Covid 19; Frontline Health Warriors Need Care

The ferocity of the second wave of Covid-19, compounded by an acute paucity of hospital beds and medical supplies and health care staff strength that is rapidly falling short of the spiralling need, has left an unprecedented trail of infections and deaths.

Watching this chaos-riddled painful gloom from close quarters are doctors, nurses, technicians, ward boys, mortuary and community health workers. The trauma of dealing with so much sickness and their helplessness in accommodating all needy patients, even as they risk catching the virus every day, is taking a huge mental toll on these frontline warriors.

They are reaching the end of their tether as patients, including their own colleagues, are slipping out of their hands at an alarming pace and grieving relatives are bombarding them with all kinds of requests and recriminations.

Care Givers Seeking Attention  

India features close to the bottom in international rankings in most health indices. The Covid-19 pandemic has exposed the fundamental problems plaguing the healthcare system, be it physical infrastructure, manpower or health management. At least two-thirds of India’s 1.3 billion people depend on the public healthcare system. However, the country has only 8.5 hospital beds and eight physicians per 10,000 people. Compare this with Japan and South Korea, which have 120 and 130 beds per 10,000 people respectively. As a result, many Indian communities, especially women and children, rely on ASHAs for primary healthcare.

On account of the burgeoning costs of private healthcare and the inability of public healthcare to respond to the needs of the huge population, India’s remote villages are traditionally relying on indigenous health systems of basic care supported by community agents. Community health workers are greatly improving the life of millions of people where doctors and nurses do not go. Community healthcare providers, like paramedics, are taught essential services such as maternal and child healthcare. The strategy is to move beyond doctors and nurses and shift down to lay people, peers and family.

 Mental Health Issues

The new peaks of  active cases of covid witnessed daily in the recent past have strained resources and stretched the workforce thin, leading to a war-like situation. The state of affairs has rendered the overwhelmed and overworked healthcare staff vulnerable to a host of psychiatric issues.

They are physically burnt out, emotionally exhausted and mentally distressed due to the extreme work pressure since the pandemic broke out more than a year ago as also keeping away from their loved ones for fear of exposing them to the infection. It is triggering anxiety, insomnia, depression, frustration and other problems among an increasing number of medical professionals. Some of them are resorting to excessive use of ‘substances’ to cope with the stress.

It is essential to address their problem not only for their own sake but also because only healthy physicians can offer optimal services.

A ‘burnout helpline’ for healthcare workers in all district hospitals of the country is bound to assist the affected caregivers throughout the country. Building a network of psychotherapists on whom the medical personnel can fall back on must be prioritised, as their mental well-being is vital to fostering a resilient and strong healthcare workforce.

(Dr Naresh Purohit is a Medical Expert and Advisor National Communicable Disease Control Programme. He is also Advisor to six other National Health Programmes and visiting Professor in five Medical Universities of  Southern India including Thrissur based  Kerala University of Health Sciences. (The views and opinion expressed in this article are those of the author)

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