Dr. Roman Dhital
As on every other day in my telemedicine duty, I was busy answering calls all afternoon. As soon as I hung up and went to the bathroom, my phone rang again. I hurried from the bathroom to pick up the call. I heard a familiar voice on the line. That person was pleading for help; he sounded stressed and anxious. "I am sick! I got infected with Covid-19! I have been trying to reach hospitals, but they do not have beds. I learned about this program from Facebook and called you right away." It was my friend on the phone. I had just met him ten days back and I had not talked to him after that. There were overwhelming no of COVID cases in the hospital I was working at, so I was busy with my own work. I panicked for a moment after hearing my friend's voice, but soon I got hold of myself and talked to my friend. We discussed his symptoms and as everything seemed fine, I reassured him about his health and asked him to stay in isolation.
The second wave was kind of expected by all in Nepal but no one was prepared for it. By early May 2021, Nepal was under the grip of COVID second wave. The number of infected cases soared sky high and hospitals ran out of capacity. There was scarcity of beds, ventilators, oxygen and other medical supplies in every hospital. I remember drenching in sweat after being in PPE for 24 hours straight. Sometimes, I felt suffocated in multiple layers of masks. However, whenever I saw my patients gasping for air and struggling for life, I would forget my discomfort and get back to work. When I saw the patients on ventilator support with epinephrine pumps in their veins, adrenaline rushed in me as well.
The hospitals were overcrowded, but not everyone who came to the hospital needed hospitalization. So the proper triaging of the patients was necessary. Patients who recovered from Covid-19 sometimes had persistent and annoying symptoms. So follow-up of the discharged patients from the hospital was equally important. So, our motive was to triage patients, treat those with mild disease at home and reduce the burden in the hospitals. Furthermore, the people in the remote parts of Nepal, who did not have access to proper health facilities and had little idea about the pandemic and were not prepared to cope with its consequences. We, as medical professionals, were aware of these challenges the patients were facing, but the initiation to resolve these issues hadn't been started actively for a long time.
Then, one fine afternoon, as I was scrolling through my social media page, I came across a post from Health Foundation Nepal asking for volunteers to work in a telehealth project for COVID patients. Without any second thought, I immediately applied for the position and in a few days I was with a great team of volunteers who all were motivated to help people out.
I couldn't contain my excitement when I received my first phone call on the first day of my telemedicine duty. I was familiar with the protocols for hospital-admitted patients, but a virtual visit through telephone was new to me. So, I prepared well, referring to different national and international guidelines. My first call was from a family where all of them were infected at that time. I talked to them for quite some time and later we both ended up on a good note. I was happy that I could help them mitigate their fears.
I heard many heart wrenching stories over the phone. One day, I received a call from Kailali, one of the most remote parts of Nepal. The patient despite testing negative for COVID was very much anxious that he might have contracted the disease. I talked to him for a long time and slowly listened to all his fears, and in the end, he had somewhat released his fears and said that he felt lighter and much at ease. I was glad I could bond with him even through the phone.
Volunteering for HFN has been a lifetime experience for me and my fellow volunteers.This pandemic helped us develop a newer perspective on health care delivery through telehealth, understand the problem better, and come up with innovative solutions. I believe we can utilize telemedicine service to treat patients with other various diseases and provide frequent follow-ups.
To sum up, it was a very good experience working for HFN. I learned a lot and could help people at their weakest times. At the end of the day, this is all that matters to me as a doctor.