An open letter from a doctor fighting Covid-19 from the front

I, Dr. Deepak Mundhe, am working as a Junior Resident Doctor at KEM Hospital. I and several of my colleagues are on covid duty at KEM hospital, Kasturba Hospital, Seven Hills Hospital, Nair Hospital etc.

I was on this corona duty for almost a month. I just got a break for rest. We work 6- to 8-hour shifts during the day and 12-hour shifts at night, providing day and night medical care in times of future medical emergencies. Over the last few days, we have been going through a terrible physical and mental breakdown, especially after wearing PPE (Personal Protective Equipment) while on duty. The severity of this difficult time is becoming more and more apparent. PPE is important to reduce the risk of infection, but, it is not possible to eat or drink water for six-seven hours after wearing PPE, nor is it possible to urinate during shifts. We are all in the age group of 24-30, but the other working staff, nurses who are elderly, diabetics, etc. I can’t even imagine how they do it.

As the heat of Mumbai is increasing day by day and as the risk of exposure to corona in AC is high, the ACs are being kept off in the hospitals. So, many times we just get bathed in our own sweat from the hair tip to toe nail by using the water proof PPE. It becomes more difficult during night shift but due to the risk of infection and the need to use only one PPE per shift due to its worldwide shortage, there is no other choice.

Due to the N-95 mask, the 3-Ply surgical mask on it and the face shield on it, it is not possible to breathe properly and it causes fatigue, headaches and other problems. While exhaling, fog settles on the face shield and blurs the view. Even in this situation we are trying to stay constantly alert and consider each patient as the potential danger and make quick decisions by treating them as per the prescribed rules. Every day we check about 250 patients. Many patients come to us just because they are scared. The voice does not reach them and so we have to talk at a higher pitch which dries out our throat, but still we can’t drink water as we are wearing PPE suits. The situation is beyond helplessness but we have to bear with it.

I am the current president of KEM MARD (Mahrashtra association of resident doctors). The resident medical officers working in other hospitals in Maharashtra are in touch and we are all going through the same stage. We have many problems but this is not the time to talk about these problems and so we are working between life and death whatever the situation be. Some of my friends who work with me and also other doctors and health workers from many other hospitals while working in this pandemic are getting infected by corona virus and sadly the number is increasing.

It takes about six years to become an MBBS doctor, while it takes more time to become a specialty/super specialty doctor. According to World Health Organization, there is only one doctor for every 1000 patients. But in India, we have one MBBS doctor for every 10926 patients. So the difficulties faced by Interns, nursing staff, cleaners and other health care professionals needs to be addressed more expeditiously, as the government will not only have to tackle today’s crisis, but also the keeping in mind the need of these healthworkers for the future to keep India’s health system strong.

I am from Vidarbha which is often a subject of fun and discrimination for Mumbai-Pune people,My native is of Buldhana district, Chikhala village in Lonar. I am the first MBBS doctor in the village just because of the quality education I got from Jawahar Navodaya vidyalaya. My parents who do not have medical and educational background do not know much about it. But listening to the nonsense and exaggerated news which runs 24/7, not only my parents but also my colleagues’ parents are worried and we are able to understand the anxiety in their quiverring voices from the conversation on the phone. As much as possible, we try to keep in touch by video call. My previous posting was in rural area and I had few leaves left so decided to visit my family as I haven’t been home since Diwali, but it wasn’t possible because for this emergency situation. Considering the outbreak of corona in Mumbai and the overall situation in Mumbai, even Lord Brahma cannot be sure when this threat will end in Mumbai.

Media wandering for high TRP & uncontrolled social media, Aamir Khan, Akshay Kumar etc filmmakers have created huge misconceptions, mistrust among the masses about doctors and health care system. The ventilators, that we have always denigrated, there is no better machine in the world than the ventilators that bring the patient back from the brink of death. Today when the country like America is struggling with its shortage, many companies in India are also working on the battlefield to create ventilators.

The trust between the doctor and the patient is more important than the skill of the doctor for the patient to be cured. All the doctors, nursing staff and health workers who fighting, risking their lives in this medical emergency against COVID-19 should be honored. There is certainly no reason to be optimistic that attacks on doctors and medical staff will decrease. But, I’m hoping that the lost trust of public in the health system would be restored and hopefully transformed into a positive change in India’s overall health system.

I will be back to work soon after my leave, but we should all stay at home, strictly following the rules laid down by the government and doctors, and be committed to helping in the fight against this infection.

Dr. Deepak Mundhe
KEM Hospital, Mumbai

From his Facebook page

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