Sharing knowhow and joining forces towards Health for All
Contribution to the Annual Report 2015 of the MMI Network

...behind the headlines intertwined

...behind the headlines intertwined

Burkina Faso is a land-locked country in Western Africa. The Human Development Index ranks it 183rd among 187 countries. Since 2002 the University Hospital of Brescia, Italy has an ongoing collaboration with the Mother&Child department of the Hospital of the Camillian Fathers in Ouagadougou (HOSCO). This report shows the hidden side of political turmoil, which too often hits out of eyeshot the most vulnerable.

The Hospital of the Camillian Fathers assists normally 3000 birth/year and has one of the largest neonatal units with 50 cots. There is also a large malnutrition Day Hospital and an HIV service with actually over 150 children on Highly Active Anti-Retroviral Therapy (HAART). Furthermore around 100 children are seen every day for general illnesses and vaccinations.

On October 2014 a peaceful revolution overthrew the 27-year old regime, the ruling president fled and a transitional government was installed. On September 17th 2015 the country was hit by a coup from the very well equipped guard regiment of the former president against the interim government. The elite soldiers stormed a cabinet meeting and seized the interim president and the prime minister along with other officials. Supporters of the interim government assembled in the streets and trade unions immediately proclaimed an unlimited strike, which was widely observed even by the health personnel. Furthermore, the military enforced a 24/24 curfew; closing of the borders and shooting on the streets contributed to paralyze all normal activities quickly.

In this situation most of the public and many private hospitals were shut down, but the HOSCO stayed wide open and consequently had to face a significant increase in patients in need.

In fact during the 10 days running from Sept 17 to 28, 888 women were seen (about an eight-fold increase to the normal affluence). 318 normal births were attended and 107 C-sections were performed (>10-fold increase). Forty-one of those neonates were retained in the hospital and another 33 showed up for emergency care and hospitalization as other clinics in the city were closed. Another 461 women came for other pregnancy-related pathologies.

Of course other services (like vaccines, routine post-pregnancy and healthy baby visits) were suspended. From the 72 HIV+ children scheduled for follow-up and – more important – pharmacy refill, only 49 were able to come before running out of stock (some of them defying the curfew), while 23 had an interruption of the HAART, which may cause them resistance problems in near future. None of the children hospitalized for malnutrition or HIV was discharged. One abandoned boy of about 10 months was also brought there by a fire brigade.

In addition, though not an hospital equipped for other than obstetric and neonatal emergencies, a couple of injured (fire arms, accidents) patients were also cared for. All this was possible as most of the personnel did come to work and many stayed there for double shifts. In order to assure safe travel between the homes and the HOSCO, ambulances accompanied staff back and forth. In addition, many Camillien Sisters and Fathers, also those usually not involved with the Hospital, joined forces and the young Italian paediatricians even decided to live in the Hospital 24/24 for the whole period to assure assistance to those in need.

In the end, the regular army – which stood with the people and the transitional government – surrounded the insurgent regiment, seized control of their base and disarmed them, allowing the legitimate government to organize general elections, which were held in November 2015 and won by Mr Kaboré in the first round.

Healthcare workers and patients quickly returned to normal, but more than 3 months after the putsch, further fall-out of this disgraceful event becomes evident, as the national ART-distributor is running out of paediatric drugs for HAART and reagents needed urgently for timely diagnostics and therapy-control, which seem not to have been ordered during the turmoil…

In addition, the effect of the supply disruption and consequently discontinuation of the antiviral therapy during and after the coup in some of our patients on the development of resistance of their viral clade will become fully evident only in future, but worries us already now.

While still working to resolve this shortage, on January 15, 2016 an Al-Qaeda-linked terrorist commando attacked a near-by Café and Hotel, taking hostages and killing 27 people (among them also a child!), leaving 54 wounded on the streets. The ensuing man-hunt in the region led again to a curfew, paralyzing (shortly) the country one more time.

But let us finish with a positive note: On March 3rd, 2016 the Secretary General of the United Nations, Mr Ban Ki-moon, in order to show his solidarity and support, visited this hard hit country – and our Unit at HOSCO!

  • Contributed by P. Ouedraogo, L. Sampebre, C. Distefano, V. Folsi, P. Villani and
    RF Schumacher; institutions represented: Hospital of the Camillian Fathers in Ouagadougou, Burkina Faso; Medicus Mundi Italia, Brescia, Italy; University Children’s Hospital, Brescia
  • More information: www.medicusmundi.it

Contribution by Medicus Mundi Italy to the Annual Report 2015 of the MMI Network

 
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