It’s war in the Covid ward

It’s war in the Covid ward

MASERU – For many people, the mere mention of Covid-19 is enough to make them quake in their boots. But take a moment to commiserate with the health professionals who are risking their lives to treat Covid-19 patients in quarantine centres. For them, their job has become the sum of all fears.
The risks health professionals such as doctors and nurses face daily include getting infected, the mental strain of seeing their patients die, having to break the bad news to relatives of the deceased and keeping their own family and friends at a safe distance for fear of passing the virus to them.

It is a situation that health professionals were ill-prepared for.
“I don’t think anyone, even me, was prepared for anything like this from school,” said Dr ’Mamotena Ramabolu, who works at Berea Hospital.
The government has designated Berea Hospital as a quarantine facility for Maseru and all northern districts. For professionals working at the hospital every day is a struggle.

“Being a health professional during the Covid-19 era is an emotional and difficult time for all of us,” Dr Ramabolu told thepost.
Dr Ramabolu joined the isolation ward at Berea Hospital in June last year when cases first soared during the first wave of the pandemic. She said she first came in contact with a Covid-19 case in August last year.
“The first wave was there but it wasn’t as bad as the second one. It was severe but moderate and manageable,” she said.
She said the first months of working in the isolation ward were stressful as Covid-19 was a scare for everyone, and health professionals were no exception.

“We were all afraid and we ended up having psychosomatic symptoms a week after working in there. It was a response of the fear we had towards the disease, although we tested negative,” she said.
She said back then, patients were admitted with symptoms and some were asymptomatic, with mild and severe diseases.
“We didn’t have the whole picture by then and patients relied only on us for physical support as they had none from outside except through phones,” she said.

“Our support wasn’t enough but it was a necessity as they were in isolation.”
She said it was also emotional being the only physical contact of patients and once she entered the ward, she automatically became their family.
“Some of the patients still know me when I meet them outside the hospital. Even the conversations we had were like those of people who have known each other for a long time. This showed me how people depended on me not only for me to help them but support them emotionally to go through the ordeal.”

Dr Ramabolu said everything was disorganised as they were still trying to find their feet.
She said the second wave, which started last December through to April, was worse.
“It was the worst thing I had ever seen as a doctor or medical student,” she said.

She said patients were all over and people were transferred to the hospital, which was struggling with scarce oxygen for patients.
“It was so bad and for me it was very traumatising and for the first time I even wondered whether being a doctor was (the right) profession for me.”
“It was emotionally draining because no one wants to tell someone that their loved ones are dying and there is nothing I as a doctor can do about it,” she said, adding: “This was the conversation I had every day.”
“The family would come running, seeking hope from me, but I had to be frank and would tell them the truth.”
She said they had to come up with a solution, rather than prolonging false hopes for the family members.

“We had to be frank, tell them where we are, what we have and what we need but didn’t have. It was a very emotional thing,” Dr Ramabolu said, adding that health personnel had to come to the front office and talk to families.
“The second wave was the most traumatic.”
She said they were forced to run around for oxygen and the sad thing was every time they started to find their footing, infections eased.
“We always feel like we are prepared but once a new wave comes, it takes a whole four weeks or more for us to set up a system that actually works. We always get ready after a whole lot of devastation.”

During the second wave, professionals were deployed – nurses, ward attendants and porters and Non-Governmental Organisations (NGOs) but infections had already started to increase.
There was a time when the ward had one patient and “we had so much help and we even had nurses to spare”.
They expected the third wave around Easter but it didn’t come. As a result most of the support in human resources went away and the last support of the Covid team nurses was around May.
The third wave came and “we are back to square one.”
She said now doctors have to pull oxygen cylinders as there are no porters.

“I pull a 60 kg cylinder, which is higher than me and I drag it to patients. We have to deliver it in cylinders,” she said.
“Now we went from the second wave where we didn’t have enough cylinders and now that we have them, we are going through a physical trauma of pulling them rather than doing our job. A cylinder is changed in intervals of four to eight hours.”
She said they now have back pains.
“We find ourselves not being able to fully function because when I am supposed to be a doctor, I am not being a doctor but a potter, a nurse, ward attendant and by the time I am being a doctor, it’s already late and I have to knock off,” she said.
“I am exhausted.”

Dr Ramabolu said they are at a point where they feel they are being stretched to the limit and they are not even able to function effectively.
She said she is getting used to the emotional turmoil.
“We know that Covid is here and is likely to stay but somehow we are unable to prepare even when we see the problem. It takes so much time to prepare and address it to the extent that assistance comes later after everything has calmed down.”
Dr Ramabolu said taking everything one day at a time helps her cope on a daily basis.

Every day after work she is so adamant that tomorrow “I don’t think I can do it again”.
But there is no other alternative.
“Every day when I knock off I can feel my body aching, my soul bleeding and that I am emotionally stretched.”
What keeps her going is “the smiles I get from my patients”.
“Their appreciation helps a lot because what we are going through is an ordeal itself.”

“We don’t need temporary solutions but somehow we are resorting to temporary ones and indeed it brings disaster. We need to set up permanent systems,” she said.
“This flu may go away but there will be the next flu that will still cause havoc. We would rather stop trying to patch holes but bring permanent solutions.”
She said the country’s health system is very young and needs to grow.
“Pandemics such as this reveal the gaps and rather than patching them, we need to assess and start from the ground and build something permanent that will withstand the next pandemic,” she said.

“We need more doctors. I shouldn’t be managing 30 patients on my own on a nine-hour shift. I shouldn’t be having three nurses looking after 15 critical patients.”
“We have so many nurses in the country, why are they not being hired permanently?” she asked.
Dr Ramabolu said Covid-19 has taught her to be humble and empathetic.
“I don’t have all the answers as a doctor but recognising that is a strength that I gained. Seeing my family in the eyes of a patient had always made me imagine my own hence the empathy. I put myself in both patients and their relatives’ shoes.”

She said she has been lucky not to be infected.
She had flu in the second wave but she tested negative.
“I feel blessed to have been working in a quarantine ward but never got infected.”
Another professional, Dr Tšepiso Makhonofane from the same hospital, joined the quarantine facility in May last year.
“It’s very difficult working in a quarantine facility,” Dr Makhonofane said.
She said when Covid started the country was not prepared and one year down the line, the problems are still the same.

“Lack of human resources, X-ray facilities, lab problems and oxygen are still a challenge,” she said.
She said the challenges are affecting her emotionally as at times all the patients need is oxygen to survive.
“Without it, patients die on our watch. Oxygen would have helped,” she said.

For many people, the mere mention of Covid-19 is enough to make them quake in their boots. But take a moment to commiserate with the health professionals who are risking their lives to treat Covid-19 patients in quarantine centres. For them, their job has become the sum of all fears.
The risks health professionals such as doctors and nurses face daily include getting infected, the mental strain of seeing their patients die, having to break the bad news to relatives of the deceased and keeping their own family and friends at a safe distance for fear of passing the virus to them.
It is a situation that health professionals were ill-prepared for.

“I don’t think anyone, even me, was prepared for anything like this from school,” said Dr ’Mamotena Ramabolu, who works at Berea Hospital.
The government has designated Berea Hospital as a quarantine facility for Maseru and all northern districts. For professionals working at the hospital every day is a struggle.
“Being a health professional during the Covid-19 era is an emotional and difficult time for all of us,” Dr Ramabolu told thepost.

Dr Ramabolu joined the isolation ward at Berea Hospital in June last year when cases first soared during the first wave of the pandemic. She said she first came in contact with a Covid-19 case in August last year.
“The first wave was there but it wasn’t as bad as the second one. It was severe but moderate and manageable,” she said.
She said the first months of working in the isolation ward were stressful as Covid-19 was a scare for everyone, and health professionals were no exception.

“We were all afraid and we ended up having psychosomatic symptoms a week after working in there. It was a response of the fear we had towards the disease, although we tested negative,” she said.
She said back then, patients were admitted with symptoms and some were asymptomatic, with mild and severe diseases.
“We didn’t have the whole picture by then and patients relied only on us for physical support as they had none from outside except through phones,” she said.
“Our support wasn’t enough but it was a necessity as they were in isolation.”

She said it was also emotional being the only physical contact of patients and once she entered the ward, she automatically became their family.
“Some of the patients still know me when I meet them outside the hospital. Even the conversations we had were like those of people who have known each other for a long time. This showed me how people depended on me not only for me to help them but support them emotionally to go through the ordeal.”
Dr Ramabolu said everything was disorganised as they were still trying to find their feet.
She said the second wave, which started last December through to April, was worse.

“It was the worst thing I had ever seen as a doctor or medical student,” she said.
She said patients were all over and people were transferred to the hospital, which was struggling with scarce oxygen for patients.
“It was so bad and for me it was very traumatising and for the first time I even wondered whether being a doctor was (the right) profession for me.”
“It was emotionally draining because no one wants to tell someone that their loved ones are dying and there is nothing I as a doctor can do about it,” she said, adding: “This was the conversation I had every day.”
“The family would come running, seeking hope from me, but I had to be frank and would tell them the truth.”

She said they had to come up with a solution, rather than prolonging false hopes for the family members.
“We had to be frank, tell them where we are, what we have and what we need but didn’t have. It was a very emotional thing,” Dr Ramabolu said, adding that health personnel had to come to the front office and talk to families.
“The second wave was the most traumatic.”
She said they were forced to run around for oxygen and the sad thing was every time they started to find their footing, infections eased.

“We always feel like we are prepared but once a new wave comes, it takes a whole four weeks or more for us to set up a system that actually works. We always get ready after a whole lot of devastation.”
During the second wave, professionals were deployed – nurses, ward attendants and porters and Non-Governmental Organisations (NGOs) but infections had already started to increase.
There was a time when the ward had one patient and “we had so much help and we even had nurses to spare”.
They expected the third wave around Easter but it didn’t come. As a result most of the support in human resources went away and the last support of the Covid team nurses was around May.

The third wave came and “we are back to square one.”
She said now doctors have to pull oxygen cylinders as there are no porters.
“I pull a 60 kg cylinder, which is higher than me and I drag it to patients. We have to deliver it in cylinders,” she said.
“Now we went from the second wave where we didn’t have enough cylinders and now that we have them, we are going through a physical trauma of pulling them rather than doing our job. A cylinder is changed in intervals of four to eight hours.”
She said they now have back pains.

“We find ourselves not being able to fully function because when I am supposed to be a doctor, I am not being a doctor but a potter, a nurse, ward attendant and by the time I am being a doctor, it’s already late and I have to knock off,” she said.
“I am exhausted.”
Dr Ramabolu said they are at a point where they feel they are being stretched to the limit and they are not even able to function effectively.
She said she is getting used to the emotional turmoil.
“We know that Covid is here and is likely to stay but somehow we are unable to prepare even when we see the problem. It takes so much time to prepare and address it to the extent that assistance comes later after everything has calmed down.”

Dr Ramabolu said taking everything one day at a time helps her cope on a daily basis.
Every day after work she is so adamant that tomorrow “I don’t think I can do it again”.
But there is no other alternative.
“Every day when I knock off I can feel my body aching, my soul bleeding and that I am emotionally stretched.”
What keeps her going is “the smiles I get from my patients”.
“Their appreciation helps a lot because what we are going through is an ordeal itself.”

“We don’t need temporary solutions but somehow we are resorting to temporary ones and indeed it brings disaster. We need to set up permanent systems,” she said.
“This flu may go away but there will be the next flu that will still cause havoc. We would rather stop trying to patch holes but bring permanent solutions.”
She said the country’s health system is very young and needs to grow.
“Pandemics such as this reveal the gaps and rather than patching them, we need to assess and start from the ground and build something permanent that will withstand the next pandemic,” she said.

“We need more doctors. I shouldn’t be managing 30 patients on my own on a nine-hour shift. I shouldn’t be having three nurses looking after 15 critical patients.”
“We have so many nurses in the country, why are they not being hired permanently?” she asked.
Dr Ramabolu said Covid-19 has taught her to be humble and empathetic.
“I don’t have all the answers as a doctor but recognising that is a strength that I gained. Seeing my family in the eyes of a patient had always made me imagine my own hence the empathy. I put myself in both patients and their relatives’ shoes.”
She said she has been lucky not to be infected.
She had flu in the second wave but she tested negative.
“I feel blessed to have been working in a quarantine ward but never got infected.”

Another professional, Dr Tšepiso Makhonofane from the same hospital, joined the quarantine facility in May last year.
“It’s very difficult working in a quarantine facility,” Dr Makhonofane said.
She said when Covid started the country was not prepared and one year down the line, the problems are still the same.
“Lack of human resources, X-ray facilities, lab problems and oxygen are still a challenge,” she said.
She said the challenges are affecting her emotionally as at times all the patients need is oxygen to survive.
“Without it, patients die on our watch. Oxygen would have helped,” she said.

‘Mapule Motsopa

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