A day in the life of a health worker

With the long run of devastating scenes happened across the country every day, nurses, health workers and doctors showed up to work to fight against an ongoing battle against Covid-19 pandemic that had pushed them harder than anything in their careers.

On a regular basis, for the last year, frontline health workers have witnessed suffering, heart breaks and deaths on a scale they have had hardly imagined, while at the same time risking themselves to exposure, having to console the patients even they themselves needed a dose of healing therapy, dealing with limited resources, covering for sick staff and deeply worrying about bringing Covid-19 to their families.

Kanakarathnam has been serving in the medical field for more than 14 years. Generally known as Kanagu, he is one among the frontline workers who had cumulative impact each day spent in the battle against Covid-19.

On a normal day in early 2020, Kanagu’s alarm goes off at 5.30 a.m. An attendant at the Base Hospital, Dikoya (Central Sri Lanka) and living in a boarding place away from his family, Kanagu continues to stay in the bed and ponders; “how many newly diagnosed Covid-19 patients today? How many deaths I have to face today? Is this the day I catch Covid-19?”

Gobbling up whatever the food he manages to get, Kanagu arrives to the hospital Covid-19 unit at 6.30 a.m., signs in, checks and records his temperature, changes into his heavily layered protective dress and enters his second home, knowing that, to ensure hygiene measures, he can’t step out of the unit for the next 12 hours.

In the unit, it’s just him, the care team and the Covid-19 patients. Gone are the days when family members get to sit at the bedsides – but now if anyone is comforting the patient, it’s Kanagu.

In an hour he gets a call from the Ministry of Health (MoH), Gampola (Central, Sri Lanka) asking him to bring the ambulance to take an infected patient. Kanagu’s heart stops for a moment for his family including his wife and two daughters (17 and 14 yrs) is living in Gampola. He’s worried that no one is there for his family except him, to get them groceries, essential items and sanitary kits and he was extremely worried that they might catch the virus as they go out for their day to day needs. But still he manages to arrange a driver to the ambulance and brings in the patient, while quickly dialing his wife’s number and alerting them to be more safe, though he desperately wanted to be by their side.

At 8.30 a.m., a patient suddenly experiences shortness of breath. His Oxygen level drops down to a dangerous level and Kanagu runs to him to intubate and puts him onto a ventilator. Kanagu’s still hopeful about his quick recovery.

By 9.00 a.m., Kanagu gets another call from a patient’s emergency contact, asking for an update on his condition and expressed how upset the patient’s family is, as they can’t be there in person. Kanagu provides the best comfort he could muster.

Kanagu dons and doffs his personal protective dress and equipment (PPE) once in every two hours, as he attends each new patient. As the hospital was running short of PPE, Kanagu had to re-use them after a proper sterilization.

He gets a quick glimpse of himself in the mirror as he changes into new PPE and notices the bruises and flecking the tight N95 face mask has left on his face. But he finds those marks matching his chapped hands resulted from constant handwashing, as well as his frayed hair and sleep deprived eyes.

At 10 a.m., the patient experiencing a shortness of breath is in a critical stage. Kanagu quickly sets a bed in the Intensive Care Unit (ICU) at the ground floor and climbs up to the first floor to bring the patient down. But, Kanagu shatters down knowing that the patient just died. “The first Covid-19 death I have witnessed in person” Kanagu’s voice breaks.

Now Kanagu has to bring the dead patient in the ambulance to Punanai (East, Sri Lanka), where an isolated cremation unit was set. Fighting with his own mishmash emotions he finally decides to get into the ambulance and takes the diseased patient.

“I didn’t want to tell my wife nor daughters that I was about to bring a dead patient in the ambulance. They will be shocked, sad and nervous thinking about my safety. I drove the ambulance 230 kilometers to Punanai, handed over the diseased for cremation and drove back to Dikoya” Kanagu says.

“He was 77 years old but very healthy. He has had contracted this killer virus when he was on a tour with his family. I put my best to bring him safe to his loved ones but all in vain. I felt like I am his own son, when I shouldered the responsibility of cremating him”, Kanagu consoles himself.

Kanaku gets back to his boarding place late in the night. He makes a beeline to the shower so he can avoid exposing his colleagues in the next doors to Covid-19.

Kanagu splatters some jam and butter on a piece of bread he had bought the day before. With so much commitment, energy and time devoted to the hospital, his normal routine to include a balanced diet, regular exercise, self-care and family time has fallen by the wayside.

And then he answers a call from the hospital, with the bread in his hand halfway eaten through. The person on the other end of the call says “Your colleague spikes a fever and is sent to quarantine. His workload is divided among the remaining staff as there’s no staff pool to pull from. You might have to attend to few more patients tomorrow. So, come to work early”.

Taking a deep breath Kanagu calls his wife and checks on his daughters who are already asleep.

As he sets his alarm for 4.30 a.m., he reflects on that day and feels pretty proud of all what he has done and grateful to god for preventing him and his family from this virus.

The next two weeks Kanagu’s running round the clock, noting down patients’ vital signs and medical histories, asking them about more symptoms, arranging for physical, rapid antigen tests, drawing blood samples, recommending care options, maintaining detailed and updated records, sharing knowledge and awareness among patients and their families, providing them emotional support, setting up treatment rooms, sanitizing, assembling and arranging medical equipment, bringing diseased patients to the East and sharing the works of his colleagues who are testing positive to the virus.

Finally, it’s time for Kanagu to go home for 7 days after continuously working for more than 14 days. His salary day is a week ahead and he goes to a doctor working in the same hospital, borrows some money, gets as much as possible groceries, fruits and vegetables to his wife and children, who are still managing with basic ration.

He waits for hours to take the only bus available and travels 50 kilometers to Gampola. As the neighborhood children see him walking to his house, they start to run away and hide into their houses screaming Corona is coming. Kanagu’s eyes wells up and he speeds up his way home. The smiles of his excited daughters are what patch his broken heart.

Building on the experiences, World Vision Lanka with the support of European Union Civil Protection and Humanitarian Aid (ECHO) implemented “Covid-19 Prevention Project”, a 12 months action to improve Covid-19 prevention, care and treatment through strengthened functionality of health systems in the Northern, Eastern, Central, Western and North Western provinces of Sri Lanka. This action supports the national Covid-19 strategic preparedness and response plan particularly on case management and on vaccination.

To bring more awareness among the public and to curb the hardships people like Kanagu were going through, the Covid-19 Prevention Project was successful in executing its quick initiatives on addressing the requirements of health facilities and enhance their capacities to care and treat more patients, identifying and addressing the gaps in basic items such as sheets, pillows, towels and hygiene kits that not only give dignity to patients but reduce cross contamination and further positive cases.

To prevent healthcare workers from reusing masks and PPEs the project ensured they have sufficient stock of PPE for their safety and mental wellbeing and the continued functionality of the treatment centres.

The project has also provided the most vulnerable communities with handwashing stations, water boilers, washing machine, laundry detergent and recreational items for psychosocial support of the patients as well as the healthcare workers and a vaccination roll-outs on an enormous level.

Kanagu’s day reflects reality for hundred of thousands of healthcare workers across the country and the end to his story is one with long lasting ramifications not only for him and his career but for the health system that employs him and the patients he looks after.

World Vision Lanka will continue to celebrate these hidden heroes like Kanagu for going extra miles to serve for their communities.