DAKAR, Senegal (AP) – A crisis over the supply of medical oxygen for coronavirus patients has hit countries in Africa and Latin America, which were ignored at the start of the pandemic and doctors say the shortage has led to unnecessary deaths.
It takes about 12 weeks to install an oxygen plant in a hospital and even less time to convert industrial oxygen production systems into a medical-grade network. But in Brazil and Nigeria, as well as in less populated countries, decisions were made to fully address inadequate supplies only last month, after hospitals were overwhelmed and patients began to die.
The medical oxygen availability gap “is one of the defining health issues of our age, I think,” said Peter Piot, director of the London School of Hygiene & Tropical Medicine, who said he survived a serious coronavirus infection thanks to the oxygen provided. he received.
Doctors in Nigeria keep a close eye on traffic as oxygen flows through the streets of Lagos at the touch of a button. Desperate families of patients around the world sometimes turn to the black market. Governments are only taking action after hospitals have been overwhelmed and those infected have died with dozens dead.
In the Brazilian state of Amazonas, a few scammers were caught reselling fire extinguishers that had been painted to look like medical oxygen tanks. In Peru people camped in rows to get cylinders for sick relatives.
Only after the lack of oxygen was blamed for the deaths of four people in an Egyptian hospital in January and six people in a hospital in Pakistan in December, the governments addressed the problems.
John Nkengasong, director of the Africa Centers for Disease Control and Prevention, said medical oxygen is a “huge critical need” on the continent with 1.3 billion people and is a major reason that COVID-19 patients are more likely to die during peaks there.
Even before the pandemic, the 2,600 oxygen concentrators and 69 functioning oxygen plants in sub-Saharan Africa met less than half the need, leading to avoidable deaths, especially from pneumonia, said Dr. John Adabie Appiah of the World Health Organization.
The number of concentrators has grown to about 6,000, mainly through international donations, but the oxygen produced is not pure enough for the critically ill. The number of plants that can generate higher concentrations is now at 119.
But without formal requests from governments, nearly $ 20 billion in World Bank coronavirus funds for the world’s poorest countries has gone unspent so far, the organization told The Associated Press.
Nigeria “struggled to find oxygen to treat cases” in January, said Chikwe Ihekweazu, head of the Center for Disease Control.
A main hospital in Lagos, a city of 14.3 million inhabitants, saw the number of virus cases increase 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 raise an additional 38 set up oxygen factories and an additional $ 670,000 to repair factories in five hospitals.
Some oxygen suppliers have drastically increased prices, according to a doctor at Lagos University Teaching Hospital who spoke on the condition of anonymity because he was not allowed to speak to reporters. That has pushed the cost of a cylinder 10-fold, to $ 260 – more than the average monthly wage – and a critically ill patient may need as much as four cylinders a day.
Money and influence don’t always help.
Femi Odekunle, a Nigerian academic and close ally of the president, was without adequate oxygen at Abuja University Teaching Hospital for nearly 12 days until two state governors and officials from the Ministry of Health intervened. He died anyway, and relatives and friends blame the oxygen deficiency, the Premium Times reported. The hospital attributed his death to his severe infection.
In Malawi, the president pledged funding for protective equipment for medical workers and the immediate purchase of 1,000 oxygen bottles.
Corruption has been blamed for malfunctions at a new oxygen plant in a hospital in the Ugandan capital Kampala, the Daily Monitor reported. Workers had to rely on rusty oxygen cylinders blamed for the deaths of at least two patients.
“While top health officials basked in the oxygen of good publicity, patients were literally suffocating,” the paper said.
Leith Greenslade of the Every Breath Counts Coalition, which advocates wider access to medical oxygen, said the impending shortages were clear last spring.
“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 deficit is increasing at a crisis level, ”she said.
The World Bank set aside $ 50 billion for the world’s poorest countries during the pandemic alone, and allocated $ 30.8 billion, including $ 80 million for oxygen-related upgrades.
“We make money available to countries, but it is countries and governments that have to make a decision about how much to spend and what to spend it on,” said Dr. Mickey Chopra, who helps with the World Bank’s global medical logistics response.
A global task force focusing on oxygen was formally announced Thursday and will include the World Health Organization and the World Bank. $ 90 million has already been identified in immediate oxygen financing needs for 20 developing countries, including Nigeria and Malawi.
Many countries see oxygen supply primarily as an industrial product for more lucrative sectors such as mining, not healthcare, and it has not been the focus of many international donors. Oxygen factories need technicians, good infrastructure and electricity – all of which are scarce in developing countries.
The main supplier of medical oxygen to the Brazilian state of Amazonas, White Martins, was operating at half its capacity before the pandemic. The first infections hit the isolated city in March and caused so many deaths that a burial ground was carved out of the jungle.
Doctors in the capital, Manaus, were forced to choose which patients to treat last month because the oxygen supply decreased.
Brazil’s Supreme Court began an investigation into the management of the crisis after White Martins said an “unexpected surge in demand” led to shortages.
“There was a lack of planning on behalf of the government,” said Newton de Oliveira, president of Indústria Brasileira de Gases, a major oxygen supplier.
Only after an average of 50 deaths per day did the government say it would build 73 oxygen factories in the state. Within a month, 26 were in use.
Oxygen deficiency remains critical in Peru, where Dani Luz Llamocca waited five days outside a distribution center in Lima and said her virus-ridden father had less than half a tank of oxygen. She was willing to wait as long as it took. “If not, my father will die,” said Llamocca.
In total, health experts estimate that 500,000 patients in developing countries currently require 1.1 million oxygen bottles per day.
WHO’s Appiah said mining countries could retrofit their systems to produce medical-grade oxygen. India’s national trade association for gas manufacturers suggested that last April and industrial storage tanks were being reused in hospitals, said Surendra Singh, a manager at the multinational Linde.
“It’s not rocket science,” said Saket Tiku, president of the All India Industrial Gases Manufacturers Association. “The decision has saved thousands of lives.”
Hinnant reported from Paris. Sam Olukoya and Lekan Oyekanmi in Lagos, Nigeria, Aniruddha Ghosal in New Delhi, Franklin Briceño in Lima, Peru; Sam Magdy in Cairo, Diane Jeantet in Rio de Janeiro, Cara Anna in Nairobi, Kenya, Riaz Khan in Peshawar, Pakistan, and Rodney Muhumuza in Kampala, Uganda contributed.
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