When I entered the office of Dr Sangeeta Mishra, Director of Koshi Zonal Hospital in Biratnagar, she was discussing a few points with one of the doctors. After the two doctors were done with their discussion, which was brief, I put forth my two questions: What are the preparations at this hospital to fight COVID-19 and How are frontline medical professionals/healthcare workers coping with the stress.
Dr Mishra starts briefing me about the steps taken by the hospital to prevent the spread of the virus while treating incoming patients. She is calm and collected as she gives me the information. As the briefing on preparations is about to be done, she starts getting frantic calls about where and how to keep the three people in quarantine. Dr Mishra is now struggling between the interview and incessant phone calls with the ambulance drives, the CDO, and hospital staff.
Just as she is done coordinating between various persons on the phone, a representative from the local tailor knocks her door with some samples of the locally sewn PPE. They are a two-piece garment, just like a single-person raincoat. That is not the design she had sent to the tailor. She reminds the representative about her jumpsuit-like design, returns the samples, and requests for another batch as soon as possible.
Another series of phone calls distract her yet again.
Keeping her phone down she lets out a contended broad smile and says, “It is a stressful time of course, but I am not allowed to say that because a lot of people’s hopes are dependent upon me. By being in this chair, I have no option but to stay positive even during the time of crisis.”
Dr Mishra says healthcare workers at the hospital are scared for their own wellbeing mostly due to the lack of protective gears (PPE, masks, gloves, goggles) but also because of the misinformation that some online news portals have been disseminating. She says, “At this time, the government should use the media in a right way so that factual information is circulated to the citizens. Even doctors here are scared due to the lack of accurate data regarding COVID-19.”
A mother of two, Dr Mishra says even her youngest kid avoids her request for cuddles when she reaches home after a long and tiring day at the hospital. “When I reach home, I try my best to stay away from work-related stress. I have to answer my phone calls, but that’s it. It is crucial that I give myself some time and space at home so that I am ready to handle the stressful work environment the next day,” she says.
Dr Dikshanta Pokhrel, of Post-mortem ward at Koshi Hospital says, “We are scared because we haven’t been provided with protective gears. We’ve been using home-made PPE as of yet. The availability of PPE would have boosted our self-confidence, but that’s not happening. Imagine what would happen if soldiers fighting in the frontline of a war were sent without guns and other weapons. How would they feel, how would they fight? Our situation is like those soldiers without weapons.”
Amid a global pandemic when healthcare institutions have been stretched to their capacity’s limit, ignoring the needs and safety of healthcare workers is certain to consequently hamper public health. Their psychosocial health is also equally important. “Even healthcare professionals are in need of counselling at the moment. Every day, I council my staffs in the morning before I begin my work,” says Dr Mishra.
“Though the central government issued a strategy to fight this battle, the strategy is not concrete. Despite coordination from the local and provincial levels, there still are loopholes that the government has overlooked. There is no chain of command. Lack of coordination as well as a focal person to deal with technical matters has given me the most difficult time,” she says.
When asked if the hospital and herself are ready to handle if a patient tests COVID-19 positive, Dr Mishra says, “I believe we can handle it. We are doctors and it is our duty to save lives. But I would not force my hospital staff to treat such a patient if they are not given proper safety gears. The life and wellbeing of healthcare workers are also equally important.”
“We should stay positive and well-informed. If contact tracing is done and the number of cases don’t drastically increase within the next 7-10 days, I’m sure things will go back to normal soon. It is important that all of us embrace positivity at the moment,” concludes a hopeful Dr Mishra.