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Monday 15 January 13:53

Resilience in Health-Care Systems to Avoid Disasters

News: May 25, 2020

Health care systems

The ongoing Covid-19 pandemic has placed world health systems under unprecedented pressures. However, less is reported about the situation in low income countries where the capacity and funding are fractions of what it is like in Europe or the United States. A webinar organized by Global Sustainable Futures on 18 May shed some light on hazards, resilience and signals.

“In DRC, Democratic Republic of Congo, there are basically no ventilators available at all”, explains Johan von Schreeb, Professor in Global Disaster Medicine at Karolinska Institute in Stockholm. Actually, the country has about 20 USD to spend on health care annually, per inhabitant. The funding available in Sweden amounts to more than 5,000 USD per inhabitant and year. And in the United States, the spending equals more than 10,000 USD - i.e. 500 times the resources per citizen in Congo.

Shock absorbing health systems

The socio-economic status of the population in low-income countries make people vulnerable. Add a hazard to that, a significant risk factor like the coronavirus, and it will lead towards a shock and potentially a disaster.

“Health systems exposed to shocks have three possible strategies”, says Johan von Schreeb, “absorb, adapt or transform”. By absorbing the shock, health systems may, for example, experience a decreased number of admissions to hospitals; the number of surgeries go down while the number of covid-19 cases go up.

A lockdown, like many countries have implemented, also in Sub-Saharan Africa is basically a tool to win some time. While the lockdown is in effect, health systems may build capacity. In Sweden, the capacity for intensive care was quadrupled in a few weeks’ time. At the same time, a lockdown increases vulnerability – which may push the hazard into a disaster.

Building capacity and collaboration

The international organisations, like WHO, in principle send the same kind of messages to low-income countries: “build capacity”. But it takes leadership, Johan von Schreeb emphasises, there is always a risk of being seen as colonial, like “you tell us what to do without any resources”.

The Sahlgrenska Academy at University of Gothenburg has organised quite a wide range of programmes and projects in collaboration with low-income countries globally. Gunilla Krantz is Professor in public health, with a specific interest in domestic violence in different countries. However, looking in particular at Sub-Saharan Africa, Gunilla Krantz mentions a range of ongoing public health projects where University researchers are engaged – in Rwanda, Tanzania, Kenya, DRC, Malawi and Ethiopia, covering topics such as viral infections, malaria treatment, nutrition, and midwifery.

There certainly are some challenges and worries at the moment, caused by the pandemic, including such issues as travelling, communication, web-based education and training, but “Zoom is good from a capacity-building perspective”, says Gunilla Krantz.



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