Things are a ramping up here in Tanzania, as we now have our first case reported in our city of Mwanza. For my husband, George, and me—both of us Maryknoll lay missioners serving as physicians—things have been a bit crazy as we are getting prepared for what we fear is coming. As of last Monday, April 6, we had a still relatively small official count of 24 cases in Tanzania, but COVID-19 has now arrived in Dar es Salaam, Mwanza and Zanzibar.
At our small, rural, Catholic Bukumbi Hospital, 25 miles south of Mwanza, we are very ill-prepared, as I imagine most hospitals in Tanzania are. To make matters worse, the roof of the children’s ward blew off in a bad storm several months ago, and there are no plans to replace it (due to money of course), so kids are now sharing the female ward with the adult women patients. This means that we now have many people crammed into the two small rooms of the female ward (eight to 10 patients in beds, plus one family member taking care of each patient).
George, who is the pediatrician at Bukumbi, is worried about the spread of COVID-19 if one child has it. But we may likely never know if a child has it because so few tests are being done in the whole country. People are being tested at Bugando Medical Centre, the big referral hospital in Mwanza, but only if they have symptoms and have also recently traveled internationally.
And of course the symptoms of COVID-19 are the same symptoms of regular pneumonia, which is one of the main causes of mortality for children under the age of 5. There are almost always patients of George’s with fever and cough.
I have been asked to temporarily take over as doctor in charge of the Care and Treatment Center (our HIV care center). At the end of February, Rosa, the CTC director who is a doctor from the IMA (an international Catholic mission group), went to visit her elderly parents back in Italy. She had planned to return before the other CTC doc, a young Tanzanian woman, finished her contract and left for speciality training in Dar. But now of course Rosa is stuck in Italy, so I got a new job.
So far so good, but of course our HIV-positive patients are very vulnerable to any infection, especially those without good control of their HIV, so the effects of a COVID-19 outbreak are very scary to consider.
I’m trying to give people longer-term refills on their antiretroviral medications to avoid as much as possible people coming into the healthcare setting during an outbreak unless it’s necessary. But we also don’t have enough extra supply of the medication to do that for everyone right now. We are waiting for more to be delivered soon.
On top of everything, the running water system for the CTC has been broken for a month or more, so the clinical officer, the nurses, lab techs, pharmacy techs and me are all sharing one bucket-with-spigot, sitting on a stool above a basin in the middle of the hallway. Talk about barriers to hand hygiene!
At our Tanzanian president’s direction, churches continue to remain open, and as of today, Easter Masses were still scheduled to go ahead. We greatly fear that this year’s Easter celebrations will be massive virus-transmitting events that will usher in full-scale outbreak here.