OPINION | Support our healthcare workers: Say it with socks

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  • The Covid-19 pandemic has placed much more stress on healthcare workers than usual.
  • Numerous statistics show that mental health issues are particularly high among doctors.
  • To support SA's healthcare workers, members of the public are invited to take sock selfies on Friday and share them on Ithemba’s Facebook page.

“We’ve been trained to look after our patients, but we need to look after our colleagues, and above all, we need to look after ourselves.” This is the message of Geoff Toogood, Australian cardiologist and founder of the CrazySocks4Docs (CS4D) campaign to his fellow healthcare workers in South Africa.

In two short video messages, Toogood, straight after a swim – he is an avid open water swimmer – stresses the fact that the stigma surrounding the mental health needs of healthcare workers must be reduced in order for them to acknowledge their own frailty.

Under Covid-19 the need for this has increased manifold, he says, as the pandemic placed so much more stress on healthcare workers. Indeed, a study in the UK found that healthcare workers are “suffering more than combat troops”. Nearly half of intensive care staff there reported symptoms of severe depression and anxiety.

Critical suicide rate among doctors

Toogood knows these symptoms only too well. He started the awareness campaign in 2017 after his own experiences concerning his mental health. One day, when he wore mismatched socks to work, he overheard sniggering remarks about his mental health. Ironically, at the time he coped quite well.

His mismatched socks were just the only unchewed socks he could find – the rest were all victims of his new puppy. But this incident was the start of CS4D to help healthcare workers to open up about their own mental health.

Toogood also refers to the critical suicide rate amongst doctors – something that will be reduced only if stigma is reduced. Numerous statistics show that mental health issues are particularly high among doctors. In fact, studies show that suicide is regarded as an “occupational hazard” – the only cause of death that is higher in physicians than non-physicians.

The Ithemba Foundation, a non-profit that raises awareness around mental health – ithemba means hope – liaised with Toogood to bring the campaign to South Africa for the first time in 2018. It was so well received that in 2019 pharmaceutical company Cipla sponsored socks, as is the case again this year.

But as much as the CS4D campaign raises awareness of our healthcare workers’ mental health needs, it is also an opportunity for us, the public, to show we #Care4OurCarers. Toogood emphasises: “There has never been a more pressing need for the message about stigma and improving self-care.”

As he recalls: “When I was battling the demons of severe depression and suicidal ideation, the word resilience was mentioned.” In fact, it was presented to him as a statement: “You’re just not resilient enough.” And: “If only you were stronger.” And: “You’re just not able to cope.” And this one: “You know, not everyone is cut out to be a doctor … Have you considered another career?”

Learning what self-care means

Stigma is the reason why so many healthcare professionals would rather not talk about their own struggles. Nor healthcare students. Maybe especially not healthcare students, fearing that they might be discriminated against. Studies show that increased suicidal ideation already begins in medical school. But besides learning how to be a healthcare professional, students simultaneously have to learn what self-care means. That is also why students and staff on health sciences campuses across South Africa participate enthusiastically in #CS4D Day.

As Elmi Muller, dean of Stellenbosch University’s Faculty of Medicine and Health Sciences, says: “CS4D Day is an opportune time to reflect on the under-recognised concern regarding the mental health strain healthcare workers and those in training are under.”

She stresses that they are continuously assessing teaching, learning and working environments “to uncover potential barriers to proper guidance or treatment-seeking”.

Shabir Madhi, dean of the University of the Witwatersrand’s Faculty of Health Sciences, says, “The uncertainty over the past two years with the Covid-19 pandemic, compounded by the political, social and economic strive, has undoubtedly affected almost all South Africans.” This affected, and continues to affect, the mental well-being of healthcare workers.

Also, the CEO of Netcare, Richard Friedland, adds that the Covid-19 pandemic has added an “acute burden”. Caring for those who provide care, he says, “is key to ensuring that we, in turn, can keep our promise to provide the best and safest care to our patients”.

Sharing sock selfies

Cipla’s CEO, Paul Miller, adds: “We realise that mental health is as important as physical health and have, therefore, worked over the past few years to create awareness in this regard. We want people to know that it’s OK not to be OK, and that there is hope and there is help.”

In the words of Vusumuzi Nhlapho, CEO of the South African Medical Association (SAMA): “When you’re focused on a career in helping others with their health, it can be hard to admit when you need help yourself.” Healthcare workers don’t necessarily see the signs of depression in themselves, but it is “vital to get outside help and accept that we are sometimes also patients”.

As every year, members of the public are invited to take sock selfies on Friday and share them on Ithemba’s Facebook page (, using #CrazySocks4Docs or #CS4D. Students on South Africa’s ten health sciences campuses stand a chance to win ten prizes each of R1 000 cash – all they need to do is to post their sock selfies on the Facebook page and remember to include on which campus they are. And then get family and friends to “like” their sock selfies. The selfie with the most likes on each of the campuses will win its owner that cash prize.

So, all you now need to do is to get your happy socks ready and show you Care4OurCarers this coming Friday. As Toogood says: “Have fun, and please look after yourselves.”

*Lizette Rabe is a professor at Stellenbosch University and the founder of Ithemba Foundation, a non-profit with the public benefit goals of raising awareness of mental health and raising funds for research.

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