“A Crazy Week; COVID-19 Pandemic and Oxygen Crises” A story of myself and my teammates, Addis Ababa, Ethiopia, Feb, 2021

“A Crazy Week; COVID-19 Pandemic and Oxygen Crises” A story of myself and my teammates, Addis Ababa, Ethiopia, Feb, 2021

Our country was the first among low and middle income countries to start planning about oxygen. In 2016, with support from partners, the Ethiopian Ministry of Health (MOH) designed?and implemented a?comprehensive oxygen and pulse oximetry scale up road map, which resulted in significant?improvements in oxygen availability and clinical use.?As of May 5, 2020, the actual oxygen production was 1515, and the demand during similar time was 2628 M3/Hr. The supply chain system was terrible, leading to a huge traffic queue of trucks with empty cylinders in few older oxygen-producing private plants because of lack of comprehensive location information for each plant.?I had a hilarious week last year.?This story highlights my crazy and its implication in?Ethiopia's oxygen ecosystem during COVID-19 pandemic so that others can learn from our pain and protect themselves from getting the infection.

It was the first week of Feb, 2021. A crazy week. The second wave of COVID-19 hits Addis Ababa more than anytime. The rise of oxygen demand in regions like Harar and Diredawa became notable. The same week the biggest private oxygen production plant knock-back due to maintenance failure. My phone rings now and then. Hospital CEOs, Regional Health Bureau Heads, my bosses and journos are calling for their sake to add spice to the crazy week. On the second of February with one of my teammates we headed to the owner of one of the private oxygen plants. He was keen to provide us a warm welcome to his office. Started the conversation. My phone is ringing every single minute. The owner asked “Is everything okay?” I replied that everything is not okay. We are running out of oxygen in most of our health facilities specially COVID treatment centers. This problem used to be in Addis Ababa only but now it turned out to be a problem everywhere in the country and we came to you to discuss how to make the nonfunctional plant back to work and two new plants installed in one week to improve the production a little higher. The conversation went well and we all started listing solutions, deadlines and recommendations. My phone keeps on ringing.

In the middle of our conversation the business owners asked “can you use any oxygen?” I was a bit confused and answered his question with another question “What do you mean?” I have a friend who is of Indian origin and owns a big oxygen plant but he uses the oxygen for steel production. We called him immediately. Arranged time for tomorrow morning for inspection with a few engineers to check if it can be used for medical purposes. We went to the plant at Dukem, 25 KM away from Addis Ababa. The biomedical engineers conducted inspection, quality measurement and other regulatory pieces and gave us a go ahead to use the plant. After a daylong adjustments, protocol writing, work procedure setting and capacity assessment the production started at midnight. This plant had a capacity to fill 1000 big (40L) oxygen cylinders a day. 35% of oxygen demand from Addis Ababa facilities. The crazy week has got a bit of an answer but not a correct answer. With this experience my team at Dukem explored additional plants used for similar purposes and adjusted them to medical use. With this intervention 50% of Addis Ababa oxygen demand was covered. My team finally got a day-long sleep after a week-long stress. If we fail to invest in medical oxygen, we are failing to save precious life.

Make life a little easier in the ICU by investing on medical oxygen production, distribution and use

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