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NSRI salutes our volunteers on the frontline of the fight against Covid-19. Meet Dr Tomé Mendes, a registrar in General Surgery at Groote Schuur Hospital (GSH) in Cape Town, a Class 1 coxswain, and duty coxswain for Charlie crew at Station 3 (Table Bay). As healthcare workers, we all started with precautions and preparations long before the announcement on 26 March, and I realised quite early on that it would be difficult to adequately split my time and focus between volunteering and my work commitments. My priority had to be the pandemic so that I could keep myself and my fellow crew as prepared and as safe as possible. My main concern was that once the pandemic took hold in South Africa, I would be at high risk of exposure and could pass it on to my family or fellow crew.I discussed this with the leadership at Station 3 and decided that I would take a back seat throughout the pandemic. My focus would be on supporting and training the crew to prepare for the pandemic but I would no longer take part in routine training. I would also only be involved in calls where there was a medical component or where my contribution outweighed the potential risk.A brief glimpse of a world without traumaI was working in the GSH Trauma Unit at the start of lockdown and after the announcement we saw an immediate reduction in cases. The majority of trauma in South Africa is alcohol-related, and the ban has played a significant role in reducing the burden on our hospital. During level 5 lockdown when Covid-19 case numbers were still quite low, there were nights when we saw almost no patients and we found ourselves with trauma wards sitting near empty. It was a brief glimpse of what a world without trauma looks like, and it was actually quite pleasant.But there was also something unsettling about it as none of us really knew what to expect. We were equipped with protocols and PPE, but with so little known about the virus we knew there would be situations we could never be completely prepared for. No textbook or protocol showed you the right way to perform a trauma resuscitation in full PPE while maintaining the safety of the environment and all team members. We had to learn this on the go and apply the protocols in the best way possible. We were fortunately guided by regular updates from our seniors and management and this made a big difference.I then moved to New Somerset Hospital (NSH) in May and worked in the department of General Surgery for the majority of the surge in cases. While I was not working directly in the Covid-19 wards, we did routinely see and assess Covid-19 patients who also had surgical concerns.Unfortunately the initial peace was short-lived at both hospitals and, as the pandemic took hold and cases surged, any empty wards were quickly converted into Covid-19 areas. Both hospitals were soon running at full capacity again and had to undergo a radical transformation to cope. This was only made possible by some inspiring teamwork from several departments at the hospitals.I worked for months with people without seeing their facesFor me, the biggest difference has definitely been the change in mindset in the way we approach everything. Covid-19 is first and foremost on everyone’s mind – from how to get coffee to performing a resuscitation or operation safely. From the moment we get to work until we are home and showered, it factors into everything we do, the aim being to maintain the safety of staff and patients. This has loosely been referred to as ‘personal protective behaviour’ and is probably the most important aspect of keeping safe.Unfortunately this comes with a downside, as many of the social aspects of work are curtailed. I worked for months with people without ever seeing their actual faces, recognising them only by voice and their particular selection of PPE. Even sharing cake on a birthday became taboo and had to happen with strict protocols and behind closed doors! Despite this, teams did their best to keep up the camaraderie and spirits during the pandemic, a crucial aspect of getting through something like this.One of the strangest things about working in a hospital during the pandemic has been that visitors were not allowed. We were no longer able to speak in person to families about their loved ones or see them interacting with their family. This whole element of patient care has been affected and we’ve seen the effects of this on patients and their recovery. All of us have had to have difficult conversations over the phone with patient’s families, and it is among the toughest aspects of working during the pandemic.So much has changed and our new normal is so far from what we were used to before. It was something none of us expected we would be doing this year, and it just shows how fragile the balance with our world can be. It has forced us to reassess all of our goals and priorities, both professional and personal.It's also been tough having to isolate from family and friends for fear of exposing them unnecessarily. While we all know this is a temporary and necessary thing, it definitely takes its toll and I look forward to this changing when things settle down.We need to be kind and support each otherThe mental impact of this pandemic has been potentially underestimated and will show up more the longer it drags on. We need to keep supporting each other and our different communities more than ever. Be patient and be kind to those around you, provide a helping hand when you can and try to understand the experiences and stresses of others. Seek professional help if you feel overwhelmed; it is a highly stressful time and no one should have to go about it alone.I have been fortunate to experience this pandemic so far as part of a massive team. From family and friends, through to work colleagues, patients, and everyone who still gives that 8pm cheer, each aspect has its place on my team and has influenced my experience. I have always believed in the power of a team, and would not have wanted to tackle this in any other way. I can only hope that this pandemic will make many more people feel the same way; then at least there will be some positive to have come out of it.While it has been tough staying away from the station and crew during the pandemic, I am very appreciative of their support and understanding, especially from the other Class 1 coxswains and members of Charlie crew that stepped up and kept things going without hesitation. It was relatively easy staying involved when remote meetings and training sessions dominated the initial stages of the lockdown. As sea-based training resumed, it has been tougher to watch from a distance, but I look forward to getting back out there soon!Is there someone special in your life who is working on the frontlines? We would love to hear your story. Email and stand a chance to win your choice of a t-shirt or sweatshirt from the NSRI shop
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