Xolisa Peters*, a nurse at Cape Town’s Tygerberg Hospital, says she prays more now, during the coronavirus outbreak, than she did before.
Her drive to the brown-bricked building in Bellville in Cape Town’s northern suburbs is quiet and reflective. She doesn’t know if this shift at work will make her a statistic.
Peters works in the paediatric ward but, although this is far removed from the areas of the hospital treating Covid-19 patients, she’s not unaffected by the Western Cape’s exponentially increasing number of positive cases.
Public-sector workers unions say about 150 staff members at Tygerberg have tested positive for the coronavirus to date.
“We’ve had so many nursing staff either testing positive or currently in quarantine that I can arrive at my ward this morning and then be asked to go work in another ward that has Covid patients. I have to mentally prepare myself every day,” Peters says.
Although she’s not borne the brunt of the outbreak just yet, being on the front lines of the medical response is starting to take its toll on the 30-something nurse. “You only have so much mental energy to deal with so much every single day. I will never refuse an assignment; I will always help. But you reach a point where you just feel exhausted…
“Every day as I get in I ask: ‘Is this the day where there’s an explosion of patients with flu-like symptoms? Will there be enough staff?’ It’s very frustrating not being able to prepare your mind before work because you just don’t know what is going to happen.”
Another nurse, who only wants to be identified as Sister Asanda, works in Tygerberg’s Covid intensive care ward, the epicentre of the medical response in the Western Cape, if not South Africa. She details the mental strain of working in the hospital that is considered the ground-zero of treating coronavirus patients.
Here doctors and nurses are forced to place patients under ventilation as a last medical resort. Many don’t survive. The staff here deal with death every day.
“It is very stressful. One of my colleagues in my ward just tested positive. It’s very difficult, but we need to support each other. We have some people who’ve become hysterical when they found out one of their colleagues is positive, especially since we’ve had staff in this hospital die already,” says the nurse, who has 16 years of service.
Of the six healthcare workers in the Western Cape who have died from Covid-19, two were working at Tygerberg hospital.
Two weeks ago, trauma nurse Anncha Kepkey died after contracting the coronavirus. Sister Asanda says she knew Kepkey since the time they studied together. On Kepkey’s social media profile, her picture is bordered by a frame that reads, “I can’t stay home, I’m an essential worker.”
“I was broken when I heard that news. She was a wonderful person. We lost someone who was hands-on and dedicated,” Asanda says.
“Nothing in our training prepared us for this. I’ve done my four-year course, I did ICU [intensive care unit] training, I did primary healthcare [and] I have experience in dealing with infectious disease, but this is not the same.
“We’ll usually have at most two patients with a serious infection, but now it’s a whole ward of the same thing,” she adds.
Sister Sylvia Makamu also works in the paediatric ward at Tygerberg hospital. She was among nurses picketing outside the hospital earlier this week with the support of trade union The National Union of Public Service and Allied Workers.
The union is calling on the hospital management to ensure that nurses are protected with personal protective equipment, and ensure health workers are tested after coming in contact with a positive case.
Makamu said she wants to be tested, although she’s not showing symptoms, because it will put her mind at ease.
“There are children who are Covid-positive in my ward. I don’t feel safe. When there are staff shortages, I get posted to wards where people are in quarantine, awaiting their test results.
“When people come back tested as positive, I don’t get to be tested if I don’t show symptoms, and that worries me,” Makamu says.
Western Cape Health authorities admit the outbreak in the province is now beginning to affect health workers. It is a pattern that has been seen around the world. As more people need medical attention, more staff are affected themselves.
“All over the world, the human resource system becomes affected and overloaded. We have to prioritise healthcare workers. Almost half of the staff in the province who have been affected have already recovered,” says Western Cape health MEC Nomafrench Mbombo.
Testing workers suspected of being Covid-positive is a priority, says Mbombo, but this is taking place at the expense of other people, who now have to wait longer.
The psychological effect of the outbreak has also been recognised. The department wants to prevent fatigue and a drop in morale.
The head of the Western Cape department of health, Keith Cloete, says the department is regularly meeting with labour unions to brief them on the plan to fight the virus.
“The anxiety is not about policy. The anxiety is people feeling tired and anxious. We [are] backing that up with support [for nurses] and we may need to bring in more psychosocial and psychological support,” Cloete says.
*Not her real name