Hatzolah heroes on the frontline

NICOLA MILTZ

As the number of positive cases continues to soar in the community, Hatzolah despatchers and responders face seemingly insurmountable challenges which they deal with no matter the risks to themselves mentally and physically.

“The challenges every day are immense,” said Singer, 32, “Most people are running and hiding away from the danger that lurks, but we walk straight into it.

“It’s a battle we haven’t fought before. There’s a lot of risk. It’s a difficult time to be working. It’s like something out of a movie. COVID-19 is like walking into a death trap,” he says of the situation he and his fellow Hatzolah paramedics are dealing with.

“Right now, we don’t even know where to take our next patient as the hospitals are so full.”

This is an unprecedented time in the lives of these forward-thinking and fast-acting paramedics whose lives have changed dramatically since the start of the pandemic.

Every shift from sunset to sunrise (18:00 to 06:00) is relentlessly long, hard, and unpredictable, full of anomalies, surprises, and twists and turns. At the time of going to press on Wednesday, Hatzolah recorded 258 active COVID-19 cases, 106 new cases since Friday, and 140 closed cases.

Singer, who works 24-hour long shifts, said one of the main challenges was to treat patients while wearing full personal protective equipment (PPE). “We look and feel like aliens,” he said, “It’s so hot underneath all that PPE, we battle to see though the protective eyewear, we struggle to hear patients through the masks, the visors, and all the headgear. It’s hard to work wearing two sets of gloves.

“My equipment and jump bag probably weighs between 20kg to 30kg, and then there are the extras like oxygen, ECG monitor, and drug bag, which all add up to about 50kg,” said Singer.

But worst of all is the lack of human touch and real eye contact in a situation where it’s become almost impossible to provide empathy and humanity in a moment where patients are truly petrified.

“We can’t connect with our patients on a deep and meaningful level like we are used to. It’s so unnatural. We can’t touch them, or offer a hug, or even hear them through their sobs. We are used to working in close proximity to our patients, and now we are at a distance. They can’t see our smiles, it’s heartbreaking. A lot of what we do at Hatzolah is comforting patients by offering just a knowing smile or touch. People often break down when they see us, and now it’s so hard to comfort them wearing all this stuff.”

Even more distressing is knowing that for some spouses, especially the elderly, it might be the last time they see their loved ones as they are whisked off to hospital in an ambulance.

“When we arrive, for some patients, it’s the last time they see the people they love. This is really hard for us,” said Singer.

“The truth is I love what I do, the risks are worth the rewards. Helping people during the worst moment in their life and making a difference keeps us all going,” said Singer, one of three full-time ALS responders.

“The number of respiratory and high infection calls have dramatically increased in the past two months with call volumes rising daily,” said Executive General Manager Darren Kahn. “Our motto is ‘Hatzolah cares’. Our main role is to care for people within the community who need our help, 24 hours, seven days a week.”

Hatzolah has nine full-time responders and three full-time despatchers, Kahn says. There are a further 50 volunteer responders and 23 volunteer despatchers. There are 31 volunteers in the crisis response unit who are trained counsellors offering psychological first aid to patients needing emotional and mental support during the pandemic.

Once a shift has been completed, the paramedics can take up to an hour and a half to decontaminate their vehicles, adding extra time to an already exhausting shift.

Talya Chemel, a physiotherapist in private practice, is a volunteer despatcher for Hatzolah. She receives the calls at home, assesses them, and sends ambulances in emergencies. “People are anxious and overwhelmed,” she says. “Many are just worried and confused, scared, and they need to talk to someone while they are isolated and alone.”

Her 12-hour shift begins at 18:00, after a long working day. She works from home with calls diverted to her at any time of the night. “My heart beats fast as I lie in bed with my eyes closed in a light sleep waiting for the calls to break the silence,” she said.

It’s not unusual to be jolted by calls at 02:00 from frightened patients struggling to breathe. Immediately she springs into action.

“People call at the worst moment in their life when they are totally freaked out. It’s impossible to help when they are screaming. My job is to get them to calm down to get life-saving information. It’s difficult for people to tell me the most basic information like a street address when they are in a panic.

“The first thing I tell them is, ‘Take a deep breath, and let me help you. Trust me to hold your hand [over the phone of course] and let me walk you through this nightmare’.”

Lately, calling hospitals to secure a bed in intensive care is a challenge as beds are filling up fast. “This is done while at the same time calming down another patient over the phone on an unrelated call,” Chemel said. “I can hear another call beeping in my ear, but I can still be busy comforting another caller – a desperate spouse trying through their tears to tell you what’s wrong.

“This can be followed by an attempt to help a lonely person through their most difficult and scary thoughts as they self-isolate. The greatest challenge of all is to be unable to assist a soul because of a caller’s panic ridden attempt to ask for help. There are endless scenarios. It’s so rewarding helping people, especially when things run smoothly, and there’s hope. Being a dispatcher comes with immense responsibility yet endless opportunity.”

During one recent Shabbos shift, she took 24 calls, filled out 24 forms, and handled 14 emergencies.

“It’s a scary, eventful, extremely pressurising, unpredictable, and highly challenging time,” said Singer following one of his 24-hour shifts this week.

“We are tired. We know the nights will be long and the potential is there for things to go belly up. This is something we can’t foresee. It’s scary.”

Lance Abramson, the chairperson of Hatzolah, said the organisation was witnessing an ongoing escalation in infections in the community based on the COVID-19-positive patients it’s monitoring at home and those it has transported to hospital.

There are 398 patients on the COVID-19 Wellness Monitoring Programme, the brainchild of Operations Manager Uriel Rosen. The programme is for any community member who has symptoms associated with the virus, has tested positive for COVID-19, or is displaying symptoms of the virus.

“Once you’ve signed up to the programme, one of the wellness volunteers will contact the patient and Hatzolah will deliver a thermometer and pulse oximetry device which will check the patient’s pulse and oxygen levels,” said Abramson. “The patient is contacted regularly during their isolation and their well-being is tracked this way.”

The organisation has spent about R1.5 million on personal protective and other equipment. It has purchased 300 pulse oximeters which cost R650 each, and hundreds of thermometers.

“Hatzolah is about saving lives, but there’s so much more to it. It’s about caring for you as a person. It will do anything to make sure that you are taken care of. That’s true chesed, true kindness,” said Chemel.

At the time of going to press, there were 215 855 confirmed cases, 102 299 recoveries, and 3 502 deaths in South Africa.