Daily Maverick 168

Covid-19 Frontline Fighters: ‘When staff become patients, it’s heartbreaking’

By Shiraaz Mohamed 9 January 2021

Paramedics RafeeÕah Ajimudin (leaning forward) and Siya Venkile from the Saaberie Chishty Ambulance Service prepare their ambulance. Part of being a paramedic is to educate members of the public on Covid safety protocols. Photo / Shiraaz Mohamed

Some of South Africa’s heroes in personal protective gear take us to the frontline of the pandemic, giving us a glimpse into the world behind the statistics.

First published in the Daily Maverick 168 weekly newspaper.

‘It doesn’t get easier when you lose a patient and it never gets easier informing the family. You go home and cry, but the next day you just go back to work and do it all again.”

These are the words of an intensive care unit (ICU) doctor working in a Gauteng hospital, describing what it is like being on the frontline of the Covid-19 pandemic.

“It’s stressful and emotionally draining. These ICU patients are very ill and you know that if you don’t give 100%, they might not make it through the night. The course of the disease is so unpredictable.”

And even when healthcare workers do give more than their all, patients still don’t make it.

At the time of writing, 31,368 people across South Africa had died after contracting Covid-19.

Mental stress, physical exhaustion, the pain of losing patients and colleagues, separation from families and stigma are the added stresses that frontline workers face in the in the fight against the pandemic.

The ICU doctor

Jane (not her real name) is an ICU doctor in a Gauteng hospital. She speaks to us from her bedroom, where she is isolating after contracting the coronavirus. She has no doubt that she picked up the virus at work, where she recently completed seven 12-hour ICU shifts in two weeks.

“I am currently relying on my family,” she says. “They’ve been extremely helpful. They leave food and anything else I might need outside my door. It does cause some stress, as I do not want them to get sick as well… It is depressing being alone.”

Principle Investigator at Mzansi Ethical Research Centre, Dr Safiyya Chohan (R) injecting administers a vitamin injection on her colleague. Due to the strain that medical workers endure, they regularly take vitamin shots to help boost them mentally and physically.
Photo / Shiraaz Mohamed

For now, Jane has been managing her illness at home. She is keeping track of her oxygen levels but should complications arise she will have to rely on her colleagues.

It’s a role she has played for her colleagues too. “We had our matron in ICU with us for 76 days. She fought for her life and is now home.”

But patients don’t always get ICU beds.

“The amount of patients coming in is exceeding available resources. The doctors and nurses cannot keep up with the numbers. Our biggest problem at present is finding ICU beds.

A radiographer about to perform a scan on a patient (Not Covid positive) in a Johannesburg hospital. Dealing with Covid patients exposes radiographers to the virus as they need to be in physical contact with patient.
Photo / Shiraaz Mohamed

“If our ward patients deteriorate and there are no ICU beds in our hospital, we move them back to the emergency unit and try ventilating them there if equipment is available. Half of our emergency unit was recently blocked with patients in need of ICU beds. We moved stretchers and oxygen bottles outside just to be able to assist the patients coming in.

“We’ve now come to a point where we have to start choosing who we are going to intubate or not.”

The radiographer

Shenaaz (not her real name) doesn’t greet anyone when she arrives home from a shift at the X-ray department of a Johannesburg hospital. She has not contracted the virus despite coming into close contact with Covid patients on a daily basis.

“When I get to work I change into scrubs provided by the hospital. I keep my gum boots at work, reserved for the ICU [where she goes with a mobile X-ray machine to take scans]. We wear covers over our normal shoes. So when I come home I have my personal clothes on that I have not worn while in contact with patients.”

Volunteers from the Saaberie Chishty Burial Society prepare for a Covid funeral at the Avalon Cemetery on the border of Lenasia and Soweto.
Photo / Shiraaz Mohamed

Even so, she walks straight to the shower when she returns home. “They are used to me at home now,” she says wryly.

“I am not scared of contracting the virus. Everything is from Allah and I pray for protection. But it’s physically tiring and emotionally draining to see how patients deteriorate. And when staff members become patients who cannot help themselves, it’s heartbreaking.”

The Covid tester

Portia Coleman conducts Covid tests at the Wanderers Street taxi rank in Johannesburg. “My work during this pandemic, especially now with the second wave, is not easy. My main duty is to help my country fight the virus in every possible way, ensuring that the number of cases [is] reduced.”

For Coleman, the daily increase in the number of positive case is distressing. On Wednesday, South Africa reached a grim milestone as it breached the 20,000 mark for new cases identified in 24 hours. By then, the total cumulative Covid-19 cases in South Africa stood at 1,149,591.

The tester gets tested. Covid Tester Portia Kolman (L) undergoes a Covid test from her colleague Siphiwe Mazibuko. To limit the spread of the virus, frontline workers regularly undergo Covid tests.
Photo / Shiraaz Mohamed

Coleman says her work is stressful:  “There’s physical stress and fatigue from long hours; emotional stress from having to deal with positive cases that are on a rise daily; and also from not spending much time with our families.

“Then there is the stress and worry about the possibility that we might be infected and end up infecting our families in the process.”

The ward hostess

Ward hostesses are among the few people outside of medical personnel who have access to Covid-19 patients in hospitals – even relatives have to rely on the kindness of strangers to pass on a message or to check in on a loved one.

Susan (not her real name) is just one of these hostesses at a Jo’burg hospital, where her duties include taking food and water to patients.

“Ek is poepbang. Net nou het ek ook Covid. (I am shit scared. Soon I will also have Covid.),” she told DM168.

Paramedic RafeeÕah Ajimudin from the Saaberie Chishty Ambulance who tested positive for Covid a few months back realised the severity of the pandemic after attending to a call where a doctor who was Covid positive needed medical assistance.
Photo / Shiraaz Mohamed

Susan says ward hosts are not allowed to physically interact with patients.

“We don’t touch the patients, we just leave what they want and leave the room. It’s scary working close to Covid patients and we are always concerned because you can’t see the virus and we don’t know when we will get it or not. At work we are not allowed to leave the ward except for when we go home. We don’t want the germs to spread to the other wards,” she says.

Susan’s work outfit includes a new apron and gloves and a reusable N95 mask for every patient she serves.

The burial society volunteer

“We are scared, but we leave it in Allah’s hands. Allah is there to protect us. If we don’t do it, who is going to do it?,” Faizel (not his real name) tells DM168 about his work as a volunteer at the Saaberie Chishty Society in Lenasia.

Faizel asks that his identity be concealed as he feels his volunteer service is not for the public to know, but for the Almighty to acknowledge.

Volunteers from the Saaberie Chishty Burial Society prepare to perform ‘Ghusl’ (ritual washing of dead bodies. in Islma) on a Covid body at the Avalon Cemetery on the border of Lenasia and Soweto. Volunteers working in direct contact of the deceased are donned in full PPE from head to toe and is removed after each ‘Ghusl’.
Photo / Shiraaz Mohamed

“It is dangerous, this virus is dangerous… Things slowed down after the first wave, but its picking up again with the second wave.

“We [have done] over 170 burials [at Avalon Cemetery].

“At one stage we did 10 Covid funerals a day. We would have breakfast, lunch and supper here [at the cemetery]. So far, we have done 13 Covid funerals in one and a half weeks since the second wave.”

Faizel says they have a specific area where they don and doff their personal protective gear: “You have to take off each item and sanatise after each one. Alhamdulillah (praise be to Allah) none of us has caught the virus yet,” he says.

The paramedics

Rafee’ah Ajimudin and Siya Venkile are paramedics at the Saaberie Chishty Society in Lenasia.

Ajimudin, who has recovered after contracting the virus a few months ago, saw the severity of the pandemic after she was dispatched to treat a doctor who was Covid positive.

Volunteers from the Saaberie Chishty Burial Society prepare to wash a Covid funeral at the Avalon Cemetery on the border of Lenasia and Soweto.
Photo / Shiraaz Mohamed

“He was presenting with severe symptoms. It made me think about how he is the one who normally helps everyone but it turned out that he was in need of help.”

Venkile, a mother of two, says her biggest fear is contracting the virus and passing it on to her children. “As paramedics, it’s been very difficult. When you come to work you get very emotional, there is a lot of things we experience and see.

“Sometimes when I treat a patient who dies it stays on my mind for a long time. I go home at night and lie in bed and think about it. But I am trying to be okay. I just ask God for me to be strong.”

After each patient transfer, the paramedics have to sanitise the vehicle.

“As soon as we drop off the patient at a hospital, we spray the whole ambulance with a de-germ. Once at the base, we do a ‘wipe down’, which is like a deep clean,” says Venkile. “The ambulance gets washed, sanitised and zapped with a germ zapping robot that uses UV light to kill all the germs. A fogging system is also used. Everything in the ambulance has to be cleaned.”

A radiographer views the X rays of a Covid patient at a hospital in Johannesburg.
Photo / Shiraaz Mohamed

The clinical trial investigator

Dr Safiyya Chohan works for the Mzansi Ethical Research Centre in Johannesburg and is searching for a Covid vaccine.

“Generally, medical doctors and frontline healthcare workers are exhausted – physically, mentally and emotionally. 2020 was a year like no other that has challenged healthcare workers in every avenue. The constant deaths, especially during the present peak, leave us feeling distraught, defeated and helpless… Giving up is not an option.”

She recently contracted the virus. DM168

DM168 acknowledges and gives thanks to all frontline workers for their sacrifices and for working tirelessly during this pandemic. We salute you.

Some healthcare workers spoke to us on condition of anonymity as they are not authorised to speak to the media.

This story first appeared in our weekly Daily Maverick 168 newspaper which is available for free to Pick n Pay Smart Shoppers at these Pick n Pay stores.

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