Doctors denounce "insecurity" in hospitals against covid-19

“I'm going to get tired and I'm not going back. It's better if they kick me out, my life comes first,” says Graciela, a doctor who has worked at the Ministry of Health for more than ten years. His statement stems from the "irresponsibility" of his superiors who are treating the covid-19 pandemic in a "negligent" way.

Graciela, like her colleagues Humberto and Sofía, who work in different hospitals and health centers, requested that her identity be kept confidential. She is scared. He considers that the guidelines that the Government is downloading to the country's health units expose doctors, nurses, patients, and everyone who walks through the corridors of hospitals.

Since before covid-19 “entered” Nicaragua, the first order doctors received was not to share any type of information about the pandemic with patients, thus avoiding “mass hysteria.” As long as the virus was not in the country, there was no need to bring it up, he recalls being told by one of the doctors who runs the hospital where he works.

“That just opened my eyes. I considered that it was time to launch a national campaign, but they did nothing," said Graciela, who later entered a stage of frustration, because on March 18, the date the government announced the first positive case, the order that came from El Carmen was contrary to what all the countries of the world were implementing.

They were told that they could not wear masks and that the use of gloves would only be allowed for “very necessary” tasks. The orders that the regime imposed in hospitals were not well received by health personnel.

Graciela recalls that, the day after these measures were announced, several of her colleagues requested masks to carry out their routine activities in their work areas, and management's response was to specifically monitor the use of masks, monitor whether they really it was necessary to use them, and grant a reduced number of them.

“They said that everything was fine, that there were few cases, and that if we used masks we would alarm people,” said Graciela, who added that, after that day and after seeing that several patients arrived with symptoms of covid -19 to the hospital, discontent and fear increased. It was no longer just about not talking to the public about the issue, but about unnecessary exposure to suspicious cases.

“Fear” began to walk the corridors of the hospital. The medical staff did not understand why this decision was being made, since in other countries, such as China, doctors used a lot of protection.

https://www.confidencial.com.ni/gobierno-anuncia-nuevo-caso-sospectoso-de-coronavirus/

“We have seen patients who come in with symptoms and go through all the wards, coughing, and in front of patients who are healthy. They expose them and they don't care”, repeats Graciela, who considered that this is an unnecessary exposure, since some of these people are later sent home or simply told that it is not covid-19, but a common fever.

Covid-19 “has no political color”

At the national level, the Nicaraguan authorities have declared that they will not order a quarantine, nor will they close the country's borders. The photos of children receiving tourists who got off a cruise ship, or of thousands of state workers and supporters of the government party participating in a massive walk, have surprised the foreign authorities who are in charge of managing the crisis in their own countries. .

“They are irresponsible,” says Humberto, a doctor who is around 35 years old and who is the only breadwinner for his family. Like Gabriela, his bosses ordered him that it was forbidden to use any type of mask, gloves or protection that would cause "panic" in patients.

In this hospital, most of those who oppose the “irresponsible” measures are Sandinistas. “I am”, repeats Humberto, however -he explains- having a political ideology of one side or the other, does not deny that the health of patients, doctors and their families is being attacked.

“The coronavirus has no political color,” he insists. “But our hands are tied,” adds this doctor, who describes the tension in his work environment due to fear of becoming infected with the virus. The idea of ​​resigning has crossed his mind, however, he thinks about the future of his family, of the economy in general, and the idea vanishes.

This Tuesday Rosario Murillo, Vice President of Nicaragua, said in her daily address that it is important "not to panic", "to remain calm, prudent, patient and trust in God, taking care of us, loving us, protecting us all."

Regarding the way in which the Government is handling the information on cases and tests carried out, Humberto points out that there is a lot of information that is being hidden and he does not understand the reason.

For example, he pointed out that at the hospital where he works several citizens have arrived as suspected cases, but then they are sent home without any information about it. He has sometimes had to deal with this type of patients, because after doing the test, they are referred to other areas where he attends. Without protection and with the prohibition not to “create a panic”, you have no choice but to be careful.

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“We are all upset, they are playing with our health, that of our relatives”, he repeats, and fears that if this same situation continues, without protection measures in hospitals, it is very likely that the number of cases will increase and “ we have to bury ours”.

10 beds for every 10,000 Nicaraguans

The situation in municipal health centers is similar to that of hospitals in the capital, with respect to prohibitions, because in terms of capacity and equipment , the low availability of beds and staff, is more precarious. "Imagine that we don't even have a sheet to lay on the stretchers," Sofía, another doctor, told this media outlet.

According to the National Health Map in Nicaragua, prepared by the Ministry of Health, the network of public health units nationwide has 73 hospitals, 143 health centers, 1,333 health posts, 5 specialized centers, 178 homes maternity hospitals with 2,365 beds and 91 houses for people with special needs.

The official figures reveal that in Nicaragua, for every 10,000 inhabitants there are 12 hospital beds, 10 doctors, 8 nurses and 9 nursing assistants.

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“The pandemic is going to strip the health system,” says Sofía, who says that in the face of covid-19, the government is being “negligent” and “irresponsible.” The doctor considered that President Ortega had in his hands the opportunity to prepare rigorously, but instead she chose to leave Nicaragua unprotected.

In health centers like the one where she works, the directors of these units have chosen to hide face masks, gloves and reprimand staff who wear a mask to work.

“They have the boxes in the warehouse. And they get annoyed if you wash your hands frequently, if we use gel alcohol or if we try to keep our distance from the patients," said the doctor.

What the Government should do

Although the Minsa reported on Monday the decision to “guide” quarantine in Nicaragua to people arriving from countries with “active transmission” of covid-19, the three Doctors interviewed by CONFIDENCIAL agree that this measure is insufficient when compared to those undertaken with our neighboring countries.

The government needs to stop directing walks, house-to-house visits, and promote an awareness campaign, but without exposing the public, says Humberto. Likewise, he considered it important that as long as there is no solution to the pandemic, they should suspend classes, promote teleworking and protect the medical staff, because in the end they are the ones who will be at the service of the population.

Sofía considers that it is necessary that, in addition to the prevention plan, the Government allocate resources to supply the medical centers of the municipalities, because when the number of patients overwhelms the hospitals, other measures will have to be adopted that allow them to have beds, sheets and equipment to treat all the sick.

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“Stop hiding masks, stop telling us that we can't talk about the pandemic. It is necessary that they become aware and begin to lead the country as it should be”, said the doctor.

Graciela advised the Government to reverse its strategy and apply the recommendations that international organizations and other countries are adopting.

“If the doctors who value our lives continue to be negligent, either we are going to resign, or we are going to acquire the virus, and that in the midst of a pandemic, it would be serious,” concluded Graciela.

Medical Unit demands protection from Minsa

A statement by the Nicaraguan Medical Unit demanded that the Ministry of Health guarantee "the right to protection and biosafety standards for health workers."

Health professionals, being the first link in care, have a direct risk of contagion from the coronavirus and it is essential to guarantee that they have and have the appropriate security measures and means, explains the report, which includes recommendations for the Government and civil society.

The doctor must protect himself and require the minimum necessary self-protection material, Personal Protection Equipment (PPE) that includes, among others, masks, gloves, appropriate clothing, eye and facial protection.

“It is not acceptable that in some public centers for the provision of health services medical personnel are being coerced not to use protective measures, particularly masks, on the grounds that this would alarm the population,” says the statement. .

Additionally, the Medical Unit urges the Ministry of Health to guarantee strict compliance with "biosafety regulations against covid-19 to protect the health of health personnel who classify, treat and take laboratory samples."

In countries heavily affected by the pandemic, a high percentage of health personnel have been infected by the pandemic. The Medical Unit demands, among the preventive measures, the creation of separate facilities dedicated to the management of Covid-19 patients, and a rigorous evaluation of health personnel based on age risk factors, and chronic diseases

“These health personnel should not be exposed to handling Covid-19 patients. These personnel could participate in virtual health care and counseling programs, as well as in administrative work. All these measures must be implemented in both the public and private sectors”, indicates the Medical Unit.

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