Road ahead will be draining, Western Cape medics warn Gauteng colleagues ahead of Covid-19 spike

01 July 2020 - 13:14 By Naledi Shange and Iavan Pijoos
FROM ONE NURSE TO ANOTHER: Wear personal protective equipment, practise good sanitation and keep your distance. Take immune boosters, and prepare to take it one day at a time. File image.
FROM ONE NURSE TO ANOTHER: Wear personal protective equipment, practise good sanitation and keep your distance. Take immune boosters, and prepare to take it one day at a time. File image.
Image: Sandile Ndlovu

Celebrate small victories. Be there for each other. Face your fears and anxieties head on. Educate yourself on fresh research about the virus.

These are some of the pointers Western Cape health-care workers can share with Gauteng front liners, who are preparing for a tough road ahead. With rapidly spreading infections, the inland province is expected to overtake the Western Cape to become the country's epicentre in days to come.

Nurses and doctors from the Western Cape say that their Gauteng colleagues will need to care for one another and offer each other support during this time.

“Develop support systems among yourselves to remain in touch with each other. You can be ‘physically distant but socially connected’. This is helpful particularly as the pressure can be relentless,” said Western Cape health department's chief of operations, Dr Saadiq Kariem.

Kariem advised doctors and nurses to immediately deal with their fears and anxieties related to the coronavirus but also reminded them that there were other patients, not suffering from Covid-19, who needed care and attention.

“The trauma and violence [of the] pandemic in our country adds additional pressure onto the health-care system, but we have to also deal with these patients as diligently as we can,” Kariem said.

To boost staff morale, he encouraged hospital officials to share positive stories from among the front line staff and to celebrate them.

One of the province's nurses, Keisha Meintjies, advised Gauteng nurses to ensure they were adequately informed about Covid-19 as this helped to ease the stress and pressure.

She spent a great deal of time reading up on the virus and getting knowledge about developments.

“Switching off,” even when at home, was never an option, she said.

Kariem agreed that it was good to stay informed.

“Stay in contact with the latest clinical developments internationally and locally and share best practices among each other and with the rest of the health services in the country.

“You are not alone in this pandemic and we are all working hard to do the absolute best for our patients and society at large,” he said.

It's emotionally and physically draining. Until you are in the storm of it, you won’t understand
Nurse Nozuko Radebe

Meintjies said working hours and workload would get heavier as more staff became infected.

“We have been under a lot of stress because we have become short of staff due to many of our colleagues testing positive and going into isolation. Those who are not positive work under a lot of pressure.

“All you can do is wear your personal protective equipment, practise good sanitisation and keep your distance. As President Cyril Ramaphosa said a few weeks ago, it’s going to get worse before it gets better.”

“In Cape Town we are taking immune boosters, our multivitamins and all of those things ... and prepare ourselves to take it one day at a time,” she said. “Now is the time for us to just be humble and appreciate every single day.”

Another Western Cape health-care worker, Nozuko Radebe, warned her Gauteng colleagues to brace themselves for “emotionally and physically draining'” work days.

“Nothing prepares you for it. You may think you have experienced it already, but until you are in the storm of it, you won’t understand. Everything changes for you - work, home, even your sleeping patterns change,” said Radebe, who is employed in a public facility.

“It becomes harder when people who you work with daily or who you see in the hospital test positive, or even worse, they die,” she said.

Now, more than ever, nurses need to offer comfort to Covid-19 positive patients, as visitors remain barred, Radebe said. “You are the one who offers an encouraging smile, even when you know things are not looking good. It is tough,” she said.

The SA Medical Association (Sama) said many in the medical fraternity were experiencing hardships.

“Both in the public and private sector, especially hotspot areas, severe emotional anxiety and distress are experienced by majority of staff,” said Sama chairperson Dr Angelique Coetzee.

“There seems to a lack of confidence in what is expected - especially the nursing staff - on protocols, PPE and what to do with lack of resources in the various health-care facilities,” she said.

Coetzee expressed concern at the amount of support offered to medics who are on the front line.

“Currently in the private sector, there is very little [support]. In the public sector the various provincial departments of health should have used the lockdown to get their house in order, but alas it seems that there is a problem. Even private hospitals did not get it right 100%,” she said.

Doctor Keith Cloete, who is the chief of operations for Western Cape health, said what they had also noted from their staff was that, besides the fear of contracting the virus, transmitting it to their families and the frustration concerning the availability of PPE, health-care workers were also stressed by the community's attitude towards the virus. 

"[There are] feelings of frustrations which were identified ... as a result of community members who didn’t adhere to lockdown protocols such as wearing a mask, washing hands, and social distancing and subsequently adding to the high level of Covid-19 infections,” Cloete said. 

The health department had done all it could in the province to cater for their staff, including providing accommodation closer to their places of work, and provision of transport services for health workers. 

Dr Aslam Dasoo of the Progressive Health Forum said Gauteng's health department needed to strengthen its prevention strategies.

“The current level of penetration of information to many communities is much less than required. You have to talk to people at a community level and I think the failure to mobilise local leadership, traditional leadership, churches and teachers who are in communities to transmit the message in a focused way has occurred and that has to stop,” he said.

“It’s never too late. We must start right now in fixing the messaging and, of course, there is the institutional measures that can be taken, like in the Western Cape where there is rapid management of hotspots to prevent further spread.

“That we believe has collectively worked in the Western Cape to slow down very deep rising infections and we can do that here and in the rest of the country,” Dasoo said.

Meintjies said the virus had prevented her from seeing her two children, who live in the Eastern Cape, since March. Besides the travel restrictions, she thought it best to stay away to keep her family safe.

“It's a sacrifice that all those who have taken this pledge need to make,” said Radebe, who has suffered a similar fate, missing family funerals.

Meintjies said while their oath involved promising to heal and nurture, the coronavirus at times left them feeling helpless. She added that while there was support in the form of counselling offered to staff, this was not always feasible. “Even though we have access to these facilities, you are placed in such a position that you don't even have time for any of that. You emotionally have to deal with everything that you are dealing with,” she said.

Radebe said for her, prayer and reliance on God had become a way of life. “I don't take away from the power of counselling but I really believe it is God who carries us through. It is now more evident than ever that nursing is a calling. It's not for everyone and that's why not everyone would survive what we go through. So for my Gauteng colleagues, prayer is needed.”