HEALTH

Another silent threat in pandemic

By REUBEN TABEL
FOR 30 years now, Felix Soal has dedicated his life to patient care at the Mendi General Hospital in Southern Highlands.
During his long career in health care, Soal has seen many challenges that come with the territory – outbreaks of tribal fighting remain common in the highlands. But nothing comes close to what Covid-19 has unleashed around the world in recent months.
Trained to stay calm under pressure, Soal says the stress of dealing with an unknown virus at such a large scale has taken a toll on healthcare workers, causing many to feel anxious, irritable and frustrated.
Addressing these mental health concerns among front-line responders, the International Committee of the Red Cross (ICRC) held four training workshops in various provinces to help close to 60 participants deal with the unprecedented situation. For many participants, this is the only exposure to awareness-raising about mental health that they’ve had. As a participant at one of these workshops, Soal shares his fears that surfaced soon after the pandemic hit PNG.

“In the beginning, it was the fear of the unknown,” he says. “I was worried about taking the virus home and infecting my family. Our relatives stopped visiting us as they were apprehensive too.”
He pauses. “I felt discriminated against.”
This stigmatisation has been one of the biggest stressors for many medical personnel, as was revealed from feedback after the workshop. “In some cases, stigmatisation was already an unfortunate reality for them – both from their families and communities,” shares ICRC delegate Charlotte Blackman, who led the ICRC workshops.
“One participant said her husband told her ‘not to come home’ if she continued working in the hospital.”
Citing discussions held during the workshop, she adds, “the sources of stress include fear of getting infected, fear of transmitting the disease to their loved ones, fear of stigmatisation, the potential death of their colleagues or patients or the exhaustion of their work.”
Around the world, Covid-19 threatens both physical and mental health. In PNG, where health facilities can be remote and difficult to access, the pandemic only makes a tough situation worse. The pandemic brings uncertainty – the sudden or unexpected loss of lives, livelihoods – on top of the toll on communities left by tribal fighting. It all adds up. Anxiety, sadness, hopelessness, insomnia, fatigue, irritability and anger are just some of the ways the threat of pandemic can leave a mark on the mental health of communities.
To strengthen their coping tools, the participants were encouraged to follow only credible sources of information related to Covid-19 to avoid the anxiety that rumours could bring along.
“We also taught them to identify any change in their emotional reactions, including uncertainty, fear and anxiety, denial and minimalisation, hopelessness and helplessness, anger and aggression,” Blackman says.
Admitting that adapting to ‘the new normal’ would take time, Soal says the methods and tips shared during the workshop would not only help healthcare workers protect themselves and their families, but also avoid the stressors related to the pandemic.
“The experts from Red Cross cleared my doubts about Covid-19 and reinforced the importance of staying physically and psychologically fit during these times. If we take adequate care, we can beat this,” he notes.
For Blackman, people with existing mental health conditions might experience an increase in psychological distress and that their trauma symptoms risk being aggravated during isolation.
“Their treatment may be disrupted, and their careers could come under additional strain. We will continue to help the best way possible,” she says.
Across the highlands, the ICRC plans to continue coaching and supervising trained personnel to ensure they have the support they need. “We are also working at the community level and using information aids like videos and other tools,” she says.
Meanwhile, back at Mendi General Hospital, Soal emphasises the importance of a well-being plan and deep breathing techniques – handy during times of crisis like this one.
“Peer support is critical,” he says.
“It will be challenging to practise social distancing, frequent washing of hands with soap and avoiding crowds when our ancestors have conducted all cultural activities without using such measures. But if we embrace the changes and support each other, we will make it to the other side.
“I signed up to help our people, and I must do it.”

• Reuben Tabel is the IRC ICRC spokesperson in Mount Hagen, Western Highlands.

China pushes traditional remedies amid outbreak

As scientists race to develop a vaccine for Covid-19, Beijing has been championing traditional Chinese medicine (TCM) as a way to treat the disease.
A recent white paper released by the Chinese government claimed that 92 per cent of the country’s Covid-19 cases were treated in some way with it.
TCM is one of the world’s oldest forms of medical practice and includes a range of treatments from herbal concoctions to acupuncture to Tai Chi.
It is hugely popular in China across the generations, although occasionally fierce debates erupt online about its use.
Experts say China is seeking to expand the appeal of TCM both at home and abroad, but healthcare professionals remain sceptical of its usefulness.
China’s National Health Commission has a special TCM chapter in its coronavirus guidelines, while state media have been highlighting its alleged role in past outbreaks such as Sars in 2003.
Six traditional remedies have been advertised as Covid-19 treatments, the two prominent ones being Lianhua Qingwen – containing 13 herbs such as forsythia suspense and rhodiola rose – and Jinhua Qinggan – which was developed during the 2009 H1N1 outbreak and is made of 12 components including honeysuckle, mint and liquorice.
TCM’s supporters argue that there is no downside to using them but experts say rigorous scientific tests are needed before such formulas are deemed safe.

The US National Institutes of Health said that while it may help with symptom relief, its overall effectiveness against the coronavirus is inconclusive.
“For TCM there is no good evidence and therefore its use is not just unjustified, but dangerous,” Edzard Ernst, a retired UK-based researcher of complementary medicines, was quoted as saying in Nature journal recently.
Nevertheless, TCM is growing in China and seeing an increase in demand internationally. China’s State Council last year estimated that the TCM industry would be worth $420bn (£337bn) by the end of 2020.
President Xi is said to be a “hardcore fan” of the ancient practice and has called it a “treasure of Chinese civilisation”.
But, Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, notes that “safety and efficacy issues plague TCM sector and most Chinese people still prefer modern medicine over TCM”.
China’s National Institute for Food and Drug Control last year found toxins in some TCM samples.
Soft power play
Despite Beijing’s persistent efforts to internationalise TCM, many people outside China remain unaware of it.
Critics say China is now using the pandemic as a way to promote it abroad – an accusation that has been denied in state media.
However China has been sending TCM supplies and practitioners alongside conventional drugs and equipment to Africa, Central Asia and Europe.
“We are willing to share the ‘Chinese experience’ and ‘Chinese solution’ of treating Covid-19, and let more countries get to know Chinese medicine, understand Chinese medicine, and use Chinese medicine,” Yu Yanhong, deputy head of China’s National Administration of Traditional Chinese Medicine, said in March.
Mr Huang believes China’s promotion of TCM abroad amounts to a soft power push.
“The government narrative that portrays TCM as being effective against Covid-19 also serves to promote the superiority of China’s anti-Covid approach, at a time when Western approaches appear to be ineffective in containing the spread of the virus,” he said.
TCM’s international profile rose last year after the WHO formally recognised it following years of lobbying by China – a move condemned by the international medical community.
The WHO then became embroiled in further controversy after it removed a warning about the use of traditional remedies to treat Covid-19 from its English- and Chinese-language recommendations.
-BBC