DAKAR, Senegal (AP) – A crisis over the supply of medical oxygen to coronavirus patients has hit countries in Africa and Latin America, where warnings at the start of the pandemic have disobeyed and doctors say the shortage has led to unnecessary deaths has.
It takes about 12 weeks to install an oxygen plant in the hospital and even less time to convert industrial oxygen production systems into a medical network. But in Brazil and Nigeria, as well as in less populated countries, it was only last month that it was decided to address insufficient supplies, after hospitals were overwhelmed and patients began to die.
The gap in the availability of medical oxygen “is, in my opinion, one of the most important issues in our age,” said Peter Piot, director of the London School of Hygiene & Tropical Medicine, saying he was surviving a serious coronavirus infection due to the oxygen he received.
Doctors in Nigeria are watching the traffic anxiously as oxygen deliveries move through the streets of Lagos. There and in other countries, desperate patient families sometimes turn to the black market. Governments only act after hospitals are overwhelmed and the infected die by the dozens.
In Amazonas, Brazil, scammers have been caught selling fire extinguishers painted to look like medical oxygen tanks. In Peru, people camped in queues to get cylinders for sick family members.
Only after the oxygen shortage was blamed for the deaths of four people in January in an Egyptian hospital and six people in Pakistan in December, governments addressed the problems.
John Nkengasong, director of the Africa Centers for Disease Control & Prevention, said medical oxygen was a “major critical need” across the continent of 1.3 billion people and it is a major reason that COVID-19 patients are more likely to die there during an increase in cases.
Even before the pandemic, the 2,600 oxygen concentrators in sub-Saharan Africa and 69 functioning oxygen plants provided less than half of the demand, leading to preventable deaths, especially due to pneumonia. John Adabie Appiah of the World Health Organization said.
The number of concentrators has grown to about 6,000, mostly from international donations, but the oxygen produced is not pure enough for critically ill people. The number of plants that can generate higher concentrations is now 119.
Nigeria “struggled to find oxygen to deal with cases” in January, said Chikwe Ihekweazu, head of its Disease Control Center.
At a major hospital in Lagos, a city of 14.3 million, virus cases increased fivefold in January, with 75 medical workers infected in the first six weeks of 2021. Only then did President Muhammadu Buhari release $ 17 million to build another 38 oxygen plants and another $ 670,000 to repair plants in five hospitals.
Some oxygen providers have increased prices dramatically, according to a doctor from Lagos University Teaching Hospital, who spoke on condition of anonymity because he is not allowed to speak to reporters. It has increased the cost of a cylinder 10 times, to $ 260 – more than the average monthly wage – and a critically ill patient may need up to four cylinders a day.
Money and influence do not always help.
Femi Odekunle, a Nigerian academic and close ally of the president, went to the Abuja University Teaching Hospital for almost twelve days without adequate oxygen until two heads of state and officials of the Ministry of Health intervened. He died anyway, and family members and friends blame the oxygen deficiency, reports the online newspaper Premium Times. The hospital attributed his death to his serious infection.
In Malawi, the president promised funding for protective equipment for medical workers and the immediate purchase of 1,000 oxygen cylinders, adding that he would fly them in if necessary.
Corruption has been blamed for defects in a new oxygen plant at a hospital in Uganda’s capital, Kampala, the Daily Monitor reported in November. Workers had to rely on rusty oxygen cylinders blamed for the deaths of at least two patients.
“While the best health officials enjoyed the oxygen of good publicity, patients literally suffocated to death,” the newspaper said. “It seems that behind the delays and the funding gaps the corners have been cut.”
Leith Greenslade, coordinator of the Every Breath Counts Coalition, which is campaigning for wider access to medical oxygen, said the looming shortages this past spring are clear.
“Very little has been done. “Now you have a second wave, not only in Africa, but also in Latin America and Asia, and the oxygen shortage is reaching crisis levels,” she said.
The World Bank has set aside $ 50 billion for only the poorest countries in the world, but only $ 30.8 billion has been committed, including $ 80 million for oxygen-related upgrades at the request of Afghanistan, Bangladesh, Benin, the Central African Republic, and Chad. Congo, Gambia, Ghana, Grenada, Kenya, Mali, Rwanda, Sierra Leone and Tajikistan. That leaves nearly $ 20 billion available until a June 2021 deadline to spend it, the World Bank said.
“We make money available to countries, but it is countries, governments that have to decide how much they spend and what they spend on,” said Dr. Mickey Chopra said. He helps with the World Bank’s global medical logistical response.
Many countries view oxygen supply primarily as an industrial product for more profitable sectors such as mining, not healthcare, and this has not yet been a focus of many international donors. Oxygen manufacturing plants need technicians, good infrastructure and electricity – these are scarce in developing countries.
The main supplier of medical oxygen to the Amazon state in Brazil, White Martins, worked at half capacity before the pandemic. The first infections hit the isolated city in March and led to so many deaths that a cemetery was carved out of the jungle.
Doctors in the capital Manaus were forced to choose last month which patients to treat as their oxygen supply dwindled.
The Brazilian Supreme Court has launched an investigation into crisis management after White Martins said an “unexpected increase in demand” was leading to shortages.
“There was a lack of planning on behalf of the government,” said Newton de Oliveira, president of Industrria Brasileira de Gases, a major oxygen supplier.
Only after the deaths averaged 50 a day did the government say it would build 73 oxygen plants in the state. Within a month, 26 were up and running.
Deficits are still critical in Peru, where Dani Luz Llamocca waited five days outside a distribution center in Lima, saying her virus-stricken father was less than half a tank of oxygen. She was willing to wait as long as it took. “If not, my father will die,” Llamocca said.
The WHO’s Appiah said that countries with mining industries, with little change, could switch their systems to produce medical oxygen.
India’s national trading body for gas manufacturers only suggested that it was in April 2020, when the virus load was relatively low. Industrial storage tanks have been re-admitted to hospitals, says Surendra Singh, a manager for the Indian division of the multinational Linde corporation.
“This is not rocket science,” said Saket Tiku, president of the All India Industrial Gases Manufacturers Association. “The decision saved thousands of lives.”
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Hinnant reported from Paris. Aniruddha Ghosal in New Delhi, Franklin Briceño in Lima, Peru; Sam Magdy in Cairo, Diane Jeantet in Rio de Janeiro, Sam Olukoya and Lekan Oyekanmi in Lagos, Nigeria, Cara Anna in Nairobi, Kenya, Riaz Khan in Peshawar, Pakistan, and Rodney Muhumuza in Kampala, Uganda.
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