Wednesday, March 29, 2023

The year, 2020 for most hospitals began on a very positive note and I remember, that we had even hosted a doctors day get together at Gallops in February. Yes, there were some whispers about an epidemic in China, but no one had anticipated nor envisaged what was to strike us a month later. AKDN is a Global network and we did receive communication from our Head Office in Geneva, in early March, 2020, to be prepared for a flu- pandemic. The other hospitals in our network in East Africa were seeing patients coming with flu-like symptoms, and we heard stories of staff being overwhelmed and inundated, with the sheer volumes of patients, bed shortages and need for PPE ( personal protective equipment) kits and other medications.

A Global Task Force for COVID had been set up in AKDN, and the preparedness for tackling with the patients was to be assessed. The manpower, medications, infrastructure requirements and other logistics were to be planned, along with the support needed from our head office and other concerns. One good thing about our network is that there is tremendous support from our peers and the knowledge sharing that it provides, in terms of resources and experiences, especially the global perspective, when we are dealing with something like COVID, which the world was grappling with.

We had even planned for buffer manpower and stocks of PPE kits, as we had heard that most hospitals were struggling with non availability of the same. We conducted training on allocation of kits and judicious use, educating the staff of the use of PPE, and Do`s and Don’t`s of COVID -19. Trainings were conducted by Dr Trupti Gilada, our infectious diseases specialist and Dr Azizullah Khan, our ICU Director, to educate the teams on the clinical aspects of COVID.Somewhere in the 3rd week of March, we heard that the cases had started increasing, and an emergency meeting was conducted by the MCGM, and attended by the private hospitals.

While, I remember, that we were all anxious and though, having a sound scientific knowledge, no one anticipated the tsunami that would engulf us a month later. I guess, no one had faced something like this before and it was natural for everyone to be confused.  The COVID task force was set up by the government of Maharashtra, and had emiment specialists and administrators, to guide the hospitals and doctors.Having said that, the experience in dealing with the conditions was very limited and the protocols would evolve and change frequently. We had to keep ourselves updated and modify the clinical and admin protocols based on what the evolution of pandemic was guiding us. This also entailed communicating to all key stakeholders and ensuring compliances to the infection control guidelines and SOPs. 

I remember the panic when the first case of COVID was detected in our hospital, and despite all the preparation that we had undergone, handling the emotions of staff was the most difficult part of the dealing with the first wave. The team was well trained and qualified, but, there was so much fear and paranoia pertaining to the disease, that it was challenging to get people to work. This was compounded by the fact that the lockdown was announced, and people were finding it difficult to travel to work from remote locations. We had to manage with whatever staff was available and accommodate them in our hostel facilities. This entailed, managing logistics of stay and other supplies, during the phase of a lockdown.

We are immensely grateful to our team of doctors, nurses, paramedics and admin staff, who stay put for months in our hostel, to keep the hospital operations going. At that time, Prince Aly Khan Hospital, was the only hospital that did not shut down for a single day, due to robust infection control guidelines being followed and optimal management of resources. Yes, we did face our set of challenges and learnings, but it was the never say die spirit, and faith in Almighty, that there was light at the end of the road.

The first wave of COVID taught us a number of lessons; humility, collaboration, co-operation, team working, planning and resilience being one of the most important. You also learn that the human spirit can rise to the occasion and belief in the team, can make an organization survive in the toughest of situations. Change is the only constant thing, and one need not be afraid of it. Rapid change can be overwhelming for most people and as leaders, we need to work around it and not get afraid. Though fear can be a natural reaction, but it should not paralyze you. Strong leadership coupled by effective execution of strategies is of paramount importance, when the world around you is changing at an astronomical pace.

Caring for the team and nurturing the team is vitally important, and that means, not only the physical, but also the emotional needs of the individuals. Last, but not the least, the mental health of the people working in hospital settings, is an area which cannot be ignored. The long working hours, fatigue, stress and anxiety in dealing with such an unpredictable disease can have enormous consequences on patients and staff. Hence, focus on mental health should be with the aim of building mental resilience and preparedness to deal with such complex situations, when they arise, and not as a reactive strategy. A physically and mentally strong team enables an organization, to not only survive, but thrive in turbulent times.

Courtesy : In Conversation with Dr.Shabana Khan, CEO – Prince Aly Khan Hospital , Mumbai, India.