COVID-19 and the Frontlines in Nigeria
By Titi Tade, Medical Social Worker, Lagos, Nigeria
The COVID-19 Pandemic plunged the world into an unprecedented crisis. Globally, most gaps within the different health sectors in Africa were exposed due to the contagion.
In Nigeria, the initial high of identifying and isolating our index case and his close contacts by the National Centre for Disease Control (NCDC) gradually gave way to the reality of community transmission that has been aggravated by the economic fall out of the lockdown, fear of seeking COVID-19 treatment from government facilities and a general distrust of the government led COVID-19 fight as a scam. Nigeria, as at 5th June 2020, had 11,844 confirmed cases during which Lagos State maintained epicenter status with 4,694 cases.
As a Health/Social Care worker in Lagos State, I am both a member of the public who is worried about the growing rates of community transmission and a member of the “frontline” who has to provide services to the general public within a health system that is in the beginning stages of being overwhelmed. Prior to COVID-19, the health system had always faced the challenges of gross under-funding, inadequate staffing, brain drain and competition from traditional healers.
On a day to day basis our challenges mirror those of healthcare workers around the world. We worry about getting infected at work and taking the infection home to our loved ones, we worry about insufficient supply of Personal Protective Equipment (PPE) and how to safely reuse them. Due to the shutdown of commercial transportation during the lockdown, if you did not own a vehicle, you worried about how you would get to work. As the lockdown eases and people resume their daily activities, you worry about community transmission in commercial vehicles as you make your way to work.
Normally in government hospitals, the number of patients that come in on a daily basis number are in the thousands, it is not unusual for a clinic to be run by 3 nurses with 150 patients waiting to see 10 doctors. During the lockdown, most cases seen in the hospital were COVID-19 cases, emergency cases and a handful of other illnesses but nothing as overwhelming as pre COVID-19 numbers. Unfortunately, as the lockdown is being gradually eased open, the number of infections is rising, and the hospitals are opening to patients who have not been able to see their healthcare professionals in about 2 months for their regular appointments, this combination means that the number of people accessing healthcare services will outstrip the pre COVID-19 numbers. Hospitals and healthcare workers are bracing for the surge in patients with trepidation as we watch how the healthcare systems of ‘developed nations’ are being overwhelmed by treating and responding to the Coronavirus.
As the saying goes, behind every dark cloud is a silver lining. Our silver lining is the fact that since colleagues have been fighting the virus globally for over 6 months now, there are a lot of lessons to be learned from them. The digital age has made it possible for new information about how best to fight the pandemic become available in literally seconds from when the initial author posts the information on the internet. In Nigeria, we have used numerous virtual platforms such as Zoom to conduct trainings on experience learning and best practices for healthcare workers. We have also used the platforms to reach healthcare workers in locations of the country that are only just recording their first infection of the virus. The NCDC is working with affected State Governments e.g. the Lagos State Government, the Federal Ministry of Health as well as State Ministries of Health to ensure a coordinated approach to our Isolation and Treatment Centres and to shorten the timeline between testing of people to hospitalization of COVID-19 positive people. This doesn’t mean that everything works perfectly just yet, but we are learning, adapting, documenting and sharing the new information as we go along.
Everyone has been talking about the “new normal”, but what that is for us in healthcare in Nigeria is still being shaped. Everything from the way patients are booked to visit the hospital, to how healthcare professionals attend to patients will most likely change. These routine processes would now have to respect infection prevention and control measures, physical distancing and, rather harshly, be implemented with the assumption that everyone has the coronavirus until proved otherwise. It will take some adapting to the “new normal” for both healthcare providers and service users but it is a change we must embrace
So…
In Nigeria, we are adapting to these evolving rules for socializing and engaging others. We are adapting to wearing face masks anytime we are outdoors. We are adapting to the ‘new normal’. Being the resilient people that we are, we begun a trend, the fashionable re-usable face masks, which I think will stay, long after the end of the COVID-19 Pandemic.
Embracing the new normal
By Professor Oitshepile MmaB Modise, Director of the SFA Botswana Hub
Covid-19’s greatest lesson is that it has taught us that we are all one, humanity interdependent by all means practical. We are more aware of common things that bind us together irrespective of our nationalities. We feel for each other, care for each other and wish all good life. This togetherness can be likened though at a macro level to SFA family, an international network of researchers, practitioners and communities of practice which has brought together people from different educational and geographic regions. Though to a greater extent virtual, Covid-19 has propelled the need to think together, think of each other and has driven concerted international commitment to seek solutions to combat the disease. Countries of the world have realised more than ever before that they need each other to win the war against this disease.
The network did not suffer adverse effects because sooner than later, members came to the party and acclimatised to the new normal in an encouraging manner. SFA Botswana Hub has been equally affected by corona and its offshoots like lockdown. However, with members’ determination to keep together, we quickly established a WhatsApp group for ease of communication in addition to our usual e-mail. By the first week of lockdown, it was apparent that there was fear, uncertainty and a feeling of loneliness and sharing our experiences eased these emotions. All could not help but feel the pressure of Covid-19, we talked about it, shared our fears and supported each other. We sooner realised that work has to continue under our new normal. The team continued the normal business such as looking for grant applications and other opportunities for growth coming along with this pandemic. Creating time for work at home with family members around became a source of support and where necessary flexibility was exercised on work-hours based on home circumstances.
Our ‘new normal’, (referring to emerging and new ways of adapting to life forced on us by the Corona Virus) is working away from official premises using internet, for example, communicating to each other online and through phone calls. Practical steps to create a new normal such as ensuring internet connectivity and securing devices that will facilitate our work were taken. This proved to work for the Hub as we continued to share information and communicate with our administrator and the larger network. The current circumstances also enabled us to think outside the box. We became aware of the fact that some areas of Botswana are not benefiting from the government information dissemination channels like television, newspaper and some cannot even afford to buy a radio. These people get very little or no reliable information about Covid-19. The Hub then thought it would be prudent to initiate the process of securing support for community lifelong learning radios as crisis tools for disseminating and providing education during a time of crisis as well instil lifelong learning principles especially on issues that affect communities. We were able to successfully create a new relationships with colleagues in the Health Sciences and Engineering departments of the University of Botswana. This was meant to facilitate successful implementation of the Rapid Response to Covid 19 project recently submitted to the SFC-GCRF internal scheme at the University of Glasgow. Unfortunately, this application was not successful. Nevertheless, these new connections for the Hub was a great step because the two departments have expressed interest in working with us in the future. We also saw our team members exercise their creative capacity in sharing the Covid-19 message with the Network through art. Finally, while home online connectivity can be a challenge, access has made coping better. We experienced a model of coordinating activities that ensured resilience in the Network.