“We have to call it pneumonia”. Tanzania leads the way in COVID-19 denialism.
By Peter Lloyd-Sherlock
Over the past months, the world of global health has been so busy that some important stories have slipped under my radar. This morning, I came across a new report in the Guardian referring to COVID-19 in Tanzania [https://www.theguardian.com/world/2021/mar/10/tanzania-missing-president-kenya-covid-says-opposition-leader?CMP=Share_iOSApp_Other]. The focus of this report is the apparent admission of the national president (aged 61) to a hospital in neighbouring Kenya, due to symptoms of acute COVID-19.
My first reaction was to add one more name to the grisly roll-call of national leaders who have experienced the virus at first hand. The Guardian noted with irony that Tanzania’s president could also be added to the grisly roll-call of national leaders who continue to deny the seriousness of the pandemic. Apparently, President Magufuli has followed the dismal and much more high-profile example of Brazil’s Bolsonaro. For example, the BBC has published allegations that President Magafuli refuses to wear a mask and attends mass public gatherings without taking any precautions [https://www.bbc.co.uk/news/world-africa-56347756].
Digging around on the internet, revealed the depth of COVID-19 policy failure in Tanzania.
When the first case of COVID-19 was recorded in March 2020, the reaction was instant and dramatic. Within a day it was ruled that all schools and universities were to shut with immediate effect and all public gatherings were banned. This policy was not sustained and Tanzania went on to proclaim itself the “lockdown-free ‘Sweden of Africa’ [https://www.telegraph.co.uk/travel/destinations/africa/tanzania/articles/how-to-visit-no-coronavirus-lockdown/].
It is not possible to assess the effectiveness of these measures as in May 2020 the government decided to stop publishing any data on COVID-19 and, shockingly, banned health facilities from conducting COVID-19 tests. This remains the case until today. Applying an Orwellian “double-think”, the President and senior officials frequently claimed that the lack of data demonstrated that COVID-19 was not a significant issue for Tanzania [https://www.bbc.co.uk/news/topics/cjnwl8q4qdrt/tanzania?ns_mchannel=social&ns_source=twitter&ns_campaign=bbc_live&ns_linkname=603f7af2b4f28002d08ca872%26Tanzania%20nuns%20and%20priests%20dying%20%27with%20Covid%20symptoms%27%262021-03-03T12%3A14%3A43.263Z&ns_fee=0&pinned_post_locator=urn:asset:523cc643-4b65-4cbf-9f69-e226208b0a80&pinned_post_asset_id=603f7af2b4f28002d08ca872&pinned_post_type=share].
In February 2021, the national Health Minister announced that Tanzania would not accept COVID-19 vaccines from other countries. According to the Lancet:
“In the glare of cameras, Gwajima and the health officials drank a herbal concoction including ginger, garlic, and lemons, and inhaled steam from herbs, promoting them as natural means of killing the virus. Gwajima went on to warn journalists about reporting unofficial figures on COVID-19 or any disease.” [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00362-7/fulltext]
Despite efforts to repress reporting on the real state of the pandemic, some information has leaked out over recent months. And this information strongly challenges the government’s version of events.
Health workers have referred to large numbers of older people seeking hospital care but not being allowed to test them or to diagnose them as COVID-19 cases [https://www.theguardian.com/world/2021/mar/10/tanzania-missing-president-kenya-covid-says-opposition-leader?CMP=Share_iOSApp_Other]. Hospital staff refer to being overwhelmed and facing critical shortages of beds and oxygen [https://www.theguardian.com/world/2021/feb/28/tanzania-leader-says-prayer-will-cure-covid-as-hospitals-overflow]. Yet when a senior health official visited a major hospital he claimed there were no COVID-19 cases, referring to “rumours which may cause unnecessary panic” [https://www.theguardian.com/world/2021/feb/28/tanzania-leader-says-prayer-will-cure-covid-as-hospitals-overflow].
In early March, a representative of the Catholic Church in Tanzania claimed 60 nuns and 25 priests had died in just the previous two months after showing symptoms of coronavirus, including respiratory distress. They added that none of the 500 health centres they operate in Tanzania are allowed to test for COVID-19. [https://www.bbc.co.uk/news/topics/cjnwl8q4qdrt/tanzania?ns_mchannel=social&ns_source=twitter&ns_campaign=bbc_live&ns_linkname=603f7af2b4f28002d08ca872%26Tanzania%20nuns%20and%20priests%20dying%20%27with%20Covid%20symptoms%27%262021-03-03T12%3A14%3A43.263Z&ns_fee=0&pinned_post_locator=urn:asset:523cc643-4b65-4cbf-9f69-e226208b0a80&pinned_post_asset_id=603f7af2b4f28002d08ca872&pinned_post_type=share].
There are reports that numbers of funerals (one of the most reliable indicators of excess mortality in poor countries) have increased dramatically in recent months, reaching levels that are higher than those in “living memory”. [https://www.theguardian.com/world/2021/feb/28/tanzania-leader-says-prayer-will-cure-covid-as-hospitals-overflow]. For older Tanzanians this “living memory” will include the 1990s, when Tanzania had one of the highest levels of HIV/AIDS mortality in the world.
The World Health Organisation has repeatedly made public calls for Tanzania to take a more responsible approach to the COVID-19 pandemic, and has expressed concern that it is also placing neighbouring countries at risk [https://www.theguardian.com/world/2021/feb/28/tanzania-leader-says-prayer-will-cure-covid-as-hospitals-overflow].
As in all countries, older people in Tanzania will be disproportionately affected by the COVID-19 pandemic. Without reliable information, it is difficult to assess what that will mean in reality. According to HelpAge only four per cent of older people in Tanzania receive a pension and their access to basic health services was already minimal before the pandemic. [https://www.helpage.org/where-we-work/africa/tanzania/]. Research of outpatient health facilities conducted shortly before the pandemic reported that compliance with basic hygiene and infection control was generally inadequate [https://pubmed.ncbi.nlm.nih.gov/32389195/].
The Guardian provides a compelling story about one older man who experienced acute symptoms of COVID-19 and was admitted to hospital, but was not able to access the acute care he needed. His daughter commented:
“They said we could only keep him where he was and hope for the best. They called it pneumonia but said ‘Your father has the same condition that everybody is facing everywhere’… Since January we have lost six family members…. I wouldn’t want anyone to watch their father die the way I did. It’s so wrong.” https://www.theguardian.com/world/2021/feb/28/tanzania-leader-says-prayer-will-cure-covid-as-hospitals-overflow
Tragically, most older people in Tanzania who experience acute COVID-19 will not even get as far as a hospital.