Surgeries take back seat as Coronavirus rages

In March last year when COVID-19 was first detected in Kenya, the country’s 47 governors rushed to set up isolation centres in their respective counties.
The centres were to be equipped to deal with the rising numbers of patients who had contracted the disease.

Several months later, hospitals were jammed with COVID-19 patients, forcing governors to redeploy healthcare workers to concentrate on battling the pandemic.

This move led to stalling of some critical medical procedures and services such as surgery, leaving those in need in pain after Intensive Care Units (ICU) were dedicated to deal with serious COVID-19 patients.

For healthcare workers in most public hospitals, it was a delicate balancing act, as they dealt with the pandemic while trying not to ignore other critical medical procedures that patients needed.

At the Coast General Teaching and Referral Hospital (CGTRH) – the largest hospital in the Coast region, which serves Kwale, Kilifi, Taita Taveta, Tana River, Lamu and Mombasa counties – surgeons were forced to come up with alternative plans to help prevent their patients from succumbing to their ailments.

“I had to take care of my patients. Because there were no surgeries; it meant taking care of their medical condition through medicines just to keep them going,” said Dr Peter Sore, a cardiac and thoracic surgeon who heads the heart clinic at CGTRH.

Dr Sore said surgeons at the hospital were forced to come up with initiatives to manage patients suffering from chronic illnesses.
The specialist had planned to operate his critically ill patients only to shelve their surgeries due to COVID-19 and instead focused on relieving their pain.

“It was sad watching our helpless patients die; we could not do anything since theatres had been turned into COVID-19 facilities,” On March 22 this year, the doctor was heartbroken when the much awaited resumption of open heart surgery at CGTRH was cancelled.

“Everything was set for resumption of the open heart surgery. We were collaborating with our specialist colleagues from Kenyatta National Hospital who were to travel to Mombasa for the operations, but could not after President Uhuru Kenyatta announced lockdown in five counties with high infection rates including Nairobi. That was a major setback,” said Dr Sore.

At his clinic in the facility, he used to attend to 25 patients but nowadays only 10 patients turn up. “Surgeries are crucial for patients’ survival,” said Dr Sore.

CGTRH has six main operational theatres. However, shortage of ICU staff has been another major challenge.

“Some of the staff who were manning the ICU for surgical patients were redeployed to take care of those battling the virus. It was sad that surgeries could not be performed because

ICUs were converted to COVID-19 facilities to take care of those battling the virus,” added the senior doctor.

The specialist is among doctors who have been conducting surgeries on COVID-19 patients with surgical issues.

Dr Sore said he was distressed when some of his patients succumbed at home due to the pandemic.

“My patients were afraid of the hospital, saying they could contract COVID-19, but their conditions, which needed surgeries, worsened day by day. I knew things were really bad when one of my patients who needed an endoscopy succumbed because we could not do the crucial surgery to save his life,” said the medic with over 30 years’ experience.

To ascertain the extent of COVID-19 impact on healthcare, Dr Sore advised the government to conduct research to show how the disease has affected Kenyans.

“COVID-19 has affected surgery practice, slowing down our work and leaving our patients in agony. We have new procedures; before conducting any surgery, you have to do a COVID-19 test,” he said.

Dr Hemed Twahir, an official of the Mombasa County COVID-19 Response Committee, said the pandemic has brought to the fore critical health issues that should be addressed.

“The most important lesson I have learnt is why we must enhance and strengthen primary healthcare. A lot of what is happening could have been handled better and a lot of positives that have been witnessed is because we have managed to strengthen primary healthcare,” said Dr Twahir.

The medical director at the Aga Khan Hospital in Mombasa lauded the government for incorporating community health workers who have enhanced contact tracing and hygiene in communities.

“The basic primary healthcare unit is very crucial. In the future, we should learn that treating a problem is more expensive than prevention. I have learnt that you cannot deal with a pandemic on your own,” Dr Twahir added.

The pediatrician said the world managed to control Spanish flu in 1918 better than it has done with coronavirus.

“Because there wasn’t as much traveling as currently. If we put ourselves together globally, we can come up with appropriate good outcomes. Within a year of coronavirus vaccine, we have had malaria vaccine coming up, that is a very big lesson,” he said.

Due to the pandemic, Dr Twahir said most hospitals have now strengthened their health systems, especially for critical healthcare.

“For a long time a lot of health institutions all over the country were lacking critical care, essential things like oxygen and ICU. But COVID-19 has taught us that we need to be prepared in taking care of critical care patients, counties have now gotten ready,” said the pediatrician.

Mombasa Governor Hassan Joho resolved to improve accessibility to quality and dignified affordable healthcare with heavy investment in medical infrastructure, equipment and human capital.

“We are strengthening the local healthcare systems, enhancing training and capacity building of our medical staff while also increasing awareness of respiratory complications in the community,” he said.


Tourism and conservation suffer as pandemic wreaks havoc

For 21 years, Bamburi Nature Trail Hill, commonly known as Haller Park, has never closed its doors to visitors. 

The sanctuary for lost and orphaned wildlife has been a haven for anyone who wanted to spend their day relaxing in a peaceful environment and getting acquainted with friendly animals. But when I visited recently, seeking an interview, Karima Nyinge, who heads the department for visitors, shocked me with the news. “We have closed the park for now due to the COVID-19 disease,” he said.

 Haller Park was named so in honor of Dr. Rene Haller in recognition of his efforts, in conjunction with Bamburi Portland Cement Company, in transforming the abandoned quarry into a breathtaking ecological paradise.

The park is located south of the cement plant along the Mombasa-Malindi highway. It covers 75 hectares of land and houses a variety of animals, including hippos, buffalos, giraffes, waterbucks and oryx. The night walks in the park, conference services, among other activities, are now a thing of the past, thanks to the COVID-19 pandemic.

Mr. Nyinge says the government regulations to prevent the spread of the coronavirus have made it difficult for the park to operate since they host large groups per day. 

“We have closed because some of the rules are hard to observe, especially because visitors like to converge around hippos and giraffes and feed them, which will see us break the rule on social distancing,” he says. 

Another hurdle is contact tracing in case one of the visitors tests positive for the disease.

 Mr. Nyinge says it would be difficult for them to trace all the contacts that might have come into contact with the person. He says the park receives up to 160,000 tourists a year, but this year they are likely to fall way below the number. But luckily, some of the workers were retained to continue feeding the animals and maintain their daily routine. 

“The animals have been trained. For example, a hippo would come out when they are called. It’s a routine for them and we don’t want them to forget it,” says Nyinge. 

The situation is not different for the Tsavo Heritage Foundation in Voi, Taita Taveta County, which champions the landscape restoration of the Tsavo Ecosystem and Dispersal Areas. Jacob Kipongoso, the Foundation CEO and environment activist, says since the first case of COVID-19 was announced in Kenya they put on hold all their plans on conserving the environment. 

According to Kipongoso, most of their work involves people, hence it is difficult to uphold keeping the social distancing rule. “For now all the plans we had to plant trees here at Voi were put on hold. We have nothing to do since all the work we were supposed to do involves people,” he says.

“We were supposed to have a big meeting with environmental activists in May and an international conference in December, but both were postponed.” 

Kipongoso says poachers have taken advantage of the situation to increase their poaching activities because they know there is not enough security at the sanctuary. He urges the government to provide the activists with personal protective equipment so that they continue planting trees and attain the 10 percent forest cover the State is advocating for.

Kenya Wildlife Service (KWS) Director General Brig (Rtd) John Waweru says the tourism sector has recorded a 92 percent drop in revenues since March when the first case of COVID19 was detected in the country. 

The KWS boss was addressing a webinar organized by Internews in conjunction with the East African Community and World Conservation Union (IUCN) last week.

Waweru says other threats include a drop-in visitors’ numbers by 76 percent, an increase in poaching of endangered species, increased transnational crime through porous borders, escalation in bushmeat poaching and associated crime and increased human-wildlife conflicts due to influx of people in the rural areas. He says they are now planning to use technology to improve security at the parks. 

“We are planning to use drowns for surveillance at the parks to stop poaching activities. We are also planning to train our rangers to be multi-skilled and offer different services at the park,” says Waweru. 

While addressing the same webinar, Christophe Bazivamo, the Deputy Secretary-General for Productive and Social Sectors in the East African Community (EAC), said the region relies heavily on the abundance and diversity of wildlife to boost its economic growth, earn foreign exchange and creates jobs. 

He suggests a number of interventions in the wake of the pandemic, including EAC member states providing stimulus packages for tourism small and medium enterprises (SMEs), community-based conservation initiatives, and promotion of regional and domestic tourism. 

Other measures include diversifying conservation revenue streams, strengthening one health platform, and developing protected areas management plans.




The invisible people

By Ellen Msungu I

The nightmare that is COVID-19 has undoubtedly shaken the world. For persons with disabilities, they have remained invisible. 

Ms. Angeline Akai echoes these sentiments. She is a visually impaired person who, until the pandemic showed up, was working as a consultant sensitizing people on the plight of persons with disabilities. 

Today, she sits at home with his nephew, jobless. According to the government, she is not an essential service provider and therefore has to work from home, but, no client comes to her at home. 

 Everyone is skeptical, and, like the Ministry of Health advised, “you should treat everyone as a suspect of COVID-19, hence the need for social distancing.” 

For more than three months now, she has not been receiving clients. Her income is no more and her savings are depleting as time goes by.

“I do not like asking for help from friends, but I am afraid I’m now relying on friends, which, I feel is a threat to my dignity,” says Ms. Akai. The government released funds to help the vulnerable but speaking to some of the people with disabilities, they said that they are yet to receive any assistance. 

“I have asked my area chief if he has heard of any registration that is ongoing for people like us, but he told me he is not aware of any of such,” says Ms. Akai. If she were to go out, as usual, she will need aid to walk her through the streets of Nairobi, and, her nephew is not one of the options because he is still young. Her vulnerability to unknowingly coming into contact with persons with the coronavirus is high. Ms. Akai is not alone. 

Catherine Syokau is a Communication Officer, with a physical disability. Her story is quite different. Unlike Ms. Akai, she still goes to work, but only thrice or twice a week. That means that her productivity, like most Kenyans, has reduced. 

“Working from home is a challenge for me, I do not have internet connection so there are some duties that I cannot perform from home,” says Syokau. Her routine when going to work is still the same, only that this time, she has to have a hand sanitizer all the time just to be safe.

At the bus station though, as it has always been for her, she is helped to board the bus to and from work. She, therefore, is at risk of getting too close to people whose viral status, she may not know. She is forced to sanitize her wheelchair so many times as recommended by public health officials. The Nairobi Metropolis put up water points for people to wash their hands while in town as one of the ways of containing the virus. 

One thing that unfortunately did not cross their minds, is that people like Ms. Syokau are not privileged to use taps that high. “I cannot wash my hands in town, I only sanitize. What about my fellow vulnerable people who cannot afford sanitizers?” she asks. 

Tom Ndede, who works with persons with disabilities, feels that the “hearing impaired are the most neglected people during the ongoing relief items distributions compared to other persons with disabilities.” 

Delving deep into the issue, you will understand why that is his intuition and he says the main barrier is communication. Whilst the Ministry of Health briefing could have a sign language interpreter, not everyone has the luxury to watch that, and on radio, communicating to a person with hearing impairment is impossible. They are left out when crucial decisions regarding the pandemic like the curfew are made. 

“Sometime back, a young man who is deaf in Kakamega who had not heard about the curfew was beaten up by police because they did not understand his situation,” says Mr. Ndede. 

That did not sit well with the members of the deaf community. Their appeal to the chair of the National COVID-19 response team, therefore, is to highlight some of the challenges facing persons with disabilities during the pandemic.


Let governments facilitate free movement of seed under the COVID-19 crisis

As the world reels under the debilitating effects of a serious health crisis with “SARS-CoV-2” and the disease it causes “coronavirus disease 2019” (COVID-19), now declared by the World Health Organization as a pandemic, it is important that authorities world over think outside the box to secure a food secure world post coronavirus time.

Even as we, science journalists from MESHA, join the rest of the world in supporting measures to prevent further spread of the virus, do believe that the world’s long-term stability rests on several pillars, one of which is food security.

We wholly recognize that unrestricted international movement of seed is critical to ensure food security. Today there is no country that could fully supply farmers with seed of their choice solely from their own production. Seed companies produce and trial seed in different countries all over the world as a way to mitigate the risk of crop failures due to adverse weather conditions.

It is therefore imperative that all African countries allow free movements of seed at this time of the year.

By finding optimal locations for seed production, timing of harvest, and localized expertise, the seed sector ensures the steady supply of seed for farmers everywhere.

Therefore, closing borders or even slowing down the transboundary movement of seeds could create a significant problem in the seed supply chain.

Given the current situation of the COVID-19 pandemic, a few countries have stopped movement of seeds across borders. This is sad. If this trend is allowed to continue, it will be catastrophic for African countries of unimaginable proportions in the next few months as there will be inadequate harvests a situation that will lead to food insecurity, malnutrition and hunger.

Since seed has not been found to be a causal agent of the coronavirus, we appeal to all Member States to refrain from interrupting seed movement.

If the seed does not move anymore because people are scared of this pandemic, it will be difficult for the continent/the region to recover from the likely repercussions for a long time to come.

Already the situation of food security in Africa is precarious and any further interference with the seed value chain will bode ill for all of us.

We join others, especially voices from the seed sector in asking governments to facilitate the international movement of seed and not to impose restrictive measures. Given their past records in practicing due diligence, we are confident that seed companies will take all necessary measures to guarantee the health and safety of workers who are involved in the shipment of seed.

Let all the concerned authorities all over Africa, and the world ensure the most favourable conditions possible for the supply of farmers with all plant productive material they need for a successful harvest in 2020, while respecting all necessary restrictions for the health of all people.

That way, we would have secured a food secure world post the coronavirus pandemic.


Global research on coronavirus disease gets a boost

By Christine Ochogo

Scientists, physicians, funders, and policy makers globally have launched a COVID-19 Clinical Research Coalition to accelerate research on the prevention and treatment of the pandemic in low- and middle-income countries.

This coalition formed by 70 institutions from over 30 countries aims to accelerate desperately needed COVID-19 research in those areas where the virus could wreak havoc on already-fragile health systems and cause the greatest health impact on vulnerable populations.

According to World Health Organization (WHO) Coronavirus disease (COVID-19) is an infectious disease caused by a new virus.

The disease believed to have originated from Wuhan, a small market in China, has continuously been spreading globally from when it first broke out in November 2019.

The members of the coalition argue that international research collaboration and coordination is needed urgently to support African, Latin American, Eastern European, and certain Asian countries to respond effectively to the worsening pandemic and speed up research adapted to resource-limited settings.

“The coalition brings together an unprecedented array of health experts, including public-sector research institutes, ministries of health, academia, not-for-profit research and development organizations, NGOs, international organizations, and funders all committed to finding COVID19 solutions for resource-poor settings,” read in part a comment recently published in The Lancet.

One important research response to COVID-19 has been launched already, the World Health Organization (WHO)-led SOLIDARITY trial, an unprecedented global effort. However the authors found that out of almost 600 COVID-19 clinical trials registered, very few trials are planned in resource-poor settings. The authors commit to sharing their technical expertise and clinical trial capability to accelerate COVID-19 research in these settings.

The scale of the challenge is clearly beyond the scope of any single organization and therefore the coalition will facilitate a coordinated approach, so that all data from all regions can be collected in a similar fashion, pooled and shared in real-time. This will help countries and the WHO to make rapid evidence-based decisions on policies and practice.  

“We welcome the launch of this coalition, which takes advantage of existing multinational and multidisciplinary expertise in running clinical trials in resource poor settings, and will help the World Health Organization (WHO) in its coordinating role in the global response to COVID-19,” said Dr Soumya Swaminathan, Chief Scientist, World Health Organization.

“Although the epicenter is today elsewhere, we must prepare now for the consequences of this pandemic in more resource-constrained settings or we stand to lose many more lives,” added the doctor.

Members of the Coalition call for specific commitments to ensure access, so that effective new treatments are made available as soon as possible in resource-poor settings and are affordable and readily accessible.

Even though more than 70 organizations have joined this coalition, a call has been made to other organizations ready to contribute existing capacity to also join.

COVID-19 disease causes respiratory illness with symptoms such as cough, fever and in more severe cases victims who have been infected may have difficulties in breathing and even cause death.

The disease spread primarily through contact with infected person when they cough or sneeze. It is also spread when a person touches a surface or objects that have the virus.

In trying to control the spread of the disease, one is advised to wash their hands frequently using soap and running water, use sterilizers, avoid touching one’s face and keep social distance with people (1 meter or 3 feet).

The pandemic has so far affected over a million individuals globally, causing over 600,000 deaths. Different countries are trying to take various preventive measures in the help to curb its spread.

 In Kenya, the government has come up with measures among them asking people to stay at home and avoid social places, a daily 7.00 pm to 5.00am curfew and making use of masks.


Expert: Journalists must stay out of harm’s way while covering COVID-19

By Christine Ochogo

NAIROBI – SATURDAY, APRIL 10, 2020 – Journalists have been cautioned against using traditional ways of news gathering when covering the coronavirus pandemic.

Just like all other humans, journalists are not an exemption and are equally at risk of contracting and spreading coronavirus disease given the nature of their day to day work.

Internews Global Health Media Adviser, Ms Ida Jooste is advising journalists globally to protect themselves fully if they have to leave home which she discouraged. For now she said everyone should stay at home and adhere to social distancing. “No story is worth your life hence staying safe during this unprecedented time is paramount,” she warned.

Ida was speaking during a cross border science café conducted online where over 70 science journalists from Kenya, Uganda, Zambia, Zimbabwe, Rwanda, Madagascar, Ghana and Nigeria participated.

The science media café was organised by the Media for Environment, Science, Health and Agriculture (MESHA) from Kenya, Humanitarian Information Facilitation Centre (HIFC) from Zimbabwe and Health Journalists Network in Uganda (HEJNU) whose team leader, Ms Esther Nakkazi, moderated the session. On board was also Zambia Institute of Mass Communication (ZAMCOM).

She mentioned that it was high time journalists embraced use of information technology such as, zoom, skype, WhatsApp among other social media tools.

The media advisor highlighted the importance for journalists to also adopt more revolutionary ways to gather news and information such as maximizing phone-in formats and voice recording for interviewees to avoid physical contacts with them, maintaining online production of unfolding story in credible and impactful way so as to keep audience.

She also advocated for use of protective equipment and adhering to the evolving guidance about best practice for safety such as wearing of face masks, keeping social distance, these among others.

During the café the Executive Director, International Community of Women Living with HIV, Kenya Chapter, Ms Inviolata M’mbavi, said lack of information flow from government has stifled access to medication and health services for persons living with HIV. 

She added that all the attention is now focussed on COVID-19 at the expense of other ailments. However she noted that some facilities had devised ways of serving them such as providing ARVs for three weeks per visit.

 “The COVID-19 situation is complicating lives of majority of HIV patients and this has increased their stress levels since they are unable to access antiretroviral therapy (ART) and other medication,” she added.