Our heroes on the frontlines

TALI FEINBERG

They are doctors, nurses, paramedics, volunteers, and specialists who are heading into the eye of the storm of this highly contagious virus. They do it at great personal risk to themselves and their families, setting aside their own fears for the benefit of each one of us. They are the true champions in this war against COVID-19. We find out more about a fraction of these heroes in our community.

“As we enter this period of uncharted waters, we are all anxious, and sometimes terrified of what’s to come,” says Dr Raphaella Stander, a 33-year-old paediatric registrar working across the system at Red Cross War Memorial Children’s Hospital in Cape Town.

“I worry about my family and my child who is only nine months old,” she says. “I considered sending them all away, somewhere safe where I can’t expose them to this virus – although they refused to leave. The moment I’m exposed, I think I will find somewhere else to stay until this is over because the thought of harming my family is overwhelming and terrifying.”

“We are seeing doctors updating their wills. It’s definitely a dramatic moment for all healthcare workers – you can’t play it down,” says Dr Evan Shoul, an infectious diseases expert in Johannesburg. “We are nervously anticipating what could happen, but panic isn’t helpful.” Indeed, all the healthcare workers we spoke to are stoic and measured in spite of being at the coalface of the pandemic.

While some healthcare professionals and volunteers have had to step back because of their own underlying medical conditions, they all have a sense of duty and responsibility to be part of this fight, says Shoul.

He says there is a lot of camaraderie in the medical community, and local doctors have had the advantage of learning from colleagues who are in coronavirus hotspots.

Some local medical workers have already had to go into quarantine after being exposed to patients with the virus. “This is two weeks isolated from their family and kids. It’s really difficult for anyone to go through, and the psychological aspects are huge. No one should have to go through this alone,” says Shoul – which is why support is so important from others who “get it”.

He says there may be a shortage of protective masks and personal protective equipment (PPE) in South Africa, which would put doctors at much more risk of contracting the virus. Most healthcare workers are also putting protocols in place at home – changing out of their work clothes and showering before greeting their families. “It does feel like we are going to war,” he says.

Dr Andrea Mendelsohn has been at the frontlines for weeks already as a senior medical officer in a HIV/TB primary healthcare clinic in Cape Town. “I have no doubt that I have been exposed to the virus as I have been screening patients. My family is young, so I just have to do my best and hope they will be fine – but there is no guarantee.”

She says the global shortage of PPE is worrying. Doctors are also afraid about having to “play G-d” if there aren’t enough ventilators.

Working in a paediatric hospital, Stander is particularly worried about how children in this country might be affected. “The experience in Wuhan showed that children don’t get very sick [from COVID-19]. However this may be different in our very vulnerable population. We don’t have the answers to this.

“We have one of the most vulnerable child populations here in South Africa: 59% of children live in poverty, 30% are without safe water, 18% live in overcrowded households, 20% are far from clinics, and 27% have stunted growth, a reflection of chronic malnutrition,” she says.

“We are also fearful for the lives of our children, their parents, and all the team members who will be working during lockdown – the nurses, cleaning staff, porters, clerks, and so many others. Doctors aren’t the only heroes in this story,” she says.

It’s not only doctors going into battle, but also nurses. Timor Lifschitz is a registered nurse and midwife working in a clinical environment. “We are doing flu and pneumonia vaccines as well as childhood immunisations which are our priority at the moment. My husband, an advanced life-support paramedic and I are both still working,” she says.

“There is definitely a chance we can be exposed to the virus. It can be very concerning to know we are at risk, but our duty within the healthcare system has always been to help the public, and thus we will continue, even at risk to ourselves. We are taking as many precautions to prevent ourselves getting sick as possible.

“We have a four-year-old and an almost 11-month-old at home. We are preparing ourselves during the lockdown by removing our shoes and leaving them outside before we get into the house, hand washing and sanitising as soon as we come in, and changing our clothes before attending to the children. My husband and I are also sleeping in separate rooms as a precaution to try to limit spreading the virus to each other.”

Meanwhile, paramedics and emergency services volunteers are also putting themselves at risk, often as volunteers. A volunteer paramedic who asked to remain anonymous says, “All emergency medical organisations will do as much as possible within constraints. Emergency medical services will have freedom of movement, but with that comes risk, not only for ourselves but for our families and other paramedics who work with us.”

This is why he advises that people who suspect that they have the virus take themselves to testing centres unless they aren’t in a condition to do so.

“I have a strict system when I get home, putting my clothes in the wash and making sure I’m clean before I even walk in the door. This is because we have learned that the virus can remain on clothing for up to 12 hours. Our response vehicle is also cleaned thoroughly after every call, and we all wear masks,” he says.

“I feel humbled by this, and feel I have a role to play. I’m grateful to my organisation for allowing us to help on this level, and to my family for supporting me and pushing me out the door at 03:00 and saying, ‘there is a life, go save it’.

“These are uncharted waters, and I don’t think it will be over in 21 days. But I also think we don’t need to panic. We have good resources and amazing systems in place. I feel privileged to be a part of it.”