet a pandemic, but it urged countries to prepare for its arrival on the assumption that a declaration may come.

How would the spread of coronavirus affect Botswana? Sunday Standard this week combined pieces of evidence about Botswana and the Coronavirus to build a picture of how the disease would affect the country.

With the country’s health care system unprepared for public health care emergencies and still battling with HIV/AIDS, a bleak image emerged, revealing a country fighting a rearguard action with the poor and elderly citizens suffering the worst of it.

Researchers currently think that between five and 40 coronavirus cases in 1,000 will result in death, with a best guess of nine in 1,000 or about 1%. The death toll however depends on a range of factors:  general health, age and the health system you are in.

General health

According to information from the Chinese Centre for Disease Control and Prevention, Coronavirus deaths are at least five times more common among people with diabetes, high blood pressure or heart or breathing problems. Botswana has one of the world’s biggest HIV/AIDS health care problems. In 2002 the prevalence was 38 percent in the general population. While immunizable diseases are on the decline, non-communicable diseases are also on the increase as can be observed from the trends of diseases/conditions such as hypertension, cancers and diabetes (health statistics reports). Indications are that the interaction of the Coronavirus with such conditions could deal a fatal blow for Botswana.

Age

Available statistics show that the Botswana population at risk of hypertension, diabetes and cancer is those who are fifty years and older – and the numbers are increasing. This at risk demographic group is also the most exposed. A recent Global Innovation Workshop on Ageing, Frailty and Resilience organised by the University of Botswana School of Madison and the University of Birmingham (UK) at the Sir Ketumile Masire Teaching Hospital Auditorium recently noted that the most pressing problem for Botswana’s elderly people is health care.

Clinical Psychologist, Ms Thato Molefi said Botswana’s health services are clinic-based, focused on acute conditions and do not have the capacity to deal with complex needs of older people with multiple continuing conditions.

Pabalelong Hospice Sister, Ms Vinayi Chalil, drew attention to long-term chronic conditions associated with growing old, such as heart disease, cancer, respiratory, hypertension, disorders and dementia. She stated that problems such as HIV epidemics, poor education outcomes, unemployment, and lack of access to basic services and general poverty and working age group affected the youth to provide care for their elders.

Health system

A number of studies have revealed that Botswana’s health care system is designed to deal with acute conditions/diseases, with little attention to chronic conditions which predispose patients to coronavirus fatalities like cancers, diabetes and hypertension.

A recent study by the Ministry of Health and the World Health Organisation representing AFRO found that non communicable diseases like cancers, diabetes and hypertension are on the increase. The study reported poor service delivery “as 47% of the respondents indicated that the waiting time before service provision was too long. Waiting time is major issue which customers have expressed in other fora.”

The study further revealed that, “48% felt the health facilities were far. Transport was also raised as a major constraint as 28.4% of respondents said they had difficulties with transport to health facilities hence 62% indicated that they walked. The findings above should be taken into consideration given the nature of health problems of the elderly which include arthritis and the general body aches associated with ageing”, stated the study report.

Indications are that If the corona epidemic were to takes off, and Botswana affected the country’s healthcare systems could get swamped and there are only so many intensive care units or ventilators available in the country.

If all these factors were to interact together, Botswana could be one of the hardest hit countries in the world.

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Sunday Standard July 12 – 18

Digital copy of Sunday Standard issue of July 12 - 18, 2020.