Photos by: Mongolian Red Cross Society

Mongolia is in the grips of a serious influenza A (H1N1) outbreak. The combination of extreme cold, toxic air, poverty, the risk of pneumonia and the coming Lunar New Year are posing deadly risks especially for young children. Temperatures lower than minus 40 degrees Celsius, air pollution and cramped living conditions are pushing up influenza rates, making it a kids’ crisis.  In the Songinokhairkhan District Hospital, Galsantseden Badrakh, the hospital’s chief physician and leading pediatrician, is seeing an overflow of patients.

“We had 260 patients coming to the hospital with symptoms of the virus and 45 of them were admitted,” says Galsantseden. “The next day we admitted another 80 patients.”

The entire facility only has 165 beds for children, but in just 3 or 4 days, an estimated 200 children were hospitalized.

“We added an extra 50 beds in the outpatient building, then we added extra folding beds in our hospital hallway. On 11 January, the total number of inpatients rose up to over 300, meaning that our bed capacity shot up to 200 per cent during this outbreak.”

Hospitals in the capital, Ulaanbaatar, usually have the capacity to admit 977 children but are struggling to find beds for more than 1,500 children currently hospitalized in the city. As of 24 January, four children have unfortunately died of influenza.

Mrs Enkhtsetseg M, the head of the hospital quality department, explains that the hospital is planning to add 70 beds to the children’s department.

“Admitting patients in hospital hallways isn’t an ideal situation, but this is the only way to protect the children’s health in this current emergency situation,” she says.

“There is a high risk to their lives if they stay home and are not admitted. It’s better to stay close to the doctors, even if that means they are on a folding bed in the hospital hallway, than to stay at home far from medical services.”

This influenza outbreak, along with extreme cold, air pollution, poverty and the risk of pneumonia, are combining to pose deadly risks. Due to severe air pollution, a child patient’s recovery period is longer than before. Just few days after recovery, some patients get re-infected and are admitted to hospital again. Despite a limit on doctors seeing a maximum of 16 patients per day, the doctors at the hospital are serving 25 to 30 patients a day, and working night shifts twice a week.

Mrs Uranchimeg B noticed her daughter having problems after she began coughing and had a fever. “I tried to treat her at home in the beginning, but after four days when it became clear that she was not getting better, I brought her here to the hospital and had her examined,” she says. “The doctors and medical services staff are very good and we are satisfied with their treatment. Our family depends on my husband’s income. Although he has a private business, our household finances deteriorated sharply in the past few months because he had to work alone and needed to care for us.”

 

In Khan-Uul District Hospital, the situation is just as serious. In addition to its 80 existing pediatric beds, the hospital used 90 adult beds from other departments and added an additional 30 folding beds in the hospital hallways to accommodate the sudden increase of young patients. At the peak of the outbreak, there were as many as 260 patients coming to seek treatment each day, and a minimum of 80 children were admitted to hospital per day.  A staff of 16 doctors and 30 nurses worked round the clock to treat patients at the hospital, as the Ministry of Health is predicting that the spread of the disease will continue just after the Mongolian traditional Lunar new year holidays in early February 2019.

Mrs Burentsetseg B’s three-year-old daughter has been in hospital for 14 days due to severe pneumonia. “My daughter got sicker and had difficulty breathing. She has been having health problems since she was one year old, and has been admitted to hospital roughly 20 times since then,” says Mrs Burentsetseg during an assessment visit by Red Cross volunteers.

“Due to bouts of severe pneumonia and high doses of antibiotics, she developed a poor immune system. Once a child is infected with influenza, it is very easy for them to develop pneumonia, and the smoke and air pollution in Ulaanbaatar is the major reason for this disease.  It’s quite a big challenge for us to keep our kids healthy in this heavily-polluted environment.”

The Mongolian Red Cross Society is working with the government to respond to this unfolding emergency. The Red Cross has provided portable beds to the hospital in Songinokhairkhan District and is readying to deploy trained volunteers and staff to high risk areas.  The Red Cross is also running a country-wide social media campaign designed to provide people with information they can use to avoid getting sick and to protect their families.

For more information, read the press release here.