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.

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