ACCESSING OXYGEN: AFRICA NEEDS A BREATH OF FRESH AIR

Faced with the difficulties of access to oxygen on the continent, ALIMA (The Alliance for International Medical Action) proposes simple and effective diagnostic and management solutions.

By ALIMA

November 17^th, 2022

Pneumonia can kill. In West Africa, respiratory distress caused by this inflammation of the lungs, is one of the leading causes of death in children under five.

Decades of underinvestment in the prevention, diagnosis, and treatment of respiratory diseases have left many national health systems lacking the equipment, oxygen, and trained human resources required to save children from a disease that is now easily curable with proper management.

Since 2019, with the support of Unitaid, ALIMA teams and partners Terre des hommes, Solthis and INSERM, have been working to improve the identification of respiratory diseases in Africa (particularly in Guinea, Mali, Burkina Faso and Niger) by developing the early use of diagnostic tools and by ensuring access to oxygen therapy.

Read on to discover the stories of our teams in pictures.

ACCESSING OXYGEN: AFRICA NEEDS A BREATH OF FRESH AIR

BETTER DIAGNOSIS LEADING TO BETTER CARE

To ensure that the people who need oxygen have access to it when required, we must first be able to better diagnose respiratory diseases at an early stage. This is particularly true for young children who are most at risk of these diseases, such as pneumonia. This is why ALIMA and its partners, within the framework of the AIRE project (Improving the Identification of Respiratory Distress in Children), have been working in 202 health centers in Mali, Burkina Faso, Niger, and Guinea to integrate the use of the pulse oximeter into the care of sick children. This highly effective tool is a simple diagnostic device that allows for easy measurement of oxygen saturation in patients’ bloodstreams and thus enables the detection of respiratory distress and hypoxemia.

Making pulse oximeters available at primary healthcare centers and training health workers to accurately identify signs of respiratory distress during consultations for children under five years of age, can help save the lives of many children. This is the ambition of the AIRE project which aims to demonstrate the effectiveness and acceptability of the pulse oximeter. As a result, the districts supported by AIRE are equipped with and use pulse oximeters during pediatric consultations at the primary health care level. At the same time, local communities are informed and made aware of the issue so as to be able to react quickly and request timely care. The ultimate goal of this project : convince the four project countries to integrate pulse oximeters into national protocols and prepare for their use nationwide. The dissemination of evidence produced by the AIRE project demonstrating the effectiveness and acceptability of the pulse oximeter should then generate a regional commitment to its integration at the primary health center level in West African countries.

"Our goal is to systematize the use of pulse oximeters, which are easy to use, reliable and affordable in primary health care facilities in Burkina Faso, Guinea, Mali and Niger." Marine Vignon, AIRE Project Manager.

GENERALIZE ACCESS FOR ALL

Oxygen is an essential medication for the management of patients with respiratory distress. Yet many people in Africa do not have access to it due in part to limited supply and weak health systems. Demand for oxygen is high and market bottlenecks prevent rapid supply. Even before the COVID-19 pandemic, only half of the oxygen needs were met in most middle- and low-income countries. And since then, the demand for oxygen has increased drastically.

Securing the supply of medical oxygen and setting up the right infrastructure so that countries can rapidly expand the use of oxygen is the objective of the "Breath for All" project, also made possible by the support of Unitaid. Developed by ALIMA to improve access to oxygen in Mali, Guinea, Sudan and Burkina Faso, it aims to increase oxygen production and decentralize its sources so that every patient suffering from respiratory distress can benefit from appropriate care.

6.3 million children under the age of five are at risk of dying from pneumonia between 2020 and 2030 if current trends continue (UNICEF 2020).

177,000 children under five with acute respiratory infections were treated by ALIMA teams in 2021.

PROVIDING A COMPREHENSIVE RESPONSE

Faced with the multiple challenges related to access to oxygen, ALIMA provides a holistic response. ALIMA supports patient care by providing equipment, oxygen sources, human resources and technical expertise. This ensures that local national health personnel are trained in oxygen therapy, including equipment maintenance and supply chain management.

In urban areas, such as Conakry in Guinea, ALIMA rehabilitates or installs oxygen plants and hospital oxygen networks. In rural areas, such as Dioïla in Mali, ALIMA improves access to oxygen by ensuring energetic autonomy through solar energy systems or technical innovations such as low pressure storage tanks. In addition, ALIMA provides clinical and technical training on the maintenance and use of equipment and on oxygen therapy.

BAYA, 10 MONTHS OLD, SAVED JUST IN TIME

Ten-month-old Baya Traoré is one of the many children treated for respiratory distress by the AIRE project in Mali. His story illustrates the importance of a comprehensive response to the problem of oxygen access.

Baya's family lives in Sibila, a small town 300 kilometers northeast of Bamako, the country's capital. His mother, Fatoumata, came to the Sibila community health center for a consultation for her child. Using a pulse oximeter, the center's technical director identified respiratory distress in the young boy. Baya was immediately referred to the hospital health center in Markala, 30 kilometers from Sibilia, for oxygen therapy.

This center in Markala is one of two hospitals in Mali that benefits from support of the AIRE project led by the NGO Terre des Hommes. The hospital's pediatric department was reinforced with oxygen concentrators, pulse oximeters and essential medicines to improve the management of cases of respiratory distress. The staff was also trained in oxygen therapy and in preventive maintenance of medical equipment for a better management of severe cases. Thus, the material and human conditions were in place for the proper management and care of the little boy. Without the implementation of the AIRE project, his case could have quickly turned into a tragedy.

"Before going to the hospital, I didn't know that Baya's illness was related to breathing," explains Fatoumata. At the health center, they had started treatments, but my child's condition wasn't improving. Because of the emergency, we were transported by ambulance with two doctors. Once we arrived, we were told that it was respiratory distress. We found out about this disease and, more importantly, how to treat it before it gets worse."

In the photos above, little Baya is seen recovering after receving care of, with his mother Fatoumata, his father Mamadou and his older brother Senou, 3, at their home in Sibila.