Repairing 15 Oxygen Plants in Peru Amid COVID-19

As COVID-19 cases surged across Peru in early 2021, many people had no choice but to stand in line for hours on the streets of Lima, even as they or their loved ones struggled to breathe. They weren’t lining up for masks, or tests, or sanitizer. They needed oxygen.

The lifesaving resource was already nearly impossible to find in Lima, a city of more than 9 million—running low in hospitals, selling out in stores, and price gouged by online vendors. Medical oxygen is a last line of defense against COVID-19, a virus that attacks the respiratory system. And for tens of thousands of Peruvians, it never came.

Although COVID-19 cases have since fallen, oxygen remains an essential—but limited—resource in Peru, where new variants and respiratory diseases such as tuberculosis remain ever-present threats.

To tackle the oxygen gap in Peru, Socios En Salud, as Partners In Health is known locally, plans to repair at least 15 oxygen plants across the country as part of BRING O2—PIH’s new initiative to accelerate access to safe, reliable oxygen in five countries, supported by Unitaid. As part of a broader COVID-19 response with other partners, Socios En Salud has also opened five oxygen centers to help patients access the lifesaving resource without occupying an ICU bed.

The Oxygen Gap

Oxygen is critical for patients with hypoxia—low oxygen levels in the blood—which can be caused by a multitude of conditions from tuberculosis to heart failure to newborn prematurity. COVID-19 is especially demanding on oxygen supply, with the most severely ill patients requiring over 1,000 liters of oxygen per hour.

Oxygen in Peru is typically sourced from oxygen plants (an industrial system that fits in standard-sized shipping containers), oxygen tanks (pressurized cylinders that need to be refilled), or oxygen concentrators (portable devices that the patient can have at their bedside or take home).

But in Peru, as in many low- and middle-income countries before and during COVID-19, there wasn’t enough oxygen to meet demand. By early 2021, the country’s oxygen deficit had reached 110 tons per day. An estimated 225,000 patients died at home or in the streets, waiting for oxygen that never arrived, according to Socios En Salud staff.

That breakdown happened for several reasons.

Oxygen plants in Lima’s hospitals were in disrepair, without mechanics to fix them, or lacked reliable electricity to run. Oxygen tanks and concentrators were sold out, price gouged, or delayed due to supply chain issues. That left patients and families to scramble to find oxygen anywhere they could, including the black market. But even if patients had a tank—which range in price from 500 soles ($1.31 USD) to more than 5,000 soles ($1,306 USD)—there was no guarantee of a refill.

Even as thousands struggled to breathe, hospitals were running out of beds. Peru has less than two hospital beds per 1,000 people, a reality that, at the peak of the pandemic, led to overcrowding in some hospitals and patients turned away.

Since 2020, Socios En Salud has led a comprehensive COVID-19 response in partnership with Peru’s Ministry of Health—a continuation of its longstanding work in the country, which began in 1994 in response to a deadly outbreak of multidrug-resistant tuberculosis in Carabayllo.

BRING O2 is the latest chapter in that long-running partnership.

Helping Patients Breathe

PIH launched BRING O2 earlier this year with funding from Unitaid and in partnership with Build Health International and PIVOT Health Madagascar. The initiative focuses on strengthening oxygen systems in Peru, Malawi, Lesotho, Rwanda, and Madagascar—countries where the need is great.

With the BRING O2 Initiative, Socios En Salud has redoubled its efforts to procure and provide oxygen in a variety of ways—from repairing oxygen plants to training health workers.

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Socios En Salud plans to repair at least 15 oxygen plants this year across Peru, from Loreto in the north to Arequipa along the southern coast. Most recently, Socios En Salud completed repairs of an oxygen plant at San Juan de Dios Hospital in Ancash.

These oxygen plants provide between 10,000 and 50,000 liters of oxygen per hour, enabling oxygen tanks to be refilled and oxygen outlets near the patients' bedside to provide a steady flow of the lifesaving resource.

Along with each installation or repair of an oxygen plant, Socios En Salud has trained biomedical engineers and technicians on how to use and maintain the equipment.

Oxygen plants aren't the only resource Socios En Salud has enlisted in the fight against COVID-19. Socios En Salud has also opened five oxygen centers, most recently a 14-bed center in Florencia de Mora, a city in Trujillo province, and a 26-bed center in Los Olivos de Pro, a district in Lima.

These centers are meant to prevent hospitals, particularly ICUs, from overcrowding with patients who require oxygen and monitoring, but not intensive care. The centers provide patients with beds, oxygen concentrators, and 24/7 care. Typically, patients stay three to five days.

“This will save the lives of thousands of people who continue to suffer the consequences of the coronavirus and other respiratory diseases," says Dr. Marco Tovar, Socios En Salud’s medical director.

Socios En Salud outfitted the center in Florencia de Mora with 24 oxygen concentrators and hired 60 health workers to provide around-the-clock care. The center will serve the La Libertad region—home to more than 2 million people.

Just miles away, an oxygen plant operates at Belén Hospital, installed by Socios En Salud in January. The plant can produce 20,000 liters of oxygen per hour, strengthening the hospital’s response not only to COVID-19 but to other respiratory diseases, such as pneumonia and tuberculosis.

“All those who require oxygen…will be able to access hospitalization and oxygen therapy services,” says Kerstyn Morote García, regional health manager in La Libertad. “We are very grateful for the support provided by Socios En Salud.”