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Somali medics report rapid rise in deaths as Covid-19 fears grow

Saturday May 2, 2020

Concerns that official mortality counts in African countries are a big understatement

Somali workers in protective suits stand inside a grave in Mogadishu. Photograph: Feisal Omar/Reuters

Medics, funeral workers and gravediggers in Somalia have reported an unprecedented surge of deaths in recent days amid growing fears that official counts of Covid-19 deaths reflect only a fraction of the virus’s toll in Africa .

So far Somalia, one of the poorest and most vulnerable countries on the continent, has announced an official total of 601 confirmed cases and 28 deaths.

But evidence from medics and burial workers in Mogadishu, the capital of the unstable east African country, suggest the number of deaths could be many times higher.

Mohamed Osman Warsame, an ambulance driver, said he had transported between 15 and 18 corpses to cemeteries in the capital every day for the last two weeks, many times above the usual daily figure of between two and four.

“There are a lot of deaths. It is like we are in a deadly war. People are dying so fast,” Warsame said.

On 25 April, the ministry of health reported two deaths from Covid-19, a day after Warsame collected 12 bodies for burial from homes.

In Somalia, as across large parts of Africa, the deceased are buried within hours, following Islamic custom. This makes autopsies or record-keeping harder.

Medical officials admit that many deaths are simply not reported to authorities.

“We have a limited capacity to record all deaths. We are unable to reach every home. When a patient dies, relatives hire a private ambulance or a truck and they bury the body. People are reluctant to share the information and therefore we are missing numbers,” Dr Mohamed Ali, a health officer who leads the Covid-19 response team at Mogadishu’s Martini hospital, said.

There are currently 37,000 cases confirmed in Africa and 1,600 deaths, according to official statistics, suggesting a much slower spread of Covid-19 on the continent than in other global regions. This has led to hopes that hundreds of millions of the world’s poorest people may escape the worst of the pandemic.

However, just four countries – South Africa, Morocco, Egypt and Algeria – account for more than half the cases. All four have relatively well-developed health systems and the ability to test large numbers of suspected cases.

Elsewhere many governments are struggling to implement basic measures to track the pandemic.

Earlier this week, Dr Benjamin Djoudalbaye, head of policy and health diplomacy at the African Union’s Centre for Disease Control, said the spread of Covid-19 was “not something you can hide”.

“You see what you can see. You go to the hospital and you will see the [people there]. As the capacity of testing increases, so we will see the real situation,” Djoudalbaye told reporters.

There are already fears of a major outbreak of Covid-19 in northern Nigeria, though this has been denied by authorities, and that official statistics in Tanzania – where president John Magafuli has rejected advice to impose a lockdown – do not reflect the real situation.

Dahir Mohamud, a funeral worker at Geed-Timir graveyard in Mogadishu, said he had dealt with more than 30 bodies in under five days, 10 times the usual number. Almost all were elderly men who died after a short illness.

Abdullahi Mohamed Jama, a gravedigger in Mogadishu’s Calamada graveyard, said his team dug 21 to 22 graves on Sunday, Monday and Tuesday last week, around four times the usual total.

“Previously we used to dig graves on demand. These days we don’t wait for calls because there are many deaths every day. All these deaths are illness-related and they are elderly people. It is very sensitive to talk about Covid-19 and relatives will only tell us it is urgent death,” Abdullahi Dhere said.

Hamdi Ahmed Diriye, a university student, said his elderly uncle and grandmother had both recently died after displaying high temperatures and respiratory problems associated with Covid-19.

“When my uncle became sick we rushed to the hospital but the doctors refused to admit him …We did not want to go to the government facility because we have heard people had died there so we took back him to home where he died,” Diriye said. “Then my grandmother showed similar symptoms but unfortunately she died very quickly.”

Mohamed Abdi Hayir, the information minister, said the government recognised that many recent deaths were due to Covid-19.

“[Relatives] are saying someone died of malaria or hepatitis. That is not true. The Somali government recognises that all recent deaths are of Covid-19,” Hayir said.

There is no information on the possible spread of the disease in the swaths of Somalia run by al-Shabaab, an Islamist extremist group affiliated with al-Qaida.

The World Health Organization has warned of 10 million cases in Africa within three to six months, though experts say that the total could be lower if authorities are able to move swiftly to contain outbreaks of the disease.


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