Namibia: Asthma Patients Fear COVID-19 Amid Shortage of Inhalers

Some people afflicted with asthma fear they may be severely hit by the coronavirus as the salbutamol medication they use to treat their respiratory condition has been out of stock for months.

Salbutamol, also known as albuterol, is a medication that opens up the medium and large airways in the lungs.

It is used to treat asthma, including asthma attacks, exercise-induced bronchoconstriction, and chronic obstructive pulmonary disease. The drug is administered through an inhaler or nebuliser.

As a result of the salbutamol shortage, asthma patients fear they are more at risk of Covid-19, which attacks the lungs and causes respiratory complications.

The World Health Organisation says patients with underlying respiratory-related illnesses such as asthma are at higher risk of becoming critically ill due to Covid-19.

Windhoek resident Laban Amadhila (33), who suffers from asthma, told The Namibian that the last time he went to the state health facility was at the beginning of February and he was told the inhalers were out of stock.

"I have been buying [salbutamol] at private pharmacies since then and the inhalers cost about N$50 each. I always buy the inhaler once or twice per month," he said.

Another asthma patient based in Windhoek who spoke to The Namibian on condition of anonymity, last week complained that she has been going to the Katutura Health Clinic for the past three months for her salbutamol prescription, but has always been referred to private pharmacies.

"I am not on medical aid since I am unemployed, so I cannot afford buying the medicine at private pharmacies," the patient said, adding that they pay as little as N$4 at state facilities, but have to fork out around N$60 at private pharmacies for an inhaler.

Moving around without the inhaler is risky, she said, because asthma attacks come anytime, anywhere.

"I feel like my life is at risk, especially at this time of corona [virus] which I am vulnerable to since asthma is already a respiratory illness. When will the hospitals have inhalers then? They are expensive and I do not know how long I will have to continue buying them (from private pharmacies).

"I find it hard to breathe most of the time (during an attack) and I can end up using five or more inhalers per month depending on how often attacks occur and on how my breathing is like," said the patient.

Another patient in Windhoek told The Namibian that she usually has her asthma follow-ups the Katutura Health Clinic, where she was told that salbutamol inhalers were out of stock and was referred to private pharmacies.

"I sometimes go to the hospital for oxygen and I cannot afford going there every time I encounter difficulty breathing," she said.

Health minister Kalumbi Shangula, who confirmed the shortage, said there are alternatives to salbutamol.

"They can get other [asthma] medicine instead of salbutamol that is out of stock," he said.

The alternatives include drugs such as chlorphenamine tablets and beclomethasone inhaler which are used twice a day. However, patients say these alternative medications are not as as effective as the Salbutamol.

Windhoek-based Dr Ferlin de Almeida says salbutalmol is a rapid reliever for an asthma attack, which is why it is used in cases of emergencies.

De Almeida said beclomethasone is used to help control the asthma level, which is why it is used twice daily and takes time to help ease an attack.

The Namibian last week visited the Katutura Intermediate Hospital, Katutura Health Centre, Okuryangava and Donkerhoek clinics with staff at the pharmacies confirming they did not have salbutamol in stock.

State hospitals at Engela in Ohangwena, Tsumeb in Oshikoto, Walvis Bay in Erongo, and Oshakati in the Oshana regions also confirmed that they did not have Salbutamol although they said patients are being given alternative medication.

Keetmanshoop State Hospital had a limited stock of the drug.

Salbutamol has been out of stock for close to five months.

Two weeks ago, the Namibia Oncology Centre received some of the medication which had been stuck at the border due to lockdown-related delays.

Health executive director Ben Nangombe last month confirmed that the shortage of most drugs in the country including contraceptives was due to Covid-19.

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