Dr. Chris Hirabayashi explains UNICEF’s response to coronavirus in the East Asia and Pacific region.

The novel coronavirus disease (SARS-CoV-2) is bringing the world to a standstill as countries scramble to respond to the deadly pandemic. As of Monday 23 March, globally there are over 330,000 confirmed cases and over 14,000 people have died.
 
Even countries with well-developed health systems are grappling with how to provide medical care for an overwhelming number of critically ill patients, should the worst-case predictions prove true.
 
The reality is, even the most prepared countries may not be able to cope.
 
If the virus spreads rapidly in developing countries, with health systems that are already weak or under-resourced, the outbreak could be even more devastating.
 
A sign points the way to a hospital in a remote district of Timor-Leste. © UNICEF Australia/2019/Porritt

Since early January 2020, UNICEF has been working closely with the World Health Organization (WHO), Governments and our partners to stop the transmission of the virus and minimise its effects.
 
Our teams have delivered 13 tons of urgently needed supplies to affected areas, including protective suits, masks, goggles and gloves for use by health workers. Regionally, UNICEF plans to deliver a further US$12.2 million in supplies to support the response. 

Regional Health Advisor Dr. Chris Hirabayashi is part of the emergency team managing UNICEF’s response in the East Asia and Pacific region.
 
His team currently works with 28 countries across the region, through 14 country offices. At this point in time, nine of those countries have reported cases of coronavirus.
 
 “The situation is real,” says Dr. Chris.  
A shipment of UNICEF boxes of protective equipment, including protective suits, surgical masks and respiratory masks arrives in Shanghai, China on 29 January 2020. © UNICEF/UNI284471
UNICEF delivers 20 tents as part of our support to the Philippine Government's COVID-19 response, on 11 March 2020. The tents will be used in hospitals to improve the triage system for cases requiring testing and in-patient care. UNICEF is supporting the Government's response by amplifying risk communication, providing critical emergency supplies and training health workers. © UNICEF/UNI310637/Verzosa

Across the region, the ability of countries to respond varies. “Some countries in the region have strong health systems, such as Thailand, Malaysia, and China,” explains Dr. Chris.
 
“But other countries, such as Papua New Guinea, Timor-Leste and some Pacific nations have very weak systems.”

  
“Some Pacific nations have
very weak [health] systems.”
“This is largely due to inequitable health service delivery systems, a lack of quality human resources and a lack of referral systems.”

“Countries, like Timor-Leste for example, are still developing their health system and rely on external funding. Those systems are particularly weak.”
A hospital ward in Papua New Guinea. © UNICEF/2019/Gage
 
“Some countries have limited public
hospital services - particularly ventilators
- and this equipment is critical to
save the lives of critical patients.”
 
“Even if a public hospital has 10-20 ventilators, 80 per cent may already be occupied.”

If an increasing number of patients in a critical condition present to a hospital that is under resourced, the hospital may not be able to provide treatment for them.
 
“Some patients may not survive.”
 
Some health centres are already under-resourced or lacking the basic infrastructure needed to respond to existing health needs in the country, prior to the risk posed by the coronavirus pandemic. 

​In Timor-Leste, village level health clinics can often experience blackouts, and up to 70 per cent of rural health posts have no access to running water. 
Children in Timor-Leste wash their hands at school, using a facility previously donated by UNICEF. © UNICEF/UN0157018/Helin

 
This is an issue across many of the countries UNICEF works in, with an estimated 16 per cent of healthcare facilities globally, or around 1 in 6, without functional toilets or handwashing facilities – a critical issue with handwashing one of the main ways we can prevent the spread of the virus.
 
The overburdening of the healthcare system is Dr. Chris’s main concern as the coronavirus outbreak spreads.
 
“The capacity may be very limited. If many people come into these hospitals and health clinics, they may easily run out of stocks and supplies.”
 
People may not be able to access healthcare for regular needs, like antenatal care, newborn screening, or immunisation. Or they may be afraid to attend healthcare services due to fear of contracting the virus.

 
“For women and children this
is a very worrisome situation.”
 
“For women and children this is a very worrisome situation,” says Dr. Chris. We may see mothers in some countries opting to give birth at home without trained medical support which may increase maternal and newborn mortality.
 
 
Mum Natalia holds her newborn baby boy Socrates who is just six hours old in this photo, at a UNICEF-supported health clinic in Timor-Leste, May 2019. Dr. Chris is concerned COVID-19 will overwhelm already under-resourced health centres in parts of East Asia and the Pacific, leaving mothers and children without medical care. © UNICEF Australia/2019/Porritt

UNICEF’s teams are working with countries in the region to strengthen their health systems and provide technical advice to Governments on how to respond.
 
We are also working to ensure people have access to accurate information, and misinformation is corrected. So far, UNICEF has reached over 80 million people in the region with protection and prevention messages.
 
By encouraging people to wash their hands, practice cough etiquette, and generally look after their health, we can reduce the spread of the virus and through this reduce the impact on health services.
 
UNICEF plans to reach an additional 210 million people throughout the region with health messaging.
A young child washes his hands from a water tap that was installed by UNICEF at a school in the Southern Highlands Province, Papua New Guinea. © UNICEF/UN0293132/Holt
 
For countries in the Pacific, gaining access to medical supplies is also critical, but may be challenging, explains Dr. Chris.
 
“For countries in the Pacific, we need to consider factors like weaker health systems.”

 
“We need to have funding to support
these countries. If there is limited funding
then there will be limited resources.”
UNICEF requires USD $36.5 million to fund its response in the region, to protect vulnerable children and families, and contribute to the containment of the novel coronavirus. Currently, there is a funding gap of $13.1m.

 

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