Health workers say they feel the burden of the COVID-19 pandemic which has caused serious mental health illnesses in the health sector.
According to a Health Awareness Report study by the Zimbabwe Association of Doctors for Human Rights (ZADHR) , the absence of adequate psychosocial support services coupled with discrimination from workmates and society, especially for doctors who were working in the COVID-19 frontline exposed medical doctors to numerous mental health challenges at the height of the COVID-19 pandemic.
The mental health impact of COVID-19 has always been expected to be huge in society due to the nature of the disease and the various coping mechanisms that come along with it. However, these mental health challenges are expected to affect health workers more than the general population.
“HCWs are already predisposed to mental health conditions, and there is evidence from the literature of increased mental and psychological stress within HCWs during outbreaks of infectious diseases.
“For example, frontline and non-front line health workers who responded to the Ebola virus outbreak in Africa and those who responded to the Severe Acute Respiratory Syndrome (SARS) in Hong Kong and Beijing experienced varying symptoms of psychological disorders,” read the report.
ZADHR Secretary-General, Dr Norman Matara said the medical sector was not spared from the effects of the pandemic.
“Losing a patient is something that actually affects your mental health and it has been seen that when there is a pandemic, that pressure or mental health stress actually increases. It has been seen where there have been outbreaks like the Ebola in Liberia and also the emergence of SARS in 2001 and 2008 respectively where it was seen that medical practitioners who responded to the SARS outbreak in South Korea recorded increased mental health issues,” said Dr Matara.
He added that COVID-19 had its own unique features that impacted negatively on the mental health of doctors for example the absence of Personal Protective Equipment (PPE), an increase in COVID-19 cases within healthcare workers and the death of healthcare workers, and sensationalized media reporting actually increased mental health stress.
“The workload also during COVID-19 played a part. Even us as healthcare workers, we actually designed our unit to call them Red-Zones or Greene Zones, etc. Red is always associated with danger so we actually did ourselves a disservice by labeling the units red zones. There are also the lifestyle changes that came with the COVID-19 for example the constant wearing of masks, the constant sanitization, lockdowns, social distancing and all those things actually affected the mental health of people.”
He further revealed that in just three months into the pandemic, over 50 nurses in Mashonaland Central had resigned in Zimbabwe citing mental health-related challenges.
He added that the fact that Zimbabwe has very few mental health workers within the public health system also made the situation worse for the healthcare workers.
“You see that there are only 18 psychiatrists covering the whole of Zimbabwe and you see that from those 18 psychiatrists, they are mainly concentrated within the cities in Harare and Bulawayo and we have about 917 mental health nurses across the country which translates to about 6500 metal health nurses per 100,000 people.
“We have only six clinical psychologists in government and 10 professional therapists and 13 clinical social workers in the country. This data is from the World Health Organisation (WHO) by 2020. There are only 11 mental health facilities across the entire country in the public health sector and most of these facilities are not 100% functional and there are constant and insufficient mental health grants, we always see mental health patients not getting medications,” said Dr Matara.
Some of the common mental health problems in Zimbabwe are Schizophrenia, Bipolar disorder, major expressing disorder, epilepsy, alcohol intake abuse, drug abuse, suicide and parasuicide. He added that doctors in some cases had to adopt negative coping mechanisms so as to survive the mental health pressures that were brought about by the COVUD-19.
Policymakers, health institutions, and health-related organizations must institute an array of supportive interventions to ameliorate the existing gaps in accessing mental health and psychosocial support to HCWs in Zimbabwe.
During the beginning of the pandemic, in 2020, there was the depletion of personal protective equipment (PPE) and uncertainty over the quality and supply of PPE puts healthcare workers in constant fear of contracting the virus and thus impacting their mental health.
Health workers had to go on industrial action over shortage of PPE, and a High Court order was granted compelling the government to provide a constant supply of PPE. Secondly, there was an increase in cases of COVID-19 within health workers, deaths of health care workers and the media reporting of such deaths instilled fear in other HCWs and amplified the negative effects of COVID-19 on their mental health.
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