On the COVID-19 battleground

Hema Thapa, one of the first healthworkers involved in COVID-19 response in Nepal, reflects on the mental health impacts of the experience and the support provided by UNICEF in the form of online counselling sessions for frontline healthworkers

Preena Shrestha
13 July 2020

“It was like having to enter a flooded river with no idea of whether you would make it to the other side. We just had to jump in and do our best to swim.”

This is how Hema Thapa, nurse administrator at the Narayani Hospital in Birgunj in Parsa District in southern Nepal, describes her experience of being on the frontlines of the COVID-19 crisis at a time when the pandemic had just begun its spread in the country. Hema, who has been working for 25 years, was part of the team at the hospital that treated some of the first few people in Nepal to acquire the infection, and recalls a period of extreme stress, uncertainty and fear.

“We knew the pandemic was headed our way, but until that point, it had felt like something distant and surreal,” Hema says. “Once it was here, however, we were scrambling to cope.”

For Hema and her team, one of the main challenges at the time was how little was known about the disease.

This image shows Hema Thapa, nurse administrator at the Narayani Hospital in Birgunj, Parsa District, in southern Nepal.
Photo courtesy: Hema Thapa

“We were all on edge,” she says of herself and the other healthworkers involved in treating patients with COVID-19, “we were never quite sure if the safety precautions we were taking were enough, because this was completely new territory.”

Then there was the extended time away from family. Hema was doing two-week shifts at the isolation ward, during each of which she and the team had to stay at a nearby hotel that had been booked specifically to accommodate healthworkers. After a two-week work shift was over, the healthworkers then had to quarantine themselves for another two weeks before going back to their families.

Being a woman frontline worker added to the challenge, according to Hema, given how she had to juggle her duties at work with caring for her family – including elderly members – all of whom were deeply worried for her.

“Every time I left the house, I wondered if I would be coming back,” she says. “It was like going into battle.”

These long stretches of working two weeks at a time, for 12 hours a day, under extremely stressful conditions, while being separated from loved ones, took a toll on Hema’s mind and body. “The virus was all we talked about, thought about,” she says. “It even took over my dreams.” She also routinely lost her appetite and was feeling numb and exhausted. And adding to the difficulty was having to keep these experiences bottled up.

“Although we did talk and share a lot amongst the team, as a senior, I wanted to be strong for the patients as well as my junior nursing colleagues – I wanted to keep their spirits up,” she says. “So, I ended up keeping a lot of my feelings to myself.”

Recognizing the unique mental health challenges faced by healthworkers like Hema mobilized in COVID-19 response, UNICEF has been organizing online sessions connecting them to mental health experts. During these sessions, healthworkers are encouraged to share their worries and fears associated with working in COVID-19 conditions, and include discussions on the different ways in which stress and mental health problems can manifest in people, recommendations related to sleep hygiene, routine modification and exercises that healthworkers can undertake to relax, as well as some ways they can take care of the mental health of their children and families.

So far, seven such webinars have been successfully conducted for over 105 healthworkers mobilized across different COVID designated hospitals and quarantine centres in Province 2.

For Hema, who participated in one of these sessions together with other colleagues from Narayani Hospital, the opportunity to finally let out her feelings was cathartic.

“It was such a relief to unload all those thoughts and emotions that I had been holding in for so long,” she says. “Getting to share that with others and hearing their perspective was great.”

This image shows a screenshot of a mental health webinar
UNICEF Nepal/2020/GKandel
Screenshot of online mental health session with Hema Thapa and her colleagues at the Narayani Hospital

She’s also been practicing the different breathing techniques that were suggested during the session, and taking better care of herself. “One of the key things I took away was the need to make yourself a priority, and to do things that make you happy,” she says.

Hema says the battle against COVID-19 is far from over, and that means frontline healthworkers have a long, difficult road ahead of them.

“Now more than ever, there needs to be enough support to ensure that we are as mentally and physically prepared and motivated to continue our duties as possible.”