TIMBUKTU, Mali (AP) – Harandan Toure started taking pills for malaria when he first had a fever, but over time his illness only worsened.
Ultimately, the doctors told him that he was one of hundreds of people infected with coronavirus in this city, long known for being inaccessible to the rest of the world.
There are no commercial flights to Timbuktu, whose remote location in the Sahara desert has long made the name of the city synonymous with the ends of the Earth.
Health officials say the global pandemic has managed to achieve this goal. More than 500 cases have already been reported, including at least nine deaths, making it the largest disease outbreak in Mali outside the capital.
The local hospital located outside the tent currently has 32 patients with COVID-19. There is no fan available. The temperature rises regularly above 45 degrees Celsius (113 degrees Fahrenheit), exacerbating the suffering of patients when they struggle with fever.
“I was on the verge of death because there were times when I was suffocating like a fish that had just been pulled out of a river,” said Toure, a teacher in his 50s who cannot pinpoint exactly where he could have got the virus.
“At night I could not sleep, I feel that there was a tonne stone on my chest that strangled me and kept me from falling asleep. I could barely breathe, he said. “For a moment I asked to die so that I could be at peace because of the suffering I was going through, but God, inexplicably, miraculously, gave me a reprieve.”
COVID-19 first arrived in Mali back in March, when two cases occurred – one in the capital of Bamako, where international flights land, and the other in Kayes, a city with close ties to the Malian diaspora in Europe.
By April, the virus had traveled 1,000 kilometers (620 miles) from the capital to Timbuktu, over a 24-hour journey along the road. Only a few buses go from the capital a week, although cars used as public transport also make the trip.
The official death toll reached nine, but at least six people who died later also tested positive.
So far, the hospital has had enough oxygen tanks to treat patients fighting COVID-19. But having enough nurses to manage it remains a problem, especially now that 32 patients with COVID-19 are too sick to recover at home in custody.
Unfortunately, few doctors treat those who suffer from coronavirus, whose complications confuse doctors around the world. There are no radiologists who can read chest x-rays, there are no lung specialists with experience with respiratory diseases, or doctors specializing in kidney diseases, which have become one of the serious complications of COVID-19.
“We don’t have a public health doctor, let alone an epidemiologist,” complains Jibril Casogue, regional director of health in Timbuktu.
Location is not easy when it comes to recruiting more healthcare providers. The risk of violence remains high in this region, where extremist groups have long abducted Westerners. Regular peacekeeping patrols in the US daily recall how unstable northern Mali remains for more than seven years after Islamic extremists were removed from power here.
From the surrounding desert, extremists continue to plant roadside bombs in the north, reinforcing isolation. The US mission does fly to Bamako and vice versa and often delivers COVID-19 tests from remote locations to the capital.
When this is not possible, local health officials resort to sending them to public buses, adding delays to the processing time in the event of a bus breakdown.
This month, the Mali Ministry of Health sent a mobile laboratory and a team to Timbuktu to conduct more than 100 tests per day.
This is an important step in Mali, where two months after the outbreak in May, the International Rescue Committee said that the country is still conducting only 173 tests per 1 million people. In comparison, at the time, the United States conducted 38,394 tests for 1 million against the backdrop of widespread criticism, which was too little.
There is also concern about what could happen if the virus infects even more remote areas of northern Mali, where the presence of extremists makes it difficult for health groups to go out and test. Experts warn that it is especially difficult to track the outbreak among the nomadic population in the north.
In Timbuktu, life has changed little against the background of the virus. Groups of people still pray in the mosque, the use of a mask is not imposed, and many doubt that COVID-19 kills people.
Moussa Hama Sankare, head of the hospital, expressed concern that people making secret visits at night to see patients with COVID-19 placed in their homes.
Ture, the patient is now recovering, worried that people do not take the virus seriously enough.
“People started leaving masks and going out without them,” he says. “If people do not protect themselves, I am afraid that this disease will hit Timbuktu hard.”
Associated Press writer Krista Larson in Dakar, Senegal, contributed to this report.