COVID-19: the sacrifices and dilemma of frontline medics

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Health workers. Photo credit: WHO

MAIDUGURIIt’s 5 pm and Dr Mustapha ​Mohammed ​is back to his office. 

It was time to go home after a hectic day. 

As he washed his hands with soap and water, he looked into his the mirror before him, and what he saw adds to his private misery.

No doubt the job of managing COVID-19 patients at the University of Maiduguri Teaching Hospital isolation centre is fast telling on him. He could see it from his eyes. The fatigue cannot be hidden. 

But neither his tired eyes ​nor ​the general toll that the stressful duty took on his body were his major trouble now. Two ​other ​things bother his mind​ each time he​’s​ round​ing​ off to go home. ​The issues he cannot run away from but must develop personally strategy to deal with it. ​

As he was about to depart the office, a news headline flashed on his ​phone ​screen “113 health workers infected with COVID-19”. His heart sank​. ​ 

“Every day when it is time to leave the hospital for our homes, one is left with the fear of not taking the virus to infect one’s family at home,” he sai​d, with an obvious air of worry. ​ 

“Of course, before we go into the isolation ​wards, we are properly kitted with body protect equipment and when we are done working there, we are properly ​disinfec​ted, I still make sure I change the clothing on me with a fresh one before heading home. When you get home, after once again sanitizing your body, one still feels not very free to mingle with the family,” he said. 

Apart from the traumatizing fear of not infecting oneself and family, Dr Muhammed said he also suffer​ed a lot​ stigmatization from neighbors and friends who kn​e​w that he had direct contact with COVID-19 patients. 

“Though people may pretend they understand the nature of work you​ ​do, one could still observe how they try as much as possible to avoid coming near you, even at social distance level,” he said.

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Maryam Bukar, a Nurse at one of the public hospitals in Borno state, said she feels terrified each day she sets out for work. 

“We don’t have PPEs and that leaves many of us scared,” she said. 

“The greater possibility that one may contract the disease and even take it home to infect loved ones disorients ones. 

“All we do was to follows orders and ensure that we use hands gloves, faces mask and frequently sanitize or wash our hands​ with soap and water ​and then pray to God that all these preventive measures work.”​

“Sometimes I feel like not going home to see my family. I fear for them as much as I love them. And when I get home I tried to avoid my daughter running to hug me as she normally does. Each time I avoid her hugs, she cries and that hurts me. She never knew that her hugs energise​s​ me each time I come home tired; she never knew I needed it even more than her. But here we have COVID-19​,​ or the fear for it​,​ coming in-between me and my baby,” ​she said. ​

Maryam said her and many other nurses’ concern was not even much about the poor motivation and reward system for those who staked out their li​ves​ to provide care for others, but how they are exposed to treat all patients in a hospital​s​ that lack no testing equipment for COVID-19.

“Our biggest challenge is the issue of poor screening in most our public hospitals,” she said. 

“We are forced to attend to patients including those with mild but likely symptoms of the new coronavirus. Patients are only tested when their cases of fever ​or cough ​are on the high side, then they are referred for the ​COVID-19 ​screening​ centre​. Else, we must provide all the required services to the patients. This involves card registration, the taking of vital signs and then administration of drugs after the patients have seen​ by the doctors.”​

She said many of her colle​a​g​u​es had contracted the COVID-19 while working in the hospital. ​Some had to stay at home and self-isolate and even treat themselves, while others had to go into the isolation centre​

“Stigma is a major issue even amongst we the health practitioners,” she said. 

Many of our colleagues contracted the virus and sadly our fellow colleagues were the ones taking the lead in spread the news and thereby stigmatize them. 

Ayabaryu Sunday, a female nurse who has been working at the Maiduguri Teaching hospital since 2009 when the Boko Haram insurgency began said she hasn’t been so worried about her safety than now.

“This is difficult times for me, and I have never been so scared about my safety each time I step into the hospital wards,” said Ms Sunday who wouldn’t want to be named in this report because they are now being sanctioned for speaking to the media on the issue concerning COVID-19.

“In the past one still have to take extra caution while attending to patients brought into the hospital especially the ones with injuries or ailment as a result of the ongoing Boko Haram insurgency. But now, with the COVID-19 pandemic, our lives are more threatened here in the hospital. 

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Health workers at the Cacovid isolation centre, Mainland, Infectious disease hospital, Yaba, in Lagos, Nigeria. (Photo by: Emmanuel Osodi/Majority World/Universal Images Group via Getty Images)

“It is very difficult for a nurse to observe the social distance or keeping 1.5 meters from a patient. We have to come closer to the patients and we do not have any special body protection equipment to help us keep safe.”

The nurse added that “many doctors and nurses have tested positive” to the COVID-19 because none of them had any BPE on when the first index case was brought into the hospital about two weeks ago.

Relying only on her face mask, and the hand-washing soap and sanitizer provided in the wards, Nurse Sunday said most of them risk it all every day to help other patients survive.

“If at all we can have modern medical tools like a digital or infrared thermometer, we may not have to go close to the patient to take the vital tests. But without these modern tools, many of us are exposed to the risk contracting the COVID-19; and it gives us a lot of concerns as we have to go home daily to mix up with our families,” said, Ms Sunday.

Grace James, a surgical nurse at the University of Maiduguri Teaching Hospital said she and her other colleagues “are left to worry about their personal safety” while attending to patients with surgical injuries.

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“Most of the patients especially those injured as a result of attacks by the insurgents are brought to our department,” she noted.

“But now, more than ever before, I have to worry about my health and safety as we go into the theatre for any kind of surgery; I have to put on gloves, wear my goggles and masks before I can go near the patients.

She said the hospital did not provide any special BPE for nurses and doctors except those in the theatre ward.

Ms James said every day before a patient is operated upon in the theatre where she works, she has to take his or her vital tests, incubate the patient and get such patient ready for the surgeon.

“We are about to go into the theatre as I speak with you now, and I have to incubate the patient by inserting a medical tube in his trachea through the mouth to allow for mechanical ventilation, and that process even exposes one to the dangers of contractingCOVID-19.​”​

​”​In the past, I see a patient as someone whose life is under threat and I do everything to save him or her; but now I see every patient as a potential threat to me even as I have no option than to go on to do all that is necessary to save such patient,” she said.

Ms James confirmed that “very many” of ​her​ colleagues, especially the medical staff of this hospital ha​d​ tested positive for the COVID-19.

“They are mostly asymptomatic but their tests came out positive and they have to self-isolate, and that too has brought pressure on we that have not tested positive because we are not experiencing a shortage of manpower,” she said.

As of June 2020, over 800 medical practitioners have tested positive for COVID-19 in Nigeria alone. This figure goes far to say the level of risk medical workers, both female and male take every day by daring the dangers of the frontline to provide care to those in dire need. And as a result, many of them have become the victims of the very ailment they set out to provide a cure. 

A​s of July 30th Nigeria has recorded a total of 42,689 cases ​with 878 deaths. However, due to the diligence and sacrifices being made by the courageous health workers, a total of 19,270 patients have been treated and helped to recover from the COVID-19 infection so far.

* This article was published with support from Participatory Communication for Gender Development (PAGED) Initiative

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