Plight of medical technologists during the pandemic
From outside, collecting samples from patients may look easy. In reality, there is tremendous work pressure, staff shortage and constant exposure to the coronavirus
Working at the coronavirus ward of a hospital for prolonged hours can be frightening. At times while swallowing, you feel as if the virus is entering your body.
That is what medical technologists, one of the frontline service providers along with doctors and nurses, sometimes experience these days.
"I feel uneasy to breathe, and while swallowing, it feels as if Covid-19 is entering my body through my own saliva," said Farhana Fahmi (alias), a medical technologist who collects samples from suspected patients and brings them back to the lab for testing. She, however, declined to name her workplace because she is not authorised to talk to the media.
Just like other ordinary days, these technologists have to go to the office every day. But this is not an ordinary time – the coronavirus has already infected over thirteen thousand people in the country and killed 214 as of May 9.
From outside, the work of a medical technologist may look easy. In reality, there is tremendous work pressure, staff shortage and constant exposure to the coronavirus.
Fahmi comes to the office by 9am and by 10am, she is out to collect samples from patients' houses, hospitals, and morgues until 5pm.
"When the virus first broke out here,we did not have to go out to collect samples,' said Fahmi. "However, after March 18, when the first victim succumbed to death, our workload drastically increased."
The Institute of Epidemiology, Disease Control and Research (IEDCR) first released data on infections in Bangladesh on March 8. The first death was reported on March 18.
When the infection started spreading, medical technologists had to work 15 to 16 hours a day without any weekly days off. Later, in the face of their demand, new staff was hired to reduce the duty to 9-5, shared Fahmi.
The Public Service Commission (PSC) recently appointed 2000 doctors and approximately 5,054 experienced nurses. However, hiring of medical technologists was not considered.
Currently, out of 7,920 posts for medical technologists under the department of health, only 5,184 are on the roster. The remaining posts are yet to be filled.
"The government can easily hire new people and reduce the workload of medical technologists," said Habibul Islam (alias), a medical technologist at the field-level.
"The World Health Organisation (WHO) standard requires three nurses and five technologists for every doctor," said Islam. "In this light, our workforce is almost negligible."
In the early days of the outbreak, there was no official transport for medical technologists for collecting samples. They would hire CNG auto-rickshaws or Uber cars.
"By the time we were using office vehicles, people already knew about the coronavirus. So wherever we went, we had to endure some sort of harassment. When people saw our car, they would cry out loud, 'the corona is coming, the corona car coming' and gather around us, firing questions."
According to Fahmi, people providing their swabs face even more harassment. "One time, after we took samples from a residence in Dhaka, the house was locked from the outside. But with the gentleman lived his mother, a diabetic patient who needed regular check-ups. Later, the report came back negative."
"A new problem has arisen in recent times", said Habibul Islam, adding, "Patients raise questions about the quality of our Covid-19 test. This started after some samples got rejected for being collected without proper procedure in Sylhet. These were collected by immunisation staff appointed by the government on an emergency basis. They were trained for one or two days via video conference."
"It has been close to 12 years since permanent staff was hired in this sector. Even in this crisis, authorities are trying to get things done by unprofessional workers. Naturally, they are making mistakes and we are bearing the brunt. The saddest part is that representatives of medical technologists are not seen in the team during the district based discussions on the pandemic with the government," he said.
Like any other frontline service providers, medical technologists are also going through physical and mental stress. Sometimes they need to wear Personal Protective Equipment (PPE) for long hours and do not get a chance to drink or eat.
They witness patients who are suffering from severe shortness of breath. And out in morgues, while collecting samples from the deceased, it is a particularly nerve-wracking situation.
"Prolonged use of PPE causes profuse sweating. The most annoying thing is when sweat trickles down the forehead and blurs the eyes. But you cannot wipe them,"Fahmi said.
"Still, when I see coronavirus patients trying to take care of themselves alone, my suffering feels much less compared to theirs."
"Sometimes Covid-19 patients gasp for air due to breathing difficulties. It cannot be explained to those who have not seen it. When I see such a patient, I feel like if I could just breathe less and share some of it with that poor fellow!"
"During those times you do not fear getting infected, or feel that you are simply doing your job,' Fahmi added sadly. "You know, when a patient dies after we collected his/her sample, everything feels meaningless. A minute ago s/he was here, and then gone – just like that."
Fahmi compared the experience with that of a nightmare. "Their faces haunt you whenever you are alone. It needs a lot of motivation to continue what you are doing."
So far, 7 to 8 of Fahmi's co-workers have been infected with the coronavirus. A number of them could not stave off the infection despite taking extreme precautions, including wearing N95 masks.
"We are unable to quarantine ourselves due to shortage of staff," said Shahana Shirin (alias), another frontline medical technologist. "Though, WHO guideline explicitly states that any person coming in contact with an infected patient must be quarantined."
Shirin said her family members and neighbours are at risk of getting the infection due to her not being able to stay away from them. She anxiously added that contractual employees of government projects and private hospitals did not have health insurance. Only the permanent staff, employed under the government revenue sector, have health insurance coverage.
Fahmifinds it difficult to de-stress. Sleep almost never comes or comes in a drowsy form. Still, one needs to hang in there.
"In my spare time, I listen to music, watch movies, read poetry to forget these experiences, if I can forget something," Fahmi said. "I did not tell my parents that I am working directly with Covid-19 patients, because they would then worry and ask me to quit my job. But I cannot ignore my responsibility, not in this grave time."
WHO has repeatedly urged to ensure the safety of health workers. Otherwise, safety of others will remain at risk.
Bangladesh Medical Association (BMA), one of the central professional organisations of doctors, has kept a log of infected doctors, nurses and other health workers. The account is, however, not up to date.
According to the BMA, 881 health workers had been found infected with the coronavirus as of April 30. Among them, 392 are doctors, 191 are nurses and 298 are other health workers.