HEALTH: VOICES FROM THE FRONT LINES

Updated Jun 24 2020

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Healthcare workers in Pakistan are on the front lines of the battle against the rising numbers of coronavirus cases across the country. Not only are they at the greatest danger working in an environment of infection when they do get infected, it puts an even greater strain on the healthcare system, as those who tend to others themselves have to be cared for. Out of the 3,635 reported positive cases among medical professionals in Pakistan, 35 have already lost their lives to the pandemic. Eos interviewed nine doctors from various major cities who contracted Covid-19 and have now recovered from the virus. They spoke about the circumstances of their infections, how they survived their isolation and the toll it took on their families.

DR SARWAT BAT00L FAZIL, GYNAECOLOGIST AT PAKISTAN INSTITUTE OF MEDICAL SCIENCES (PIMS), ISLAMABAD `We get so many patients who may be carrying the coronavirus they may be showing some symptoms or they may be asymptomatic, but we attend to every patient. And we don`t test gyne patients for Covid-19.

`Though I cannot be sure about how I might have contracted Covid-19, I do think about this one patient we had to do a caesarean section on.

It was a very complicated case. She had multiple issues, including problems with her lungs and she also had ventilator history. Sadly, we were unable to save her. Two weeks later, I had aches and pains but then I thought that I have been on duty for 30 hours and I`ll feel fine after taking some rest.

`As a precaution, I took the swab test for detecting Covid-19. It came out as negative. And frankly, the aching also went away, so I thought nothing of it. Two [morcl weeks went by and one of the other doctors in my batch fell ill and tested positive. Having worked closely with her, I got myself tested again, also because I was feeling unwell again. This time I tested positive.

`There were no quarantine areas or rooms for doctors who might have caught the virus at work at PIMS and I was asked to isolate myself in a small doctors` locker room, without even a bathroom, for the entire day after my test results Lcamej.

That`s when I recorded my plight, which went viral and was aired on various news channels, too.

After that, I was settled in an isolation area created for doctors and hospital employees.

`I hail from Gilgit. While I was quarantined at the hospital, my father, husband and son thought about going to Gilgit but they got themselves tested first. My father and son cleared [the testl but my husband, also a doctor, tested positive.

He was asymptomatic and he recovered within eight or nine days.

`By the grace of God, I am feeling much better now. I have tested negative though I was coughing for several days after. I have also gotten my antibodies test done. It shows I have antibodies. A colleague`s father needs plasma and I have the same blood type, AB+. I will donate.

DR RIZWAN KUNDI, UROLOGIST AT THE KIDNEY CENTRE, PESHAWAR `A majority of people in Khyber Pakhtunkhwa don`t follow standard operating procedures [SOPsl. Among them, many may be positive, but those who are asymptomatic don`t even show symptoms. We lhealth-care workersj areexposed to threats 24/7. I just wish people were more careful. Some of them know what is wrong with them and they hide their history from us.

This type of thing is common in KP.

`I was on emergency duty for three days straight, which is normal for ER doctors. After our duty hours, we are also off for three days as it is necessary to take rest. On my third day at work, I had body aches with a dry cough and fever. The test then only told me what I knew already.

`My mother is diabetic. I couldn`t take the risk of taking this [virus] home with me. Immediately, I shifted to the doctors`hostel. They had a quarantine arrangement there, thank God! Then I had to deal with my worried mother`s calls to inquire after my health. We doctors and our families are also human. The psychological tension we feel is no different than anyone else`s.

`Still, we carry on with our work, within our limited resources. As it is, the hospitals here don`t follow SOPs according to the WHO standards.

Some 450 doctors in our province are Covid-19 positive on record, but the real number must be around 600, if you ask me. Six doctors have also succumbed.

DR JAVERIA HAYAT KHAN, GENERAL SURGEON AT THE DISTRICT HEADQUARTERS (DHQ) HOSPITAL, KDA, KOHAT `I had severe body aches during Ramazan.

At first, I thought it was due to the hectic pace of my work and fasting. But when I got myself tested, I came out as positive. The fever, the pain all over, the headaches, the shortness of breath, were nothing like I have ever experienced. I have now cleared the test [I am negativej but I still have a cough and get headaches. I have also gotten an antibodies test done from Shaukat Khanum but, you know what? I have not as yet developed any antibodies. I can`t donate plasma.

`I am so worried. I have elderly parents in Peshawar and I have a five-year-old son, who is staying with them as my husband is abroad.

I was not living with my family. Work has brought me to Kohat where I have also found accommodation for myself. I lived here in selfisolation for 14 days and now, after testing negative, I am back at work. But [I`m worried] with my antibodies not as yet kicking in, what if I fall sick again? The first attack was bad itself, who`s to tell how bad the next will be. I wear the N95 mask at all times, because I am on duty all the time. It has left deep creases on my face. But I worry about the viral load.

`We are so short of doctors and nurses here. Being a surgeon, I am constantly on my feet though I feel I need more time for convalescence. When I get headaches, I just want to lie down for a bit but I don`t have time for that. Taking more leave is a luxury we doctors cannot afford, especially at this time of crisis. We face huge problems at the DHQ Hospital. There is a shortage of specialist doctors who can operate the ventilators. The ventilators, too, we are running on cylinders which get empty in three hours. Who`s to say if they are filled completely? Sometimes there is a problem with PPE availability, too.

DR SALMAN HASEEB, DERMATOLOGIST AT THE SERVICES HOSPITAL, LAHORE `There was a shortage of doctors in theCorona Ward at the time so I was transferred there, even though I am a dermatologist. It is fine, too. We are doctors first, we help where help is needed. We have taken an oath for this.

`Besides, more than 40 percent of doctors in Punjab are Covid-19 positive and in quarantine so there is a continuous shortage of human resource, too. This was earlier when there was also a shortage of Personal Protective Equipment [PPE suitsj and proper masks and gear to cover the face. We would go [to workl with whatever we had, and obviously we were unprotected and exposed.

`Unknowingly, I also passed on the virus to my maternal aunt and two cousins. I felt bad about that. I help the sick, I don`t want to make others sick. But I did. My mother, a retired schoolteacher, helped me regain my morale.

Our families are behind us always. It is they who help us get back up again after falling down. I am now back at work and feeling line and stronger as I tend to my patients.

DR MAROOF VAINCE, MEDICAL SPECIALIST OF FCPS MEDICINE AT ALLIED HOSPITAL, FAISALABAD `I was on duty for three straight days chand raat, Eid and the day after Eid. I think that is the time when I must have contracted Covid-19.

`There are two types of patients these days those who have already tested positive for the coronavirus and who we are tending to in isolation wards, and there are those we see otherwise, including private patients. The ones in isolation wards, we are more careful with. We use PPE when seeing them. But with the rest we are not that well-covered up. No one has the coronavirus label imprinted on their forehead, so someone like us, who are surrounded by sick people, can never be too sure where they caught the virus from.

`The virus also doesn`t differentiate between people. It won`t say`Oh, he`s a doctor. Let`s spare him `I felt unwell so got myself tested and, as feared, the result came out as positive. That was when I went into self-isolation at home.

`We have to keep the faith. We have to believe that God is with us. He will look after us as we go about doing our duties. It is what keeps us going.

I have just recently tested negative and am back to work.

DR OMER SULTAN, A YOUNG DOCTOR AND CONSULTANT PHYSICIAN AT THE JINNAH POST GRADUATE MEDICAL CENTRE (JPMC), KARACHI `I contracted Covid-19, which was bound to happen one day or the other considering the circumstances we have to work in. But what isreally painful to me is losing my father to this virus. My father, Mohammad Sultan Ahmed, was only 66 years old. I had not seen him fall ill in the last 35 years. It was my mother who suffers from heart ailments but it is my father who is gone now, so quickly, in an instant. He had symptoms on May 31 and he was gone on June 8. I was not prepared for it.

`People should understand. The coronavirus is no joke. It is very real. So please take it very seriously. They should also be more understanding. When we as doctors get to hear accusations such as administering poison in injections or keeping dead bodies in order to steal organs, it is very painful especially for someone like me who has lost a loved one due to his choice of career. I know I must have taken it home to my father. My father was my biggest morale-booster. But now he is gone.

`I have not yet tested negative but as soon as I do, I will be back to work, because there is a shortage of doctors and medical staff in our hospitals. What to say of them, when there is even a shortage of sanitary workers here. The disinfecting is done by non-governmental organisations and that, too, not regularly.

PROFESSOR DR A.R. JAMALI, SENIOR ORTHOPAEDIC SURGEON AT JPMC, KARACHI `Perhaps I caught it from a diabetic patient who had come for amputation, perhaps from a colleague`s mother, who had taken a fallen and injured herself. It`s irrelevant how I caught the virus, because we are doctors working with sick persons. It could have been from anywhere. We worked wearing masks and gloves as the PPE were reserved for the doctors working in the isolation wards.

`When the symptoms manifested and I got myself tested, the result was negative. So I just took antibiotics and that was it. But after a few days, I felt even worse and had stomach pain as well. A blood test then showed my platelet count at 14,000. That is very low. It was feared that maybe I was suffering from dengue. It was, in fact, Covid-19 as another test done at Aga Khan Hospital showed. The swab test is about 60 percent accurate with a 40 percent chance of error.

`I was very unwell. I was in the hospital for 24 days and was discharged only recently.

Meanwhile, my better half, Dr Seemin [head of emergency at JPMCJ, also fell gravely ill before Eid, though she didn`t have the virus.

Now both of us are convalescing at home. We have two sons. The older one is in Canada and couldn`t travel to be with us and the younger one is taking care of us.DR SIRAJ UD DAULAH, PROFESSOR OF PAT HOLOGY AT ZIAUDDIN MEDICAL UNIVERSITY HOSPITAL, KARACHI`There are eight of us siblings, three of us, myself, my brother and sister live in three separate houses within the same compound, inside one boundary wall. We all got sick simultaneously, so we can`t say who contracted the coronavirus first. Being a pathologist myself, and doing lab work of cancer patients, I was always aware of the dangers around me. We must keep on doing our duty as there is yet no treatment for this virus.

The only way is to learn to survive, taking the necessary precautions of staying home, working from home, etc., until a cure can be found.

`I felt feverish on May 20. I also had body aches, which told me I had been infected. When I called up my brother, he said he was also feeling unwell and we immediately knew. I was quite unwell for two days and on the third day, when I was better, I got the PCR test done.

`The system is overwhelmed with people getting infected left, right and centre. Hence, the testing vehicle with staff could only come in the evening. By the time the results came, my symptoms wem gone completely, though I had tested positive, like my elder brother Dr Tipu Sultan and my younger sister Dr Shaheen Zafar.

Surprisingly, my wife Dr Yasmeen Syed, who was also tested, as they test the entire household, was clear perhaps because her blood group is O, said to be most resistant to the virus. But my brother`s wife and two daughters-in-law had also been infected.

`I will call myself the luckiest as my infection was minimal. The other two had to suffer for eight to 10 days. We are all doctors so we were monitoring our oxygen saturation to make sure we didn`t need to be hospitalised.

`The virus is different with different people. I am 72 years old and my brother is two years older than me but we are line now and have tested negative too. Just yesterday, I donated a unit of plasma because I am rich with antibodies. I will do so again.

DR SHAHEEN ZAFAR, SENIOR GYNAECOLOGIST IN KARACHI `I was so careful that I had stopped going to my clinic from March 24, when the Sindh government had announced the lockdown.

I thought I would rejoin after Ramazan and Eid but then I fell ill and tested positive for Covid-19 and had to isolate myself.

`I isolated myself in my room in my house. I kept a trolley outside my room door with a few plates, a bowl and utensils. When my family came with the food, I would direct them what I wanted and how much. Then when they`d leave and after I had eaten, I would wash my plates and utensils myself and place them there on the trolley again.

`I kept in touch with everyone and remained updated on the news through my phone. I also watched the entire first season of Erlugrul Ghazi on it during this entire time.

`Another thing which I have started doing in self-isolation is calligraphy. Yes, I know we doctors are not exactly known for our good handwriting. But it is something that I have developed as a hobby.


The writer is a member of staff She tweets @HasanShazi