CABAR.ASIA
"The administration said we were at 'war'"
How health workers of Kazakhstan fight Covid-19 pandemic
By: Zulfiya Raisova
Since Kazakhstan declared pandemic, over 46,000 health workers have been involved in the fight against coronavirus. As of September 23, 2020, 13,139 health workers had been infected with Covid-19, which is 22 per cent of their total number. 198 of them have died.
Bayan Ospanbayeva,
director of unit No. 5, Children's City Clinical Infectious Hospital of Almaty
- It was very scary. They warned us if we did not have enough beds, our unit would be used as a place for coronavirus patients. Every day I thought, "Please, not today." I was so scared. And then we had the news that we would open for Covid patients. All pregnant women and doctors of pre-retirement and retirement age were sent to another hospital, while young people remained in the infectious hospital. We were living in a hotel. I have been living here for six months and I have not seen my family since then.

For a week or so, we worked with contact patients and our fear disappeared. But then our workers got infected one by one. Then, our fear got back and it was even scarier. Then, it was decided to close down the hospital to stop the infection and the number of patients increased every day – we all were closed down for lockdown.

We were on lockdown at a hotel for two weeks, we were undergoing medical tests every week and new cases were identified all the time. My husband, my doctor got ill. It was a big blow for me at that moment. Moreover, another doctor who assisted me became ill. I was left alone and then two surgeons started to assist me.

After my self-isolation period, seriously ill patients were admitted to the hospital. It was a scary picture as they were all with wounds and sutures. My first thoughts were that I could not do it and I needed to refuse. I was frightened. When I was a student, I saw such wounds so I chose to become a paediatrician. It means that I assessed my capacities reasonably and I knew I could not work with patients with surgical wounds. However, the two surgeons that assisted me helped me to get over my fears.

It was difficult emotionally to overcome this as I did not see my children, my husband was ill, and we received seriously ill patients every day.
I expressed my emotions with tears after work. Sometimes, I did not even have energy to cry because I was so tired.
Bayan Ospanbayeva
director of unit No. 5 of the Children's City Clinical Infectious Disease of Almaty
In three weeks, I was again put to quarantine as the two surgeons I worked with got ill. I was again afraid of getting ill, but thankfully no coronavirus was identified in me within two weeks. Two weeks later, we again started working with my team.

Now the situation has become stable, whereas at first it was difficult because we did not know how to treat, everyone was in a rush, we did not have enough medications, we did not have food, and it was a peak of the disease. Now we know what we deal with. In the beginning, the people did not want to believe, although we did everything to the people, but they made us guilty and thought we were in a global conspiracy.
When people learned their diagnosis, they reacted grievously, especially when the infection was treated for a long time. It was difficult to tell they were positive for the infection; it was hard to tell the infection could not be treated for a long time; it was hard to know that the patient you treated deceased; it was hard not to see your family for a long time.

Once, when I spoke to my kids, my tears were just running down my face and my daughter asked me, "Why are you crying? Don't cry". I could not explain to my kids about the coronavirus as they were small, and I said that I was at work treating people and that I needed to help them.
Kerimbek Bakdaulet,
surgeon, Nur-Sultan
- I lived in a hostel, and I wasn't at home and didn't see my family for two months, I talked to them only by phone. We didn't contact anyone, we lived only in the 'work-hostel-work' mode.

I used to work at a multiprofile hospital and then we were said we would be working with coronavirus patients. They taught us how to treat patients within a short time. Infectious diseases is a totally different profile for us, it's something new, and you don't know how to treat them correctly as you don't have a unified treatment plan. Once I started working at the infectious hospital, I was scared that I could get ill myself and could not get back home.
When we started working, the administration said we were "at war". We knew we could die. At the same time, we realised: who else but us? If now us, then our people, our country, our relative might die.
Kerimbek Bakdaulet
Surgeon
So, we pulled together and started working. At first, it was very difficult and unusual to work in this coverall – it was very hot, we lacked air, goggles fogged up and you cannot see anything.

We were told to change the coverall every three-four hours, and we changed it every six or even eight hours just because we did not have enough time. People continued to get in. and you don't even notice how time flies by.

Seriously ill patients were admitted and some of them needed to be taken to the intensive care unit, which was full. What could we do? We did the following thing: we put patients to the intensive care unit for two or three hours as we did not have free beds there.
Everyone was crying in the polyclinic – not only doctors, but also technical staff, as they could not work anymore. All we had to do was to calm them down. Coronavirus patients are different, I haven't seen or treated such patients before. They had a psychological trauma as they were afraid of death. They were always nervous and aggressive. However, we were warned about that during training.

We not only treated them, but also provided counselling. In particular, women and girls were crying, having hysterics and even attempted to escape from the hospital. But we calmed them down and encouraged them as best we could. We said everything was going to be ok.
We did not have time to eat; sometimes we left the unit in turns with other doctors. We always tried to get enough sleep, as we knew that sleeping was very important. We slept whenever we had a chance to sleep. During breaks, we were constantly reading new information about treating of coronavirus infection in foreign sources. We were fully involved in the fight against this disease and tried to get prepared ourselves to any outcome. Now, the situation is stable and our hospital was closed down as there were no more patients, doctors were placed on leave and the hospital is being disinfected.
We all need psychological rehabilitation now. I think we need it badly as what we have seen is a real war. We've seen death every day, worsening of patients' condition, just like during a war.

People you knew were dying every day. Many of our teachers have died, they are the health workers we will never see again.

Saltanat Azanova,
general practitioner, Kostanai


(real name was changed at her request)
- I am very tired. I work in a red zone. The polyclinic is divided into red and safe zones. People with infectious diseases are placed into a red zone. They do not let you in the safe zone after you've been in the red zone. At first, I worked with regular patients, and when one doctor asked to help her with coronavirus patients, I did so because she always helped me. I thought why not help her if she asked me to help. I was ready to work altruistically, and then I did not even know they would be paying us for that.

I went to help her as my working hours were from 8:00 till 18:00. It was very difficult to work for 10 hours a day. At first, two doctors were receiving patients, then three, then four, and the number of health workers was increasing gradually as we did not have time to treat.

My record was 64 patients a day. I received and examined them, and I referred them to diagnostics, when needed. These were mainly adults, and I personally treated only three children. Our rate per hour was increased, and the Fund for Social Medical Insurance paid us extra 212 thousand tenge (498 dollars).

I was not afraid as I already recovered from the disease. My relatives still worry about me, but I can do nothing as this is my job.

There have been many sick people. They do not know how to treat and believe all media posts. The state had better control these posts than other things.


They drink everything and then come and say, "Horseradish did not help, what should I drink now?" They impair their stomach first and then have acute gastritis. Also, we have patients who have inhaled baking powder solution. One man nearly burned his respiratory tract. Then he said, "I felt bad afterwards, I won't do that again, that's why I came here."

When it was the third week, I had eye twitching after those stories of self-treatment.

This is the fault of our state, to some extent, as it makes antibiotics available for sale and people just go and buy them. Once they have complications, they have to visit a doctor. They come and tell about their peculiar symptoms, but in fact the disease has the same course in all people. It's just that some recover quickly and others longer.

Photo: pikabu.ru

We enter the policlinic in the morning, put on our anti-plague suits, boot covers, gloves, hats and receive patients in this equipment. One nurse assists one doctor.

Some patients come to me and say, "Oh, it's you again." I have always wondered how they recognise me as we all look the same wearing all these suits. Then I realised that they recognised me because of my glasses.
During the follow-up visit, I ask them about their health and ask to remind me what I prescribed them. They say, "Nothing." I tell them, "It's a good course of disease. Keep on not taking any medications."

Those who visited me properly and I prescribed nothing to them, they recover faster.
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