医療崩壊の最前線、トイレにまで積み重ねられた遺体　エクアドル

【グアヤキルＡＦＰ＝時事】中南米における新型コロナウイルスの流行地の一つ、エクアドルのグアヤキルでは医療崩壊が起きており、最前線に立つ医療従事者は毎日恐怖に直面している。医療従事者らによると、グアヤキルのある病院には新型コロナウイルス感染症（COVID-19）患者が殺到。遺体安置所も満杯なため、職員らが遺体をトイレに積み重ねなければならない状況に置かれている。（写真は資料写真）
　匿名を条件に取材に応じた男性看護師（３５）によると、かつて看護師１人当たりの受け持ち患者数は１５人だったが、３月に新型ウイルスの流行による公衆衛生上の緊急事態が発生すると、わずか２４時間のうちに３０人に急増したという。
　男性看護師は、「とても大勢が搬送されてきた……彼らは私たちのせいで死んだも同然だ」「患者たちは孤独で、悲嘆に暮れている。治療は消化管に大きなダメージを与え、大便を漏らす人もいる。彼らは具合が悪く、この先ずっとそれが続くのではないかと思っている。そして隣の患者が窒息しかけ、酸素が欲しいと声を上げるのを聞く」と語った。
　病院だけでなく、遺体安置所も飽和状態になっている。
　男性看護師は、「遺体安置所の職員はこれ以上遺体を受け入れてくれないので、私たちが遺体を包み、トイレに安置せざるを得ないことが何度もあった」と語った。遺体安置所の職員が引き取りに来るのは、６人か７人の遺体が積み重なった時だけだという。
　男性看護師の同僚の女性看護師（２６）もこの混沌（こんとん）とした状況を認めた。女性看護師はＡＦＰの取材に対し、トイレにも、床にも、アームチェアにもたくさんの遺体が安置されていると説明した。
　公式統計によると、エクアドルではこれまでに２万３０００人近くが新型ウイルスに感染し、約６００人が死亡しており、グアヤキルが最も被害の大きな都市となっている。
　しかし、実際の死者数は、これよりもはるかに多いと考えられている。グアヤキルが州都となっているグアヤス州では４月、上旬だけで同月平均の３倍超となる６７００人の死亡が確認された。
　新型ウイルスの１日当たりの死者数は先週、減少に転じたが、今回の体験に苦しんでいるという男性看護師にとってはあまり慰めにはならなかった。
　２４時間勤務を終え、痛む足で帰宅して眠ろうとしても、今度は「悪夢」にさいなまれる。夢の中では転ぶまで走り続け、「トイレのドアを開くとあのたくさんの遺体が……眠りに戻ることはできない」のだという。
　自宅での生活も変わった。厳格な隔離措置に従っているので、両親や兄弟と顔を合わせることはできない。
　男性看護師は帰宅すると、一連の儀式を行う。車と靴を消毒し、中庭でホースを使って水浴びし、お湯で衣服を洗う。
　「食事はプラスチックのテーブルで、誰からも離れたところで取る。自室を出る時はマスクを着ける。誰も抱きしめることはできない。ペットさえも」と男性看護師は語った。【翻訳編集ＡＦＰＢＢＮｅｗｓ】

〔ＡＦＰ＝時事〕（2020/04/30-13:06）

Front line medics in one of Latin America's coronavirus epicenters are lifting the lid on the daily horrors they face in an Ecuadoran city whose health system has collapsed.
In one hospital in Guayaquil overwhelmed by COVID-19 patients, staff have had to pile up bodies in bathrooms because the morgues are full, health workers say.
In another, a medic told AFP that doctors have been forced to wrap up and store corpses to be able to reuse the beds they died on.
Ecuador has recorded close to 23,000 coronavirus cases and nearly 600 deaths, with Guayaquil by far its worst affected city. But the real toll is thought to be far higher.
A 35-year-old nurse at the first hospital who spoke on condition of anonymity said that the trauma of what he saw had affected him professionally and personally.
When the health emergency broke out in March, every nurse went from caring for 15 patients to 30 in the space of just 24 hours, he added.
So many people arrived that... they were practically dying in our hands, said the nurse.
Patients were discharged or referred to other facilities to free up all these beds for coronavirus patients, he told AFP.
They took out anesthesia machines from operating rooms to replace them with ventilators.
People are alone, sad, the treatment wreaks havoc on the gastrointestinal tract, some defecate; they feel bad and think they will always feel that way, and they see that the person next to them starts to suffocate and scream that they need oxygen.
It isn't just hospitals that have been overwhelmed, but morgues too.
The morgue staff wouldn't take any more, so many times we had to wrap up bodies and store them in the bathrooms, the nurse said.
Only when the bodies were stacked up six or seven high did they come to collect them.
A 26-year-old colleague, also a nurse, confirmed the chaotic scenes.
There were many dead in the bathrooms, many lying on the floors, many dead in armchairs, she told AFP.
- 'Sanitary disaster' -
Guayaquil's health system has collapsed under the pressure of the coronavirus, and it seems to be having catastrophic knock-on effects.
In the first half of April, the province of Guayas, whose capital is Guayaquil, recorded 6,700 deaths, more than three times the monthly average.
The disparity suggests that the real COVID-19 death toll is far greater than the official nationwide tally of fewer than 600.
President Lenin Moreno has acknowledged that Ecuador's official coronavirus tallies are short of the true figures.
A 28-year-old doctor at a second Guayaquil hospital, who also insisted on anonymity, conjured a similarly grim picture of health services in crisis.
Bodies were in the corridors of the emergency ward because the morgue was full, the medic told AFP, describing 20 to 25 corpses waiting to be taken away.
It was up to us to collect and wrap the corpse and store it so we could disinfect the bed for the next patient, he added.
At the first hospital, refrigerated containers were brought in to store bodies, some of which remained for up to 10 days.
Some family members break the covers... so the fluids come out. It's a sanitary disaster, said the 35-year-old male nurse.
- 'It kills you psychologically' -
The number of daily deaths fell last week but that was scant consolation for this nurse, who says he is tormented by what he has experienced.
When he goes home, after a 24-hour shift, his feet hurting, he tries to rest but then the nightmare strikes.
He dreams of running until he falls and knocks open the bathroom door with the number of bodies... and you can't go back to sleep.
His home life has also changed. He is following strict isolation so cannot see his parents or brother.
When he goes home he begins his ritual of disinfecting his car and shoes, hosing himself down on the patio before washing his clothes in hot water.
I eat on a plastic table away from everyone. I leave my home with a mask, I can't hug anyone, not even the pets, he said.
Every now and then he thinks about the psychological mark left on him every time he has to make do with hooking them up to cannula tubes when what they really need is a ventilator.
They tell you, 'It's okay -- give them oxygen and a slow drip serum and leave them,' he told AFP.
But what if that was my mom? What if it was my dad? That kills you. It kills you psychologically.
AFP sought comment from health authorities in Guayaquil but did not get a reply.
A national public health authority official said he had been in an emergency unit in Guayaquil where bodies were piled up.
A morgue for eight deceased persons and you have to manage 150 bodies, what can you do? You have to put them anywhere nearby that you have space, he told AFP.
The official said the number of cases in Guayaquil rose dramatically and rapidly in a matter of days, overwhelming an inadequate emergency healthcare system.
There was such a speed of contagion that it reflected a large number of seriously ill and a large number of deaths at a specific time, he said.