Hospitals in Angola's capital Luanda have been overwhelmed by yellow fever patients. At the David Bernadino Children's Hospital, five hundred children are admitted every day.
Fever, muscle pains, nausea, bleeding: These are the signs of yellow fever. For months now, Angola has been hit by the yellow fever scare. Since the epidemic broke out last year, there have been at least 230 deaths, according to official figures. During the same period, there were 1,700 confirmed and suspected cases of yellow fever in the country.
The government has repeatedly stressed that all necessary measures have been taken. It claims to have vaccinated more than eighty percent of residents living in Luanda.
Stagnant water is a common sight in Luanda and a breeding place for the mosquitoes that transmit yellow fever
Fears of further spread into Kenya and Congo
The epidemic does not seem to be under control yet. The World Health Organization (WHO) warned that it could spread to other countries, especially those that share borders with Angola.
In Democratic Republic Congo (DRC), for example, over 150 yellow fever cases have been reported since March and 21 people have so far died from the disease. WHO sees a connection with cases in Angola. Many of the infected people in DRC are known to have been in Angola. In Kenya, at least one of the people who died is also believed to have been in Angola.
Arrivals at the international airport in Angola are subjected to a yellow fever vaccination, but those leaving the country are not examined to see whether they have the disease. The same applies to countries sharing borders with Angola. There are no effective controls to screen those who might have been infected by yellow fever.
Long queues for a vaccine
As early as five in the morning, long queues start forming at hospitals. DW's correspondents in Luanda often report about 'disastrous conditions' in hospitals.
Contrary to official statements, the vaccination campaigns are conducted in a chaotic manner. There are not enough vaccines available, paving the way for a black market to thrive. Victims come mainly from poor communities, DW correspondents report.
"Without money or personal contacts its not possible to get vaccinated," said Marinela, a mother of two young children. At the David Bernadino Children's Hospital, the only one in the district, she joined the early morning queue.
"They should make the vaccines available at different locations, for example, in schools or in churches," she said.
A flourishing black market
Those who can afford to pay high prices for what should be provided free of charge bypass the long queues and obtain the vaccine on a black market.
In recent months, a kind of 'vaccine-mafia' has emerged, which wants to limit still further the supply of medication, Angolan Interior Minister Angelo da Veiga Tavares said at a recent press conference. The vaccine was being systematically stolen, diverted and sold expensively to the highest bidder, he said, adding that quite often nurses or doctors were themselves involved in the illegal vaccine trade.
"We have arrested some of these criminals. They were conducting informal vaccination campaigns and collected, in some cases, very large sums of money," the interior minister said. Rosa Bessa, who is responsible for the health sector in the province of Luanda, appealed publicly to all citizens: "No one should spend money for vaccination." Bessa asked residents to be patient and promised that the vaccine would soon be available in sufficient quantities.
Angola's poor health sector
Most Angolans have run out of patience because of the country’s ailing health sector. Alcides Sakala, spokesperson for UNITA, the largest opposition party, painted a bleak picture of the health situation in Angola. The situation is much more serious than officially presented and out of the government's control, he said in an interview with DW.
"The figures that the government gives are wrong, and we consider it our duty to publish figures which approximately correspond to reality," said Sakala. "In March an unusual number of people died in Greater Luanda - in public hospitals alone there were 4,570 deaths. The city mortuaries are full and hygiene conditions are dire."
Sakala said this was due to poor management by government. "What we are witnessing is the total collapse of the national health system in Angola." "
'Much is not expected'
For a long time, Angolans have suffered from inadequate health care. This year the government intends to spend 2.3 billion euros ($2.5 billion) for the health sector, which is about 5 percent of government expenditure.
Angola had committed in international agreements to allocate 15 percent of the total budget to the health sector. But in an interview with DW, Angolan economist Carlos Rosado said fifteen percent was unrealistic.
"Given the severe financial crisis in Angola, coupled with a decline in oil prices, we would be glad if the health budget remains the same, otherwise not much is expected," he said.
In the meantime, civil society organizations are calling for an emergency plan to curb the further spread of yellow fever and improve emergency services in the country's hospitals. They also want the authorities to eliminate garbage and the many open air drains.
Also, because of construction work in Luanda, the debris contributes substantially to the proliferation of mosquitoes, which are responsible for transmitting the virus.
Borralho Ndomba contributed to this report