Doctors’ lives laced with trauma
Healthcare workers are struggling with stress, anxiety, and burnout
After seven days of duty and a 14-day quarantine, Dr Asadul Mazid Nomaan could finally see his three and a half-year-old daughter Nirina.
He is the anaesthesiologist at the anaesthesiology and intensive care unit (ICU) department of the capital's Mugda General Hospital.
Dr Asadul is living with the trauma of being away from family, seeing patients die every day, failing to provide ICU beds to critical patients, watching colleagues get infected, and the fear of contracting the virus himself.
He told The Business Standard that in the 10-bed ICU of the hospital, the condition of two-three patients worsens every day. When the patients die, in many cases, their relatives refuse to take the body.
"Usually, after the death of a Covid-19 patient, the body has to be kept in bed for four hours in front of the ICU and then the body has to be disposed of. This is a kind of trauma.
"When a patient dies, it takes seven to eight hours to vacate and disinfect his or her bed. Meanwhile, if the condition of any other patient from the ward turns serious, it becomes impossible to take the patient to the ICU. I feel helpless because I cannot do anything for them," he explained.
It is very difficult to stay in the ICU for six hours while wearing personal protective equipment (PPE), including mask and eye shield, as air conditioners cannot be run in the ICU of a Covid-19 patient, the doctor said.
"The PPE kits are water and air proof. We keep sweating in the heat. Patients also keep making complaints the whole time.
"None of their relatives are allowed as well. The relatives of the patient usually take care of their meal. Now we also have to look after that. Because of wearing PPEs, we cannot have iftar or sehri often."
Dr Asadul, who has been on duty at the Mugda General Hospital since April 20, said, "I have to stay alone at the hotel. After seven days of duty, I live with the fear of getting infected for the next 14 days.
"In every shift, a doctor or a nurse gets infected. Patient management, during duty, is not that difficult. But the mental trauma of getting infected if something goes slightly wrong, is the most lethal.
Dr Rajib Saha has been working as a consultant at the medicine department of the Dhaka Mohanagar General Hospital for two months.
"Patients feel good when the doctors touch them as a sign of assurance. But they cannot even see the doctor's face now because of PPE. Doctors do not visit the patients repeatedly which ultimately leads to more complaints from them," he told The Business Standard.
"Also, we have to worry about our families while staying away from them for 21 days. Not being able to provide services like before, a constant fear of getting infected, and being away from family is traumatic."
As of May 17, some 1,771 health workers – including 644 doctors, 461 nurses and six other healthcare workers – were infected with Covid-19. Of them, three doctors died.
According to the United Nations and the World Health Organization (WHO), there is a "high prevalence" of mental distress across the globe due to the Covid-19 pandemic, especially among healthcare workers.
"The impact of the pandemic on people's mental health is already extremely concerning," WHO Director General Tedros Adhanom Ghebreyesus said.
During the pandemic, 47 percent of healthcare workers in Canada reported a need for psychological support, 50 percent of them in the People's Republic of China reported depression, and 42 percent healthcare workers in Pakistan reported moderate psychological distress and 26 percent reported severe psychological distress, a new UN policy brief says.
Psychotherapist Mahmuda Muhsina Bushra told The Business Standard, "Mental stress of the healthcare providers is increasing in Bangladesh. Now we have more doctors and nurses coming to us.
"As there is no medicine for Covid-19, a sense of helplessness is prevailing among the doctors. Usually, patients come to the doctor and return home healthy but many patients are dying now. The helplessness, remorse, sadness, and sometimes frustration of not being able to save patients are taking a toll on the doctors.
"Many doctors are getting infected in several hospitals at the same time. As a result, their workload is increasing and so is their annoyance. Doctors are human too. They do not have the opportunity to stay home like other people.
"It is crucial to give professional psychotherapy to the doctors and be empathetic to them to protect their mental health.
Dr Shameem Rizwan, joint member secretary of the health directorate's Covid-19 control unit, told Business Standard that measures are being taken to protect the mental health of the healthcare providers.
"Nine psycho-social counsellors on 'Shastho Batayon,' the National Institute of Mental Health and Hospital, and the psychotherapy unit of the University of Dhaka are counselling doctors, nurses and healthcare workers on different online platforms."