Alice* was a dedicated nursing student at the college of
health sciences when we were all in undergraduate. She was also very religious
and she walked the talk. Every Friday evening, along with a few others of her
faith, she visited with the sick in the hospital wards, not as a nurse but as
symbol of encouragement. Together, they sang the vespers and ushered in the
Sabbath.
In her third year of school, she developed a persistent
cough. She always took her diet very seriously and ate only wholesome foods, hence
maintaining a trim body but she was now losing weight markedly. At night, she
couldn’t sleep well, waking up drenched in sweat severally.
After three weeks of trying to hold it together, she sought
care and was diagnosed with tuberculosis. Her big heart had walked her right
into the lair. Tuberculosis is more easily transmitted during the night. During
the day, the sun’s naturally occurring ultra-violet light is protective.
Alice’s Friday night interactions with her patients had made her one of them.
Alice’s experience may have come earlier on but it happens to
all health workers in the course of their career. My very first one came three
months into my internship. I was two weeks away from finishing my first
rotation, paediatrics. In the crowded paediatric emergency department, a little
girl was brought in by the parents. She had watery eyes and a dry cough. As I
leaned forward to examine her chest with my stethoscope, she coughed right in
my face. That is when I spotted the vesicular rash on her neck area. I knew my
goose was cooked.
I spent a week in bed oscillating between chills and fever
while my entire body broke out in the extremely itchy chicken pox rash. I even
had the rash in my mouth. Despite chickenpox being mostly a mild infection in
children, it can get severe in adults and in extreme cases, can lead to
mortality. But one never truly appreciates what that means until it happens to
them. To add insult to injury, the question on everyone asks is where you grew
up where you did not come into contact with it as a child; like it is a
developmental milestone you missed!
This was the beginning of what I thought was going to be an
illustrious career. Two episodes of needle prick injuries and having to take
anti-retroviral drugs to protect myself from HIV and I was quickly turning into
a veteran. We all quickly learn to wear our stripes with pride. The experiences
are vast, from physical assault from mentally ill patients, to respiratory
tract infections, to rare cases such as a colleague who dislocated her wrist
during a particularly difficult caesarian sections.
Outside of direct patient contact are health workers who work
in high risk areas such as laboratories. They are constantly exposed to
dangerous organisms, infectious body fluids, chemicals and reagents. Laboratory
accidents can be extremely catastrophic.
But who is keeping tabs? Despite the daily dangers that
health workers face as an occupational hazard, there is no safety net to
cushion them against such. Take for instance the case of Dr. Stella Ameyo
Adadevoh, the Nigerian doctor who put her life on the line to protect Nigeria
from the Ebola epidemic. She diagnosed Nigeria’s patient zero, Patrick Sawyer,
a Liberian national who had come into the country to seek faith healing.
The timely diagnosis and subsequent decisions taken to
immediately institute quarantine, meant she put herself in immediate danger.
Nigeria was not ready for Ebola and she had to make do with what they had to
protect the rest of the country. Despite causing a diplomatic row between the
two countries, being accused of restraining a foreigner against his will, she
did not budge.
Did she die a heroine? Absolutely. Was her sacrifice in vain?
Not at all. She saved one of Africa’s most populous countries from sliding into
the mire of a devastating epidemic. In Nigeria, she will always be immortalized
as the larger than life heroine. In the medical profession, we will hold her in
awe. She epitomized the very definition of selfless.
This then begs the question, what do countries do to protect
those who, by virtue of their calling, are expected to stand in the gap, not
only for their patients, but the entire population at large when called upon to
do so? During the height of the Ebola epidemic, many health workers were in
panic, most especially those who worked in the emergency departments. They knew
they were the first contact with the patients. Few felt sufficiently trained to
get into a hazmat suit and handle a patient with Ebola. Even fewer were ready
and willing to be quarantined with a patient for the required duration.
In Kenya, there is not even a basic life insurance policy to
cater for health workers who may die in the line of duty. This is a clear
indication of the disregard for the risk involved. Just like a soldier goes to
war for his country, knowing his body may come home in a box, so do health
workers. Every day they navigate spaces that put them at risk of physical harm.
Ebola may not be an everyday occurrence but tuberculosis and HIV are.
It is important to wake up to this realization. Health
workers, just like all other people, also have families that care for them and
would be deeply pained to lose them in the line of duty. They have dependents
who would be left destitute in their absence. This is a gap we must aim to fill
as a matter of urgency. We cannot continue to take our health workforce for
granted in such a callous manner.
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