Baldeep Singh: COVID-19 in the Developing World

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The pandemic has exposed critical flaws in American health care, but Dr. Baldeep Singh says the COVID-19 crisis looks very different in the developing world.

I have been thinking a lot about the global response to the coronavirus outbreak since I returned from Kenya last month, where I worked at a hospital in a small town, called Webuye. As you might expect, the conditions at the hospital included shortages of supplies, medicines and expertise. The numbers of patients, and lack of PPE, overwhelmed the medical team, but instead of COVID, the staff and their patients were battling a longstanding siege with old diseases like TB, malaria and HIV. I was completely humbled by the courage local people showed in facing life’s obstacles, and that of health care workers who risked their own well being to treat patients on an ongoing basis.

The population of Kenya, as in many developing countries, has continued to wage a daily battle with infectious disease for decades. Many of the health care workers I spoke with in Kenya resigned themselves to the knowledge that if COVID was to grow dramatically in Africa, it would be devastating. But in many respects, fear of the coming scourge and potential loss of life is not new.

That is not to say that the current COVID crisis is not unprecedented, nor tragic. But in talking to Kenyan health workers, coronavirus poses the latest threat in a long line of infections that have ravaged developing countries.

Experts estimate that this year’s global deaths from COVID may climb to around 500,000. In comparison, annually 400,000 people across the globe perish from malaria, 1.2 million from TB, 800,000 from AIDS-related illnesses, and 5-7 million from diarrheal disease. In many of these countries, death forms part of daily life. In addition to this stress, consider the added strain that comes from injury, food insecurity and violence. While COVID upends the first world, it could further devastate the poorest populations.


Living with this level of risk of infection, year after year, and decade after decade, has taken a deep toll, and yet many of the poorest across the globe have faced it every day of their lives.

With a Perspective. this is Dr. Baldeep Singh.

Dr. Baldeep Singh is an internist at Stanford Hospital.