By Doctor Beena Madhavath UMI

Mumbai, July 21, 2020: The beginning

My journey with Covid 19 pandemic began in February, when I heard about the first few cases in India. Initially, I was gripped with fear and anxiety as I knew very well what had happened in China and Italy. I was also not sure about how we will be able to manage this crisis, given Indian socioeconomic context and fragile health care infrastructure.

The management committee of our hospital, Holy Family Mumbai, recognized that coronavirus is going to be a major pandemic and would severely affect our country, especially Mumbai. Planning and follow up action immediately began. We were one of the first hospitals to follow infection control measures, including fever clinics and training.

As more cases were reported across the city we started to offer triage and referral services, when many hospitals went into lockdown in fear of the pandemic. Later in mid-March, we procured high quality personal protective equipment (PPE), to provide the best possible protection to our medical team. Several rounds of intensive training and motivation building sessions were conducted regularly for doctors as well as for other employees. At the same time, standard operative protocols were prepared.

It took almost one month to operationalize the Covid-19 ward and (CU(Intensive Care Unit) since the regulations with regards to isolation wards required major changes in our existing set-up. We were one of the first hospitals to partner with the government in the battle against Covid-19 when we signed an official MOU (Memorandum of Understanding) with local authorities (MCGM) and started a Covid care center.

Thereafter, we allotted 25 beds in the hospital exclusively for the care of the patients which included 12 ICU beds. Today, due to the spiraling number of cases in Mumbai city, on an average, we are caring for about 130 COVID positive patients daily with 26 of them on ventilators.

Joyful Experiences

Every healthcare worker at the forefront of the war against coronavirus are not only facing the daunting task of handling patients, but are also fighting to keep their own worries and emotional stress at bay.

So, what motivates doctors to keep working under such strenuous conditions? First of all when a patient recovers and becomes Covid negative it really lifts our spirits and motivates us to do better work and serve our patients and nation when it is needed the most. My personal experience as a practicing doctor was challenging as well exciting.

The joy of saving a life: I can very vividly remember an incident. A 71-year-old patient was brought to our emergency with the complaints of breathlessness and fever. On examination he was in altered sensorium and had oxygen saturation of 58 percent. He was resuscitated and stabilized in casualty, later shifted to ICU and put on ventilator.

It took almost two weeks for him to recover completely. After his discharge when he came to whisper a note of thanks, I was moved by his gesture, indeed a rewarding moment for the entire medical team. As tears rolled down my cheeks, I savored the joy of saving one life – a feeling much beyond any other joys in life.

The joy of alleviating suffering: I also had an opportunity to assist the birthing process of one of my Covid positive pregnant woman. Wearing a PPE kit and conducting the delivery was a new experience for me. As I finished the delivery, with folded hands and tears in her eyes she expressed her gratitude to me. It was such a blissful experience for me. These experiences etched a lasting impression, which shall remain green in my memory and fresh in my heart. There is always a sense of fulfillment and satisfaction amidst all the fatigue and exhaustion of this harrowing times.

The joy of sharing best practices with others: All these were a great learning curve for me. I also got an opportunity to share my knowledge and a few of the best practices with the other hospitals in our network through two webinars which were organized by Catholic Health Association of India (CHAI). I am also a member of the crises management cell of the Archdiocese of Bombay, which holds regular meetings to review the situation as well as the Catholic response to corona pandemic. I too am in a way getting enriched as I contribute my expertise and experience, in a time when it’s needed the most.

The joy of giving leadership: Another pioneering involvement with Covid-19 began, when I was invited by CHAI to partner in a project named Corona Care Life. This was a web based platform with call center facility for anyone who wanted to talk about the corona virus over phone. Infected people looking for comfort and support or people with fear and suspicion about their own condition could avail this facility.

An online platform was launched to provide counseling session in different languages jointly by CHAI, Project vision, Billion lives, Sister Doctor’s Forum of India and several other organizations. I coordinated this activity among the Sister Doctors. Some sister doctors volunteered for this generously, to reach out to others with compassion and kindness.

Painful Experiences

Let me also share the challenges faced by healthcare workers and hospitals. To put on the personal protective kit and to work in the isolation ward is a unique experience. Once the PPE is donned, one cannot eat, drink or use the washrooms till the duty shift ends, which is of six hours duration or more.

The suffocating PPE: Wearing PPE, N 95 mask, goggles and face shields, gives a suffocating feeling to most of us. Many a time, misting of protective goggles causes blurring of vision. After donning we have to speak loudly in order to be audible, and it becomes very tiring to communicate with patients and other team members in the medical team, resulting in frequent fatigue.

In addition to this, a lot of information has to be given on telephone, as anxious relatives can’t come to Isolation ward. Besides this, the weather in Mumbai is so hot and humid that we are drenched in sweat within minutes after wearing the PPE. Which makes it becomes really hard to move around. With all these difficulties, no wonder the frontline warriors of the Covid-19 are feeling exhausted and stressed out.

Anxiety of the caregivers and their parents: There’s a lot of anxiety among family members of our medical team who are far away in their homes. Ever since the Covid-19 numbers rose high in India, there are horrifying news about Mumbai in many news channels. Many of our nursing staff from southern India are compelled by their parents to resign from their job. This is an additional burden on us.

Along with other members of management team I had to spend a lot of time to listen, reassure and motivate them. Some of them even had to miss important family celebrations and events. A few of our nurses also had to postpone their own wedding dates. I wonder whether any one will remember their sacrifices and selfless service, in caring for the sick and suffering humanity.

Caregivers contracting infection: About a month ago a doctor and three nuns from my team, started showing Covid symptoms they tested positive and were admitted to the same isolation ward. The news of their sickness shook me. I was distressed and anxious. On the one hand the worries about their wellbeing, and on the other hand, the fear of contracting the illness. I was stressed about the Covid ward management with acute shortage of human resources. That’s the time we developed a strategy and backup plan for human resource constrains.

Pressure from activists and media: Mumbai has some of the finest health facilities and doctors. Yet certain times it is difficult to manage. We have also refused patients because of non-availability of beds. It is unfortunate that we were pressurized by some media houses and activists to admit Covid positive patients even during non-availability of beds.

This was not only stressful, but the misinformation and biased partial truth fed through newspapers and social media, has had a negative and demotivating impact on our personnel who are dedicated even beyond the call of duty. It is extremely sad that doctors and medical staff, who are the frontline warriors in the fight against the pandemic, are at the receiving end of threatening calls from these activists and agitated relatives.

Experiencing the Divine amid Crises

While Covid 19 global crisis has caused much anxiety, suffering and uncertainty, this also was a time of intense prayer for us. Many of our Sister’s communities offered special prayers for us. Their prayer and support helped us to gather courage, wisdom and strength in these days of trials. I experienced God’s providence and protection in a tangible way as we received spiritual and material support from many friends, well-wishers and benefactors. Their generosity and magnanimity helped our hospital to steer ahead even when we had suffered financial crises. The powerful presence of the Divine Healer and his miraculous healing touch is experienced by all of us, especially our patients as they restored back to health and wholeness.

Amid all these challenges we are committed to the fight this deadly pandemic. The exceptional courage, heroic commitment, relentless efforts, and yeomen service rendered by many of the health care workers to combat Covid 19, is commendable and praiseworthy. I hope and pray that very soon we will be able to find the light at the end of the tunnel. Mary, Mother of the afflicted, continue to pray for us, that we may be protected, comforted and guided, in this difficult journey.

(Sister Beena Madhavath belongs to the Ursulines of Mary Immaculate, an Italian-origin congregation. She obtained her MBBS and MS degree in Obstetrics and Gynecology from St. John’s Medical College, Bangalore in southern India. She has a diploma in Minimal Access Surgery from World Laparoscopy Hospital Gurgaon and Fellowship in Laparoscopic surgery from Kiel University Germany. She completed certificate course in healthcare design and implementation from Melbourne University, Australia. Presently she is the deputy director of the Holy Family Hospital in Bandra, Mumbai. She also works as a consultant Gynecologist. Her other responsibilities include provincial Councilor for Medical Apostolate of Sacred Heart Province of UMI Sisters, national president of the Sister Doctors Forum of India, health secretary for the Mumbai Archdiocese.)

Source: Catholic Health Association of India