Covid-19 shows not all heroes wear capes – but all wear masks
From doctors to nurses, hospital porters and funeral parlour workers, the initial fear and anxiety around the virus has been tempered over time by education. By Nomatter Ndebele and photos Thom Pierce
Nomshado Manana: Porter, Mpumalanga
For 15 years, Nomshado Manana has been accustomed to attending to patients when they arrive at KwaMhlanga Community Hospital in KwaMhlanga. The process of helping patients out of their transport and into the hospital was always strenuous. But now, with the onset of the pandemic, it’s not only strenuous, but it is also riddled with fear and uncertainty.
“Things have really changed. Sometimes I don’t enjoy being at work anymore because I am so stressed about getting sick myself or infecting my family,” said Manana. The interactions between porters and patients have really become strained during this time as both parties have started to view each other with suspicion. “You know people can come in with a fever and it could be completely unrelated to Covid-19, but lately the minute someone is screened and they have a high temperature, we immediately think Covid,” she explained.
The need to screen patients on arrival has also added an extra aspect to Manana’s work. “I can’t just go straight to a patient and help them anymore, I need to find someone to screen them first, and if they come out with a high fever you can immediately see them become anxious and they can even see our anxiety too. And that doesn’t feel good for patients.”
As more information has become available Manana’s fears and worries have eased. Learning about comorbidities was a big turning point. “When we learnt that if you did not have comorbidities, you had a high chance of surviving the virus, things felt much better,” she said.
Although Manana still worries about possible infection, she said that she and her colleagues had become used to working with “persons under investigation”. And as the numbers decrease, workers feel less overwhelmed. “It’s almost like we’re immune to it now, not necessarily physically but mentally. We have much more information, so things are a lot more bearable.”
Jinal Bhiman: Medical scientist, NICD, Gauteng
For many of us our anxieties and worries around Covid-19 started when the government put the whole country into lockdown. Unbeknown to the rest of us, however, Jinal Bhiman, a medical scientist at the National Institute for Communicable Diseases (NICD), and her team had been in a race against time from the middle of January. Long before thousands of us even knew we had a problem, medical scientists like Bhiman were already working on a solution.
The team at the NICD put their heads together and started to develop a test kit. This was the first momentous task that faced the them. They needed to create a test that would allow Covid-19 infections to be identified. “We tested for a month and a bit, and for the longest time we had nothing. We started to worry that our test was not picking the virus up,” said Bhiman.
The team continued their work every day and held their breath every night. Many people at the NICD volunteered to take up shifts and many of the old hands committed to long hours for weeks on end in the hope that their kit would yield results.
Finally, they had a breakthrough. “It was actually my daughter’s first birthday and that evening the usually prompt update on the team’s WhatsApp group was late. That was the first sign,” she recalled. The moment they had been waiting for finally had arrived and it was bittersweet.
“We were pleased that we picked it up, but it also meant that someone was ill,” said Bhiman. After that, the team shifted its focus to expanding testing kits and advising the government.
The work at the lab has not stopped – the team has now taken the role of monitoring the virus and conducting research. Its efforts are now driven towards advising and assisting other countries on the continent.
Sibusiso Njilo: Professional nurse, Soweto
When the Covid-19 storm started raging across Gauteng, Sibusiso Njilo was one of the frontline workers who had to undergo a quarantine period after a positive case was identified at Senaoane Clinic in Senoane, Soweto, where he works.
Suddenly the anxiety he had felt for his patients was for himself and his family. Luckily, Njilo tested negative and he was able to get back to work to try to look after his community.
Although there has been widespread information about the importance and advantages of wearing masks, not everyone is playing by the rules. “Some patients will come to the clinic without wearing a mask and demand to be seen. We have to be strict and turn them away, because they are putting us, themselves and other patients at risk,” he said.
For Njilo, much of his navigating the pandemic as a professional nurse has been an exercise in maintaining strict regulations and making sure people understand that the rules are made for a reason.
At the start of the lockdown, many people came to the clinic for testing after having been screened at their places of work and been advised to get tested. “We started to realise that people were coming to the clinic for testing because their temperature was 37 degrees. Their employers were sending them away and not allowing them to come back to work without testing for Covid,” Njilo said.
Although the employees considered themselves to be conscientious, they were inadvertently putting pressure on a healthcare facility that should have been saving its resources for critically ill patients. “The numbers were so high and we just didn’t have enough testing kits. We had to ask people to come back the next day.”
Despite having to be strict with some patients, Njilo hopes that one day his patients will look back and think of him as having been fair and committed to keeping everyone safe.
Karla Bezuidenhout: Doctor, Northern Cape
When Dr Karla Bezuidenhout first heard about the coronavirus outbreak on the news, she had no way of knowing what a huge job lay ahead for her and hear team at Kimberley Hospital in Kimberley.
The doctors had no choice but to get ready for the coming storm. Through many meetings the team started developing protocols; they discussed how they could best protect healthcare workers. Naturally, the hospital experienced growing pains, from figuring out how to manage infection control in a hospital to prioritising the safety of nurses who had to use public transport to get to and from work.
Bezuidenhout, a nephrologist, dedicated a lot of time to making sure that her colleagues felt protected and valued. This was even more important at a time when anxieties were at an all-time high. “What is important for me, even without the pandemic, is that people enjoy working here, that they learn and grow. When you support people in that way, it translates to good patient care,” she said. The onset of the pandemic became a lesson in teamwork, in valuing people’s contribution and looking out for one another.
Even though Bezuidenhout and her team have worked long and arduous hours, her commitment to saving lives knows no bounds. Instead of complaining about the number of patients they’ve had to see, her biggest worry is that they still aren’t seeing enough people. “I am just so worried that people are not getting to us. What if they are dying out there?”
Her role during the pandemic is more than just being a doctor. “It’s about being a doctor, and a manager and a policeman.”
In all of this, Bezuidenhout is adamant that without the support of her team, they would never have got as far as seeing as many recoveries as they have.
“I cannot overemphasise their part. There hasn’t been a single complaint. The junior doctors haven’t been on leave this year. People have truly gone above and beyond [the call of duty], whether they are pushing patients in wheelchairs or dealing with mountains of admin,” she said.
Despite all of this work, the doctors have found the patience and strength to motivate their patients daily. “We just keep saying to them, ‘Keep breathing, keep fighting.’ ”
Vader Molefe: Mortician, North West
It is 8pm when I finally get hold of Vader Molefe. He works as a mortician at Mamokane Funerals in Klerksdorp. “I’ve just finished work. We’ve been waiting on a delivery of caskets,” he said.
By now Vader and his colleagues are accustomed to long hours and sleepless nights. Their workload as morticians has almost tripled as the country battles the pandemic. Mamokane Funerals has been helping Klerksdorp Tshepong Hospital to store the bodies of deceased patients.
Even for someone like Molefe, who is somewhat accustomed to death, working on the frontline has been overwhelming. “Even before our numbers started picking up in North West we were picking up five to six bodies every day. When things really got serious we were called into work at 10am and were up all night,” recalled Molefe.
What used to be an “ordinary” pick-up for the funeral parlour has become a much more rigorous exercise. “When we get the bodies, they are wrapped in three bags. We then add another one. We transport the body in a panel van, and when we arrive at the parlour we put the [coronavirus]-positive bodies in a specific fridge. After that we remove our PPE, have a shower and go out to sanitise the vehicles,” said Molefe.
Regardless of how many bodies come in, the process is exactly the same. “If there are six bodies in a day, then we shower six times,” said Molefe.
One of the greatest challenges that Molefe and his colleagues have faced in this time is coming across as the gatekeepers of grieving. Regulations now stipulate that only two family members are allowed to view bodies in order to identify them. Molefe and his colleagues often have to be the bearers of bad news when five members of one family turn up at the parlour. “It’s hard. We say to them: ‘We know there are five of you here, but we can [only] allow two of you to identify the body.’ The two people who are elected to identify the body are then put into full PPE for the viewing,” he said.
Grief is a difficult thing and in times like this, it is made even harder when people are unable to rely on familiar funeral rites. There is also still a lot of stigma associated with Covid-19. “A lot of the families refuse to believe or accept that their family members have died from Covid-19. And most people are terrified when they have to come and identify the bodies.”
Like most frontline workers, Molefe said it had been an incredibly difficult time. “But you know what, this thing is here and it is real, but it will pass. For now, ijob yijob [a job is a job].”
Lokuthula Maphalala: Doctor, Eastern Cape
Initially, 35-year-old Dr Lokuthula Maphalala was told that she would not be directly involved in the Covid-19 response at Port Elizabeth’s Dora Nginza Provincial Hospital. A few weeks later, her office was repurposed as a donning room. Shortly after that, she and a matron created a space where patients who had tested positive for Covid-19 would be admitted. “The matron and I literally moved the beds by ourselves. We pushed them into the right position while everyone else watched in utter disbelief.”
The preparation of the Covid-19 ward was an uphill battle. Plans that were set up theoretically fell apart when the first patient turned up at the hospital. Almost instantly, everyone realised that their plan was impractical and that it was time to go back to the drawing board. Maphalala recalls that there were “so many meetings” and many negotiations. “It took a while before people realised that Covid-19 was here and that they had to work together.”
Reflecting on that initial period of preparation, Maphalala believes that many of her colleagues struggled to vocalise their valid fears and anxieties. “What people needed to say was ‘I am scared and I don’t want to see patients.’ Not being able to say those words meant that their fears and anxieties manifested as resistance to treating patients at the facility.”
Workers were so afraid of coming into contact with the virus that they fell back on past issues as reasons to not deal with Covid-19 patients. “People were complaining about the fact that we had broken windows, which is an issue, but this was not the time to be striking about broken windows.”
Change and acceptance were slow, but once workers started to realise that Covid-19 was no longer “out there”, people started to come together.
At the peak of the pandemic, Dora Nginza was seeing up to 25 patients a day. Most were dead on arrival and others were said to have passed on in the cars they were travelling in. For Maphalala those deaths also spoke to what people believe the value of their own lives to be. “So many people would turn up at the hospital when it was too late. Had they turned up even a day before, we could have saved their lives,” she lamented.
As things started to settle down and get into a routine, workers at the hospital realised that they were stronger together. The emergency medical services are better than they’ve ever been and many of the workers are giving of themselves in ways that none of them could ever have imagined a few months ago.
According to Maphalala, what has made things work at the hospital is all the different cogs coming together to move their response forward. “It’s not just about the doctors – it’s everyone in the system: the cleaners, the kitchen staff, the porters, the security guards. Everyone is doing their bit and that has made all the difference.”
Lesley Mabena: Cleaner, Limpopo
When the government introduced level five lockdown, most were lucky enough to be able to stay at home and stay safe. It was understood that all essential workers were to continue their services. In the context of the health system, most immediately thought of doctors, nurses and paramedics, but did not always consider the support staff who work in health facilities. Not many people thought about the likes of Lesley Mabena, who works as a cleaner at Polokwane (Pietersburg) Provincial Hospital in Polokwane.
Mabena and his colleagues were also required to be at work. They were as exposed and vulnerable as medical staff. “It was such a difficult time. We were so afraid and we knew nothing. We thought that we could even get infected just by touching the water at the hospital,” he recalled.
Hundreds of hospital workers were gripped with fear. The last thing they wanted was to be in a hospital facility. “In the beginning we didn’t turn up for work. We were so afraid that we couldn’t even bring ourselves to step into the hospital,” he said.
The situation was untenable. Hundreds of fearful workers had turned to unions in a desperate attempt to protect themselves and their families from this unknown virus. Dr Phetho Mangena took it upon himself to teach the hospital cleaners about the virus.
With more information, Mabena and his colleagues started to understand that although they were fearful, they could protect themselves from the virus. “Dr Mangena really took the time to speak to us, to educate us. Everything we know we learnt from him. But he also expects us to be responsible, and he put that responsibility in our hands. I remember the one day I went into work and forgot to change into my boots. I went into the hospital in my normal shoes. I bumped into Dr Mangena and he gave me a hell of a talking-to. He said: ‘If you don’t want to think about yourself, then think about your children.’ That made me realise that I had to take responsibility for myself,” said Mabena.
When the hospital faced challenges with staffing, he was part of a group that was requested to take on a full-time cleaning role in designated Covid-19 wards. “I felt like a hero. When people refused to come into work, we were sent in.”
Over time, the hospital started organising educational workshops for support staff. The workshops went a long way in combating misinformation, and giving people the confidence to know that they could still do their work and be protected. The hospital went to great lengths to ensure that Mabena and his colleagues had all the personal protective equipment (PPE) they required.
“I have to tell you, we have never once been without PPE, not a single day,” he said.
Reflecting on the past few months and the challenges he faced at the start of the pandemic, Mabena reckons that the biggest problem alongside fear was a lack of information.
“The real problem was that we were all just hearing rumours and then spreading those misinformed rumours [among] each other. Once we were given more knowledge, that started to die out.”
During a recent workshop at the hospital he was asked to share a bit about his experiences while working in the pandemic. “I got up and said one or two words and after that, people were volunteering to come and work in the Covid-19 ward,” he said proudly.
One of the biggest lessons he has taken from being on the frontlines of the pandemic is the importance of playing your part.
“There is a lady who worked at the hospital, and she refused to come to work. She was later diagnosed with Covid-19 and it was her colleagues who had to treat her. That just made me realise that we should guard against making decisions that could work against us in the future,” said Mabena. DM168
There is a lady who worked at the hospital, and she refused to come to work. She was later diagnosed with Covid-19 and it was her colleagues who had to treat her. That just made me realise that we should guard against making decisions that could work against us in the future.