* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Health workers fought for patients in an overwhelming pandemic, but the toll it took on them is largely hidden and unacknowledged
Chiara Lepora is Deputy Medical Director and Head of the Manson Unit at MSF. During the pandemic she worked on MSF’s COVID-19 response in Italy and Sudan.
Throughout the COVID-19 pandemic healthcare workers have been portrayed as heroes. Images of doctors and nurses on the frontlines have saturated the media, creating an illusion of superhuman medics working tirelessly to save lives, always knowing exactly what to do. It’s an attractive image.
It’s also one that ignores the huge personal impact of working on a pandemic response. Months of stress, fear and uncertainty have led to unseen repercussions. Many medics are burnt out, including those working in areas where humanitarian assistance is needed. Now, some of them need help.
I began working on Italy’s COVID-19 response in Spring 2020. I was in a team of 30 experienced Médecins Sans Frontières (MSF) staff who started working in the public health system after our international missions were cancelled due to travel restrictions.
We worked alongside medics who had no previous experience of epidemic situations. Many were preoccupied by not having the ‘expertise’ to know what to do. But even the experienced MSF staff didn’t know what was to come.
Shortages were the hardest part at the beginning. They existed at every level: hospitals, beds, ambulances, PPE, medical staff. Health workers had to make incredibly painful decisions about triaging patients to high-dependency units, regular wards or sending them home.
Many staff working in Italy’s privileged health system were not used to this. In Italy, like in the UK, we work on the fundamental principle that everyone has an equal right to healthcare. The idea that one person may gain a higher level of care than someone else due to scarcity of resources is unfamiliar and gut-wrenching.
But case numbers were growing daily, and we were up against more and more shortages. Medics would find consolation from hearing “every epidemic ends” but often they felt like it would never stop. The system was so overwhelmed, but nobody had time to rest.
When I joined the MSF team in Sudan later, the world’s understanding of COVID had changed. We had protocols and materials to protect ourselves and knowledge we could only have dreamed of earlier on. Epidemics are prevalent in Sudan all year round so there was also a good level of preparedness there. Nevertheless, we faced new and very different struggles to those I had seen in Italy.
The problem was not always COVID itself but the far-reaching consequences of the pandemic. There was a shortage of non-COVID related essential drugs due to global manufacturing and shipping delays. This meant that people we would have usually been able to save were dying and we couldn’t help them.
Shortages and restrictions led to an increase in maternal mortality, malnutrition and infant mortality. Social distancing measures imposed due to COVID meant we had to reduce the number of patients we could see daily, meaning pregnant women, children and those affected by HIV and TB couldn’t access healthcare.
Medical personnel were discouraged knowing many patients wouldn’t receive the care they needed. On top of this, Sudanese public hospitals and clinics were sometimes faced with having to turn away people who needed medical care because they didn’t own a mask and short supplies at the hospital meant they couldn’t give them one. This feeling of helplessness is crushing.
In both contexts, staff were often also worried about family members who had contracted COVID or about getting sick themselves. In MSF projects around the world, staff members have died from the virus or contracted it while providing healthcare. A colleague in Yemen had been working 24/7 on the pandemic response when he got sick. He isolated alone for 21 days before going straight back to work. This situation takes a huge mental toll even for those who recover.
There is no doubt that the medical teams I saw working around the clock in Italy or Sudan are the reason things are slowly improving. But their relentless dedication has come at a cost, one that is mostly unseen and unacknowledged.
Many are now dealing with invisible scars, which also need to be urgently treated or we may be faced with a very different type of epidemic among medical colleagues all over the world.
