By Sadie Hussain
Recent circumstances have finally shed light on the fact that some job functions are far more high risk than others. With millions of healthcare workers front lining the battle against the Pandemic, a number of related deaths are rising worldwide and more recently in Kuwait.

Alongside the inevitably higher risk of being exposed to sick patients, healthcare workers are head to head with the virus that we are all hiding from and therefore juggling with the added pressure of the Pandemic related stressors that we are all facing.

It is terribly frightening to be on the frontline, creating a new and potentially deadly contagious disease that carries so much uncertainly. Aside from the fear of the unknown, there are many challenges that are being forced on the key workers that we fail to notice.

Whilst the consistent use of PPE reduces the risk of becoming infected, PPE is in dire shortage in many places worldwide and therefore healthcare workers are struggling to carry out their functions in inadequate environments that include the shortage of medical equipment such as ventilators and ICU beds. This is saddled with the unusually high and increasing demand to work longer hours.

The ever-changing health recommendations and constant developments surrounding the nature and extent of the virus add the strain of keeping informed, with little to no time granted to absorb the information, contents of which are equally distressing.

And if the adversity of the challenges mentioned above were not already onerous, the worry of carrying the virus home and passing it to loved ones is yet another predicament being faced by many.

Balancing the overarching duty to help others, which for many led them to the profession, battles against the understandable commitment to protect themselves and loved ones. Healthcare workers are having to make enormously distressing and morally challenging decisions.
It would be discourteous not to acknowledge the burden that is being carried by our devoted warriors, a burden that is being carried for the whole world- it all takes a toll.

Whilst it will take time until the mental health toll of the Pandemic is fully understood, early data such as the study conducted by the medical journal JAMA and published on March 23 reported that amongst the approximate 1,257 healthcare workers on the frontline in China, 50.4% reported symptoms of depression, 44.6% reported symptoms of anxiety, 34% reported symptoms of insomnia and an estimated 71.5% reported symptoms of distress.

The most common root of these symptoms is the intense negative pressures including “moral injury” suffered by the individuals facing the Pandemic head-on. A term that originated in the military, “moral injury” is defined as the psychological distress resulting from either the actions or lack of, that violate an individual’s moral or ethical code. The conflict of aligning personal and professional commitments unsurprisingly falls within this form of distress and is exasperated further by the bolstering psychological resilience, esteem, outlook, and values after these healthcare workers are being exposed to these highly challenging situations.

The post-traumatic growth of our healthcare workers is at peril. Without our frontline heroes, the Kuwait healthcare system would collapse and it is therefore vital that early steps are taken to mitigate this.
Countless studies have highlighted the importance that a good support system can play in influencing and easing the stresses that contribute to these conditions.

We must stifle the seed of moral injury and prepare now in supporting our heroes with the moral dilemmas they are facing. Some steps that can be taken include:

1. Offering healthcare staff with a full and frank assessment of what they will face on the frontline, without any understatement;
2. Keeping a close eye on presenteeism, not only does this affect operational capability but the signs of working less effectively are often an early indication of poor mental health and maybe addressed more effectively;
3. Setting up a remote forum for the staff of all backgrounds to discuss the emotional and social challenges being faced, will enable team leaders to offer direct support and advice to help their staff work through some of the issues being faced; and
4. Ensuring that once the crisis recedes ongoing care is being offered.

Despite some of the remarkable stories celebrating the bravery, strength, and dedication of our healthcare workers, it is apparent that the fiasco is the result of poor planning and the failure to factor in contingencies that should be prepared for, from now.