How communities have demonstrated resilience in the time of Covid-19
As the TWG – FCAS wraps up discussions on “Covid-19 in FCAS”, we present a blog covering testimonies from our members and stakeholders (1 in Mali and 2 in Mauritania) who share accounts of positive experiences in COVID-19 management/response exhibited by their community, a particular group of stakeholders or country at large.
Testimony 1. Haidara, Mali
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic that appeared in Wuhan in December 2019 quickly became a major global pandemic with high morbidity and mortality. Mali has not remained on the sidelines of other countries, specifically the Mopti region, which was under the weight of the security crisis and the covid-19 pandemic. Thus, faced with a virus that has shaken all the most efficient and effective health systems, psychosis sets in on the side of caregivers in underdeveloped countries, particularly in Mali. Since Mali’s system was not ready to face such a scourge, it needed strong resilience to contain it. HSD-Mopti had its first confirmed case on April 15, 2020, while facing a severe lack of means (material, human and financial resources). Health workers found themselves at the heart of care. Amidst concern and panic of the population because no one knew the direct manifestations, nor the degree of severity from one patient to another, the state of Mali as part of the PEC has decided to provide hospitals with 80 million [CFA] to quickly buy equipment to provide the necessary care for affected patients. The HSD-M has decided to set up a coordination team (Anesthesiologist-resuscitator, Pharmacist, Biologist, and management) and 4 special teams detached from any other activity to only take care of the PEC of covid-19 cases. The team was composed by a doctor, 2 nurses and a hygienist for a 24-hour call from 8 a.m. to 8 a.m. the next day. Protective equipment was missing, but we succeeded thanks to the courage and determination of the staff who, at the risk of their lives, struggled to take care of the sick. Thus, all confirmed cases were automatically admitted to the care sites, including simple forms without complications. Very quickly, the reception capacities of our site having been exceeded, some patients without complications were followed at home by qualified personnel. This follow-up consisted of a twice-daily visit with temperature control and monitoring of clinical signs. Among these 43 patients followed, we did not record any complications or deaths. Cure was declared on the basis of clinical criteria (amendment or disappearance of symptoms for at least 3 consecutive days) and biological arguments (two consecutive negative PCR results taken 24 hours apart). It should be noted that during the PEC period, 5 health workers were infected and the HSD-Mopti accounting officer who unfortunately did not make it. Until December 31st, 2021, we recorded a cure rate of 94.3% while the lethality reached 5.7% exclusively in the age group 60 years and over. The most difficult thing was understanding the population, who saw covid-19 as a way for health workers to make money, hence the increase in cases because the barrier measures despite the awareness sessions on the radio, TV and at the local level through campaigns. Most importantly, we had patients with comorbidity (HIV, Diabetes and Hypertension) that we were able to save thanks to our oxygen cylinders and dynamic monitoring by the PEC teams. Many gave feedback and thanks to the caregivers upon returning home safe and sound.
Testimony 2. Gnokane, Mauritania
The Covid-19 pandemic hit Mauritania on March 13, 2020, and from then onwards the response was triggered throughout the national territory. At Bababé, the ECM had set up the triage system at the health center, organized training on preventive measures for the benefit of health workers and, in collaboration with community volunteers, the town hall and civil society, a system of watch and alert especially along the river with the Senegalese border has been set up. Personally, what struck me the most during this response were the very early curfews at 4 p.m. and given the socio-economic level of the rural population, quite a few families were impacted by these measures, ranging from the couscous seller in the evening, to the cattle seller, the shopkeepers, etc. The second aspect that struck me the most was this collaboration between health actors and communities to jointly carry out awareness-raising activities and the creation of preventive aid tools including the local handwashing device called TIP TAP.
Testimony 3. Amadou Kane, Mauritania
I experienced the period of the pandemic (start-up and first response mechanisms) in two functions. The first (March 2020 in Mauritania) by being medical coordinator of the NGO Médicos del Mundo (MdM) in Mauritania and the second (August 2020) in the position I have held within ENABEL until now. Like all countries in the world and more markedly as developing countries with still weak health systems, we felt the full brunt of Covid-19. The first challenge was first to get informed and update your knowledge. Being “the science resource person” of the structure, it was necessary somehow to answer many questions both in professional and private circles. This led us to redo a form of research, both in publications, referenced sites and all forms of media. Fighting rumors was essential. In addition, the reorganization of meeting models using teleconferences allowed us, despite the not always excellent connection quality, to have more participants in training sessions than the largest rooms in the country could allow. It was a big step because it made it possible to have in the same meeting room experts from all over the world engaged in the response. In addition, we have specifically rearranged our interventions according to the barrier measures but also to the new local conditions imposed, in particular the curfew. We had special care units (USPEC) for victims of gender-based violence for which a telephone number had been made available to provide information on GBV but also to direct victims to medical facilities. Unable to move, they were provided with a vehicle with a travel permit that picked them up in the neighborhoods from which they were calling. In respect for social distancing, wearing a mask was required in the vehicles. This adaptation thought out by all the members of the MdM health/gender team and other partners will have made it possible, in a difficult time, to maintain support for these vulnerable people. During the second phase of the response stationed in the Moughataa (District) of Dar Naim, investigations carried out with certain health structures in the area made it possible to objectify, like everyone else, that they had suffered a disorganization of the offer of care for the populations at first. Little by little ideas emerged, which made it possible to reduce the influx of patients in sometimes cramped structures, to reduce their waiting time while diversifying care. The medical teams were divided into two with agents going up in the morning and others in the afternoon. The morning and afternoon treatments were different but complementary. Thus, the APSDN, the local organization responsible for these structures, found a way to maintain its activities by considering the new situation.
Photo credit: WHO Photos
