A Multimedia Journalism Capstone Project for the Journalism and Mass Communications Department at AUC by Mira Amin
Coping with the Coronavirus: The mental health of medical professionals in the fight against COVID
Credit: Qasr al-'Ayni Hospital and Medical School, Cairo: design for new buildings. Gouache after J. T. Cackett & R. Burns Dick, 1922. Wellcome Collection. Attribution 4.0 International (CC BY 4.0)
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“We are working on our own,” said Dr. Mohamed Gameel at his favorite Café during the few late hours he typically spends unwinding from work.
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He’s worked in pediatric medicine for 11 years and is a chest consultant in two Cairo clinics and one hospital. He doesn’t feel as though he’s ever been offered any sort of psychological support in the field.
As an experienced pulmonologist, he’s been dealing with the pandemic among children and adults since before the official alarm was sounded. “In the beginning of the pandemic, when I had to examine patients with COVID, and we didn’t have the courage to face something like that, I was scared for my children…or being in the clinic and then visiting my mother… it was horror for me.”
The risk of children infecting their elderly family members and having crowded waiting rooms where patients can infect one another are just two of the serious concerns that Dr. Gameel has considered in recent months. With an increase in working hours, number of patients, and amount of critical care cases, COVID19 brought immense changes to how healthcare professionals do their work; and how they deal with the ramifications.
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In late March of 2020, the Egyptian government announced the allocation of two hotlines to be used for any citizen that needs psychological support during the pandemic. Egyptian doctors, as part of the Egyptian Medical Syndicate, have access to the support hotlines that all citizens are encouraged to use. An anonymous source from the Ministry of Health said that routine checks on the mental health of frontline doctors have been put in place.
When asked about what psychological support Dr. Gameel has received from any governmental or nongovernmental organizations, he said that he hasn’t come into contact with any.
A group of 502 healthcare workers across 20 Egyptian hospitals were surveyed in a study to measure prevalent feelings of depression, anxiety, insomnia, and distress as a result of the pandemic. The study concluded that females and fever hospital workers were at highest risk of experiencing extreme feelings. It also said that interventions to promote well-being such as healthy coping strategies need to take place and awareness needs to be spread.
In order for doctors to be able to address issues pertinent to their psychological wellbeing, they must first participate in a discussion. Dr. Adel Abdel Meguid, a pulmonologist for the past 26 years from Alexandria, believes “awareness is essential among medical workers because it might help doctors manage feelings of pressure, but sadly in Egypt there is no direction, governmental or not, for doctors during times of crisis.”
In another study conducted by the American Journal of Medicine, the importance of physicians bearing their basic needs in mind is most crucial. This is explained through a modified version of the theory of Maslow’s hierarchy of needs, pitting hydration, nutrition, adequate sleep, and healthy thoughts as absolutely essential for healthcare professionals to perform their work.
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Of the workers that do have mental health routines, some can end up prioritizing one basic need over another. Dr. Abdel Meguid finds solace in having a set time he finishes work regardless of how crowded his Maidan Chest Center clinic is: “I’ll put extra effort into my working hours and then set a certain time I get off work… as long as I allocate time to relax after work and on the weekends I can get my mind off of things.”
To better cope with the stress of his job, Dr. Gameel visits cafes and plays football but fully managing to cope with deaths and losses “comes with time, only time.”
Despite being in the midst of trouble and loss, healthcare workers are forced to look to the positive in their jobs. Dr. Gameel mentions the joyful times at his work, specifically when he refers a patient out of critical care, “I take pictures with all of my patients [and] some of them are only a few months old, and they love it.”
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After seeing photos of children by the festive-looking photo wall in his office, Dr. Gameel reminds me that COVID is serious. “If someone doesn’t take [the pandemic] seriously, I always tell them ‘المرض مش شديد Øتى يصيب عزيز’.
(Translation: The disease isn’t severe until it affects those that are dear.)
Diagram: Hierarchy of needs of healthcare workers
Overview
Fighting a virus within a country with one of the most densely populated cities in the region along with the stigma surrounding mental health is a task that healthcare workers have taken on silently for over a year.
Acknowledgements: Dr. Adel Abdelmaguid, Dr. Mohamed Gameel, Dr. Abdelrahman el Mansy, Dr. Mahmoud el Gaafar, Seif Ashraf, Professor Khaled Ezzelarab, Air Force Specialized Hospital
Timeline: Covid in the Media
02. Individual Stories
[Ambulance siren SFX]
VO
Hello, this is Mira Amin from the American University in Cairo reporting for the Multimedia Capstone Course at JRMC. In other parts of my project, I focused on the mental health issues suffered by medical workers who are on the frontline of the fight against COVID. But actually, the medical profession by default is an emotionally taxing one even without COVID. Two healthcare workers I spoke to were able to elaborate on this in my report.
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[Hospital atmosphere SFX]
VO
Doctors and nurses alike have been at the pinnacle of what is considered essential work over the past year. While pulmonologists were in highest demand during the first few months of COVID, many doctors from other specializations with emergency care units, found their practices becoming increasingly stressful.
[ambulance siren SFX]
[soft music fades in]
VO
Dr. Abdelrahman el-Mansy, an orthopedic surgeon, tells us about a mother who visited his clinic late last year.
[Hospital commotion SFX]
SOT Dr. Abdelrahman:
A woman visited me. She was a housewife. Her husband had died some time ago and she’s in charge of three children. She visited our teaching clinic that operates at a lower cost for people who can’t necessarily afford general clinic visits. I’ve seen all kinds of tough cases. The woman had carpal tunnel syndrome in both her hands.
VO
Dr. Abdelrahman’s patient wasn’t able to make a living with her illness because most of her work involved cooking and cleaning. This was in addition to her employers not wanting to have non-family-members in their homes during quarantine.
SOT Dr. Abdelrahman:
Her medical condition became quite severe. At some point she said shed wake up at night and slam her hands against the wall because she’s in so much pain. And she started crying. She said one doctor told her the surgery for one hand alone would cost around 10,000 pounds. And shots for her bad knees cost 500 pounds a dose.
VO
Dr. Abdelrahman felt he could help the woman, but there would be one challenge.
SOT Dr.Abdelrahman:
I told her I could do the operation myself and the large expenses will be covered. However, for our hospital to accept any patient in the midst of the pandemic, they require patients to provide a sort of proof that they haven’t been infected. This is somewhat expensive.
[sad music fades in]
VO
Even though he could perform the operations and treatment needed for a low cost, the hospital’s COVID clearance measures would be a setback for her.
[hospital atmosphere SFX]
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Doctors are faced with cases like these more often than not, and being responsible for helping or curing someone’s illness can cause strain on your psychological wellbeing. Seif Ashraf, a biochemist and research scientist, remembers the case of a patient that he got to know well.
[soft uplifting music fades out]
SOT Seif:
I saw him the day he was readmitted to the hospital. He liked to laugh and that day we ran around for the time we could. He wasn’t feeling very well and he told me he didn’t want to see Dr. Magdy again because he doesn’t want to be kept in the hospital again. I didn’t know what to say. He opened up to me. I didn’t see him again until he was in the ICU. I’m not really allowed ICU access because I’m not trained, its hard work. He called my name and I heard him but I didn’t go right away. When I went to him, I kept it short and said god-willing you’ll feel better. I said I had work to do and I left. A few days later, he died.
VO
To Seif, this is just one frustrating case that he still thinks about till this day. But Seif tries turns his harsh experiences at the hospital into positive fuel to do his job better.
[calming music fades in]
SOT Seif:
“Whatever happens you realize that you have the power to save a life. You end up having faith in the system. I lived that.”
“The bigger the picture is that you work within, the more value you’ll find yourself adding to what you’re doing. That’s a motive. As much as it can be a bad thing, it gives you motive.”
[soft uplifting music fades in]
VO
He told me about the importance of silencing his thoughts at night in meditation. He also told us about practicing good mental fitness.
SOT Seif:
You are in control of your mind. It’s like exercise. I used to think I was in control and I had it together but when I paid attention to my mind, through a simple breathing exercise, I realized I was wrong. I realized my mind was actually controlling me, not the opposite.
[calming breathing sound SFX]
[uplifting music fades in]
VO
The way healthcare professionals deal with the mental exhaustion from taking care of others varies. Some prefer quiet isolation and meditation, while others prefer the company of loved ones. Healthcare professionals need to keep an awareness of their mind’s needs as much as others do.
This was Mira Amin.
03. In The Making
My experience while working on this project during the Spring '21 semester
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