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World Hospitals in chaos as Fiji battles COVID-19 hell

09:59  30 july  2021
09:59  30 july  2021 Source:   aljazeera.com

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Suva, Fiji – Fiji’s spiralling COVID-19 crisis reached a terrifying new milestone this month, as the World Health Organization (WHO) reported that the country’s spread of infection was one of the highest in the world. With more than 200 dead – including three pregnant women and a 15-year-old – there have been more than 27,000 confirmed coronavirus cases in the country since the current outbreak began in April this year. Actual numbers are estimated to be much higher.

a train is parked on the side of a building: Fiji has imposed a lockdown and curfew to deal with a surge in cases linked to the Delta variant [File: David Hotchin/Reuters] © Provided by Al Jazeera Fiji has imposed a lockdown and curfew to deal with a surge in cases linked to the Delta variant [File: David Hotchin/Reuters]

With a total population of fewer than 900,000 people, Fiji is surrounded by vast expanses of the Pacific Ocean that often present enormous logistical challenges even under normal conditions.

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The largest medical facility in the country, the Colonial War Memorial (CWM) Hospital in Suva, is under-resourced at the best of times, with much of its infrastructure dating back to 1923.

As weeks turn into months and deaths continue to climb, the government has had to reluctantly stop a nationwide testing of people showing COVID-19-like symptoms, due to a lack of capacity to treat the sick. Fijians have been advised to self-isolate at home if they feel unwell and seek medical help only if they feel that their symptoms may be worsening.

“It’s devastating seeing the scenes at the hospital,” Maryann Lockington, a Suva resident told Al Jazeera. “It’s so foreign and unimaginable to expect the hospital and medical areas to look the way they do.”

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Lockington’s mother was on a ventilator in the CWM’s intensive care ward this week after her condition deteriorated rapidly.

“When my mother got sick [with COVID-19], I had to reach out to friends and family to find contacts for transport because we didn’t have a private vehicle and there were no ambulances available when we called,” she said.

It was after curfew and the nearest clinic would not take Lockington’s mother who was unresponsive. No other health centres were open. CWM was the only option.

“It seemed chaotic because a lot of patients were streaming in, family members were frantic and there were tents with patients. There are no words on how bad it is right now, especially when you have a loved one at risk. Everyone’s coping as well as they can but I honestly never thought I would see these kinds of scenes in Fiji.”

Lockington’s mother died on Thursday.

Radio New Zealand reported last week that more than 4,000 COVID-19-positive people had been turned away from hospitals on Fiji’s largest island, Viti Levu, due to a lack of beds.

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Meanwhile, a Fijian doctor speaking to ABC radio on condition of anonymity revealed that most hospitals and health centres in the country were severely understaffed and so dangerously ill-equipped that they feared for their lives. A doctor who had been working the front lines – and his parents – were admitted to the CWM intensive care unit with severe COVID-19 symptoms. All three of them died. In the week since two more healthcare professionals have also lost their lives to the virus.

The scale and intensity of Fiji’s current outbreak have sent shock waves through the region after the popular tourist destination had managed to remain essentially COVID-free for the better part of a year after closing its borders early.

The current outbreak began after a soldier providing security at a quarantine facility caught the virus from a traveller who had recently returned from India. Fiji’s health authorities believe he then passed the virus onto one of the maids in the facility, who then infected several members of her family and another soldier working in the facility, who in turn passed it onto his wife. Fiji’s first super-spreader event occurred the same week when one of the infected quarantine workers inadvertently attended a funeral with some 500 mourners.

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By April 26th, the nation’s capital, Suva, had entered a 14-day restricted movement period that forced 100,000 people to stay at home while the city was cordoned off as a containment zone. Australian testing labs confirmed what Fiji had been long dreading; the new wave was the Delta variant that first emerged in India.

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While much of Viti Levu remains on a tight 6pm (06:00 GMT) to 4am (16:00 GMT) curfew, the government has also made masks compulsory in public places and requires all businesses to ensure customers and employees scan a unique QR code via the government contact-tracing app before being allowed to enter the premises.

The vast majority of the population, however, have been slow to adopt COVID-19-safety protocols, adhere to social distancing rules or maintain strict hygiene guidelines, according to the Ministry of Health and Medical Services. Even in the face of rising deaths, Fiji continues to struggle with public compliance.

But a string of compounding factors may be more to blame than pandemic weariness.

“Every day, we hear about people being taken to task for not complying with government-COVID-19 regulations,” said Lavetanalagi Seru, a coordinator of Fiji’s youth-led NGO Alliance for Future Generations. “The majority of these people fall within the low-income bracket – either working within the unregulated informal sector or who have suddenly found themselves unemployed. They are faced with the impossible choice of having to comply with ‘stay at home’ orders and let their families go hungry or risk arrest as they go out to look for food. It is no wonder that so many reported breaches are found to be mothers or heads of households.”

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Fiji’s initial closure of borders in March 2020, allowed the country to keep COVID-19 at bay but it came at a significant economic cost.

a group of people sitting at a picnic table: People have been forced into impromptu work to make money to survive including selling fruit and vegetables at stalls outside their homes [File:Aileen Torres-Bennett/AP Photo] © Provided by Al Jazeera People have been forced into impromptu work to make money to survive including selling fruit and vegetables at stalls outside their homes [File:Aileen Torres-Bennett/AP Photo]

According to the World Bank, Fiji’s economy [gross domestic product or GDP] contracted by 19 percent in 2020; one of the worst downturns in the world and the most severe in the country’s history. With thousands of newly unemployed people, existing inequality gaps widened, exacerbated by climate-related emergencies – like severe tropical cyclones Harold and Yasa last year – as well as unequal access to social assistance.

Tens of thousands in the country’s current pandemic hot spot – around the capital – also live in informal or squatter settlements. The extremely densely populated areas typically involve crowded households, little (if any) space between ramshackle tin houses and limited sanitation and hygiene facilities.

Speaking from Suva, United Nations Resident Coordinator Sanaka Samarasinha said the conditions in which people live have a bearing on their ability to comply with the health measures.

“If you live in a settlement in a household with an extended family you are going to be interacting with a lot of people,” he said. “The Pacific culture is very communal-based and people socialise all the time so changing behaviour has been difficult and will take time. This is not just a health issue but an issue of governance and communication; two-way communication that builds trust between the governed and those who govern. That is a key issue we all need to work on in the next few months.”

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Fijian households are often larger than in non-Pacific countries and can include up to three or four generations. This puts already vulnerable groups like the elderly, sick or disabled at greater risk of contracting COVID-19.

The worsening situation has prompted several public calls for a full national lockdown to curb the outbreak but the government insists that the economic harm such an exercise would cause far outweighs any public health benefits that would be seen.

Vaccination minefield

Instead, the government is looking to mass vaccination as the only way out of the country’s growing COVID-19 woes.

In July, officials announced a “No Jab, No Job” policy; an initiative that makes vaccination compulsory for all public servants and private sector employees if they want to carry on working.

The move has not been without controversy. Several Fijian opposition members of parliament have called the decision “dictatorial” and “an infringement on the rights of people to choose”; with one MP calling the situation a “plandemic” created by governments, the United Nations and a “satanic new world order” during a parliament hearing this week.

Residents opposed to vaccinations have also labelled the vaccination rule “inhumane” and continue to advocate for traditional herbal medicines, steam therapy and hot water consumption; none of which has been proven to have any effect on the COVID-19 virus, according to the World Health Organization.

Lockington blames the anti-vaccination rhetoric and misinformation for her own family’s delay in getting vaccinated – and ultimately her mother’s death.

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“People don’t realise that their misinformation has killed people,” she said.

“People are refusing to follow health instructions, ignoring precautions and engaging in reckless behaviour because of misinformation and it’s putting so many others at risk, including my own family. There were rumours of magnetism and microchips that preyed on people’s fear. The misinformation and conspiracy theories are everywhere on social media and it’s been an uphill battle trying to keep safe during a pandemic while trying to debunk crazy information that was being sent to my family members. This is in addition to religious fundamentalism which is fuelling a lot of distrust and fear.”

Dr Rachel Devi, head of Fiji’s COVID-19 Vaccine Task Force, said last week that not enough Fijians above the age of 60 were coming forward to be vaccinated, which was one of the reasons for the high numbers of deaths of unvaccinated or partially vaccinated individuals in the age group.

a sign on a grassy field: Albert Park, a popular spot in Suva for rugby, has been closed because of the COVID-19 pandemic [File: Aileen Torres/AP Photo] © Provided by Al Jazeera Albert Park, a popular spot in Suva for rugby, has been closed because of the COVID-19 pandemic [File: Aileen Torres/AP Photo]

So far, those who have died in Fiji had either not been vaccinated or received only one of the two shots necessary for AstraZeneca.

“It took me a much longer time to convince the elders to get vaccinated and follow the precautions,” Lockington said, stressing her admiration for the dedication of the country’s medical workers. “It is because of these baseless rumours that Fiji has been slow in building up our protection. It is a race against time for people to get vaccinated because our death toll is growing.”

Thanks to support from neighbouring countries like Australia – which continues to fly in supplies of AstraZeneca as part of its one-million vaccine pledge to the country – Fiji has not had to contend with the added burden of vaccine inequity being seen in other parts of the Asia Pacific and Africa.

New Zealand, India and Japan have provided life-saving aid in the form of personal protective equipment, diagnostic tools and vaccines, while the United States coordinated the delivery of more than 150,000 doses of the Moderna vaccine last week in a bid to have pregnant women immunised.

As of July 28, 20.5 percent of Fiji’s selected adult population was fully vaccinated – a number that the government says will have to increase to above 80 percent by October, before it can even begin considering opening borders and local high-risk businesses such as gyms and nightclubs.

For  Fijians the who are unlikely to return to school this year and for the thousands of unemployed who struggle to cling to hope as their food supplies wane, that day cannot come soon enough.

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Somehow, COVID-19 cases and hospitalizations are accelerating as rapidly and dangerously as they did during last summer’s surge in the southern United States. This time, many governors aren’t just refusing or curtailing social distancing—they are failing kids and teenagers with an unwillingness to better protect them from the risks posed by the Delta variant. The current approach—a toxic stew of milquetoast vaccine advocacy, anti-mask madness, and phony health freedom rhetoric—is a recipe for failure. More than ever we need pragmatic, committed, and non-ideological leadership.

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