Ashiq Pramchand
The University of KwaZulu-Natal - Nelson R. Mandela School of Medicine
ABSTRACT
I was just about to finish my surgical rotation at Grey's Hospital in the peaceful town of Pietermaritzburg, South Africa before COVID-19 brought the world to a standstill. I reflect on how much this new pandemic has changed my life.
Our first clinical rotation in 2020 was surgery, at Grey’s Hospital--the main tertiary hospital in Pietermaritzburg, South Africa and the surrounding areas. Pietermaritzburg is a peaceful and verdant town in the province of KwaZulu Natal, about a one-hour drive away from Durban--my home city. The air is cool and fresh there and the hills seem to roll on forever.
During our seven-week surgical block, we were to rotate through general surgery, ophthalmology, ENT, urology, and orthopedics. But we were only five weeks in when we received news that COVID-19 had reached South Africa. Our university quickly established a war room, where a select group of doctors and scientists could help prepare us for this new public health threat. Many of the scientists worked with CAPRISA, the Centre for Aids Programme of Research in South Africa, which is situated right next to our university. Preparations moved quickly. Grey's Hospital turned part of its maternity ward into an isolation unit for patients who were infected. Hospitals throughout the country converted wards into isolation units. Field hospitals were established in our World Cup stadiums, and mobile testing clinics were deployed to relieve overwhelmed public health facilities. Meanwhile, we were trained in the management of COVID-19 patients within a few days. Many of us left our first COVID-19 training session with a sense of growing anticipation.
However, everyone was still nervous. Our country has an incredibly high burden of HIV and TB patients, and many of our public health hospitals were already reeling under the pressure of high patient caseloads at baseline. I have had the privilege of working in every public hospital in my home city. Many of these facilities lack sufficient personal protective equipment, medical equipment (including ventilators), and beds needed to meet the daily needs of COVID-19 patients.
Within two weeks, the South African government made a historical decision to institute a nationwide lockdown. We were seeing a new chapter in history unfolding before our very eyes. On the fifteenth of March, our university withdrew all the medical students from their clinical rotations. We had so many questions. We did not know if we would finish our year on time. Many students living in rural areas could not access online lectures or submit assignments, owing to a lack of Wi-Fi at home. We were confused and unsettled. I was at my aunt’s house in Durban when we heard the president’s address. My aunt’s immediate response was to hoard hand sanitizer and stockpile food and water. She was distraught. I tried to calm her down, but I was struggling to suppress my own anxiety as well.
On the first morning of lockdown, I awoke to the sound of silent streets--a first for Durban. If you listened closely, you could even hear birdsong--a welcome replacement for the usual cacophony of morning traffic.
Eventually, I worked out a daily quarantine routine. I try to wake up at 8:30 am consistently. Most of my time involves reading my medical textbooks, completing my research, playing the piano, exercising, and chatting with my family. There is a beautiful bird, hadeda ibis, which is native to Sub-Saharan Africa and commonly seen around Durban. They have now started nesting along the promenade, where I enjoy my evening jogs. I even started a medical-themed comedy web show, which serves as my platform for educating the general public about COVID-19 and inspiring solidarity during these uncertain times.
Our university created a series of COVID-19-related epidemiology and bioinformatics webinars for medical doctors and scientists, which I enjoy attending and then reformatting to communicate the information to a lay audience. I often use the “Ask a Question” function on Instagram to hear what my friends and family think about these recent drastic changes in the world and our way of life. I receive many questions like, “Is there a cure for coronavirus?” or, “How long will it take to make a vaccine?” I do my best to answer them and allay their fears.
There are, however, many questions, which I cannot answer, like, ”Will the world ever be the same again?” or, “How do I overcome my fear of death by coronavirus?” Inspiring hope in others and fighting fear with education demands an exquisite emotional and psychological balancing act. I feel that it is an operation just as delicate and complex as the performance of surgery. But…I am not a surgeon. I am a fifth-year medical student whose surgical rotation was cut short by COVID-19. I don’t have all the answers and I still have a lot more to learn.