Thursday 23 April 2020

In Indore's COVID-19 hospital, patients help lighten the mood, motivate health workers to keep up fight against coronavirus

Editor's note: This series will focus on the difficulties faced by the medical fraternity at COVID-19 hospitals, their duty hours, access to protective gear, facilities they get during quarantine, how are their families coping with this new reality across different states in the country. This is the third part of the series.

Amid the sombre mood in the quarantine hospital in Indore, a seven-year-old patient, who the doctors won’t name, brings moments of relief and lightness. The coronavirus-positive boy insisted that he be allowed to carry his cricket bat and ball before being shifted. Now, he challenges doctors and nurses to cricket matches every now and then. A bundle of energy, the child is a favourite among the medical staff.

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In a sort of role reversal, whenever the medical staff of the Sri Aurobindo Institute of Medical Sciences (SAIMS), one of the designated COVID-19 hospitals in Indore, are in low spirits, the patients seek to lift their mood through conversation. They share laughs and jokes with the former. “Doctor sahab, what’s wrong? You look grumpy this morning. Listen to this joke...” Whether it's a simple query or a joke, patients play the part in making the heavy atmosphere less unbearable.

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In the COVID-19 facilities at Indore in Madhya Pradesh, the healthcare staff and patients have built a unique bond. They have been staying at the same place, sharing the same food and living the same fears and hopes ever since they have arrived there. It’s like a family. There are minor incidents, but there’s also a strong sense of mutual responsibility.

Away from Maharashtra, Gujarat and Delhi, which have seen the highest number of cases as well as casualties, Indore in central India is fighting hard to contain the spread of the novel coronavirus that came relatively late to the city but has since then spread through its neighbourhoods with greater ferocity.

The Sri Aurobindo Institute of Medical Science (SAIMS) at Indore has been at the frontline against COVID-19 in the city with 500 beds. Debobrat Ghose/Firstpost

By 21 April, Indore, the commercial hub of Madhya Pradesh, had seen the deaths of 52 of its residents due to COVID-19, forming the bulk of the 80 deaths in the state, bringing Madhya Pradesh next only to Maharashtra with 251 deaths, in the national table.

It's been nearly three months since the first positive COVID-19 case was reported in India — on 30 January in Kerala. The virus subsequently started appearing in other parts of India but Madhya Pradesh was a late entrant to join the list of affected states. The first COVID-19 death in Madhya Pradesh occurred in Ujjain on 25 March, the day the lockdown began in the country.

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However, in the weeks since then, the state and its two most prominent cities — Indore and Bhopal — quickly climbed the charts, accounting for 52 and seven deaths, respectively, as on 21 April.

Death looms large at Indore

However, fear is writ large on the masked faces of Indore’s coronavirus warriors who are at the frontline of COVID-19 duty as the city, along with Madhya Pradesh's capital Bhopal, is one of the 20 high burden districts in the country affected by the pandemic.

Indore alone accounts for 915 of the 1,552 cases across the state. What scares those on coronavirus duty more is the fact that two city doctors and a police officer have succumbed to COVID-19.

Daily deaths of patients have created a kind of fear psychosis in hospitals not only among people who’ve been tested positive but also among the medical staff.

“The death of two doctors in Indore had put the entire medical fraternity in shock, panic and fear. But we ensured to be doubly guarded and extra alert because we can’t work from home as in many other professions. We’ve to be at the forefront,” said Salil Bhargava, professor and head (respiratory medicine) at the government’s Mahatma Gandhi Memorial Medical College and Manorama Raje TB (MRTB) Hospital, which is one of the COVID hospitals in Indore.

Despite taking adequate precautions, the fear of getting infected is still there whether at the OPD or inside the COVID-19 ward.

“Nothing can be predicted. There is no guarantee that doctors, nurses or sanitation workers won’t get infected. So, the fear is there, whether it’s among health workers or the police – whosoever is at the forefront,” said Ravi Dosi, head (pulmonary medicine) at SAIMS.

The chances of getting infected are high in cases when a large number of patients from a hotspot arrive in a hospital's OPD or due to accidental coughing by a patient during the process of incubation or ventilation.

Sharing his experience, Bhargava said, “It’s a very tough time for doctors and health workers, and their families. Every day, I receive six to seven calls from relatives and friends as they are worried about me. The situation is the same with other doctors as well, who are in this fight against the novel coronavirus. But I’m more concerned about those health workers who’re working in smaller places and tehsils because they need to have good quality protective gear and precautionary measures. We’re much better in Indore, Bhopal and bigger cities.”

Doctors respond to call of duty

The frontline warriors in Indore’s COVID-19 hospitals have overcome their fears and engaged themselves in treating patients.

“Initially, I too was scared but I was reminded of Hippocratic Oath, and then there was no looking back. Same is with my other colleagues as we joined this profession with the basic objective to save people. This thought gives us the strength to counter and conquer fear. None of us has ever seen anything closer to this pandemic,” Dosi said.

It’s not just about doctors; the nursing and sanitation staff too have jumped into this battle with full force, without caring about their individual problems and pains.

A resident of Akola in Maharashtra, 48-year old Kalpana Pillai or Kalpana Didi, as she is fondly called, is the nursing in-charge at SAIMS and one of the most loved ones among the staff and patients.

During this lockdown period, Pillai broke her ankle but continued to serve patients, without taking any leave. She didn’t mention her injury during her telephonic conversation with Firstpost. With a limp in her walk, Pillai crisscrosses the COVID-19 block of SAIMS throughout her duty hours to reach out to patients.

“We forget our personal problems and pains while attending patients comprising one-and-half-year-old baby to a septuagenarian," she said.

"These patients usually come all alone to the hospital, with no one from home by their side and they look up to us as ‘God’ to save their lives. When I see them, I think that I could have been on that bed as a patient, but by the grace of Lord Christ, I’m not. So, it’s my duty to help them to get well so that they can go back home safe and join their families,” she said.

Pillai has been living in Indore for the last 30 years.

As Indore saw a rise in COVID-19 patients, the founder chairman of SAIMS, Vinod Bhandari promptly converted a newly constructed block of the medical research university-cum-hospital into a COVID-19 hospital with 500 beds and a 66-bed ICU on 15 March to manage the crisis.

Dr Ravi Dosi of SAIMS hospital in Indore checking up on a patient in a COVID-19 ward. Debobrat Ghose

Today, SAIMS has the highest number of COVID-19 patients in the country – nearly 450 are admitted and a team of 276 doctors and 300 nurses, headed by 39-year old Dosi attends to them.

“We’ve developed a new virology laboratory for testing. In between, I’ve experienced so much from this pandemic that I can publish nearly 100 papers for research in future,” said Bhandari.

Desperate times need desperate measures

These frontline warriors feel that it’s a long battle against coronavirus and won’t end soon, so the workforce needs to be protected.

“Our only goal is to save coronavirus positive patients. The need of the hour is to keep doctors and paramedical staff healthy and alive because this battle against COVID-19 is not only big but long,” said Bhargava.

To overcome their fear, a few doctors and health workers had to even seek psychiatric help in Indore.

“In some cases, psychiatric help was sought for a few doctors who were attending to COVID-19 patients. We can’t dismiss the fear within the medical staff, as this the first time ever that they have faced a pandemic of this proportion. After all, they are at the forefront of the battle,” Bhandari said.

The spread of the deadly virus, erratic work hours and lockdown have compelled most of the medical staff in COVID-19 hospitals to isolate themselves either within their campuses or in their hotel rooms. They don’t want their families to get infected. And as a result, they haven’t met their families in nearly a month. Back home, they too have small children, old parents or someone sick, but they have no choice.

“The hospital is our second home. Sometimes we do feel that had someone taken the responsibility for our domestic issues, it would have been a relief for us. But frankly speaking, our parents and family members provide us with mental support by telling us not to worry and focus on saving lives. That’s our inspiration, or else we would’ve crumbled,” said Dosi.

The hospital's attempt to create an alternate family – for the doctors as well as the patients – has also helped in allaying fear that hangs uneasily all around.

An important element of this alternate family is the common SAIMS kitchen, which serves food to both the patients as well as the medical staff.

Bhandari’s 81-year old mother Usha Bhandari, a retired teacher, has been instrumental in developing a strong bonding within the hospital. She regularly coordinates with the kitchen staff about daily meals in the hospital.

“As she is unable to visit the hospital at present, she coordinates from home with our health workers and kitchen staff every day. She keeps track of every requirement and people approach her even for small things, as they treat her as a mother figure,” said Bhandari.

Video calls and WhatsApp chats, etc., have also helped the health workers remain in touch with their families.

“Nowadays, children at home love to interact with their parents more on video calls than face-to-face. So, we don’t miss much by staying away from home for such a long period. Moreover, photos are being shared daily about what’s happening at home,” Dosi laughed.

Motivation is the key

Motivation has been a key element that has kept both doctors and patients strong during this crisis.

Inside a COVID-19 ward at an Indore hospital. Debobrat Ghose/Firstpost

Citing the example of Mother Teresa, Dosi said, “Her determination, faith and selfless service to mankind for decades, won her Nobel Prize and she’s a perfect example for us on how we should deal with this crisis and look at our patients. This motivates us.”

“Moral support, empathy and mutual trust are important in motivating patients. I try to enhance their will power by motivating them. This helps them to overcome the fear of death and in the recovery process,” said Pillai.

A member of an extended Muslim family, all of whom have been quarantined at SAIMS after the death of one of their relatives due to COVID-19, told Firstpost, “Though I’ve been tested negative, I’m here for my safety. The love, care and compassion of the entire medical staff in this hospital, have made us realise that we’re a part of a big joint family and not away from home.”

Appreciation from patients has also proven helpful in fighting this battle.

“One of our coronavirus patients – an Indian origin banker living in France – told me while leaving the hospital that the care with a personal touch he got in our small government hospital at Indore was unthinkable in a European country right now. It’s overwhelming,” Bhargava shared.

Both Bhandari and Bhargava also thanked the government and local administration for their support in the form of funds, logistics, medicines, security, etc.

“Despite being in a government hospital, there’s no dearth of funds. The government has opened its coffer and in a single day, we get approvals and funds are sanctioned. And, that’s why we’re in a position to provide good treatment to patients,” Bhargava said.

“The real reward for us is to see these acutely serious patients gradually recovering and walking out of the hospitals,” he said.



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