Oman’s brave doctors taking care of mentally challenged COVID-19 patients

Story – Ali Al Badi, Gautam Viswanathan

Many of us are finding it hard to handle our current state of enforced isolation. Look outside, at the park that’s just opposite your street, and you’re likely to be filled with a desire to escape your home and do something as simple as take a walk.

It’s the simple pleasures in life all of us miss right now. Catching up with friends over a cup of hot karak tea, meeting your extended family over the weekend. Those, however, will have to wait for the greater good, and while we are waiting, let all of us be thankful that many of the facilities we take for granted are still operating as they should be, during these uncertain times.

What we speak of here is not the supermarkets that have decided to stay open so that we’re able to continue buying our basic necessities. Nor of the restaurants that continue to prepare food for us so that we may enjoy some of the pleasures still available to us, as well as help feed our children and families.

Most of us are fortunate to have the mental awareness and physical ability to perform our everyday functions and far more complex tasks with relative ease. For us to have all of our faculties in full working order makes us very lucky indeed. There are, however, that are not as blessed as we are.

As is the case around the world, many doctors and nurses in Oman, all of them dedicated and hardworking professionals, continue to provide COVID-19 patients in the country with the urgent and necessary medical care they require.

At Al Masarra Hospital in Muscat, a separate team of medical professionals, though, continues to look after mentally challenged patients infected with the coronavirus. These doctors selflessly provide regular care for these patients, so that they can once again learn the skills they require to chart out the world we live in.

Dr Amina Al Ghamari oversees Unit 2 of the COVID-19 treatment ward at the hospital. One of two units set up to treat patients at Al Masarra, Unit 2 treats female patients, while the other – Unit 1 – has been reserved for males. The hospital received its first case of coronavirus on March 19, 2020.

“Panic rose among the members of the medical team in Unit 2 which consists of 14 nurses and seven support staff, all of whom are females,” she admitted. “They were afraid because they were not sure how they’d be able to take care of their husbands and children at home, if they were to take care of these patients. They were worried about entering their homes, because of the possibility of infecting their young ones and other family members.”

To educate the community at large, the nurses at Al Masarra took it upon themselves to make videos on practising proper hygiene for themselves and their families, and broadcast these on social media, so that they could reach as many people as possible. These videos also included instructions on how to wear masks, gloves and other personal protective equipment (PPE), where necessary.

“We actively began looking for solutions to provide care for families, so that they would be put at ease and would be able to accept these women back into their homes, without fear of infection,” said Al Ghamari. “What we found worked really well in assuring them were the videos we took of us putting on our PPE before dealing with our patients.”

However, while it was relatively easy for these medical professionals so set up physical barriers to block the spread of COVID-19, many were afraid of the impact it had had on their mind, particularly when patients infected by the disease were first brought into the hospital. The virus continued to haunt them while they slept, and severely impacted the healthcare workers’ relationships with their families.

“One of the main challenges our teams faced were the nightmares they encountered while asleep, after their shifts,” said Amina Al Ghamari. “They also felt they had some of the symptoms of COVID-19, particularly coughing, sneezing, headaches and temperatures.

Fortunately, all of the doctors, nurses and support medical staff were there to support each other, and it helped many of them overcome their initial trepidations about working with these patients: the whole is, after all, sometimes greater than the sum of its parts. A WhatsApp group that included all of the hospital workers was also set up to provide assistance to these medical professionals. Caring for patients, though, is taking its toll on them.

“I receive calls from the hospital, even at midnight that require me to ease the tensions faced by our medical teams,” she added. “I am a mother and I have children, but I am trying to be stronger than others to be the ideal person for everyone so that we can easily overcome this period together. We’ve actually learned a lot from this pandemic, including dealing with panic-causing situations, pressure and facing challenges as one. We’ve also learned how to deal with our children during times of crises.”

Taking care of COVID-19 patients is challenging, given the health risks involved, but Dr Amina and her team take the responsibilities towards their patients on a different dimension. The mental disabilities they suffer from mean they cannot fully grasp what is going on around them, and it makes it difficult for them to understand that the doctors and nurses around them are there to take care.

An extremely cautious approach is required while dealing with them, because these patients do not know that contact with the medical staff on the premises can lead to the spread of infection. Fortunately, however, none of Dr Amina’s team are suffering from COVID-19. There are, at the moment, three patients receiving treatment for the disease inside Unit 2.

“We face many challenges related to mental and psychological health from our infected patients,” she revealed. “This does make our mission to care for them harder, as compared to other hospitals that are housing COVID-19 patients. Our patients unfortunately suffer from nervous agitation from time to time, and it is difficult for us to provide care to them when they are in such a state. We need to take care of them for a period of 14 days after they’ve exhibited no symptoms of the disease.

“We then talk to them to calm them down, or if they are very agitated, give them tablets to ease their discomfort,” she explained. “It is sometimes difficult to provide them with food and drink if they are in a non-cooperative state.”

Another challenge the medical staff face is the effect of wearing PPE throughout the day. While necessary, wearing this for long periods of time does have unwelcome effects on the user’s skin. “One of the difficulties the medical teams face is wearing the mask and gloves for six consecutive hours during the day and ten consecutive hours at the night, because this causes redness in the face, contraction of the facial muscles, sensitivity in the hands, fatigue, and exhaustion,” explained the doctor. “However, we realised that we needed to stick together during a time like this and are helping each other through it.”

A colleague of Dr Amina Al Ghamari, Dr Preeti Srivastav serves at the Head of Department of Medicine at Al Masarra Hospital. To treat the patients in her hospital required adjustment of the treatment methods used in other hospitals, because of their unique condition.

“The difference between our hospital and the patients in any other hospital is that we have mentally challenged people here,” she explained. “Any other hospital would have patients who would follow your instructions. If, for example, you tell them to stay inside or not do something, they will listen, but our patients are very different and this is a big challenge we have.

“With regards to COVID-19, all the hospitals in the Sultanate were asked to prepare themselves, so we do have separate male and female wards, which were in accordance of and met the specifications of the Ministry of Health,” added Srivastav. “The staff who’ve been posted to these wards were initially very, very apprehensive and afraid, because this is a virus that has caused many deaths, but I have in the past been part of teams handling H1N1, MERS and SARS, so I have worked in the intensive care units under such conditions. We are the frontline units against such infection, so the hospital readily provided us the required protective equipment.

She went on to say, “I used to personally speak to the teams in these wards and ask them to approach me if they had any problems, and we also employed our psychologist to debrief them and allay their fears. We have been in constant touch with the doctors in Al Nahda Hospital for regular updates. We know that what we have to do now is protect ourselves from this disease, so I ask everyone to follow the practices of social distancing and washing their hands so that all of us stay safe.”