Namibia: Through a Nurse's Eyes ... Inside a Covid-19 Critical Care Unit

FIVE nurses in Windhoek Central Hospital's Covid-19 intensive care unit (ICU) last week ended a 12-hour shift in tears as they lost yet another patient - a 27-year-old pregnant woman.

For the nurses working in the hospital's Covid-care unit, most days end like this.

Nurses Penehupifo Gideon (25), Victoria Amupolo (23), Deithilde Honecker (27), Renatus Imalwa (26) and Gabriel Samuel (30) have not seen so many Covid-19 patients since the virus hit Namibia in March last year.

As of last week, 11 beds were full in the ICU. The patients included a 19-year-old fighting for her life. All of the infected patients are on ventilators.

"Every day is a difficult day in this ICU," Gideon says.

The Namibian followed the five nurses in the hospital's Covid-19 ICU on Wednesday last week.

Imalwa said they experience heartbreak every time a patient does not make it, because of the bond they create with them.

"It is very difficult, especially to see patients' demise, because their conditions get worse and there is nothing you can do. That is when the attachment comes in. These are not just patients, they become family, and when they go [die], it is another heartbreaking experience every day," he said.

Saturday's report from the Ministry of Health and Social Services indicated there were 505 hospitalised Covid-19 patients in Namibia, 79 who were in ICUs countrywide.

"For us, the numbers become names on a daily basis. They become closer to you. You see your patient [whom you just lost] on social media as the families share their condolences," Honecker said.

Windhoek's state hospitals are currently running at capacity as the country's third wave of Covid-19 infections is more vigorous than before, experts have said.

GONE IN THE BLINK OF AN EYE

Gideon, Amupolo, Imalwa, Honecker and Samuel have been working in the hospital's ICU through the first and second waves, saying this time, they have only about 30 minutes of calm before a patient's machines raise alarm and they have to rush to save a life.

"Most days you look at the patients and imagine this person could be your sister, mother or family lying on this bed. You try your utmost best, but sometimes they just don't make it," Honecker said.

Gideon said the saddest part for her is when they see a patient "kind of recover", expecting them to make it, but then they are "gone in the blink of an eye".

"Those are the people who you just hoped would walk out of here, but they don't make it," Amupolo said.

The young nurses' optimism filled the halls of the unit when The Namibian visited last week, but this can change quickly, they say.

"As much as we are loud and happy, there are days when we cry and are very emotional," Gideon said.

LASTING BONDS

Imalwa said his colleagues have become his family because of the time they spend together in the ICU amid daily trauma.

"The only family I know is my colleagues, because they keep me going. It gets very tough and overwhelming, but we have each other. When things get tough, we have each other's backs," he said.

The latest information from the ministry indicates that Namibian healthcare workers have been hard hit, as at least 2 861 have had Covid-19, and 10 have succumbed to it.

Of the 2 861 confirmed cases, 2 281 are from state facilities, 575 from private facilities, and five from non-governmental organisations.

However, 87% of those who have tested positive have recovered.

The Khomas region has recorded the highest number of healthcare workers who tested positive, with 1 223, followed by the Oshana (294) and Erongo (282) regions.

ICU superintendent Ellen Niikondo said seeing so many cases and deaths is emotionally draining and overwhelming, but with time, one learns to deal with it.

She said she did not expect the country's third Covid-19 wave to record such high numbers.

Her hardest day was when a patient in a critical condition was referred to the hospital's ICU, and the nurses on duty, including herself, did everything they could to save her, but it was to no avail, Niikondo said.

Had the patient come in slightly earlier, they could have saved her life, she said.

"She was a young patient, which is more painful, because you are hoping she could have been able to do more for society, looking at her age, not that everyone cannot . . . we were thinking we could have reversed it had she arrived five to ten minutes earlier," Niikondo said.

She said they treat patients based on their condition when they are brought into the hospital.

"Some we can save, some we can't."

The superintendent said she has to remind herself not to blame herself when patients die.

She said Covid-19 also causes organ failure, unless organs are replaced.

Niikondo stressed that some patients arrive at the hospital a little too late.

"ICU is the last stage. A person starts from the clinic, ward or any other place before they get into severe distress. So when they come here, you get to see this person is critically sick. Either we save them, or not, depending on how the disease is progressing. So these are some of the challenges, but I say to myself there is little we can do, or so much we can do, depending on the condition the patient arrives in," she said.

Niikondo said social workers provide ICU nurses with psycho-social support.

"It has been a long journey. There are times when you do not have space for new patients. Sometimes it puts you in a tight spot. I wish I could really take a patient, and I can see they are critical, but what else can I do? I do not have an extra bed."

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