We also get scared, face stigma over Covid-19: Medics

Like patients who have tested positive for coronavirus, the pandemic has triggered inevitable fear and uncertainty among healthcare workers who have contracted the virus.

With fears of public rejection, victimisation and blame, the medics say their experience with the disease, that affects the respiratory system, has been twice the challenge faced by the public.

To make matters worse, the initial public health approach taken by the government seemingly criminalised the disease so much that very few patients have the courage to disclose their Covid-19 status. Roughly 800 Kenyan medics have tested positive for Covid-19, according to the Ministry of Health’s data. Ten have so far died.

This fear has led to reports about doctors and nurses keeping their distance and depriving patients of medical services during this acutely vulnerable time. Doctors, patients ailing from other diseases, and their relatives are increasingly complaining about hospitals turning away the sick. This fright has seen some hospitals decline to admit or accept patient transfers without a Covid-19 test.

EXPRESSED DISAPPOINTMENT

During a recent webinar, six health workers drawn from different cadres narrated their experiences about finding out their test results and how they are coping. What stood out during the hour-long virtual meeting were the medics’ disappointment with the manner in which their test results were relayed to them.

Most of the said their colleagues and workmates knew about their Covid-19 status before them. “I took the test on a Tuesday and took a day off. On Thursday I needed to complete a pending project, so I went to work. While there, I got the call about my results, but the news had spread through the hospital and I started getting calls from concerned people. Those calls made me question if I was really okay,” recounted a nurse who did not wish to reveal their identity.

Austine Oduor, a clinical officer in Migori County, undertook a voluntary Covid-19 test on June 4 after experiencing shivers and fatigue. But, soon after volunteering to take a test because he was stationed at one of the county’s isolation centres, the deputy secretary-general of the Kenya Union of Clinical officers was appalled by the manner in which he was picked up from his work station at a government hospital in Kuria East, Migori, following a positive result, and taken to a house which had been transformed into an isolation centre for health workers, 200 kilometres away from his duty station.

“I was suturing a patient when I was called by a cleaner notifying me that I had a call. The Ministry of Health’s officer on the other end of the call told me not to leave the facility since there was a vehicle coming to pick me. The tension and manner in which the information was relayed to me was just stressful,” narrated Oduor.

In the 21 days he stayed at the centre, 13 others had contracted the virus and brought in.

RESULTS DELAYED

Similarly, a doctor working in Mombasa County narrated his woes about the delays within the Health ministry, which saw him followed up one month after he tested positive and recovered. “I suspected I might have been infected because one week before the mass testing was launched, I had experienced some headaches,” the doctor, who requested anonymity, said.

For the doctor, two things went completely wrong: first, his results were delayed by two weeks after samples being taken and secondly, he was seemingly the last person to know about them.

“The way I got my results affected me. I received a call from a colleague telling me that people were discussing my results. This was six hours before my boss called me to officially tell me about it.”

A nurse at the Kenyatta National Hospital Infectious Disease Unit (IDU) at Mbagathi, who tested positive for the virus told HealthyNation she took a 21-day break after interacting with a patient who turned positive. The nurse, who sought anonymity, said in June, the facility was busy and it got strenuous to handle all the patients walking in.

"I cannot pinpoint a particular instance where I can say this is how I got infected, I may have been inside the IDU when the shield came down while I was bending to pick up something from the floor, or it might have happened in a different instance. I took every positive measure to keep myself and those around safe so I really do not recall a point where I slipped up," said the source.

STOP STIGMA

On July 24, the Ministry of Health launched the Employee Assistance Program (EAP) at Kenyatta National Hospital (KNH) to offer psychosocial support to help health workers cope with extremely stressful work conditions, especially during this Covid-19 pandemic. But, the journey has not been easy. In fact, just like the public, medical personnel have shied away from being identified with the disease. Some of them cite being blamed for getting infected.

“There is this notion that if you get the virus you must have done something wrong. Say, wore your mask or PPE wrongly or not at all,” explained Dr Elizabeth Wala, the programme director, health systems strengthening at Amref Health Africa.

To break the stigma, however, some medics have decided to share their experiences. Dr Wala is one such medic. Sharing her experience, she said: “I realised there was a gap in information which was fuelling stigma. So I decided to use my time in isolation documenting each day of my experience.”

Like many of the health workers, Dr Wala does not remember the point or source of exposure to the virus, but her main worry is that before receiving her results, she had mingled and interacted with close friends and relatives, and might have exposed some of them with compromised immunity to the highly contagious virus.

“My infection did not occur from a clinical setting. We were supporting the family of one of our doctors who died. So, when one of us in the group tested positive, I decided to test because I had interacted with them and I had been bedridden for a few days,” Dr Wala recounted.

JITENGE APP

Dr Wala received her results on July 22 at 9pm, she jotted.

“The last two days have been the longest ever of my life. Going through a throat swab test then waiting for the results. Checking every now and then and when they finally came on July 22, at 9pm, there it was in black and white: Covid-19 test results: POSITIVE. I froze. I was numb. I felt I hadn't read well because I didn't have my glasses on. All I could think of were my family members. My young children. My ailing mother. I've not slept. I've been down with flu-like symptoms for the past week or so. I can't taste or smell anything. But my breathing is clear. No sore throat.”

Although she has since recovered from home-based care, the initial symptoms she experienced during the first three days have eased out. Speaking to HealthyNation, she admitted that some of her greatest fears was the anxiety of how the disease would progress, and how her children would be treated by neighbours after her status was revealed.

“The Jitenge app wasn’t working and to date no one has contacted me to trace my contacts. My test and that of my family were conducted through my own initiative and with the help of my friends and colleagues, something that left me wondering what of Kenyans who only rely on the government,” she said. Jitenge is a mobile application currently being used by the Health ministry to care for quarantined clients at home or in isolated facilities.

STABLE CONDITION

Much like Dr Wala, one medic who has been at the forefront in agitating for the welfare of health workers especially during Covid-19 is acting secretary-general of the Kenya Medical Practitioners and Dentists Union (KMPDU), Dr Chibanzi Mwachonda.

Dr Mwachonda disclosed that he had contracted Covid-19 and was in a stable condition, noting: “The waxing and waning nature of the symptoms can put one in a state of apprehension. One hour you are fine, next hour your body is acting up. But overall I’m quite stable with mild symptoms.”

His work with the union has made it possible to interact with medics from various parts of the country and it is due to this that he contracted the virus.

Dr Mwachonda, who said he was in a stable condition, added that he was also taking Zinc tablets, Vitamin C tablets, Azithromycin tabs to ease some of the symptoms he was experiencing. “I have experienced fatigue despite eight hours of sleep and I wake up feeling heavy like you have been doing heavy work. I also have a sore throat and the irritation makes me feel a tingling sensation on your throat. I am glad that is gone for now,” he said.