Here is a Q&A with a nurse working with MSF in Myanmar.

Jamie

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Myanmar: Q&A with a Canadian nurse responding to COVID-19
MSF
10 SEP

John Pringle is a Canadian nurse and epidemiologist with a doctorate in public health. He has done five overseas assignments with Doctors Without Borders/Médecins Sans Frontières (MSF) and is now on the forefront of MSF’s response to COVID-19 in Myanmar, where cases have been spiking dramatically amid political turmoil and the spread of the Delta Variant.

Myanmar has been in the grip of a third deadly wave of COVID-19 infections since early July, exacerbated by the political instability which has contributed to crippling the healthcare system. Less than three percent of the population is fully vaccinated, and public hospitals have been shut or operating at a fraction of their capacity since early February, so patients are struggling to access healthcare and many are sick or dying in their homes and communities. While official estimates confirm at least 373,673 cases and 14,374 deaths due to COVID-19, the true figures are almost certainly much higher.

In response, MSF recently opened three new COVID-19 treatment centres in Myanmar, including an MSF COVID-19 hospital at the Aung San Tuberculosis centre in Yangon, where MSF has worked for many years helping to treat drug-resistant tuberculosis (TB). John helped open the COVID-19 hospital, which began admitting patients on July 28.

What are the needs the team is seeing and the work that you’re doing?

I joined MSF in Myanmar at the end of March 2021, working in advocacy and humanitarian affairs. Prior to this current outbreak of COVID-19, I was fortunate to visit MSF’s projects in Kachin and Rakhine states, where I was able to see the hard work and commitment of our teams in providing primary care and care for HIV and TB. As it became clear that this third wave of COVID-19 would be devastating, I was reassigned as Project Medical Referent to help establish the emergency COVID-19 hospital in Yangon. I have extensive experience in outbreak response with MSF, including during the West Africa Ebola crisis, so I felt equipped to take on the challenge.

It has been a privilege to see MSF in emergency mode. We quickly refurbished a hospital building, recruited a multitude of healthcare and logistics personnel, and procured oxygen and essential medicines at a time of acute shortages. We began admitting patients just a few weeks later. We are scaling up according to our capacity and have treated more than 50 patients with severe COVID-19, including many with comorbidities such as diabetes, HIV and TB. In setting up the hospital, many of our coordination staff worked from home despite being sick with COVID-19, caring for loved ones with COVID-19 or grieving. This hospital is a testament to their commitment.

What is the most challenging aspect of your work?

People with severe COVID-19 struggle to breathe and therefore depend on others to survive. By opening our hospital, we made a commitment to our patients that, as they fight for breath, we will do everything we can to care for them. Sadly, some patients arrive in critical condition, and despite our best efforts, we are unable to save them. One evening as I was resting in front of the hospital after a long day, an older gentleman emerged from a doorway. Thinking he may be one of our many new staff members, I greeted him in Burmese. He looked at me grief-stricken and said that his wife had just died. What could I say except that I was deeply sorry. He said, “We came here together and now I am leaving alone.” I was absorbing the profound sadness of this statement as he went on to explain that his wife’s lungs were already severely damaged by the time they reached our hospital, and that nothing more could have been done. Visibly exhausted, he loaded his car with his wife’s belongings: an empty oxygen cylinder, a commode chair, a bag of clothing. He declined my offer to help, but continued to converse, explaining that he had three children now grieving the loss of their mother. He said, “Year 2020 was a good year,” pausing while I grasped his reference to the political situation. “Before, we could respond to COVID-19. Now, we have no health system, nothing.”

We have since celebrated the discharge of many recovered patients. But we must consider all those who continue to suffer the effects of the military seizing power and the chaos wrought upon the healthcare system. The needs far outweigh the capacity of the humanitarian sector, but we continue to do our best. For MSF, this means providing patient-centred care impartially and independently during the public health crisis.

https://www.doctorswithoutborders.ca/myanmar-qa-canadian-nurse-responding-covid-19