The provincial tally of Balochistan as for April 4, 2020, has risen to 175 cases (2,723) total in Pakistan) while 17 have been discharged after recovery as reported by the National Institute of Health Pakistan (NIH). This surge indeed poses worry in the already shredded healthcare system of the province but even greater of a worry is the fact that these numbers include doctors and other healthcare professionals themselves.
Currently, 11 doctors have been reported positive for COVID-19 in Balochistan, most of who have been traced back to the lack of personal protection equipment while they were on duty in their respective hospitals. It is noteworthy to mention that so far one doctor has died of COVID-19 in Pakistan – Dr Osama Riaz from Gilgit Baltistan, who had been performing his duties to screen coronavirus patients with unsatisfactory personal protection.
Evidently, the main exposure that the Healthcare Professionals (HCPs) may experience is either through the COVID-19 suspected/positive patient that they are dealing with or via any contaminated surface around them within a clinical facility. In accordance with the National Action Plan for Coronavirus disease Pakistan, disinfecting surfaces regularly has been highly recommended at healthcare facilities while the Personal protection equipment (PPEs) that include Surgical masks, N95 masks, gloves, gowns and eye shields are to be used by the healthcare professionals in the following manner.
However, compliance with these recommendations in Balochistan is routinely being reported as unsatisfactory mostly due to non-availability of the required equipment in the hospitals.
According to representatives of Young Doctors Association (YDA) Balochistan, doctors in the various functional departments of Bolan Medical College Hospital and Sandeman Provincial Hospital Quetta do not even have the basic triage level equipment including masks, gloves and eye protection. Since outpatient services are halted in most of the hospitals, unscreened patients come rushing to the wards imposing a threat on the doctors who already have no protective equipment to use. YDA Balochistan has also been actively questioning the distribution criteria of the PPEs available in Balochistan that Provincial. Disaster Management Authority (PDMA) Balochistan mentioned in its Daily report on coronavirus dated March 30, 2020.
Further, the concern of enhancing the testing ability of the province is also being put out forward by the front liners which would indeed help identify dormant cases after which effective contact tracing could help bring forward any new cases to eventually be treated and help reduce the peak phase of the pandemic.
The situation of lack of PPEs, disinfectants and testing kits has also been reported from other cities of Balochistan. According to a doctor working at DHQ Kalat, she developed corona disease like symptoms because of which she had to take the test by coming back to Quetta which thankfully came out negative. She mentions that they had been working without any available gloves in the hospital and were trying to buy equipment for themselves if lucky enough to find them in the market.
On the other hand, in Quetta as well the doctor’s community is collecting donations from among its peers to be able to buy protection equipment for their respective departments.
In this regard, members of YDA Balochistan had a meeting with the Chief Minister of Balochistan Jam Kamal Khan on Friday, during his visit to BMCH Quetta, where they have been assured by the CM to provide them with the equipment on a priority basis. In a recent tweet by the CM Balochistan, the available equipment has been dispatched to the districts and will be utilized and distributed by the authorities according to the need in the area.
It is evident that execution flaws are being observed in the strategy to counter the outbreak in Balochistan, however, the dedication of all categories of the front liners in Balochistan must be applauded. It must also be noted that effective mobilization of the authorities is being seen regularly in accordance with any loopholes that are coming forward through social or mainstream media such as the issue of lack of PPEs around Balochistan.
While the government is focusing on providing the utmost facilities in the isolation of specific hospitals, the other healthcare centres must not be neglected at any cost. It is recommended by experts that a mechanism must be developed in all healthcare centres where each patient gets screened on the entrances of the hospitals, and then be guided accordingly towards a testing or isolation facility in case showing any coronavirus symptoms i.e strengthening the triage system as much as possible. Only then can viral exposure can be reduced for HCPs and directed towards a healthcare facility where equipment and testing facilities are available.
Additionally, isolation facilities and testing centres for coronavirus in Balochistan must be equipped at absolutely all times with efficient coordination with the authorities to avoid situations of unpreparedness as we saw in Sheikh Zayed Hospital and Fatima Jinnah Hospital Quetta in the recent past.