Voluntary medical responses in the time of social distancing

In his famous novel The Plague, French author Albert Camus endorses human solidarity instead of selfish response. 

For Camus, this solidarity is possible because of common decency that is a basic commitment to love or die together.

The story of The Plague evolved around a pandemic that captures the life of people in a time not unlike the present situation that we are experiencing right now due to the novel coronavirus pandemic.

In the time of country-wide shutdown, we seldom step out in fear of a possible infection. The shutdown has made transportations inaccessible. 

Meanwhile, there is a campaign for social distancing too.

The situation has created a health crisis for patients who do not have any coronavirus symptoms. Many patients have been finding it hard to get access to any medical care in hospitals.

Some groups across the country have come forward to help others in a time of utmost necessity with the commitment that Camus mentioned in his novel.

Doctors in voluntary response

The Voice of Humanity Foundation has been working to provide telemedicine services for people during the government-declared general holidays to prevent the spread of coronavirus.

Presuming the potential crisis of transportations, the foundation launched its service for people who need medical advice. 

It has made a network of doctors who are volunteering in the project.

Since March 20, more than 20 doctors from different medical colleges and hospitals are attending to patients over the telephone to provide them with necessary medical advice.

The Business Standard talked to Dr Sabina Sumi, a Rajshahi Medical College and Hospital graduate, who is currently taking higher studies at the Bangabandhu Sheikh Mujib Medical University (BSMMU) and is involved in the project.

"On average, I take 40-50 calls every day. Mostly, patients who are suffering from cold, fever, cough and respiratory problems ask for advice," she said.

Abhaynagar Samanwita Corona Mokabila Udyog – a coordinated initiative to prevent coronavirus – is operated by some volunteers from Abhaynagar upazila of Jashore.

Before the country went under total shutdown, the volunteers met at Abhaynagar and started a telemedicine programme, with doctors working in different healthcare facilities being part of it.

Currently, sixteen doctors led by BSMMU Assistant Professor Krishna Pada Saha, are providing telemedicine services under this initiative.

"From March 29 to April 1, the doctors have attended to nearly 200 phone calls. We have 80 on-field volunteers. In case of emergency, the volunteers will provide medicine and help access ambulance services," said Jewel Rana, coordinator of Abhaynagar Samanwita Corona Mokabila Udyog.

The Business Standard also talked to Shahinur Rahman, general secretary of Brahmaputra Blood Welfare Society – a Mymensingh-based voluntary group that has been organising 30 doctors of different disciplines for telemedicine services.

Since March 29, the doctors have been providing consultancy from 8am to 2am in rotation. Dr Alauddin, medical officer at Mymensingh Medical College and Hospital, is one of them.

He said, "This morning, I responded to a mother's call. Her 15-year-old daughter's limbs were swelling. I asked for her disease history. She has been suffering from thyroid. I gave necessary advice, and also asked the mother not to panic."

Meanwhile, there are 20 doctors of Rajshahi Medical College and Hospital who volunteer at least two hours from their daily routine for providing telemedicine services. They are not working under any banner.

One of the volunteers, Dr Humayun Rashid, told The Business Standard how he had joined the initiative.

"Initially, it was a social media call. Two days before I had responded positively, I informed the organisers of my work schedule. Then they assigned me for attending to phone calls between 8am and 10am. So far, I have dealt with minor diseases like cold and fever," Humayun, a BCS (medical) cadre, said.

Besides, some physicians are offering online medical consultancy individually. One of them is Dhaka Medical College and Hospital gynaecologist Dr Nupur Aktar. 

In her Facebook post on Wednesday, she announced that she will be available online between 10am and 12am at midnight to provide voluntary medical consultancy. In case a caller finds her busy over phone, Nupur requested the patients to send her text message to get reply.

On March 28, a medical officer of the health ministry, Dr Mostafa Kamal Arefin, made a similar call.

Reaching out to the infected 

If someone shows coronavirus symptoms, the neighbours and even the family members will try not to get close as part of social distancing. 

If the person dies, very few people will come forward to help. Only the designated health service providers and law enforcement personnel will take care of the body.

Organisers of the Greater Unity for Reality (GUR) – a cooperative with headquarters in Bagerhat district – have come forward to help. With their limited capacity, they are producing low-cost face masks. 

When healthcare workers were suffering a shortage of personal protective equipment (PPE), GUR started manufacturing the items locally.

Now, at least four GUR volunteers are ready to reach the vulnerable groups.

"We are not claiming that our PPE can ensure 100 percent protection, but we are ready to reach an infected patient so that he or she will not die unattended. We are not impractical," said Sheikh Mushfikur Rahman, chief executive officer of GUR.

He said the core volunteers along with a senior physician will reach a patient and take necessary steps as per the technical guidelines of the World Health Organisation (WHO).

"If required, we will carry the patient to the hospital. If the patient dies, we will be there to arrange a funeral," Mushfikur reiterated.

Presently, GUR volunteers are guided by Dr Mosharraf Hossain, Bagerhat district unit secretary-general of Bangladesh Medical Association, and Dr SM Shahnawaz, a senior physician of Bagerhat General Hospital.

Mushfikur said the initiative has attracted the local people. 

"Currently, we are not accepting new volunteers because this is a risky job," he said. 

GUR is trying to organise such voluntary groups across the country. It also has called on expatriates and solvent well-wishers to arrange WHO-certified PPE and M95 masks for new volunteers.

"If we can arrange the standard protective gears, more volunteers will be welcomed in this solidarity programme," Mushfikur concluded.