Since the first COVID-19 case was reported on March 6th, Peru has been battling the pandemic to keep the country’s healthcare system functioning. After the initial lockdown order was given on March 16, 2020, the country has faced tremendous obstacles while trying to survive the COVID-19 virus. Peru was the first country to declare a state of emergency in both North and South America. However, this declaration has not prevented the crisis from continuing to affect the country at large. With a population of 32.51 million and an upper-middle average national income, Peru has fundamental problems in its battle with the pandemic.
The Peruvian Workforce
Perhaps, one of the biggest reasons the country’s efforts in managing the pandemic is falling short is due to the state of its workforce. In 2019, 60.3% of Peru’s workforce was engaged in labor outside of state regulations, largely employed in agriculture or clothing and textile sectors. Thus, when the pandemic hit, many members of the informal workforce were forced to keep working because they could not claim unemployment insurance or turn to the government for help. When Peru extended the initial quarantine to July 31st, many informal workers had no income at all. 44% of informal workers stated that they have stopped receiving income while 31% stated their income has been “sharply reduced.” The lack of income led to an absence of access to limited resources during the pandemic and caused sanitary measures to collapse.
Peru is one of the only countries in the world that currently provides universal healthcare to all of its citizens. Yet, the country runs on a decentralized healthcare system. Instead of one central agency serving the entire nation, there are five entities: the Ministry of Health (MINSA), EsSalud, Armed Forces (FFAA), National Police (PNP), and the private sector. This might seem like a good system, but because these organizations are spread out across the country, there are often communication problems that lead to an increase in medication costs and a decrease in the quality-of-care for patients. Such issues regarding communication, as well as problems related to the accessibility of basic services, have become more apparent as a result of the pandemic.
Peru’s healthcare system is centered around big cities. The country’s capital, Lima, hosts approximately 50% of the country’s healthcare workforce. This makes it very difficult to effectively distribute resources across the country, especially to Peru’s Indigenous population, who often reside in remote areas.
The Issue of Supplying Oxygen
Unlike in other countries that are battling the pandemic, most hospitals in Peru cannot produce their own medical oxygen due to a lack of oxygen generators and instead have to source it from outside. This is a big issue in the treatment of COVID-19 patients who are suffering from respiratory infections. When there was any medical oxygen available at all, it came at a high cost for public hospitals relying on the government, and help was largely provided by small humanitarian campaigns held by organizations and churches trying to address the issue, such as “Respira Perú”.
Peru’s Defence Minister, Walter Martos, stated that the country is only producing 20% of the needed 173 tons of oxygen per day. This has led many people to turn to the black market (if they can afford it at all), or to sell various commodities to purchase tanks for their family members who are currently battling the virus.
Possible Vaccination Troubles
Peru is considered to have an upper-middle-income. What this means is that Peru does not have an income low enough to be eligible for free vaccine doses from global health initiatives, such as COVAX, which are working for global equitable access to COVID-19 vaccines.
Currently, the country is trying to make deals with multiple pharmaceutical companies, including Moderna, Johnson and Johnson, CureVac, and Gamaleya. Considering that Peru has had three presidents in one week during November of 2020, the country’s political instability has seemingly hindered their negotiations with these companies. Nonetheless, Peru was successful in getting the first batch of vaccinations into the country on February 3rd, with 300,000 doses. Now, the question remains if the country will be able to secure enough doses within a time frame that will allow the whole country to be vaccinated before the end of 2021.
The Hunger Strike
Healthcare workers in Peru announced on January 13th that they are going on an indefinite hunger strike in response to the government’s lack of strategy and support during the country’s battle with COVID-19. The workers are demanding for the head of the country’s Health Social Security, Fiorella Molinelli, to be removed from her position. The strike is being held in conjunction with many other protests concerning the current state of Peru’s healthcare system. The Peruvian ICUs are said to be at 90% capacity, with only 102 beds available across the country. Available medical personnel is also running low, as doctors are working double or triple shifts to provide enough ICU services.
More action is expected from the country’s interim president, Francisco Sagasti, who approved an order to finance the set-up of more than 16 temporary isolation centers across Peru, in addition to hiring more medical staff to expand health services. The country currently has 1.24 million active cases and 44,056 deaths related to COVID-19. If Peru is hoping for an improvement in their management of the pandemic, more government contribution is a must, both in the medical field and the handling of the workforce, instead of placing all the burden on the medical professionals’ shoulders.