Covid-19: The human faces behind the surgical masks

Health workers have mastered the art of minimising their needs, anxiety, fear and pain to serve others better. Picture: iStock/Gallo Images
Health workers have mastered the art of minimising their needs, anxiety, fear and pain to serve others better. Picture: iStock/Gallo Images

“Overwhelmed.” It is the one word that sums up my state of being at the moment.

Several colleagues have contracted the Covid-19 coronavirus, and the number of the ones who have lost the battle against this invisible enemy is increasing in South Africa and globally.

I have been wondering if I missed the module or elective meant to prepare health professionals both emotionally and psychologically for these unchartered times. Rapidly evolving clinical protocols, the threat of contracting Covid-19, information overload, fake news and uncertainty makes people tasked with providing health care apprehensive. The pandemic is amplifying the cracks in the health system and trade-offs made by frontline health workers.

READ: Seven lessons from Western Cape doctors on Covid-19

We have always understood the inherent risks of working in clinical practice. Still, we never really looked at each other and patients as possible biological hazards. Some professionals are starting to ask questions like: “Who is next? And “Is it still worth it”?

I also have to mention a conversation held recently with a friend who is contemplating throwing in the towel and closing his general practice in the coming few weeks.

It never crossed my mind that the oath we took, and the promise made to society, would compete with the need for self-preservation

Indeed, these are unprecedented times threatening our public health system, society and the economy. The pandemic has forced us to contend our humanity, interdependency, social injustices and the higher calling for cross-sectoral collaboration in the fight against Covid-19.

Fear, anxiety, confusion and grief are palpable in hospital corridors calling for purposeful, ethical and compassionate leadership during a crisis. Processing the loss of health workers like doctors, nurses, physiotherapists and administrative personnel is insurmountable.

Health service leaders ought to put the lives and wellbeing of health workers first because it is the right thing to do. The clinical practice landscape has changed, and managers need to lead with their hearts, and put themselves in the shoes of the frontline workers and their families.

READ: Covid-19 tender corruption ‘a major blow for healthcare workers’

It never crossed my mind that the oath we took, and the promise made to society, would compete with the need for self-preservation.

Health leaders have a moral obligation to mobilise resources and implement policies and procedures targeted at protecting and supporting health workers during this period.

It never crossed my mind that the oath we took, and the promise made to society, would compete with the need for self-preservation.

We vowed to uphold our promise to the world, and it’s reasonable to expect reciprocity, especially during this time

Lately, I find myself having flashbacks of the exhilarating excitement that engulfed me before our oath-taking ceremony at medical school. We acknowledged our responsibility to the profession and society.

The pandemic and the rapidly evolving clinical guidelines are causing unavoidable confusion, making us question the core of our covenant. Our hearts are bleeding, and ears are filled with loud cries from those who have lost loved ones, patients and colleagues. The pain is amplified by the feeling of failure and self-blame for colleagues and others dying under our care, despite the significant number of infected people recovering from Covid-19.

The loss of a health professional is the loss of one too many, especially if you consider the lives each one touches per work-life, compounded by the professional-to-population ratios in South Africa.

The pain cuts too deep and the feeling of guilt – asking “why him (or her)” and the realisation that it could have been you in that ICU bed.

From the early years of training, we got used to honouring our responsibilities and put patients first.

READ: Health workers at Eastern Cape facility store water in bath, fill buckets to flush toilets

Our training focuses on caring for others and less on self. It is not surprising that it is the norm for most of us to ask others to look after our sick loved ones while we take care of our patients.

We vowed to uphold our promise to the world, and it’s reasonable to expect reciprocity, especially during this time.

We have letters stating that we are essential workers. Sometimes they are not worth the paper they are printed on because of the attitude and the lack of appreciation of essential service workers in general.

Recently, we drove to Pietermaritzburg to see my dad, who is sick and elderly. We were stopped just before we crossed the interprovincial border. I was defeated by the comment from a road traffic official who checked the permit, and I had also given him my essential worker letter too.

I refuse to call this the new normal because we are social beings who thrive on human interaction and touch

The official had the audacity to ask me what I was going to do with my dad because I am not an ambulance.

I am not one to walk away from such disregard for humanity and unprofessionalism. But I sheepishly looked away, hiding my tears, and decided to spare the energy left in me for my parents in Pietermaritzburg.

In my world, the pandemic has stretched my working hours. Work has become emotionally draining instead of fulfilling. Plus we respond to a lot of queries and calls for support from friends and family, which doesn’t count as work.

We are riding an emotional rollercoaster and have learnt to hide our pain, anxiety and occasional moments of disappointment. We put on our smiles and brave faces when we leave to fight the invisible enemy, Covid-19.

We draw comfort from the smiles, messages and phone calls stamping our hearts with love, reminding us that we did not take an oath to harm ourselves.

Our friends and families check on us than ever before, reminding us that we are more than the tools of fighting the pandemic. The new abnormal is their heightened worry about our wellbeing, and our discomfort about the possibility of bringing the occupational hazard home.

I refuse to call this the new normal because we are social beings who thrive on human interaction and touch.

We have mastered the art of minimising our needs, anxiety, fear and pain to serve others better. We are silently screaming for human touch

The pandemic forces us to prescribe when and how they can dispense hugs and kisses. The longing for the warmth of their breaths, the scent of their skin and the reassuring feeling from their hearts drumming against our chests cut deeper than a scalpel.

I refuse to call this the new normal because we are social beings who thrive on human interaction and touch.

Some of our colleagues have resorted to moving out of their homes to protect their families from Covid-19.

We have mastered the art of minimising our needs, anxiety, fear and pain to serve others better. We are silently screaming for human touch, good times with friends, emotional first aid, reassurance and empathy because we are the mortal human beings behind the surgical masks.

READ: SA does not have enough staff or ventilators to treat Covid patients

We’ve never lost so many colleagues in such a short space of time, robbing us an opportunity to process our feelings, grieve, support each other and recalibrate.

We are learning to master hiding our feelings behind the masks. The wounded soldiers have to soldier on, put on their armour and wear their brave faces despite the inner battles most of us have to overcome on a daily basis. Health leaders need to communicate with vulnerability, act with compassion and prioritise health worker wellbeing and safety.

Covid-19 conversations need to get more humanised and depoliticised. We are mortal beings that are determined, vulnerable, resilient and carrying a load in our hands, hearts, minds and on our shoulders.

The pandemic has a public health label but shows its face in all sectors of the society. It has forced the government to address issues of inadequate provision of essential services like clean water and dignified ablution facilities in schools.

As a public health advocate, this gives me comfort that social determinants of health affecting the poor and vulnerable members of our society are getting the long-overdue attention.

Covid-19 is a public health crisis that is consuming human resources critical to fighting it. There is a strategic urgency to treat health workers as a vulnerable group during the pandemic.

Kubheka is from Health IQ Consulting, which provides risk management, quality improvement and clinical ethics services in the health sector

Dr Brenda Kubheka


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