Fighting Covid in a country where leaders denied the pandemic existed

A doctor on the frontline in Tanzania tells Clea Skopeliti tells how the country has no idea about the true extent of the virus and how hospitals are struggling to cope

Tanzania’s government insisted the country was ‘Covid-free’ for months (AP)

While in most countries, daily coronavirus figures have become part and parcel of the news cycle, Tanzania stands out as a worrying exception. The east African country’s government stopped reporting coronavirus figures last May, declaring God had eliminated Covid in the country of 60 million.

Tanzania’s official tally stands at just 509 Covid cases and 21 deaths. But doctors working in the country’s overwhelmed medical centres say this is a far cry from reality.

A doctor working at a private hospital in Tanzania, who spoke toThe Independent on condition of anonymity, said there is no way of knowing the true scale of cases or deaths.

“Sadly, we have no idea – everyone just knows about their own hospital. It would probably be close to what Kenya is experiencing. We’re close in terms of climate, our resources, our population profile,” Hassan* says.

The neighbouring country has registered more than 109,000 cases and nearly 1,900 fatalities – and even there, the figures are likely to be an underestimate due to a limited availability of tests.

After Tanzania’s government claimed the disease had been eradicated last summer, health workers became cautious about speaking publicly, censoring themselves on social media and in the press. “Viral pneumonia” became a codeword for Covid, the doctor says.

In his view, the decision to deny the virus’s existence and stop publishing statistics was primarily economic.

“The island of Zanzibar is having a pretty good season with tourists from Russia, with people coming in to escape their part of the world and come here, where there is ‘no Covid’,” he says. “I can think of very few other reasons why we’re not officially reporting numbers to the world.”

The Tanzanian government has not responded to requests for comment.

Although the government has recently admitted Tanzania has a coronavirus problem, soon after one of its highest-profile politicians, the vice president of Zanzibar, died of Covid, it continues to downplay the importance of restrictions and call for prayer.

At the second wave’s peak, hospitals were “chock-full”, Hassan says. “About four weeks ago, we didn’t have any empty beds. You’d have to wait for someone to either die in the ICU or get well enough to be transferred to a general ward for a spot on the ventilator.” 

The situation is beginning to improve as the second wave wanes, he says, due to the epidemiology of the virus rather than government intervention. But without a vaccination programme, a third wave appears inevitable.

“After a brief recess, cases will be back up again without vaccination,” he says. “We’ll have wave after wave until we reach some sort of herd immunity. How long that’ll take, I don’t know.”

Although people travelling from Tanzania have tested positive for more transmissible variants detected in South Africa and the UK, there’s no genomic sequencing being made public to ascertain levels of variants in the country. “It is definitely the case that we have variants,” the doctor says – staff just can’t monitor them.

Though there is little in the way of hard figures, anecdotally, the second wave of the virus appears to have ripped through Tanzania. “It feels like everyone everybody knows has gotten Covid last time or this time and has been at least mildly to moderately ill,” says Hassan, adding that he’s seen at least two people who have been reinfected with Covid.

Instead of reported figures, deaths are communicated mostly by word of mouth. “You hear stories – someone will say, ‘In my village, there’s been a couple of deaths last week’, but it’s hard to get actual objective data, or any sort of real indication,” the doctor says.

For those with family abroad, these whisper networks cross oceans. 

Believers attend the Sunday mass without wearing masks and social distancing at Ufufuo na Uzima Church (AFP/Getty)

Farida*, who lives in the UK, says from December onwards, she began to receive a stream of messages in extended family WhatsApp groups saying Tanzanian friends and family were ill with “viral pneumonia”.

Since January, eight of her family members and friends have died, including her uncle, cousin, and father.

Farida has written to her MP in the hope that international pressure could affect Tanzania’s response to the crisis and runs a blog about the situation in the east African country under an alias. She feared that by speaking openly about the situation, her mother could be denied medical treatment.

Last month, Farida watched her father die in a Tanzanian hospital over video call. The hospital had no access to testing facilities – only some centres are able to send off swabs for testing – and could not provide him with oxygen.

“The cruelty of the situation is that you can’t help but think if he was tested and there was different treatment, could things have been different?” Farida says. “He suffered because he didn’t have any oxygen. The last phone call I had with my dad was watching him suffocate on FaceTime.”

Despite the government appearing to blunt its denialist approach recently, conceding that there are some cases but the outbreak is “under control”, it has not signed up to Covax’s vaccine scheme.

Although he presses for the government to rapidly authorise the use of existing vaccines, Hassan isn’t hopeful.

“There’s no word of vaccines coming – and I don’t think there will be,” he says. “And unless the president and ministers take the vaccine, the majority will not accept it.” President John Magufuli has repeatedly cast doubt on the efficacy of inoculation. 

The doctor says among many in Tanzania, there was a feeling that by denying the reality of the pandemic, the populist leader “took away the fear of Covid”, adding: “Many believed it when the government said there’s no Covid, we’re safe, keep using natural remedies.”

Farida agrees that the president’s denialism appeared popular during the first wave, including with her own family; the country has a young population and didn’t seem to be suffering the mortality rates seen in many countries in the west. But she feels the mood is changing as the second wave affects more people. “Now people are like, something isn’t right, we’re in a different territory.”

“It’s the really poor people in Tanzania that are losing out – and Magufuli isn’t helping because he’s advocating herbal remedies,” Farida says. “It reminds me of the early days of the Aids campaign in African countries where at a tribal level, it was seen as witchcraft – it took a lot to change those mindsets.”

Farida believes even if the government U-turns on vaccines, it will take a lot of work to reverse the misinformation spread in recent months, particularly in poorer, remote areas. “The fact that Magufuli says Covid is a white man’s disease, don’t trust vaccinations – he’s sowed the seed that’s going to make it so hard to change people’s minds.”

Names have been changed to protect identities.