The plight of patients as coronavirus soars

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NOBUKHOSI Ndlovu’s mother Nomaqhawe, 47, had always struggled with acute asthma, characterised by shortness of breath, chest tightness, coughing and in most serious cases, wheezing.

Last week on Monday she suffered a sudden asthmatic attack while watching television with her eldest daughter and three other children — Nomazulu, 21, Nomathemba, 16, and Nomusa, 4.

“We thought it was the usual attack and we immediately gave her an inhaler to stabilise her breathing. However, the attack worsened to a point where she was wheezing and running out of breath,” Ndlovu, 26, said.

Wheezing is a whistling noise that occurs when the bronchial tubes, which carry air to the lungs, narrow because of inflammation or mucus build up and is most common in people with acute asthma.

“We then decided to take her to the hospital and we called an ambulance but after an hour or so the ambulance hadn’t shown up. We then asked for help from a neighbour who used his car to drive my mother and I to the hospital.

“This was around 9.30pm and we first went to a local public hospital in Bulawayo where we were turned away because we could not produce a certificate to show that my mother did not have coronavirus.

“We drove around Bulawayo trying to find a place where we could get her admitted, but we were turned away at all the places we went to because they suspected she might have coronavirus yet it was just asthma.

“Even after presenting medical documents to show that my mother had always suffered from asthma, hospital administration staff were sceptical and insisted on a coronavirus test,” Ndlovu said.

Confused and out of options, Ndlovu, who did not have the US$80 required for a private Covid-19 test, decided to go back home with her mother, who sadly died in the early hours of Tuesday.

“It’s so devastating that my mother died when her life could have easily been saved. Because the hospital personnel were so scared that she might have coronavirus she ended up losing her life. I’m now left with my three siblings and I don’t know what we are going to do and how we will survive,” said Nobukhosi, whose father was stabbed to death two years ago in Johannesburg, South Africa.

Ndlovu’s story resonates with many other patients and families who have lost loved ones after being turned away from hospitals because they either do not have a report to indicate that they are Covid-19 negative or because they have symptoms which suggest that they could have the virus.

Senior Hospital Doctors Association (SHDA) secretary general Arron Musara told the Daily News on Sunday that lack of personal protection equipment (PPE) was the major reason why both public and private hospitals were turning away patients.

“Patients are being turned away because health personnel do not have adequate PPE to attend to Covid-19 cases or suspected Covid-19 cases. This is why we tried to engage the government to avail adequate PPE, but it has failed to do that.

“When it comes to public hospitals, the situation is worse because nurses and doctors are currently on strike over PPE and salary issues. Even if the patients were to be admitted chances are there will be no one to treat them. In private hospitals, the challenge is also unavailability of adequate PPE,” Musara said.

Senior doctors and nurses have been on strike over lack of Covid-19 PPE, poor remuneration and unavailability of medicines and medical equipment.

“We have not had any communication from the government with regards to negotiations for doctors to return to work. Doctors are currently sitting at home. Some who were exposed to the virus are self-isolating at home. There is a lack of political seriousness to address our challenges,” Musara said.

He added that there was a need for the government to meet its obligation to avail PPE in order to avoid unnecessary loss of life.

“The government has received numerous consignments of PPE and it is not clear where these items are going. There is nothing that is stopping the government from availing adequate PPE in public hospitals and there is also nothing that should stop the government from donating PPE to private hospitals who are also struggling to acquire it.

“We have written to the government advising it to donate some of the PPE to private hospitals because acquiring these items is an additional cost that ends up being passed on to the patients or just being completely avoided thereby resulting in patients being turned away,” Musara further said.

Asked how the government could donate PPE to private hospitals when it has failed to supply public hospitals, Musara said the government had the capacity to avail PPE to both the public hospitals and private hospitals, given the donations that it has received.

“The government recently directed that hospitals should set up patients under investigation zones. This is a good idea which can enable patients to be tested before they are admitted and it eliminates the challenge of having patients being turned away.

“However, the zones have not been set because it comes with additional costs that both the private and public hospitals cannot bear given the current economic environment,” he said.

Community Working Group on Health (CWGH) executive director Itai Rusike also weighed in, saying that patients were being turned away because medical personnel, who have inadequate PPE, are afraid of getting infected with the virus.

More than 300 healthcare workers have been infected with the killer disease since the country recorded its first case in March this year.

“It is not that the hospitals and clinics are overwhelmed with Covid-19 cases and there is no time for other health conditions. However, because of the coronavirus fear, the health staff in our hospitals and clinics are extra worried about their own safety as there is a huge shortage of personal protective equipment for frontline health workers.

People coming to a health facility with a cough or fever are regarded suspiciously.

“The country’s health response must prevent stigma and discrimination. It should promote health seeking behaviour instead of turning away patients due to the non-availability of Covid-19 test results as this may erode the gains achieved over the years in various health programmes such as HIV and AIDS, TB, malaria and sexual reproductive health programmes,” Rusike said.

Rusike further said the time was now for the government to strengthen the role of community health workers in Zimbabwe in order to assist in the fight against Covid-19 and to respond to the immediate needs of non-Covid-19 patients

A community health worker is a member of a community who is chosen by residents or organisations to provide basic health and medical care within their community, and is capable of providing preventive, promotional and rehabilitation care.

“As Zimbabwe grapples with Covid-19, community health workers (CHW) can provide a critical first line of defence and response to keep people safe and healthy. Community health workers can help diagnose, track and stop local outbreaks while providing essential health services as trusted sources of information for community literacy on Covid-19.

“The CHW should be valued, acknowledged and appreciated and provided with incentives such as improved allowances that are paid on time, tools of the trade such as bicycles, uniforms, medical aid kits, provision of personal protective equipment and their numbers should definitely be increased as some of them are now covering huge catchment areas due to their low numbers,” Rusike said.

He added that there was need to create a budget in the Health and Child Care ministry budget to support CHWs instead of the current situation where external partners are being overburdened to support them.
On its part, the government has issued a stern warning against hospitals turning away patients who cannot provide Covid-19 test results.
“As I have said in the past it is not government policy that patients should be turned away when they do not have Covid-19 test results. All hospitals should be able to admit patients whether they have or do not have the test results.
“The ministry has also directed public and private hospitals to establish patient-under-investigation (PUI) zones to ensure that no patients are turned away,” deputy Health minister John Mangwiro said.
“The government is also committed to dealing with health workers’ grievances and will soon engage them to find a way forward.”

The plight of patients
as coronavirus soars

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