(Khartoum, Sudan) Fever, headaches and arthritis have affected Amani Hassan’s daily life since January. Amid preparations for his daughter’s wedding, the 50-year-old tried to relieve his ailments with painkillers. After the celebrations were over, his health deteriorated. And an overdose of painkillers affected his kidneys.
Until this employee of Sudan’s Ministry of Industry woke up in hospital in early March. He was diagnosed with dengue fever.
Photo by Augustin Bassilli, special collaboration
Amani Hassan
For the first time, this virus is transmitted by mosquitoes of the genus Aedes Actually spreading in Khartoum state. The reasons for this mosquito migration are yet to be determined, but Sudanese doctors fear the worst.
An emergency cell
As of March 13, 2,231 cases have been identified, including 1,076 around the capital. Usually, this eruption is confined to the east and southwest of the Horn of Africa. But this year, the hemorrhaging has claimed 43 lives, including two in Khartoum state. ” Infected mosquitoes may travel by bus, car or plane », says Asma Saad. This general practitioner is one of dozens of practitioners asked to deal with this new health crisis.
Due to lack of space, a center to treat more serious illnesses has opened in a wing of the University Hospital in Omdurman in the neighboring city of Khartoum, which until then was used to isolate Covid-19 patients.
Photo by Augustin Bassilli, special collaboration
Asma Saath
If the number of dengue cases increases further, the same building cannot continue to treat those infected with Covid-19.
Asma Saad, General Practitioner in Khartoum State
Sudan’s clinics were already weakened by 30 years of military-Islamic dictatorship led by the kleptocratic Omar al-Bashir. They are now suffering from the freezing of billions of dollars in international grants – to allow the October 25, 2021 coup – which disrupted the democratic transition launched in 2019.
” Blood platelets and no blood to transport dengue patients suffering from haemorrhage », explains Asma Saad. The teenager has seen her working conditions deteriorate since she was fired. Because of his dual exposure to dengue fever and Covid-19, he barely earns 10,000 Sudanese pounds (about C$23) a day — a figure that seems astronomical to employees of the Ministry of Health.
Disadvantaged neighborhoods are particularly affected
This public hospital funds most of the drugs and provides the minimum. Many are out of stock. Additional tests, blood or urine, for example, are the responsibility of the patient. Smiling in his white jellaba as he spat out blood moments earlier, Muaz Jehal has already spent two-thirds of his March 12 salary on his treatment. However, dengue mainly affects working-class neighborhoods like this primary school teacher’s town on the outskirts of Omdurman.
As taps often run dry, people are forced to store water in tanks that breed mosquitoes. Aedes. The World Health Organization (WHO) representative for Khartoum State, Mohammed Alhassan, insists that the most dangerous are the larvae. The latter nest in the walls of terracotta jars, the “Jir”, where they can carry the virus and survive for months.
Photo by Ashraf Shazli, Agence France-Presse
A resident of Omdurman is forced to fetch water dozens of kilometers from his home. The dengue virus mainly affects working-class neighborhoods in Sudan, and officials advise residents to clean and cover their water tanks and stay behind mosquito nets whenever possible to avoid breeding mosquitoes that carry the virus.
With WHO support, the Ministry of Health is investing in TV channels, radio antennas and public walls to disseminate prevention messages. The main recommendations are to clean and cover water tanks and stay behind mosquito nets as much as possible.
But there is difficulty in implementing these instructions. At Omdurman Hospital, the medical team tries to get Amani Hassan to comply. The 50-year-old, sitting next to his bed, assures us that he will sleep under his mosquito net tonight. ” A mosquito Aedes A daylight attack », for the umpteenth time, Dr. Asma Saad repeats to him. An insect can transmit the virus from an infected person to a healthy person.
Weather disturbances indicated
Climate change may partly explain the establishment of this pest in Khartoum.
Photo by EL TAYEB SIDDIG, REUTERS ARCHIVES
An aerial view of the city of Khartoum in September 2020, battling flooding linked to the overflowing Nile River around the Sudanese capital.
Over the past ten years, the rainfall that normally refreshes this arid region between June and October has become increasingly erratic. ” In the absence of rain, mosquitoes migrate to other areas. Accumulation of heavy rainfall in an area can lead to the development of mosquito species that did not exist before »Adil Ismail, a member of the Technical Committee on Emergencies and Epidemics Control at the Union Ministry of Health and chairman of the NGO Ellipta Forum for Culture and Science, sums it up.
This microbiologist fears that the authorities will fail to stop the epidemic before the next rains. The virus then threatens to spread to all 18 states, threatening to topple a healthcare system close to agonizing.
