At first, the country realized that most cases were coming from Europe and thus closed its borders to these countries, albeit after a few days of hesitation, which attracted criticism. Senegal is deeply connected, particularly through its diaspora, with several African countries, as well as with France and Italy, the epicentre of the epidemic in Europe for weeks. People in contact with infected individuals flying in from Europe were tracked and isolated. While the scheme worked rather well, it is not certain that it was able to identify all contact points effectively – it is necessary to identify both direct and indirect contacts with the virus. If even a few are missed, the virus will continue to spread from one place to another.
With the global spread of the pandemic and an increasingly strict lockdown imposed in many European countries, the Senegalese government could adopt more radical measures. It is not impossible that we will move to a total lockdown, or at least closer to it, in the coming days. However, French or South African-style lockdown measures could only be laboriously implemented in a country where economic and social conditions are such that a large share of the population needs to move about on a daily basis in order to earn money, survive and support other family members.
Not all Senegalese citizens, even in cities, have access to a refrigerator, a continuous electricity supply or the financial means to stock up food and other essential goods. Under these conditions, total lockdown simply cannot be applied. This is the case in many other African countries, but it is not limited to the continent. What about India, for instance, where it is reported that millions of people are fleeing from cities to the countryside where they believe they can more easily feed themselves and survive the indefinite period of confinement? In any case, the context differs greatly from that of European countries or the United States.
Does the population support the measures adopted by the government?
Yes, the population is largely mobilized to fight against the Covid-19. Everyone understands that communication stressing prevention is the only viable option, given the limits of the healthcare system to cope with serious cases requiring hospital care in the event of an outbreak of the epidemic in Senegal, and across several regions at the same time. People understand the magnitude of the threat and do what they can to contribute to the fight through prevention and well-known barrier gestures, starting with regular hand washing. The fact that the West African region experienced the terrible threat of the Ebola virus a few years ago has also helped raise awareness of the importance of prevention gestures such as hand washing.
Is the health system resilient enough to cope with the epidemic?
Senegal’s health system is on average better than that of many countries in the West African region. But of course, everything is relative. Health indicators have been improving steadily for years but still remain below what would be expected and what is achievable. Shortfalls are glaring in terms of numbers of health workers, with a ratio of less than two doctors per 10,000 inhabitants according to World Health Organization (WHO) figures, and the geographical distribution of the workforce is highly uneven, as is the case almost everywhere in the region.
Senegal is also facing medical equipment shortages. There had already been scandals in Dakar’s major hospitals due to equipment breakdowns, but all the more so in the present case where patients developing the virus’ most serious symptoms require respiratory assistance. As of April 1, Senegal would count 56 resuscitation beds, with 40 additional beds being set up. It is imperative to increase the number of beds available for patients with Covid-19 within a few weeks. As long as numbers do not explode, the health system will be able to cope. It really is a matter of scale.
The crisis we are currently experiencing is particularly challenging, but weaknesses of the West African countries’ healthcare systems and the urgent need for structural reforms pre-existed the crisis, as we examined in a report published by Wathi in February this year. Too many people, and especially children and young people, are still dying from diseases that can be cured in all the countries around the region.