As a nurse in Somalia, I know we need vaccines. Where are they?

In many ways, life as a nurse in Somalia is no different from the lives of millions of brave front-line workers across the world. We too care deeply about our patients, working tirelessly over the past two years despite nearly insurmountable challenges.

But where the differences do exist, they’re stark. And nowhere is this clearer to see than in the distribution of lifesaving oxygen, personal protective equipment (PPE), and vaccines during the pandemic.

In Somalia, the poverty rate is currently 73% and the average life expectancy is as low as 56. When COVID-19 hit, I was profoundly worried. I’ve been a nurse at Banadir Hospital, the country’s only maternal and child health hospital, for nearly six years. As the virus spread, we were inundated and overwhelmed. While working in difficult conditions and on scant resources is nothing new for many of us, this pandemic was different.

 Time and time again the main complaint we faced (and continue to face) was respiratory. Oxygen is vital to combat breathing difficulties that COVID-19 causes in seriously ill patients. They simply cannot survive without it.

Despite their best attempts, the Ministry of Health could only source oxygen from the few private plants in Somalia. To put this in context, a single patient can go through $1,200 of oxygen every 24 hours. Our stretched public health system could not keep up, and when the country’s oxygen supply ran dry, I had to turn deathly sick people away. We simply did not have the resources to care for them.

In late September 2021, the government put a cap on large gatherings, a sure sign that the virus is back. We feel this in the hospital too, as the beds in the COVID-19 ward are filling up.

Decades of civil war have left our public healthcare structures embryonic and fragile, and while positive steps (such as the new federal healthcare system) are moving in the right direction, access to medical services for the majority of Somalis is painfully out of reach.

In February 2021, the World Health Organisation estimated that more than half a million people in low- and middle-income countries were impacted by the need for oxygen treatment every single day. In Somalia, this problem persists. Ultimately, the international community has fallen short. Turkey and the WHO donated oxygen and other medical supplies, but they did not meet our massive needs.

The Somali private sector has filled some of the gap, sourcing oxygen cylinders from around the world. But relying on imports isn’t sustainable. The charity sector has also stepped up. Our country’s largest domestic NGO, Hormuud Salaam Foundation, recently fitted my hospital with Somalia’s first oxygen plant for public use. It provides the machinery to produce 1,000 cylinders of oxygen per week, each canister able to give a patient oxygen for around 8 hours. But even this is a temporary fix.

Only international governments hold the long-term solution to the pandemic in the form of access to vaccines. Like Israel, the US, and the UK begin providing third doses to their populations, it is hard not to feel abandoned. So far, global vaccine equity programmes have only delivered enough vaccines to inoculate 2% of Somalis. How is this equity?

I became a nurse to help those in need, but I also wanted to be a good role model. As a health professional in Somalia, making a difference to the next generation, I am lucky to be able to treat children and show them what opportunities there are, particularly for young girls.

But when I look at the vaccine disparity, I feel disheartened. To hear that more than 100 million vaccines are to be “thrown away”, unless global leaders urgently share surplus supplies with the world’s poorest countries, is a difficult pill to swallow.

The next wave is brewing. With the new oxygen plant, we are better prepared to hold the line this time, but without any vaccines forthcoming, millions of Somalis remain exposed. Just as many around the world in London, New York, and Wuhan stood on your doorsteps to applaud nurses in a time of crisis, I hope that the international community can support us during ours.

Deka Abdullahi Abukar

Deka Abdullahi Abukar is a nurse at Banadir Maternal and Child Health Hospital in Mogashidu, Somalia.

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