‘We haven’t been spared, we’re just not counting’: Sudan’s hidden Covid death toll

Hentet fra The Telegraph 08.08.21 | Av Will Brown og Stephen Townsley

“I can’t find my father’s grave. He died of Covid one month ago, but now I can’t find his grave,” shouts Katya* in a hoarse voice.

Tears begin to well up in the young woman’s eyes as she walks from mound to mound, looking for any sign of the man who brought her into this world.  “He was a good man. He was a doctor,” she says.

It’s a hopeless task. Gravediggers reckon there are about 250,000 people buried in the Al Sahafa in Khartoum, the Sudanese capital’s largest cemetery. 

Somehow, Katya’s father has been lost out there in the vast dusty field after a hasty burial. 

If Sudan’s official coronavirus statistics are to be believed, only 2,770 people have died since Covid-19 came knocking on the door.
This would mean that the nation of 44 million – scarred by decades of conflict, corruption and sanctions – is one of the success stories of the pandemic. But there’s a problem: almost no one believes the government figures. 

This would mean that the nation of 44 million – scarred by decades of conflict, corruption and sanctions – is one of the success stories of the pandemic. But there’s a problem: almost no one believes the government figures. 

Sudanese health care workers and researchers told the Telegraph that a hidden pandemic had probably killed thousands if not tens of thousands more. 

“From the outset, the pandemic has been a tale of two worlds,” says Dr Maysoon Dahab, co-director of the Sudan Covid-19 Research Group at the London School of Hygiene and Tropical Medicine (LSHTM).

It is thought that more than 90 per cent of Covid deaths go unreported Credit: Simon Townsley/The Telegraph
Photo by: Simon Townsley/The Telegraph
“It is a tale of nations that can afford to treat the sick and mourn the dead and ones that bury en masse largely in silence.”

Sitting in his lurid green office, the gravesite manager Ahmed Zaidan opens a large ledger filled with neat Arabic writing. Leafing through it, he points out a few names whose cause of death is Covid-19.

“Most families don’t like to say if people died of coronavirus when they’re buried because of the shame. There is still a lot of stigma here,” he explains.

“We only record Covid-19 deaths from isolation wards and specific hospitals. There are people who are dying undocumented all the time.” 

To demonstrate his point, Mr Zaidan starts leafing through the ledger again. This time he points out names that have been listed next to the words “died from lack of oxygen”. There are dozens and dozens like that, he says. 

When the pandemic first spread to Africa, experts and NGOs – many of them based in faraway Western capitals – predicted utter ruin. The virus would tear through the continent’s crowded slums, overwhelming the few, poorly equipped health facilities, killing millions, they said. 

And while richer nations were battling their first and second waves of Covid last year, the continent initially recorded some of the lowest death tolls on earth.

Many African commentators slammed the prophecies of doom, saying that they were at best misinformed and at worst based on racist stereotypes of the continent as a dark, diseased place incapable of looking after itself. 

“[The projections] were embedded in a shallow understanding of the continent, and a rush to make headlines,” Dr John Nkengasong, director of the Africa Centre for Disease Control and Prevention, told the Telegraph in October. 

But 18 months on from Africa’s first case, a far more confusing and insidious reality is beginning to emerge in some big countries like Sudan. 

A seriously ill Covid patient receives oxygen Credit: Simon Townsley/The Telegraph
Photo by: Simon Townsley/The Telegraph
“Most people hide [the disease], they don’t like coming to the hospital till its too late. Then they don’t make it here,” says Maler Margi Alsaier, a nurse at Jabre hospital in Khartoum. 

One study published in December by Sudanese and British researchers at Imperial College London and the LSHTM used a social media survey and results from randomised testing across Khartoum to estimate how many people had died from the disease.

They found that an estimated 95 to 98 per cent of Covid-19 deaths in Khartoum had probably gone unrecorded between March and November 2020.

This means that the city of six million people could have suffered more than 16,000 deaths directly linked Covid-19 in those first nine months and probably thousands more since. 

“This figure is just Khartoum and includes only direct Covid deaths. We didn’t count other people who might have died because travel restrictions meant they couldn’t get to hospital in time,” says Dr Dahab, one of the study’s authors.

“I don’t think many communities in Sudan would have been unaffected to be honest with you. Unless they were very, very cut off.” 

A big part of the problem is testing. The cash-strapped transitional government, still struggling to hold the country together after a revolution ousted the former Islamist dictatorship in 2019, can only afford to offer limited free testing. 

The majority of tests are done privately at prices that few Sudanese living hand to mouth can afford, meaning that national testing figures rarely pass a few thousand a day.  

A map hanging on the wall of the Minister of Health for Khartoum State’s office encapsulates the problem. The graphic shows clusters of coronavirus cases across the city. 

Almost all the large clusters are in richer neighbourhoods. Poorer areas, where people live in tightly packed homes, appear almost free of Covid-19. 

Sudanese doctors may be some of the best trained in the region but the challenges they face would make any medic in Britain blanche.

Even some private hospitals struggle to get enough running water, soap or electricity. 

Doctors told the Telegraph that Khartoum only has three functioning ambulances for Covid-19 emergencies. The city used to have 15 ambulances but US sanctions meant that it has been nigh on impossible to get to the spare parts needed to keep them running.

Medical staff still do not know what variants they’re dealing with because it’s too expensive to send samples abroad for testing, they say. 

The vaccine rollout has started in earnest in Khartoum but there is a great deal of scepticism about the AstraZeneca jab among more conservative parts of the population. 

A woman receives the AstraZeneca vaccine at a public vaccination centre in Khartoum Credit: Simon Townsley/The Telegraph
Photo by: Simon Townsley/The Telegraph
«Most people in my neighbourhood hear about the symptoms and side effects [of the AstaZeneca jab] and stay away. In Europe, they have all kinds of vaccines but in Sudan we only have AstraZeneca. We’re being played,» says Yasser, a 47-year-old at one vaccine centre.

“To say that we as the African continent have been spared the worst is a myth. We’re swimming in these myths. We haven’t been spared the worst. We’re just not counting,” says Dr Dahab.  

“To be counted as a Covid-19 statistic, you need to be rich. You need to be relatively wealthy to be seen. If you’re poor you die, you suffocate unseen.”