Dr. Alok Roy, Chairman & MD, Medica Group of Hospitals
Speaks about security of HCWs, resilience and the way forward now
The video is a detailed account of a conversation with him. Below is an excerpt…
Over the last 15 months, the pandemic has gripped the nation and this has inflicted stress and trauma on healthcare workers. What are some of your observations in this regard?
The situation on the frontlines is akin to a war being fought with syringes, masks and sanitizers. The biggest weapon that we have against the pandemic, however, is the courage of the frontline workers.
I familiarized myself with the mental health distress that healthcare workers were facing elsewhere in the world like the UK and US. Yet in my experience, Indian HCWs have shown greater resilience in harsh situations. In the past months, HCWs have seen tremendous workloads, low pay, criticism and blame from patients and their families, and even physical violence. Still, they successfully delivered world class care in India wherever possible, in a timely manner. Since the healthcare force is supported by their peers and families, it indicates that our society is also equally resilient.
Patient overload, infrastructural gaps and personal life balance are the 3 concerns for most HCWs. What approach has Medica Hospitals adopted to deal with these?
The first step we took was to make infrastructural changes. As PPE kits are bulky, air conditioning was necessary across all rooms in hospitals. Experts had to be consulted on airflow dynamics, which were previously unknown. Investment in air conditioning, power strengthening, exhaust mechanisms, cabling, and associated sections were made rapidly as more and more patients got admitted.
Protecting the health of workers is the only way to ensure further patient care. To protect our staff, we rented rooms in nearby hotels. This ensured that employees were at the lowest risk of infection possible, and did not have to travel across lengths of a city. Many managerial adjustments had to be made for such cohort living. Social distancing was enforced strictly and training had to be disseminated. It was challenging to work on these fronts, while simultaneously treating dozens of patients each day. However, we learnt and improvised each day.
How was your experience tackling very stressed customers?
The stress and worry that was observed in COVID-19 patients during the first wave was completely unprecedented. They were also aware of multiple other COVID patients dying each day, which added to their anxiety. While doctors and professionals did their best to manage their fears and exhaustion, the same could not be expected from scared patients. Most patients’ families held little hope for recovery, as the statistics were not encouraging, but we received a lot of appreciation whenever a patient went home well, as it was considered a miracle.
NATHEALTH’s survey showed that 65% of elective surgeries have been deferred since last year. What changes can we make to ensure that care for non-COVID patients is not deprioritized in a similar fashion again?
The pushback that is causing low elective treatment is the sense of fear. This is concerning for professionals, as some people with conditions like cancers, kidney diseases can become seriously ill. There are numerous non-COVID conditions that cannot be managed effectively at home without professional expertise. The detriment to the health of non-COVID patients is a collateral damage of the pandemic.
Having said that, hospitals have amped up their patient handling capacity very well and can accommodate more patients than ever before. Many hospitals are very well equipped to safely handle patients of other non-communicable diseases. Additionally, some doctors’ expertise was not required when hospitals were exclusively dealing with COVID patients. These professionals are well rested to continue the fight against regular NCDs. As patients’ hesitancy in approaching hospitals ends, we can tackle these diseases.
As a nation, what is a key lesson from the 2 waves that we need to carry with us?
Healthcare delivery cannot be the responsibility of just the government or the private sector separately. The pandemic has highlighted the centrality of a PPP approach to medicine. All stakeholders must work together in sync, instead of trying to claim distinct territories. Mutual understanding and regular interface are key to good private and public partnerships. Seamless collaboration is desirable beyond tiding over this pandemic. India’s healthcare status has never achieved an ideal standard, but a PPP approach is a good step towards great improvements. Poor collaboration leads to governments distrusting the private sector and vice versa. Patients’ health is compromised due to such distrust in the system.
What are some precautions that HCWs can take to protect their children?
One concerning fact is the presence of a small minority of healthcare workers who are not fully vaccinated till now. It is imperative to get vaccinated in order to protect yourself and others from COVID. Second suggestion is to not be complacent. Lowering your guard by not using PPE kits and masks properly can make workers and their children vulnerable to the virus.
How can we create a safer environment for healthcare workers, especially in light of violence against HCWs?
There are few practicalities that can be adopted as safeguards. Some precautions include ensuring presence of security staff near COVID wards and functional CCTV cameras. It is important to video-record instances of violence and physical assault for proper evidence. Hospitals should develop a relationship with nearby police stations to easily ask for aid when required.