UNBELIEBTE MEINUNG

 The truth is incontrovertible. Malice may attack it, ignorance may deride it, but in the end, there it is.

Winston Churchill

Dear world,

This virus has decided to stay longer than we previously thought. We are possibly never reverting back to normal, and honestly, I am not sure if it is a bad thing. This season has been onerous on most people. It is offering a great opportunity for self-reflection. The moment you start questioning everything you know two things will happen. You may adapt and grow or you can breakdown and never recover. Despite the challenges, I would wish to enjoy my everyday life. “You were given life; it is your duty to find something beautiful within life, no matter how slight.”

Elizabeth Gilbert

 Most of what we do and how we act is through socialization and often we take in a lot of poor practices. We must closely examine ourselves to learn from past errors. and avoid repetition. Some errors that have come to light in this season are:

1. Believing my job is better than yours

I love how this pandemic has led to the realization that every job matters and just because I directly do not feel your impact it does not mean the role played is insignificant. For example, who knew the key to infection control and prevention would be the security officer, the watchman? The person whom on most days you used to swiftly dismiss as you hurriedly rushed home or to your work station. The person whom you thought was below you and you could not even spare greeting them. The person whom you never thought to invest in terms of knowledge of hygienic practices. Bitter pill to swallow, right? Better yet that wonderful housekeeping staff who ensures the surfaces and corridors are clean. The people where in most cases have never been provided with protective gear except for their uniforms. The majority of them have nothing to shield them from the disease. Have you ever taken the time to read the ingredients contained in their cleaning solutions? Some of them are very toxic and have lifelong effects and yet few take that into consideration. Have you noticed that especially in some government institutions they also provide tea to the other team members yet again no investment in knowledge of infection control and prevention practices is placed? I hope we can now see how we have been setting ourselves up for failure. "Conceit is God’s gift to little men."Bruce Barton

2. Mimicking limits invention

 We are learning the hard way that not every information generated should be applied. There is a great need for us to develop independent thinking while continuously being inquisitive. This leads to exploring our own ways of developing solutions to problems. For instance, despite this illness being new within our African context did we openly question the use of HCQ and Arithromycin before pumping them down our patients' throats. "Whether you think you can or think you can't, you're right." Henry Ford

3. Greed above everything

 We are being forced to acknowledge just how broken our systems are. We have been forced to realize how our greed in different institutions will lead to our death first before we enjoy our lives and " those profits" we are trying to generate. In the past, we have seen the wealthy move across the world in search of quality health services while leaving the poor to fend for themselves. It is ironic how just this pandemic is, no country is spared,  deaths keep occurring all around us and the funniest bit even if you set up intensive care units in your own home it doesn't guarantee you get out of it alive.

 The pandemic has reiterated that as humans we are often an ungrateful bunch. Unless something is serving our own best interest we are not ready to help. When was the last time you willingly offered to help someone? Not through coercion or a reminder to be humane but through taking personal initiative and actively searching for this person or persons and providing whatever little or much that you had. “If money is your only measure of success, do not be surprised when it is all you have.”Wayne Gerard Trotman

We should not be quick to write off this season we should look at it as an opportunity to learn to do better and be better towards our treatment of each other.“It's not the most advanced society we should be aiming to build that only cares for efficiency, rather our aim should be to build a healthy society with the right amount of advancement and a whole lot of humaneness.”

Abhijit Naskar

INSIDE VOICES PLEASE PART 2

 "Memory is fragile and the space of a single life is brief, passing so quickly that we never get a chance to see the relationship between events; we cannot gauge the consequences of our acts, and we believe in the fiction of past, present, and future, but it may also be true that everything happens simultaneously."   Isabel Allende

 Have you recently handled a dying patient? Are you currently handling a dying patient? How do you feel about it? A few months ago I had to take a video of a dying patient for his family as a final request. He had flown into the country as a tourist but unfortunately, he got critically ill. He had traveled unaccompanied and tracing his family was quite arduous. His condition gravely worsened to a point where he was on treatment failure. When his family was finally traced and contacted it was almost too late. To help them cope with this situation his father requested a video. He could not bear seeing his son who has been physically fit in such a state. He was also buying time as he tried to figure out a way to disclose this information to the rest of his family back in their homeland. He was too heartbroken to physically see him and I felt for him. Imagine being in his situation. How strong are you to handle such events? These words sound familiar, right? Well, I have written them before in a blog post titled Inside voices please part 1. I did not abandon the conversation I just needed an appropriate time and this is it. 

 In healthcare like in any profession, it gets to a point where some things become mundane then there are other activities that you just cant acclimatize yourself with. You may be physically okay but for a briefly these moments remind you of your mortality or the mortality of your loved ones. I hope at least one person who reads this today learns from it or realizes that they are not alone. Do you remember the patient I mentioned at the start of today's post well he died the same day I took the video. For a while, I thought I was handling it appropriately. It was not my first death and surely not my last so nothing really stuck out except for this feeling of anticipatory grief that had started a few days before his death. After a few days, it turned out  I was not coping well. I found myself being too emotional, whilst alone I would cry at the most inappropriate things, I wished to be alone despite my friends wanting to spend time with me, most of my anger was unwarranted, I was hyperventilating on some days and I had nightmares so I couldn't sleep adequately. This may not come off clearly here for its just a snapshot of an extensive timeline so bear with me. I finally knew something was off when I realized I hadn't shown up for work. On this day I woke up, showered, got dressed, tried opening the door but I couldn't. I had an overwhelming feeling of anxiety so I decided to switch off my phone and went back to bed. About an hour later, I woke up took a public service vehicle, and went to a spot where I often go to meditate. For most of that day, I was unreachable. On that day I just did not understand what was happening. 

Later on that day I learned that some of my colleagues and friends had been looking for me and when my best friend showed up that's when I established the root of my problem. All this had resulted from the loss of my patient. It turned out that I had not addressed it adequately. She allowed me to vent, cry, curse out and she didn't leave till I felt better. This was the catharsis I had needed all along. I had a lot more to do thereafter, and I did. This situation reiterated the fact that no matter how used to death you think you are. There will be days that are tougher than others and it is okay.

  

 Globally Covid 19 infectivity is at an approximated 12million people and approximately 500,000deaths why I state approximately is because by the time I publish this post the figure will have changed. View current data here W.H.O data link. Current research is showing that Covid 19 mortality rate increases mainly with age extremities and having a history of an underlying medical condition. One such study is a predictor of mortality Please review it for a greater understanding. With a vast majority of our population having non-communicable diseases it means that more health workers will soon be experiencing the same things as I if not worse. Are we prepared?   I chose to share findings from a study done in China because it being an epicenter I believe it gives a good example of the magnitude of the problem. The researchers who conducted this study were aiming to examine the impact of working among populations greatly affected by the Covid19 pandemic. Their results show that a large proportion of the participants had symptoms of depression "(634 [50.4%]), anxiety (560[44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline workers, and those in Wuhan reported experiencing more severe symptom levels of depression, anxiety, insomnia, and distress". I highly recommend that you read it mental health outcomes

 Borrowing from personal experience we can try to cope with these feelings by;

1. Utilizing availed resources-Currently, most organizations and facilities have established mental wellness programs for health workers. If your facility has not, try and see how you can help in establishing them. It can be as simple as taking five minutes each day as a team to share a few things you are grateful for at the start of each shift.

2. Stop criticizing each other when you realize someone can't cope with what you can. We are all unique and different.

3. Consider utilizing our untapped skills. Maybe among us are great optimistic leaders who can offer some form of reassurance when we feel overwhelmed.

4. Take care of yourself more intentionally. When its time to rest guard that time preciously. We cope better with difficult scenarios when rested.

5. Open discussions with our different support systems. Let them know beforehand that the journey at times is really difficult and sometimes all you need it time, patience, and love.

6. Be open about what you are going through. 

7. To the leaders, supervisors, managers the roles may be different but do not judge nor be quick to dismiss. Be more empathetic to your staff. Ask them "how can we help rather than why did you do that? "It encourages effective communication.

Despite how today or tomorrow is, just know it does get better. We have successfully weathered out other pandemics as professionals and we shall get through this too. "Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying 'I will try again tomorrow."Mary Anne Radmacher