COVID-19 and frontline responders: Health professional perspectives
COVID-19 and frontline responders: Health professional perspectives
28 July 2020
COVID-19 and frontline responders: Health professional perspectives of Australasia and South Asia 2.0– 4.0 pm, Monday 27 July 2020
SUMMARY OF DISCUSSIONS, LESSONS LEARN AND FOLLOW-UP
Held on Monday 27 July 2020; 10.0 AM- 12 Noon (Dhaka Time) and jointly organized by the Centre for Governance Studies, Dhaka, Bangladesh and School of Social Science and Faculty of Humanities, Arts and Social Science of the University of Queensland, Brisbane, Australia the Webinar, “COVID-19 and frontline responders: Health professional perspectives of Australasia and South Asia” brought together 10 COVID 19 frontline health responders – doctors, nurses and medicos.
The key objective of the Webinar was to share and learn from each other the experiences of COVID 19 management from the frontline health responders of the Australasia/South Asia responders.
The Webinar panellists included 10 frontline health responders, policy managers and researchers - 5 each from Australasia and South Asia.230 plus participants from all over the world registered and attended the event.
The Webinar was opened by Mr. Zillur Rahman, Executive Director of the Centre for Governance Studies (CGS), Dhaka, Bangladesh and was moderated jointly by Mr. Zillur Rahman of CGS and Dr. Rebecca Olson of School of Social Science, University of Queensland, Brisbane, Australia.
At the start of the Webinar, Professor M. Adil Khan of School of Social Science, University of Queensland, Brisbane, Australia presented the Objectives and Expected Outcomes and summarized the lessons and at the end, outlined future follow-up actions.
Facilitate cross-cultural learning of successes and difficulties, encountered by the frontline responders in treating/handling COVID 19 patients
Appreciate the nexus between governance, policy, service provisions and service delivery at the frontline
Appreciate safety, security and emotional/trauma aspects of frontline responders and importance of support services for trauma mitigations
Create opportunities for networks and peer-to-peer dialoguing and explore options of establishing a platform for on-going information exchange for problem-solving
Continue policy research, publication, information dissemination
Professor Lynda Cheshire, Head of School of Social Science, University of Queensland, Australia and Ms. Adriana Alberti, Chief, Capacity Development Unit, Division of Public Institutions and Digital Government (DPIDG) of the United Nations Department of Economic and Social Affairs (UNDESA), New York, USA inaugurated the webinar. In their Welcoming Remarks both thanked the organizers and panellists and the participants and highlighted the importance of such international webinars at this difficult pandemic time in helping each other through lessons learning. They hoped that by promoting dialogue, research and information sharing among the peers the Webinar is likely tohelp contributing to formulation of policies, building strategies and bolstering capacities of institutions and delivering services in containing and abating the scourge of COVID 19, a pandemicthat has engulfed the entire world. Ms. Albertiof UN reminded that such dialogues and partnerships are key to advancing the wellbeing of all citizens and to the realization of the 2015-2030 UN Sustainable Development Goals(SDGs).
SUMMARY OF PROCEEDINGS/LESSONS LEARNT
The webinar focused on two key broad aspects of COVID 19 issues, namely (i) institutional arrangements, measures and provisions that have since been undertaken in Australasia/South Asian countries to treat COVID 19 patients at the hospital and community level; and secondly, (ii) issues relating to safety, security, wellbeing and trauma management of frontline health responders. Following summarises the discussions and lessons learnt:
Country contexts of challenges of COVID 19 vary but solutions follow certain common parameters:
It has been revealed that although political, economic, social and resource contexts of countries like Australasia (Australia and New Zealand) and South Asia vary preparedness and quality and promptness of delivery of services have relied mainly on non-resource factors such as appreciation and proper assessment of the magnitude and nature of the problem, empathy, leadership, enabling governance and strategic planning arrangements and efficient public health system and grass-root outreaches. For example, in South Asia,India’s (Kerala) and Sri Lanka’s early preparedness and their well-functioning health systems with community level outreaches combined with early proactive actions have greatly helped in stemming the spread of the virus and successful treatment and minimisation of fatalities of COVID patients. Similarly, Australia and New Zealand examples also demonstrated how early preparedness, commitment of top leadership, strategic planning and functioning public health system with rural/regional outreaches accompanied by significant organizational restructuring at the hospitals and most importantly policy/service delivery interface helped in stemming the spread and successful treatment of the patients and minimised deaths. In this regard, Nepal’s case has been a shining example of how a remote location with meagre resources successfully tackled the pandemic mainly, through local level leadership, commitment, dedication and pro-active thinking and through innovative mobilization of local resources. Another interesting case is Bangladesh - while various recent newspaper reports have suggested that COVID 19 has put Bangladesh’s public health system in numerous difficulties, the Bangladesh panellist at the webinar, a nurse from a leading private hospital, reported that her hospital had put in place adequate structures, processes and provisions that have since ensured COVID efficient treatment for the patients and a COVID safe environment for the doctors, nurses and medicos.
Safety, security, trauma aspects of frontline responders, a crucial aspect
Adequate provisions of safety, security of and arrangements for addressing the fear, stress and trauma issues of frontline responders with gendered distinctions are crucial. Both Australia and New Zealand have put in place several tools and institutional arrangements to deal withtrauma and stress of frontline health responders. For example, the panellist from the Gold Coast University Hospital in Queensland, Australia informed that they introduced a peer support system called ‘Always-there-peer program’ to provide emotional and practical support to health workers by the trained peers and in addition, the state Government of Queensland’s(Queensland is one of the six states in Australia) Health Department has introduced ‘Employee wellbeing program’ through which health employees can access social, emotional, physical, financial and workplace wellbeing support. Similarly, the New Zealand panellist, a COVID nurse from the Auckland Hospital reported of a similar peer-support programme called, “Buddy” system in their hospital where peers counsel the frontline doctors, nurses and medicos in the hospital on a regular basis.
An all-encompassing governance framework
A COVID 19 all-encompassing governance framework that interfaces regularly with the frontline responders and health institutions, both clinical and epidemiological, at all levels - national, sub-national and local levels - and connects with the policy levels and the research community, enhances the capacity to service, manage, monitor and cure and contain the spread and mitigate the crisis cohesively and more effectively.
For example, New Zealand Prime Minister’s pro-active and firm leadership in addressing her country’s COVID crisis that helped in connecting the frontline workers with scientific community greatly contributed to its formulation of an unambiguous, uniform, firm and successful strategy to manage the crisis the country. Australia also followed a similar uniform policy strategy.
Unlike New Zealand and Australia where leadership came from top, in some South Asian countries such as Sri Lanka, India (Kerala) and Nepal, initial leadership came from their sub-national health systems where the pandemic hit first and central governments in these countries quickly responded to and embraced and incorporated lessons into national strategies.
Frontline health responders are the most credible sources of information for policy
Frontline Health Responders- doctors, nurses, contact tracers, cleaners etc. - who bear the brunt of COVID 19 challenges daily, have the most practical insights into the challenges and workable solutions. Panellists have revealed that early embrace of experiences of frontline responders have greatly helped in the formulation of suitable COVID policies and strategies, both at the hospital and at community level which have also demonstrated that continuous dialogue and interface between the health responders at the ground level and policy managers at the hospital, the community, sub-national and national levels are key to successful management of COVID risks.
The panellists/organizers agreed to/envisaged following follow-up actions:
Awareness building, research and publications
In order to build public awareness and suitable policy responses, steps the webinar organizers have committed to deepen research and publish bothop-ed type articles for immediate policy dialogue and academic articles for knowledge development.
The Webinar has revealed that continuous dialogues among the frontline responders both within and across nations is key to improving approaches to handling the COVID 19 crisis whose nature and characteristics change all the time. The panelists/organizers have thus committed themselves to responding to follow up queries through social media/email etc.
In their post-webinar follow-up emails to the organizers, the Australian and New Zealand panelists have already informed that they remain committed to assist their South Asian colleagues in any manner they can.
Steps would also be taken to facilitate in-country and cross-country peer networking/partnerships dialoguing on continuous andcross-cultural basis.In this regard, an example of an interesting if not a unique North/South partnership model that has emerged lately that in Australia that connects Australia with Bangladesh, a partnership that combines access to knowledge of superior technology with cultural sensitivity has been cited at the webinar. This North/South partnership relates to a unique model of Australia/Bangladesh COVID 19 informal and yet collegial professional collaboration.
Many Bangladeshi origin doctors who work in Australia, have formed a group called, Federation of Bangladeshi Doctors in Australia (FBDA). Through webinars and other social media platforms FBDA regularly dialogues and shares information with their peers based in Bangladesh through the representatives of Bangladesh Medical Association and exchanges ideas (mainly clinical) on COVID 19 clinical aspects mainly. The striking aspect of this partnership is that the members of FBDA, whoare originally from Bangladesh and now practise in Australia combine in them the knowledge of and access to the most advanced technologies and methods and at the same time are also fully aware of the needs as well as the limitations of Bangladesh, thus positioning them uniquely to offer suggestions that are desirable and at the same time, doable in the Bangladeshi context.
In order to forge a broader South Asia/Australia health dialogues on COVID 19 efforts thoughts may be given to expand FBDA model to include South Asian doctors in Australia and link them up to their peers and extend cooperation to their COVID 19 counterparts, the frontline health responders in South Asia with knowledge sharing.
The webinar ended with a vote of thanks from Mr.Zillur Rahman, Executive Director, Centre for Governance Studies, Dhaka, Bangladesh – the lead organizer of the webinar.
Australia: Dr Hasan Shohag, A/Prof Dylan Flaws Dylan.Flaws, Dr Marc Ziegenfuss; New Zealand: Ms May Villamor, Nurse, Dr Deborah Harris, Practitioner/Nursing Academic/Researcher; South Asia: Bangladesh Deepti Bisht, Nurse (Bangladesh), Dr.Sulphi Noohu (India - Kerala), Dr. Sangeeta Mishra, Physician, (Nepal), Dr. Ahsan Aurangzeb, Physician (Pakistan), Dr. S. Mathangan, Physician, (Sri Lanka)
In this regard, a good beginning would be to link up Dr. Sangita Sharma of Nepal with Dr.Hasan Sohag, of Gold Coast University Hospital, Australia who is also a member of FBDA. Dr. Sangita wanted to know what local hospitals can do to contain and treat COVID 19 patients more effectively especially at a regional level. Dr.Hasan Sohag, the webinar panellist from Australia is working at a local hospital in Gold Coast, Australia and has been engagement with COVID 19 patients at the hospital from the very beginning and thus well aware of structures and processes that are key. He is also aware of several steps the hospital has taken to reach out to the community with medical advice, both physically as well as virtually. By linking Dr. Sangita Sharma of Nepal with Dr.Hasan Sohag of Australia we may be able to initiate Australia/South Asia (developed/developing country) dialogue on COVID 19 management.