What's wrong with Tunisia

Tunisia and the pandemic: Doctors warn of collapse

A dozen people in the emergency room, some sitting, some lying down. Some wrapped in blankets, others in their everyday clothes. One door further, patients are treated, some of them ventilated, all of this in a very small space.

A video leaked to Deutsche Welle from the hospital in a larger Tunisian city gives an idea of ​​the dramatic circumstances under which the country's doctors are fighting for the lives of patients.

"Like in war"

"The situation is like the war," said doctor Omaima El Hassani in an interview with DW. "Tunisia is struggling with the third wave today, and with very limited resources." The number of beds in her hospital is low, the admission wards for COVID patients are full, she describes the situation of the hospital in Tunis, where she is on duty. She and many of her colleagues warn of a collapse of the health system, the situation is already extremely difficult: "Patients often wait over 24 hours for a free bed."

Vaccinations are slow

According to the Johns Hopkins University (JHU, as of May 4, 2021), almost 313,000 people in Tunisia were infected with the corona virus, and around 11,000 people died from or with it. This means that Tunisia has a death rate of 3.5 percent of all infected people (for comparison: in Germany it is 2.4 percent).

Waiting for the syringe: Vaccination center in Tunis, May 2021

Tunisia is also making slow progress with vaccination. According to the JHU, a little over 400,000 doses have been inoculated so far. Around 95,000 people are fully vaccinated, about 0.81 percent of the total population. For vaccinations, the government, like many other financially weak countries in the region, is almost entirely dependent on the United Nations' COVAX program. Germany is one of the largest contributors to this.

Doctors at the limit: intensive care unit in Tunis, January 2021

"We are at risk of becoming infected"

The situation is also difficult for doctors and nurses. "We do our work without adequate protection," says El Hassani. "We have no protective clothing, there is a shortage of masks and sterilization equipment. We also work 30 hours without a break. Day after day we run the risk of becoming infected. This also puts our families at risk." Now the oxygen has also become scarce. "Almost all emergency rooms in the capital have no free oxygen beds. We had to turn away patients with shortness of breath at several wards."

For this reason, the Tunisian doctors decided to go on strike. Earlier this week, they stopped work for three days and only kept the indispensable emergency service going.

The situation is critical, says Henrik Meyer, head of the Friedrich-Ebert-Stiftung's office in Tunis. The country got through well after the first wave. "The second and third waves then struck. There is currently hardly any supply capacity in public hospitals." There is still help in the country's private clinics. "But very few Tunisians can afford them."

Criticism of the government

In this situation, the mood of the population deteriorates. The magazine "Mondafrique" accuses Prime Minister Hichem Mechichi these days of an "ostrich policy". He closes schools and universities, but leaves cafes and restaurants open. You also get angry that he restricts the mobility of the population, but at the same time allows himself to be photographed in the midst of crowds on the occasion of religious festivals.

At the same time, many Tunisians feel left alone by the state. They complain that the government is too reluctant to act and accuse the state and government representatives of not being able to agree on a clear course for fighting the pandemic. President Kais Saied accuses them of not addressing the population once in an appropriate manner because of the pandemic.

In general, the government does not act consistently, says Henrik Meyer. "The measures are not very targeted and are also not implemented consistently." However, the country also has to struggle with enormous challenges. Around 20 percent of Tunisians made a living from tourism, which is largely fallow. The restrictions hit the population hard. At present, in addition to a negative PCR test, a five-day quarantine is required for entry into Tunisia. Under these circumstances, hardly any tourists come to the country.

Pandemic and the Economy

Tunisia actually got off to a good start in fighting pandemic last spring, says development engineer Abdelhamid Jouini. At the time, the government had shown its determination. "But that changed in autumn 2020. The difficult economic situation barely allowed the course that had been so strict until then."

The doctor Omaima El Hassani, who is also a member of the "Young Tunisian Doctors" association, criticizes the government for not having provided the necessary medical infrastructure in good time. "She should have provided treatment rooms, intensive care beds and emergency medical equipment. She should also have employed more doctors."

Difficult everyday life: scene from the old town of Tunis, end of April 2021

The burden of the weak

However, parts of the population did not always behave appropriately, says Tunisia expert Meyer. "Many people are tired of pandemics. It is currently Ramadan, and when people meet in the evening they often do not wear masks. You can often see that in the authorities: employees who do not protect themselves."

Abdelhamid Jouini points out that a large part of the Tunisian population works in the informal sector. "These people were the first to be hit by the pandemic measures. That is why, in their view, they have little reason to support the government's course. Those affected know that they have to make much greater sacrifices than the more affluent part of the population."

Nocturnal Ramadan scene in Tunis: Keeping a distance is not possible everywhere

European solidarity

Foundation representative Henrik Meyer believes that Europe and Germany in particular are very committed to supporting Tunisia. He refers to the close cooperation between Tunisia and Germany that began in 2011, the year of the revolution. "This is now paying off. The Federal Foreign Office, in cooperation with political foundations and organizations such as the Society for International Cooperation (GIZ), has rededicated programs so that, for example, protective clothing and test equipment could be sent."

What is primarily called for is Tunisia itself, in the midst of its extensive crisis, says Omaima El Hassani, outlining the demands of the Tunisian doctors. The first step in overcoming the pandemic is to admit that the Ministry of Health's strategy is flawed. Then it is important to involve all parties: the ministries and the government, the universities, the organization of young Tunisian doctors. In addition, the budget of the Ministry of Health must be increased. The doctor emphasizes that it will not be possible without more money. "This is the only way to overcome this crisis."