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Are our foot soldiers equipped for this COVID-19 war?

By Admin

Added 18th May 2020 11:24 AM

While Parliament procured over 300 billion shillings for COVID-19, frontline healthcare professionals lack basic protection.

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While Parliament procured over 300 billion shillings for COVID-19, frontline healthcare professionals lack basic protection.


By Dr Ekwaro A. Obuku

Uganda’s march to victory over COVID-19 is remarkable to the extent that His Excellency Yoweri K. Museveni featured in The Washington Post, a United States-based daily. Mr. Museveni successfully led the assault against the Coronavirus pandemic, supported by his trusted General, Dr. Jane Ruth Aceng the Minister of Health. At the frontline facing this deadly virus daily are Ugandan healthcare soldiers. Are our foot soldiers equipped for this COVID-19 war and effectively protected?

SARS-CoV-2 is highly infectious. The world took two months to reach the first 100,000 cases of COVID-19 and in only 4 months we are at 4 million. Comparatively, the 2013 West African Ebola outbreak infected 28,000 people over 3 years, whilst 1.6 million worldwide caught “Swine Flu” (H1N1 influenza virus) between 2009 and 2010. Although those who died from COVID-19 are few relative to Ebola in West Africa that killed 40% of its patients, the high numbers infected with SARS-CoV-2 raised global deaths to nearly 300,000; the highest fatality recorded in recent pandemics.
Frontline healthcare professionals died from COVID-19. In its 82nd situation report, the WHO documented 22,000 healthcare professionals with COVID-19 from 52 reporting countries by 11th April 2020. On May 6th, the International Council of Nurses updated this figure to 90,000 from 30 reporting countries and projected over 200,000 healthcare professionals infected worldwide. In Bangladesh alone, over 500 doctors had COVID-19 by end of April 2020. Unfortunately, over 1,000 died globally and these fallen heroes were honoured in the online register Medscape. Dr. Labejja Achellam a re-known Ugandan consultant medic died in the UK, and his three family members caught the virus.
Two Ugandan nurses Ms. Proscovia Kabunga and Ms. Maria Gitta died in USA, (The New Vision, 21st April 2020). Although Africa’s share of COVID-19 is less than 1% of the globe, 3% to 4% of all Ebola infections in West Africa were in healthcare professionals and many died. In Uganda, Dr. Mathew Lukwiya is the face of fallen field marshals of the 2001 Ebola epidemic and many more nurses and clinical officers died too in Bundibugyo and Kibaale outbreaks in 2007 and 2012 respectively. May their souls rest in peace.
While Parliament procured over 300 billion shillings for COVID-19, frontline healthcare professionals lack basic protection. Mr. Museveni argues that a soldier would “…find it difficult to defend Uganda without boots…” when justifying the substantial UPDF classified budget. The minimum we request is a pair of disposable gloves and medical masks (basic PPE) consistently while on duty, particularly in high-volume health facilities. Ironically, nurses in Jinja hospital threatened industrial action on International Nurses Day 2020, demanding basic PPE. 
The Uganda Medical Association President, Professor Richard Idro, made endless trips to meet government officials to close this gap. So desperate was this scarcity in Kawempe Hospital that Dr. Olive Kobusingye, a Senior Consultant Surgeon, led the “Swipe-To-Pay” and UMA partnership self–help fundraising drive dubbed the “#10challenge”. That each Ugandan doctor donates 10,000 shillings to the PPE fund, does 10 press-ups and enrolls 10 more doctors into this campaign. Yet, donations of PPE have been generous from Ugandans and development partners. Earlier on, the CAO in one district in eastern Uganda warned nurses to attend to persons in COVID-19-quarantine without any basic PPE or else risk losing their jobs!  This disconnect between the government authorities and frontline health units reflects the challenges in communication and alignment of the COVID-19 national response. While healthcare professionals expected basic PPE, the Ministry of Health prescribed a need tiered by risk assessment. A widely disseminated national guideline on PPE would be helpful in clarifying expectations from frontline soldiers in this COVID19 war. 
Our preparedness beyond metropolitan Kampala was tested in Lango sub-region, where a truck driver traversed Malaba, Tororo, Mbale, Soroti, Lira, Loro and was eventually intercepted at “Kona” Kamdini, Oyam district.  This event caused pandemonium in the local communities that rejected his referral to Gulu hospital, highlighting COVID-19 related panic, anxiety, stress and stigma. Deontology ethics posit that we, Ugandan “Basawo”, put our patients lives first. However, would the Commander-In-Chief arraign his troops at the frontline without boots? A healthcare professional without PPE in this bio-warfare works in fear, panic and is a danger to self and patient. Imagine a nurse with asymptomatic COVID19 deployed at OPD or performing immunization without a medical mask! Even the WHO Chief, Dr. Ghebreyesus has been resolute about protecting the frontline healthcare professionals.
Importantly, Uganda’s labour laws promote workplace safety and are aligned to the International Labor Organisation’s “Decent Work Policies”. Key is the Occupational Safety and Health Act 2006, Employment Act 2006, Labor Unions Act 2006, Workers Compensation Act 2006 and Public Service Standing Orders 2010. Altogether, these laws define roles and responsibilities of the employer to guarantee safety to the employee; the duty of the employee to follow set guidelines on safety; the Labor Officer to close work premises that do not meet safety standards and procedures for compensating workers who are injured, fall ill or die at work. Thus, the pushback for basic PPE by Ugandan healthcare professionals is lawful.
Mr. Lawrence Bossidy, a former chief executive of General Electric, whose 2018 revenue was four times Uganda’s GDP, emphasized the importance of human capital stating that “…nothing we do is more important than hiring and developing people. At the end of the day, you bet on people, not on strategies…” As a successful revolutionary who shot himself into power, no one understands the power of foot soldiers than Mr. Museveni. In this case, frontline healthcare professionals are our “Field Force Unit” battling Corona. Safety first!
Member, Uganda Medical Association;
Twitter: @ekwaroobuku 

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