Accra — Evelyn Narki Dowuona bears a great responsibility at Ga East Municipal Hospital in the Ghanaian capital Accra, where, as in much of the world, the COVID-19 pandemic has raised the risks of health care work. Drawing on more than 10 years of nursing experience, the quality and safety manager ensures that measures to curb infection are strictly observed.
"We want to cause no harm to the patients while giving them care. We also want to ensure that our staff are safe in their working environment," she says.
Health worker safety is a critical component in the COVID-19 response. More than 10 000 health workers in 40 African countries have contracted the virus since the pandemic began.
Nurse Dowuona speaks about the risks, the worries and the efforts to limit infections.
How concerned are you about the risks?
I am very worried. Every time you hear about another colleague in your country getting infected or dying from this pandemic, it really causes a great deal of concern and sadness.
It is a big blow. You ask yourself that if the health workers are infected or dying, who will manage the pandemic. It is very sad.
So how are health workers exposed to COVID-19 infection?
One of the ways of being exposed to COVID-19 is when you don't adhere to the safety protocols. One must beware of having the feeling that you know it all, that you are above the rules and the safety protocols and that there is no danger in your actions. That perception is incorrect and dangerous. That is how you and others end up contracting the disease.
A key issue, in any setting or institution, is when there is no teamwork. That can create huge challenges, because at the end of the day, fighting COVID-19 is a team effort.
Thirdly, if there is no plan or set of laid-down rules for managing staff and ensuring they adhere to all the protocols in the workplace, then that is very detrimental.
There needs to be real coordination among all the different categories of healthcare workers in the hospital - the whole team, from the cleaners to the doctors and nurses, to the people who work in the laundry to clean the patients' linen, to the people working in the pharmacy and to the clinical psychologists working at the hospital.
It's also about the staff looking after each other - for instance in our hospital, the pharmacy makes sure the staff are given vitamin C and immune boosters as well as hand sanitizers on top of our face masks and other personal protective equipment. It is great teamwork and makes us feel united in the fight against COVID-19.
What measures can limit infections among the hospital staff?
Our hospital provided in-depth training to all our healthcare and other hospital workers on how to deal with COVID-19 patients and all other aspects of dealing with the infection which took three to four days and we do regular refresher courses.
We grouped all the cleaners and trained them on how to do waste management and environmental cleaning in the infectious areas. We considered the cleaners to be high-risk workers.
A second category was the hospital's mortuary workers who were trained on how to handle the cadavers of patients. Another group was the laundry officers who were coached on how to handle the linen of all infectious patients.
The doctors, nurses and pharmacists were all trained in the COVID-19 protocols on moderate, severe and critical patients.
We also do regular screening of staff before and after work. We have a place where we take temperatures and, if a staff member's temperature is above normal, we isolate them to protect others.
Has any of your colleagues contracted COVID-19 and how did that affect you?
We started dealing with COVID-19 in March this year and, since then, we have seen about 500 patients. We have 180 staff, none of whom had contracted COVID-19 until last week when we heard that one of our staff members had contracted it from his friend. He was isolated. Apart from that none of our staff have contracted COVID-19 and thankfully, we have not lost any staff.
I felt sad about our colleague contracting the disease because we had put in place good strategies. However, it has provided us with a learning opportunity and a challenge to look beyond and enhance our strategy.
What has been your greatest moment during this pandemic?
It was when we received our first COVID-19 patients on 21 March. The staff really came together as a team and followed all the protocols. In my presence, the staff were excellent. In my absence, they were perfect.
Other great moments were when I saw the COVID-19 patients leaving the ward healthy. Sadly, we have recorded three mortalities, but celebrating the recovery of patients is something I will not forget in a hurry.