Our Doctors – Warriors in the battle against the dual pandemics and beyond

From EMA archives

I wish to start by applauding the Ethiopian Medical Association for having taken the initiative to celebrate a national doctors’ day each year, which is observed for the fourth time on July 2, 2021. Quite deservedly, this is a momentous occasion when the association, partners, and beneficiaries recognize the Ethiopian doctors for their unfathomable dedication and stupendous contributions against multiple and profound challenges they often encounter. This year, unlike any other, we all recognize that the occasion is celebrated amidst the Coronavirus Disease (COVID-19) pandemic, which has brought immense challenges and pain for so many, including for our doctors who, along with the other fellow healthcare workers in the frontline, bear the brunt of the problem.

As has been emphasized by so many, the COVID-19 pandemic has affected every individual on the surface of the earth and has caused mass trauma on a larger scale than World War II (1). Obviously, the multifaceted impact of the pandemic will last for many years to come. On a global scale, the immediate impact of the pandemic is staggering, and this, in every sense of the word, is a truly global phenomenon. This may best be epitomized by what centuries ago the British poet, John Donne (1571- 1631), wrote: “No man is an island, entire of itself; every man is a piece of the continent, a part of the main.” indeed, never has this been truer than during the current worldwide Coronavirus plague.

In Ethiopia, by 28 June 2021, there were nearly 270,000 confirmed cases with over 4,300 deaths (2). As in many African countries, all facets of society – health, security, political, economic, and social – variably continue to be negatively impacted by the pandemic. The current rise in COVID-19 cases in many parts of the continent is extremely worrying (3).The spread of new variants of the virus, including the Delta variant, is partly behind the recent surge, and the continent is lagging with vaccination programs. In recent weeks, the number of cases and deaths has increased by almost 40% and, in some countries, the number of deaths has tripled or quadrupled (4). This is driven by a mix factors−public fatigue, social mixing, ineffective use of public health and social measures, and vaccine inequity, and the spread of new variants.

The uphill battle against the COVID-19 pandemic can draw many lessons and inspiration from global and country-level responses to the HIV pandemic. A severe COVID-19 is a real possibility in low resource settings which will have a more sobering prospect, particularly with new and more aggressive variants emerging. We have learned from the response to the HIV pandemic, and, indeed, witnessing new developments and advances in interventions often rapidly benefit the better-off countries, immensely increasing the already existing stark inequalities. Fast, decisive political and technical leadership are crucial and imperative to avert the perpetuation of the status quo. As the COVID-19 pandemic continues to have a devastating effect on health systems, and effective response to mitigate the impact of the new pandemic on other major health programs, including  HIV, tuberculosis, malaria programs, maternal and child health, remains critical to protecting the health gains achieved over the years.

Medical Doctors constitute an essential part of an effective response to the COVID-19 pandemic as well as the overall response to other public health challenges. Doctors have been experiencing high work volume, personal risk, and societal pressure to meet extraordinary demands for healthcare, in an environment that does not oftentimes reciprocate in protecting their rights (5). A substantial number of them encounter fundamental changes in their professional lives due to the pandemic. Of note, the COVID-19 health crisis has exacerbated violence against doctors (and healthcare workers); they have become unforeseen targets in the fight against the current pandemic (6). Some experience pandemic fatigue, but all have continued to shoulder the responsibility to protect themselves, their families and friends, and the community at large.  Since the emergence of the coronavirus outbreak, Doctors, like other health-care professionals have not only experienced the inherent satisfaction from healing patients and saving their lives but have also lost many battles along the way. Many doctors have sacrificed their own lives in the line of duty. Every day, these selfless warriors make sacrifices for the safety and welfare of those affected by the pandemic. I (on behalf of the fraternity) salute and give our Doctors the greatest tribute and highlight the heroic efforts of some courageous and inspiring Doctors from across the country who lost their lives while saving the lives of COVID-19 patients. I express my deepest sympathy to all the individuals and families affected by the tragic losses. 

Adopted from: https://preventepidemics.org/covid19/resources/protecting-hcw/)

As our indomitable Doctors are marching in the battle against the scourge of the COVID 19 pandemic, they need to continue unravelling mysteries and myths through penetrating research and fully integrate innovative approaches in their daily work.They need to support efforts to build institutions that can effectively and ethically respond to current and future emergencies. They need to foster actions that enhance social justice, improve health equity, thereby averting disparities. In as much there are immense challenges, the emergence of the COVID-19 is characterized by an unprecedented pace of scientific advance, particularly in understanding the virus, its clinical and epidemiological impact, and in the development of vaccines and therapeutics. As emphasized by others (7), the silver linings of the pandemic should be fully harnessed today and, perhaps for years to come by our worriers in the fight against this ugly pandemic.

References

  1. Antonio Guterres. United Nations Secretary General. Coronavirus: Greatest test since World War II. 1 April 202. Available from: https://www.bbc.com/news/world-52114829
  2. Health Emergency Dashboard. Available from: https://covid19.who.int/region/afro/ country/et.
  3. World Health Organization Regional Office for Africa. Coronavirus (COVID)-19. Strategic Response to COVID-19 in the WHO African Region. Available from: https://www.afro.who. int/health-topics/coronavirus-covid-19
  4. Statista. Number of coronavirus (COVID-19) deaths in the African continent as of June 24, 2021, by country.
  5. Johnson SB, Butcher F. Doctors during the COVID-19 pandemic: What are their duties and what is owed to them? J Med Ethics 2021;47:12–15.
  6. Iyengar KP, Jain VK, Vaishya R. Current situation with doctors and healthcare workers during COVID-19 pandemic in India. Postgrad Med J August 2020. Available from: https://pmj.bmj.com/content/postgradmedj/early/2020/08/18/postgradmedj-20203849 6.full.pdf.
  7. Wondimu W, Girma G. Challenges and Silver Linings of COVID-19 in Ethiopia –Short Review.  Journal of Multidisciplinary Healthcare 2020:13 917–922.

Sileshi Lulseged, MD, MMed

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