To the one fighting against all odds: Doctors Without Borders

Currently working in Bihar at a Covid-19 treatment centre, Dr Nimrat Kaur, Regional Deputy Project Coordinator - Asia at Medecins Sans Frontieres, also known as Doctors Without Borders, has been treating patients under harsh, often unhygienic and overcrowded conditions, where their access to healthcare is already compromised.

IANSlife spoke to the doctor to find out about the ground reality and conditions of the doctors there, the impact of the pandemic on healthcare workers and how she and her team from keep themselves safe. Doctors Without Borders is an independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare in over 70 countries.

Read excerpts:

Q: What are the risks you face while treating COVID-19 patients and how you protect yourself?

Kaur: It is a very confusing time for a lot of people. I am here in Patna with the objective to help people cope with a complex and difficult situation and to offer them dignified and humane treatment as well as adequate medical care based on Doctors Without Borders experience of working in emergencies across the world.

The patients when they come here at first are scared and stigmatised based on what they have been hearing in their communities of the state of treatment centres/healthcare systems. We have seen patients across all age groups, ranging from 15 to 65 years of age. Once they see the facilities available, they are calmer and receptive to the treatment.

Protecting healthcare workers and ensuring that the medical staff does not fall sick is very essential for the project like this. We have ensured that infection prevention and control measures are in place, creating isolation areas, and using personal protection equipment at all times. For MSF, safety is a priority and this project is no exception -- which means we have all the necessary PPEs and all staff have had training so they know how to use it.

Q: Tell us about a Covid-19 case which has stayed with you.

Kaur: I have first-hand seen how Covid-19 impacts an entire family and not just one person. Many of the patients I treat live under harsh, often unhygienic and overcrowded conditions, where their access to healthcare is already compromised. I had this patient who lost her partner and before she could mourn the loss, she was rushed to a hospital because the whole family, including children, were tested positive. She started developing symptoms and was being treated but everyone could see how difficult it was for the children to see their mother now fighting a disease which took away their father.

To receive treatment for a disease that has enough stigma and fear enveloping it, while you grieve for an immediate loss can be extremely traumatic. While we provide medical care, psycho-social support is an integral part of every treatment. Because of my training, I am able to listen and sympathise because we know what it's like. Being able to talk like that, to cry in front of people who understand what you're experiencing, is really important. It helps you know you're not alone and gives you the strength to keep fighting.

Q: How do you cope with the pressure?

Kaur: When I heard about the opportunity to volunteer in Patna, my first instinct was: I trained for this and I want to be on the frontline for this. This is probably never going to happen again in my career. I think for most medical staff, this personal struggle to help and to stay safe so that their families don't worry causes more anxiety and fear than the actual management of the virus.

We're trained to manage the illness. But what has been discouraging or rather difficult to see is the discrimination frontline workers faced across the country. You see them working to the bone because they know it means life or death for their country people.

Q: How is the pandemic affecting the frontline workers?

Kaur: The first step in tackling an outbreak like this is the protection of frontline staff. Without them, we couldn't respond to the pandemic. Thousands of them are falling ill across affected countries, so having an adequate supply of PPE and keeping them safe and free from infection is key. Additionally, we have to be empathetic. People are risking their lives, not just medical staff but even the non-medical staff like hygiene workers, technicians and others on the frontline, to ensure they can save as many lives as possible.

We are working at least 12 hours a day wearing PPE -- we know it's a vital protective gear, but it's not easy to function in these as, in even breaks, we cannot go to the washroom, cannot drink water, cannot eat, cannot sleep, and mostly soaked in sweat. It is quite difficult.