CAPE TOWN, South Africa (AP) – For months, experts have been warning of a possible nightmare scenario: After overwhelming health systems in some of the world’s richest regions, the corona virus is gaining foothold in poor or war-torn countries that are poorly equipped and sweeps through the population.
Now some of those fears are being realized.
In South Yemen, health workers are leaving their posts en masse due to a lack of protective equipment, and some hospitals are banning patients who have difficulty breathing. In the war-ravaged region of Darfur in Sudan, where there is little testing capacity, a mysterious disease similar to COVID-19 is spreading through IDP camps.
There are many cases in India and Pakistan, where more than 1.5 billion people live together and where authorities say rural lockdowns are no longer an option due to high poverty.
In Latin America, Brazil has a confirmed caseload and deaths after the US, and the leader is unwilling to take steps to stem the spread of the virus. Alarming escalations are taking place in Peru, Chile, Ecuador and Panama, even after they have imposed early closures.
The first reports of disorder also come from hospitals in South Africa, which has the continent’s most developed economy. Sick patients lie on beds in corridors while a hospital has no space left. Another time, an emergency mortuary was needed for more than 700 bodies.
“We are now harvesting the whirlwind,” said Francois Venter, a South African health expert at the University of Witswatersrand in Johannesburg.
There are 10 million confirmed cases and more than 500,000 reported deaths worldwide, according to a report by Johns Hopkins University of government reports. Experts say that both numbers are a serious underpower of the pandemic’s real toll, due to limited testing and missed mild cases.
South Africa has more than a third of confirmed cases of COVID-19 in Africa. It is ahead of other African countries in the pandemic timeline and nearing its peak. If the facilities break under pressure, it will be a grim warning as South Africa’s health system is known as the best on the continent.
Most poor countries took early action. Some, such as Uganda, which had already built an advanced detection system during the years of fighting viral haemorrhagic fever, have so far been demonstrably more successful than the US and other wealthy nations in fighting the corona virus.
However, since the start of the pandemic, poor and conflict-ridden countries have generally been, and remain, a major disadvantage.
The global battle for protective equipment has pushed up prices. Test kits were also difficult to obtain. Tracking and quarantining patients requires a large number of health professionals.
“It’s all a knock-on effect,” said Kate White, MSF emergency chief. “If you have countries that are not economically as good as others, they will be negatively affected.”
Global health experts say testing is key, but months after the pandemic, few developing countries can run the tens of thousands of tests needed every week to detect and contain outbreaks.
“Most of the places we work can’t have that level of test capability, and that’s the level you need to really get things under control,” White said.
South Africa leads Africa in the field of testing, but an initially promising program has now overrun in Cape Town, which alone has reported more cases than any other African country except Egypt. Critical kit shortages have forced city officials to stop testing individuals under the age of 55 unless they are in a serious health condition or are in a hospital.
Venter said a Cape Town-like wave could easily be next in “the major cities of Nigeria, Congo, Kenya” and that they “don’t have the health resources we have.”
Lockdowns are probably the most effective security, but they have even taken a heavy toll on middle-class families in Europe and North America and are devastating economically in developing countries.
The closure of India, the world’s largest, caused countless migrant workers in the big cities to lose their jobs overnight. Fearing hunger, thousands went to the highways on foot to return to their hometowns, and many died in road accidents or died of dehydration.
The government has since established quarantine facilities and now offers dedicated rail services to get people home safely, but there are concerns that migration has already spread the virus to rural areas of India, where health infrastructure is even weaker.
Poverty has also accelerated the pandemic in Latin America, where millions of people had to find casual jobs and then return to crowded homes where they spread the virus to family members.
Peru’s strict three-month shutdown failed to quell its outbreak and now has the sixth highest number of cases in the world in a population of 32 million, according to Johns Hopkins University. Intensive care units are almost 88% occupied and the virus shows no signs of slowing down.
“Hospitals are about to collapse,” said epidemiologist Ciro Maguiña, a professor of medicine at Cayetano Heredia University in the capital, Lima.
Relief groups have tried to help, but they have been through their own struggles. Doctors Without Borders says the price it pays for masks has risen threefold at some point and is still higher than usual.
The group also faces obstacles in the transportation of medical supplies to remote areas, as international and domestic flights have been drastically reduced. And as wealthy donor countries struggle with their own outbreaks, there are concerns that they will cut humanitarian aid.
Yemen has been in civil war for the past five years and was already home to the worst humanitarian crisis in the world before the virus hit. Now, the Houthi rebels are suppressing all information about an outbreak in the north and the health system in the government-controlled south is collapsing.
“Coronavirus has invaded our homes, our cities and our countryside,” said Dr. Abdul Rahman al-Azraqi, an internal medicine specialist and former hospital director in the city of Taiz, who is split between rival forces. He estimates that 90% of Yemeni patients die at home.
“Our hospital has no doctors, only a few nurses and administrators. In fact, there is no medical treatment. ‘
Krauss reported from Jerusalem. Associated Press writers Andrew Meldrum in Johannesburg, Emily Schmall in New Delhi, Isabel DeBre in Cairo, Franklin Briceño in Lima, Peru and Michael Weissenstein in Havana contributed to this report.
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