MOGADISHU/NAIROBI – Despite the pandemic, the hustle and bustle does not stop on the streets of Mogadishu, Somalia’s most populous city, which is facing a growing number of coronavirus infections and deaths.
The only hospital equipped to treat coronavirus patients is already overwhelmed as cases rise in the country located on the Horn of Africa.
Somalia has recorded over 2,200 COVID-19 cases and some 80 deaths to date. A lack of testing means the true number of cases is likely higher.
“People are afraid to share their health status because they feel ashamed in public, which is why we are not getting the real figure,” Somali doctor Mohamed Abshir explains to EFE.
On the street, where pedestrians walk without masks, the atmosphere has not changed much since the outbreak began.
“Since the lockdown, our business facilities are functioning well and our daily retails are decreasing, which is badly impacting our economic status,” says Abshir Gab, a merchant from Mogadishu.
Most of the capital’s 2.5 million residents are seemingly oblivious to the pandemic, particularly those living on the outskirts of Mogadishu, many of them internally displaced by drought, flooding, terrorism or war.
“We depend on daily casual work to cover our daily income,” Maruan Sheikh Adan, who is an environmental migrant, tells EFE.
There is some good news though. The price of basic goods and medicines has stabilized after the government imposed a tax exemption on imported goods.
The bad news is that Somalia has one of the most precarious health systems in the world, burdened by decades of conflict.
Mogadishu Mayor Omar Filish, raised the number of deaths to more than 500 earlier this month, a figure he attributed to the testimonies of doctors, gravediggers and family members of suspected patients.
According to Filish, health authorities have recorded between 17 and 49 deaths a day in the city since April 19, although official data barely records five daily deaths.
“The situation is on the verge of spiraling out of control. We are seeing widespread community transmission in a country that will not be able to handle a multitude of severely ill patients at once,” International Rescue Committee (IRC) Somalia director Richard Crothers recently warned.
The health system, which only has around 20 ICU beds and 19 ventilators, depends almost entirely on NGOs.
The city has only one free ambulance service, Aamin, and it continues to be the most reliable when an attack shakes the capital. Nowadays all of its 20 vehicles have been deployed to tend to COVID-19 callouts.
“People are calling the ambulance and we are asking a couple of questions on the telephone. If they cannot stay at home, we transfer them to the hospital,” Aamin director Abdulkadir Adan tells EFE.
They are transferred to the Martini hospital, the only one prepared to treat COVID-19, which already welcomes more patients than its capacity allows, says Abdifatah Ayub, one of the members of the epidemic’s management committee.
“We are trying our best to contain the virus and scale up our response and advise people to follow the instructions” Mohamed Abshir, deputy manager of the hospital, tells EFE.
To convince Somalis of something, you have to have the elders and Muslim clerics on your side.
“The religious community, especially the sheiks, were resistant to closing mosques,” independent analyst Abdullahi Abdille Shahow says.
These centers have become instrumental in spreading false information including that coronavirus does not affect Africans or that sunbathing in the morning cures the disease.
Many of these health hoaxes have been echoed in Friday sermons by imams linked to Islamist militant group Al Shabaab.
In Al Shabaab fiefdoms, cleric Fuad Mohamed Khalaf, known as Fuad Shongole, tells the faithful that coronavirus is “a punishment from Allah to the infidels for their evil, and for standing against sharia implementation in Muslim lands.”
In late April Ali Dhere, a spokesman for the terrorist group which controls almost all of rural central and southern Somalia acknowledged the disease for the first time but said it was a foreign problem people should be too concerned about.
While the Somali government has used the Koran in its fight against the virus by talking of the importance of hand-washing, Al Shabaab uses it to blame the government and accuse the African Union of bringing it to the country after the first case was detected on its base on March 16.
Koranic schools in areas ruled by Al Shabaab are still open and crowded with students as are mosques where the faithful go at least twice a day, according to Dhere.
“I don’t know how Shabaab would react this time,” says Shahow.
The analyst recalls the group caused more than 250,000 deaths during the 2011 famine by blocking humanitarian organizations from delivering aid to their territories.
So far, medical visits to areas like Baidoa in the southwest or Galkayo in the north have decreased, Doctors Without Borders (MSF) has warned.
“It could be due to the population’s fear of going to health centers, restrictions or even rumors of what could happen to you if you contract COVID-19,” a spokesperson for the NGO tells EFE.
The coronavirus is the latest ingredient in an already simmering cocktail of terrorism, famine, a spiral of drought and floods and a plague of locusts that refuses to leave the Horn of Africa.
“Somalia has faced decades of violence and cycles of drought and floods, leaving its health care system ill equipped to respond to this outbreak,” IRC director for Somalia says.
Recent rains and floods have sparked a new wave of displacement, with 200,000 people affected and the threat of more cases of malaria and cholera.
As MSF Somalia chief Gautam Chatterjee warns:
“Families will be hit by climate disasters, women will continue to give birth, children will continue to fall sick from malnutrition and patients with chronic diseases will continue to need medication. All of this is taking place at a time when the humanitarian response capacity is stretched globally.”