Death without answers: an agonising 24-hour hunt for medical help in Guinea-Bissau

In their 15 years collectively, Maimuna Catchura had not recognized her husband to be ailing. But one evening in late January, 39-year-old lawyer, activist and musician Bernardo Catchura couldn’t sleep, and complained of extreme abdomen ache.

The ache compelled Catchura from his mattress at his home in Bissau, Guinea-Bissau’s capital. That evening he would navigate the nation’s medical care maze, visiting pharmacies, clinics and hospitals. Before the evening was by, he even thought of crossing the border into Senegal to get help.

But wherever he regarded, nobody was accessible to help the daddy of three, and fewer than 24 hours after his pains started, he was useless. It was a tragic destiny for the person who had spent a long time campaigning for enhancements to Guinea-Bissau’s healthcare system.

Catchura was a number one member of the activist band Cientistas Realistas, which used music to succeed in and mobilise younger individuals and protest towards authorities failings. “What happened was exactly what he was always talking about in his songs about the health system,” says his widow, Maimuna.

A rustic with a inhabitants of 1.9 million in west Africa, Guinea-Bissau boasts well-conserved environmental parks and a proud historical past of hard-fought national liberation. But its individuals face power instability and financial inequality. Almost 70% of the inhabitants live on less than $1.90 a day and greater than 10% are food insecure. The life expectancy is 58 years.

Healthcare consultants say that at each step on the street to medical consideration sufferers face potholes similar to pretend remedy, shortages of kit and medical experience, and frequent strikes by well being employees.

When painkillers weren’t serving to, Catchura known as a non-public clinic. No one answered the telephone so a good friend drove him and his spouse to the general public army hospital in Bissau.

Most roads are unpaved, however as a result of January is in dry season, the drive solely took 20 minutes and was comparatively easy. In wet season, torrential downpours depart craters in town’s pink earth and make journey tough.

At the army hospital medics mentioned Catchura wanted surgical procedure, however that they’d no services to function. They despatched him on to the nation’s largest public hospital, Simão Mendes.

But Guinea-Bissau was in the grip of a nationwide well being employees’ strike, and regardless of its standing as a referral hospital that ought to supply specialised therapy, nobody at Simão Mendes was certified to deal with Catchura, his household say.

Aissatu Forbs Djalo, a physician at Simão Mendes and member of the nationwide well being employees’ union, says salaries are too low and sometimes go unpaid. Doctors are paid on common £250 a month and nurses as much as £130.

“The government budget does not allow the health system to pay the doctors what they need,” says Djalo.

Political instability has crippled public providers, particularly healthcare. In 2016, Guinea-Bissau had one doctor for every 10,000 individuals.

There have been 10 accomplished or tried coups in the nation since independence in 1974.

“Until we have a stable government, which can complete its tenure, we will not be able to stabilise the public sector,” says Dr Magda Robalo, excessive commissioner for Covid-19 and a former well being minister. “For you to have money to pay workers, you need to be able to collect money.

“There is no supervision and performance reviews. There is no meritocracy.”

A physician who owned a non-public clinic suggested Catchura to go there. But when he arrived on the one-story, blue and white constructing, the lights had been out. The clinic had closed for the night.

Catchura thought of embarking on the four-hour automobile journey to neighbouring Senegal. Travelling outdoors the nation for even gentle well being complaints is commonplace however he was, by now, in intense ache.

“A lot of people die from diseases that can be prevented,” says Djalo. “If someone has a cardiovascular illness, they may die due to lack of specialists, and we do not have diagnostic equipment.”

Simão Mendes had a partnership with a hospital in Senegal the place it may ship sufferers, however Covid restrictions ended it.

At 7am, Catchura and his spouse returned to the personal clinic, the place he waited 4 hours to be admitted. Maimuna went dwelling to make soup for her husband. She was certain he could be hungry when he returned from surgical procedure. But there was no operation.

Catchura died and Maimuna nonetheless doesn’t know the trigger. Failure to establish causes for dying are one other frequent incidence in Guinea-Bissau, the place Djalo says there are few pathologists.