April 10, 2020

COVID-19: Our challenges treating patients

Illustrative, Medical staff

•Bemoan plight, shortage of personal protective equipment
•Gloves, sanitizers are luxuries here, says FMC Owerri staff
•‘It’s strenuous treating patients, watching out for yourself’
•We’ve life insurance for workers at LUTH, says CMD
•As confirmed cases rise nationwide, now 288

  By Sola Ogundipe, Health Editor, & Chioma Obinna

LAGOS — As COVID-19 infection spreads in the country, medical doctors, nurses, laboratory scientists and other allied health workers have decried shortage of protective equipment and supplies in hospitals.

Health workers are at the frontline of the COVID-19 outbreak response and as such are exposed to hazards that put them at risk of infection.

These hazards include pathogen exposure, long working hours, psychological stress, fatigue, occupational burnout, stigma, and physical and psychological violence.

Investigation by Vanguard showed that simple protective equipment as hand gloves, different types of masks are in short supply.

In some hospitals across the country, despite the fact that medical officers have been directed to treat all patients as COVID-19 patients, following reports that Nigeria is currently battling with community infections, many health personnel   still attend to patients without Personal Protective Equipment, PPE.

Shortage of PPEs

A senior medical officer who spoke to Vanguard on conditions of strict anonymity, said health workers in a good number of the 27 General Hospitals in Lagos, apart from Island Maternity Hospital, were currently faced with shortage of PPEs, masks, gloves and other hospital supplies.

According to the doctor, even staff in the casualty and Accident & Emergency departments who should use them at all times are suffering same fate.

“There are not enough face masks or hand gloves, including the PPEs. Even where you have PPEs, they are not complete. We were asked to be seeing all patients as COVID-19 patients but how can you do that without PPEs?

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“How can you operate in a hospital without face masks and hand gloves? That is our challenge now.”

‘Gloves, sanitizers are luxuries’

At the Federal Medical Centre, FMC Owerri, health workers in the hospital complained of lack of working materials.

According to the workers, hand gloves, sanitisers and face mask are a luxury.

They told Vanguard that they were forced to wear one face mask for a whole day, as  nurses sometimes, were asked to sign their names against locally-made face masks.

“Workers here are not happy.   It does not look like there is anything like COVID-19. Everything is still like usual.   Health workers here are working without face masks. When you demand for it, they will tell you the masks are reserved for only consultants.

“Even, most doctors here beg for hand gloves to see patients. It is that bad. If we have a case of COVID-19 here, many of us may not survive it,” one of the nurses told Vanguard.

Some of them disclosed further that their rights and responsibilities, including the specific measures needed to protect occupational safety and health, are not being fulfilled.

Nurses are generally unhappy over what they describe as government insensitivity to their  plight as  frontline care-givers in the raging  coronavirus pandemic.

Other health workers who spoke about the challenges they face, expressed disappointment with government at all levels on hand, and at Nigerians generally on the other.

“We have been working around the clock since the onset of this pandemic. It is worse with the lock-down. In my hospital, we work in shifts, but the shifts are not like normal shifts. Some of us work for days without going home.

“Our welfare is not adequately taken care of. without adequate provision of personal protective equipments, PPEs, flat rate hazard allowance, without special compensation for crucial services as implemented in other climes during the COVID-19 outbreak,” the source said.

The source said the newly introduced graduated emolument for health workers was rather discriminatory and demotivating.

It’s overwhelming work

A senior staff nurse in Lagos said working in the isolation centre was exhausting, saying “many of us start the day already exhausted. For me as a healthcare worker, I am on essential duty and there is nothing like working from home.

“I must be at my duty post. And even when I’m off duty after extended shifts, I still do  chartings and follow ups.

“  Many of the patients in isolation are traumatised and depressed and usually require counselling. I am tasked with providing care for them and gaining their trust.”

Another health worker said: “Coping with COVID-19 is overwhelming. We have to watch out for ourselves too and ensure we do not get infected.

‘’We’re trying to keep up, but sometimes things do get chaotic and even our leadership appears confused, but we always rally around and pull things  back  together. The patients usually cooperate with us because their lives depend on it.”

Not true, says Owerri FMC boss

Reacting to the allegation, the Chief Medical Director, Federal Medical Centre, Owerri , Imo State, Dr Kingsley Achigbu,  said  the report was not true.

“It is a big lie.  People keep telling stories all over the place. Why can’t people get responsible?  There is scarcity for protective equipments all over the world, not just in Nigeria.

“When you tell people to make judicious use of these things, it becomes an issue. I have thousands of them in my centre. People don’t understand that at the height of this shut-down, some things are no longer coming into the country. I don’t understand Nigerians. They want to pull down everything.

“We have to give it to those at the front line. Nobody can say he or she cannot do anything in FMC because there are no gloves.  COVID-19 is not just about wearing gloves, it is not the patients that is supposed to be your only problem.

“The door handles and the things you touched. People are advised to wash their hands with soap but if you need gloves, that has to do with what you want to do in the hospital, we have gloves.  I don’t even know where this is coming from.

“FMC Owerri is about the largest in the country, even bigger than some teaching hospitals.  And FMC became ready for COVID-19 much more before any other centre.”

On locally-made masks, he noted that Nigerians had huge problems, saying “there are many types of masks, N-95, etc, surgical mask, there are even home-made masks, each one applies to the area it is needed.

You cannot wear a cloth mask to go into the theatre, you will need a N-95 mask; you cannot wear a cloth mask to triage a suspected COVID-19 case.  Masks are applied based on the area they are needed. If somebody is a cleaner, you don’t give him or her a N-95 masks.’’

A triage is a process of sorting people based on their needs for immediate treatment.  It is usually done in emergency room.

Life insurance for LUTH staff

In response, the management of Lagos University Teaching Hospital, LUTH, said it had approved life insurance for all staff working to help rid Nigeria of COVID-19.

Chief Medical Director of LUTH, Prof Chris Bode, who acknowledged the difficulties involved in managing the condition, said the hospital is working closely with the Nigeria Centre for Disease Control, NCDC, and Federal Ministry of Health, FMoH, to contain the disease.

“To ensure proper protection of staff, Bode said front-line officers must wear N-95 masks and stay at least six feet away while triaging any patient and will call in the Infectious Diseases Unit to see any suspected case.

“We shall do this with love of each other and care for our patients. We shall give respect and dignity to each other as COVID-19 warriors and patients to whom we represent the only hope in these difficult days. Non-resident staff working on this will be housed within or near LUTH.”

Bode encouraged health workers of the institution not to resign to fears and give hope and care to those who need them to be brave.