Responding to COVID-19 at the Mangochi Emergency Treatment Unit

Health workers experiences

By Sellina Kainja
Eunice Marorongwe on duty recording blood samples
UNICEF Malawi/2020/Malumbo Simwaka
11 September 2020

Among those most affected by COVID-19 are frontline healthcare workers who are at the forefront fighting the disease.

Eunice Marorongwe, 49, is a senior nurse/midwife technician who used to work at the Emergency Treatment Unit (ETU) at Mangochi District Hospital. She is one of the many healthcare workers in Malawi who were infected with the virus. But she has since recovered.

Prior to getting infected, Eunice made sure that she followed all precautionary measures, including putting on personal protective wear before she stepped into the wards. So, never for a moment, did she think she would be infected.

However, like most Malawians, she commutes to work, mostly riding on motorbike taxis. She suspects this could be the source of her infection because most riders do not often put on masks.

Manifestation of COVID-19 symptoms

Eunice was at work when she started losing her sense of smell and taste. Within a week, she started feeling sick—coughing, sneezing and experiencing body pains.

In the second week, she started feeling joint pains, a headache and started sneezing.

Despite this, it did not dawn on her that these could be COVID-19 symptoms.

“I didn’t think much about COVID-19 because inwardly, I was telling myself that there was no way I could get COVID-19 because I always put on personal protective gear when I was working. Again, I have high blood pressure and, because of that, I often have mild headaches and body pains. I was convinced these were just the usual high blood pressure symptoms,” she said.

However, the symptoms got worse. She started coughing, felt too weak to walk and had difficulty breathing. This is when she decided to go for a COVID-19 test.  

When she told some of her co-workers about her decision to get tested, they laughed it off and told her not to worry. Still, Eunice insisted because she realised that the headache was unusual.

A COVID-19 testing kit at Mangochi ETU
UNICEF Malawi/2020/Malumbo Simwaka
A COVID-19 testing kit at Mangochi ETU

While waiting for the results, she was advised to self-quarantine. The results came back positive. After 10 days in self-isolation, she went back to retake the test. The results came back negative.

Since her recovery, Eunice has been sharing her experience with her peers and community. She has been advocating for the adherence to strict COVID-19 preventive measures such as washing hands with soap, using hand sanitisers, wearing face masks and observing physical distancing.

“In my experience as a COVID-19 patient, I got to understand that COVID-19 is not a death sentence. People are recovering from the disease and continue to live their normal lives. Our bodies are able to fight COVID-19. What we need to do is to look after ourselves by, among other things, ensuring that our immunity is boosted. I got sick and recovered. I am now back at work,” she says.

The Government of Ireland’s support to the ETU

The Government of Ireland provided MK 400 million to UNICEF to support the Ministry of Health with COVID-19 response in Mangochi and Karonga districts.

The ETU at Mangochi District Hospital was established through this support with the aim to help in COVID-19 case management.

The Government of Ireland also supports surveillance activities such as point of entry screening, contact tracing, training of Health Surveillance Assistants and Malawi Red Cross volunteers.

“Mangochi is one of the many points of entry in Malawi with high traffic of people crossing the border due to trade and others returning from neighbouring countries, including South Africa. It is critical to ensure that the district can respond to COVID-19 through training of health workers and provision of personal protective equipment and other essential supplies. This will not only protect health workers but also ensure continuity of essential health services,” says UNICEF’s Emergency Health Specialist David Matseketse.

Managing COVID-19 cases at the ETU

Anthony Mchizi, is another nurse/midwife technician working in the ETU Ward at Mangochi District Hospital and he touts the importance of the ETU in COVID-19 case management.

Anthony reckons that the ETU Ward has helped to protect both patients and healthcare workers from COVID-19.

Anthony Mchizi inside an isolation room, fully dressed in PPE
UNICEF Malawi/2020/Malumbo Simwaka
Anthony Mchizi inside an isolation room, fully dressed in PPE

“Imagine if we had no ETU and we were treating COVID-19 patients in the general ward? This would have led to more infections. With the ETU, we are able to pay adequate attention to COVID-19 patients.”

Currently, there are five beds and one room that serves as an ICU. There are three oxygen concentrators.

Anthony says the supplies are in short supply, especially Personal Protective Equipment (PPE) such as face masks and methylated spirit which they use for cleaning face shields.

Despite volunteering to work in the ETU, Anthony says every day he fears that he might get infected. He also stresses about the stigma from family and friends.

“Working in the ETU can be quite scary. My biggest fear is catching the virus and passing it on to my family. I also worry about the stigma from friends who tend to shun me once they realise that I work in the isolation centre. I have accepted that such fears will always be there. It does not, however, affect my work. I love this job,” he said.

Usually, those working in the ETU do not go home after attending to COVID-19 patients. They self-quarantine at the hospital hostel to ensure that they do not spread the virus to family members.

One of the major challenges that Anthony emphasises is the shortage of oxygen concentrators and the lack of back-up power. He said intermittent power blackouts affect their work as power sometimes goes off while a patient is on a ventilator.

So far, patients admitted to the ETU have recovered and have since been discharged except for one who died on his way to Lilongwe when he requested to be moved to Kamuzu Central Hospital.

There are currently two nurses, one maid and one clinician working at the ETU. Anthony agrees with Eunice’s sentiments that there is need to follow COVID-19 preventive measures in order to contain the disease.