Appeals for donations to help hospitals multiply from Tunisia, in the grip of a “collapse” of its health system, a term used by the spokesperson for the Tunisian Ministry of Health. While the Tunisian embassy in France calls on the diaspora to collect money, but also medical and paramedical equipment, President Emmanuel Macron affirmed on Monday his desire to increase the aid granted by France to countries most affected by the pandemic – with a “special” thought for Tunisia. How did this country, which had successfully anticipated the first epidemic wave of March 2020, become, a year later, the most affected on the continent? Return on a slow descent into hell.
First epidemic under control
‘We must keep this vigilance which pays off (…) We have succeeded in controlling this epidemic’. On May 12, 2020, in an exclusive interview with France 24, Tunisian Prime Minister Elyes Fakhfakh gave an initial assessment of the management of the health crisis. The Covid-19 had already claimed more than 280,000 victims in 187 countries, France already had 27,000 while Tunisia had recorded only 45 deaths. Even in the Maghreb, then relatively spared from the pandemic, the country was a good student, compared to Algeria or Egypt, which had both passed the 500 dead mark. As early as April, when Tunisia only recorded one death from Covid-19, the authorities had bet on prevention by imposing strict confinement. A month later, at the time of deconfinement, the Prime Minister welcomed the fact that the ‘contract of confidence’ concluded between the authorities and the Tunisians to contain the pandemic is working, while avoiding any triumphalism: “We are maintaining the same approach , always anticipate, always remain vigilant ”.
Explosion of cases
This vigilance is put to the test in the fall of 2020, with the arrival on the African continent of the second wave. This intervenes in a tense context: undermined by political dissensions which led to the formation, in September, of a government of technocrats, the country is facing major social movements linked to a deep economic crisis – with, in particular , demonstrations by hospital staff denouncing the lack of investment in the public and the impunity of bad managers. During this period, the number of cases is skyrocketing in the country. Hospitals are already suffering from a staff shortage and many doctors are calling for tougher health measures. Cornered, the government decreed, on January 12, a four-day confinement as well as a curfew. An initiative that is not enough to stem the tide with a balance sheet approaching, in February, the 70 daily deaths.
While its Moroccan and Algerian neighbors are launching their vaccination campaign in January, it is not until March 13 that Tunisia administers its first doses. The cause is delays in the adoption of the two bills required by vaccine suppliers, in addition to delays in delivery of the Covax program. It is finally thanks to 30,000 doses of Sputnik V that the caregiver vaccination campaign will begin. Accused of inertia, the authorities promise to vaccinate 3 million Tunisians before June. But they will not be able to catch up. With 2.14 million doses administered on July 11, the country has only managed to fully immunize 5.3% of its population. At the same time, Tunisia is facing difficulties in the supply of medical oxygen . With the influx of serious cases in hospitals, the risk of shortages is felt, increasing the pressure on staff already dealing with large material deficits.
A third “catastrophic” wave
Faced with a third epidemic outbreak since April, Tunisia is no exception in Africa, not even in the Maghreb. However, when Morocco or Algeria record about fifteen daily deaths, Tunisia is now breaking records with an average of 140 daily deaths over the last seven days . Compared to its population, this ratio is now the highest in Africa. A record increase, therefore, in the country which already has the highest death rate on the continent – more than 16,000 deaths for 11.7 million inhabitants.
The spokesperson for the Ministry of Health acknowledged Thursday that the situation was ‘catastrophic’ with more than 92% of intensive care beds occupied in the public sector. While the capital’s hospitals have already reached the saturation stage, photos circulating on social networks show patients treated on the floor for lack of beds. “Last year at the same time, campaigns calling for donations had already taken place when there were very few cases because Tunisians are well aware of the fragility of their hospital system which already suffers, in normal times, a lack of budget and resources ”, underlines the correspondent of France 24 in Tunis, Lilia Blaise.
Heavily indebted and severely affected by the cessation of tourism, its first sector of activity, Tunisia is counting more than ever on the support of the international community. Algeria, Saudi Arabia, Qatar and France have announced the dispatch of medical aid as well as doses of vaccines. Paris has at the same time decided to place Tunisia on its red list, temporarily suspending the comings and goings of unvaccinated travelers ‘without a compelling reason’.