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Compassion in a crisis

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FLETCHER—Access to oxygen is important

As she scurried to and fro to provide the best care to patients at Kamuzu Central Hospital’s Covid Isolation Centre, one of Emma Jingini’s biggest fear was contracting the contagion in the course of her work.

That time, hundreds of healthcare workers had already contracted the virus and the highly virulent strain in the second wave almost knocked the country’s already stressed health system to its knees.

But with time, Jingini became more and more confident in handling cases.

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Her approach to work had significantly improved.

The nurse at the referral facility in the capital Lilongwe realised there were seemingly simple activities in managing Covid cases which she and others might not have paid enough attention to.

“How we as healthcare workers even put on personal protective equipment when handling Covid patients matters a lot,” Jingini says.

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She recalls that the very management of isolation centres was not properly guided by standard operating procedures (SOPs) and that healthcare workers and guardians were at great risk too.

Jingini was one of 510 health personnel across the country who were drilled by an eight-person specialised team from the global Emergency Health Unity (EHU) in responding to the infectious disease that has claimed over 1,150 lives since the first case was registered in the country in April last year.

The team, which was in the country for three months, was deployed by Save the Children to offer technical support to the Ministry of Health as the country grappled with the second wave of the virus.

“They found us in the midst of the second wave and helped us in strengthening infection prevention and control. They did an assessment and noted gaps which needed to be addressed. The team from EHU also helped us to produce SOPs which we started using in the treatment units,” Jingini explains.

She admits that after the collaboration with the EHU experts, most healthcare workers are now able to use the correct PPE when handling Covid or suspected cases.

Nurse Rachel Fletcher— who led the EHU team—says a crisis like Covid compounds challenges already existing in a health sector such as Malawi’s.

“A peak of an outbreak increases the number of inpatients in hospitals and you need more doctors and nurses. It is a historical challenge.

“There is also the challenge of medical consumables. In Covid times, access to oxygen is very important. Of course, oxygen is important even during non-Covid times but sometimes it is there in short supply,” Fletcher says.

The nurse, who also spent almost a year fighting the Ebola outbreak in West Africa in 2014, recounts that there was a little bit of a struggle in terms of healthcare workers in Malawi managing Covid cases in line with technical guidelines.

Thus, Fletcher adds, working with various focal points within the Ministry of Health (MoH), the EHU experts particularly concentrated on case management and infection prevention and control, among other areas.

The team was linked in with the ministry, the health cluster, the National Oxygen Taskforce and the National IPC Subcommittee, among others.

MoH Deputy Director of Infection Prevention, Dr Owen Musopole, says the support that Save the Children has provided through the global EHU will remain handy even in cases of future outbreaks.

He discloses that there have been gaps even in properly screening patients and assigning intensity or urgency to illnesses to decide the order of treatment.

“Covid cases have drastically gone down and we think partly it is because of the way we have managed our cases. It has helped us to reduce cross-infection.

“We also think our healthcare workers have the skills to manage further infections. There are fears of a third wave but we think if it can come, we can ably manage it,” Musopole explains.

He holds in high regard the “compassion” that the EHU team showed “in a crisis” that heavily devastated the nation.

The support they have provided will forever be treasured,” Musopole declares, waving a thin booklet containing the new guidelines for working in Covid isolation and treatment centres.

And Save the Children Health Advisor, Gome Jenda, concurs that in a humanitarian crisis, sustainability is imperative.

Jenda says the child-centred organisation had to first come up with an approach that deals with immediate response.

“We believe that, by training our healthcare workers and revising the SOPs and some of the guidelines, through the specialists that we brought, we have enhanced and solidified our investments,” he says.

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