Answering the call of duty The Medical Professionals of Sri Lanka

we must not forget the courage and sacrifice of our doctors and nurses (AFP)

Take a moment to reflect on how your life has changed since the Covid-19 virus brought our world to a standstill. Our income and economic future have become uncertain. Those of us with children must look after them at home due to school closures. Food, medicine and basic supplies are scarce as we remain cloistered in our homes. The only solace we can find is in the fact that if we stay at home and take the precautions prescribed by public health officials; thus keeping our households safe from this deadly virus.

But there is a section of our society who has no such sense of security. The nearly 20,000 doctors and over 30,000 nurses of Sri Lanka have the same problems we do in their households. It is in addition to these day-to-day challenges that we have called upon them to be our soldiers on the frontlines of a new kind of war. These medical professionals do not have the luxury of hiding from the virus as we must.

Instead, their jobs are to risk exposure to this new threat as they diagnose and treat patients, truly knowing that around the world over 160 doctors, nurses, medical technicians and other healthcare workers have already been killed by standing in harm’s way to combat Covid-19. Several times medics have been infected and have had to worry about the risk their jobs were causing to their families.

Perhaps the first medical professional to succumb to Covid-19 is symbolic of the role doctors play in our modern world. By the time this crisis concludes, the name “Li Wenliang” should be a household name. Born in 1986, Li was a gifted academic and basketball fan, who became an ophthalmologist at Wuhan Central Hospital in 2014. On 30 December last year, Li warned several colleagues in a chat group of patients who were exhibiting alarming symptoms and testing positive for a new SARS coronavirus. His government chastised him for ‘spreading rumours’. Undeterred, he continued to raise the alarm while fighting selflessly to save the lives of his patients. A week later, he contracted the virus, and was hospitalised. Li vowed to return to the frontlines after his recovery. 

The recovery never came. He succumbed to the disease a month later, leaving behind his pregnant wife and young son. His sacrifice has since been recognised by China’s apex anti-corruption body, the WHO and a resolution of the US Senate. Indeed, it is in the footsteps of Li Wenliang that our own doctors follow today. Dr. Li will never ever be forgotten and his tormentors never forgiven.

We only know about Dr. Li’s role in trying to warn us about the danger of this disease thanks to the international news media, which gave voice to the warnings by the World Health Organisation and put leaders around the world on the hot seat, insisting that they take this threat seriously and pressuring governments into tough albeit belated action.

Even in late January, governments from so-called superpowers to developing countries were playing down Covid-19 as ‘just the flu’ and something not to be concerned about. It was the media that kept them on their toes. Now, despite widespread lockdown, media workers in Sri Lanka and around the world are risking their lives to bring us the news, going out to take pictures, interview sources, produce newscasts and write stories. In many cases, the media have given a voice to doctors’ organisations like the SLMA and GMOA, and the trade groups representing nurses and public health inspectors.

Even in late January, governments from so-called superpowers to developing countries were playing down Covid-19 as ‘just the flu’ and something not to be concerned about. It was the media that kept them on their toes 

Not the time to score petty political points
However, in some electronic and social media outlets, these medical professionals have been vilified by those who disagree with or are made politically vulnerable by their comments. This is disgraceful. The Covid-19 crisis is one that the brightest minds in the entire world are grappling with as the situation evolves rapidly. No one can see through a crystal ball and singlehandedly guess the right strategies. It is essential that our medical professionals and their representatives have the freedom to air their views and needs to the public, so that they can inform the debate on how we grapple with this crisis.

What we cannot afford is to tolerate those who try to tarnish and divide medical professionals in a crisis like this just to pursue their own political interests. Anyone who is using this pandemic and the emotions it spawns to promote any political agenda, whether an election or otherwise, is laying bare their lack of empathy or human qualities. Before you become a politician, or doctor or soldier, you must first be a human being. This is a time for integration not segregation. It doesn’t matter what political beliefs you think a doctor holds or who they support. Their ethnicity, gender, age and background do not matter. They are united in the goal of protecting us. We should respect and honour their sacrifice. The government has a unique opportunity to unify not just our medical staff, but our entire country against Covid-19. 

every in-person interaction our doctors have with any patient is another risk they are taking

Whether or not you agree with, for example, the decision to dissolve Parliament last month, the Election Commission’s decision that they can’t have elections, or the decisions by the organizers of the Ananda-Nalanda and Royal Thomian “big matches” not to cancel their events, this is not the time to score petty political points. All these decisions have been subject to coordinated attacks on social media that do little to bring us together against the enemy that is out to kill us all. Whatever you think of each of these decisions, they were taken by people who we would like to believe did what they thought was right at the time. History can judge them later. Today, we need to deal with the realities of these decisions and move forward.

When I read about the London-based Sri Lankan geriatrician Dr. Anton Sebastianpillai tragically losing his life to Covid-19 last week, I was reminded that in economic terms, Sri Lanka is also a net exporter of medical doctors. Thousands of Sri Lankans from top medical schools are practising medicine in every corner of the globe, using their training and expertise to defend humanity from this new threat.

My own family’s paediatrician is married to another physician. His son and daughter are both physicians, and they are both married to physicians. In this one family alone, six doctors from two generations are putting their lives on the line to keep their country safe. Just imagine if your parents, and your children and their spouses were all out at war while you prayed for them at home. The strain on all families like this must be unbearable. And yet, they put their duty first, their households and sustenance a distant second. The same is true of nurses, public health inspectors, technicians and other hospital staff around the country. The least we owe them is to heed their advice.

Stay at home, stay safe, wash our hands and do everything we can to avoid infecting ourselves or others.
Our medical professionals also know that the “official number of cases” we see in the media, today standing at nearly 200, is just the tip of the iceberg, and only the number of people we know from positive testing have been infected with covid-19. As their peers in other countries have found, many of those infected with covid-19 may take up to two weeks to show any symptoms or show no symptoms at all. Therefore, every in-person interaction our doctors have with any patient is another risk they are taking on behalf of their nation.

When it comes to our medical professionals, we should go a step further and call upon the private sector to ease the burden of government in looking after this new generation of heroes. Our luxury hotels around the country are at a standstill, with their employees’ jobs at stake. We know they are facing tremendous losses and in many cases their survival is at stake, but the next six to eight weeks will be crucial and our actions may determine the fate of Covid-19 and the economic destiny of the country. 

At least temporarily, some of them could be repurposed to provide a sanctuary for our doctors and nurses to take a shower, get some rest or enjoy a solid meal, as they work around the clock to return normalcy to our society. This is especially applicable to those large hotels owned by conglomerates that have the financial strength to endure these difficult times. They could even deliver nutritious meals to doctors and nurses at hospitals and quarantine centres. These are not ideas to get us out of this crisis sooner. They are ideas for showing our gratitude towards the people who are fighting this unprecedented battle on our behalf.

Supporting those on the front lines
To stakeholders, whether in the public or private sector, try to think of what you can do today to ease the burden that these heroic doctors and nurses bear on our behalf. What services or goods could you offer to make their lives easier, to thank them, and help them feel appreciated for what they are doing? It is only by supporting those on the front lines that we can expect to prevail against this deadly virus. At the end of the day, no battle can be won without the backing of the people.

Sri Lanka invests heavily in training and rewarding our doctors and nurses. The practicing of medicine in the national health service of Sri Lanka is one of the noblest and highly regarded professions in the land. The selection processes for our medical and nursing schools are ruthlessly vigorous, and as taxpayers we invest several millions of rupees in training and compensating our doctors and nurses. Yet none of us ever imagined that we would be conscripting them as soldiers to fight for us in the trenches against an invisible enemy. 

It is worth pausing to consider that these groups have been vociferous and paralysed our health system in the past by going on strike over squabbles around entitlements and perks. But it seems that when their country needs them the most, they are putting their lives on the line without second thoughts, embodying, as their Hippocratic Oath calls for, “the honour and noble traditions of the medical profession.” Even once normalcy returns, we must not forget the courage and sacrifice of our doctors and nurses. When you see a doctor or nurse in the future, remind them of their service during this crisis, and thank them.

To produce a doctor requires sacrifice by the state, by their family who supports their education, and by their teachers and mentors. Some doctors, especially those from rural backgrounds, are the product of generations of sweat, toil and sacrifice. As a resilient country that has overcome every struggle that has come our way, we should of course hope for the best, that Covid-19 would be eradicated from our shores before long. But for the sake of our doctors and our people alike, we must also prepare for the worst. 

We must make sure that we stockpile the best masks, gloves, gowns and other personal protective equipment they might need, and do our utmost to protect them. Today, they serve as both our soldiers and our generals in this battle, fulfilling a prophecy foretold by Emperor Napoleon Bonaparte at the peak of his rule. It was Napoleon’s Surgeon-General, Baron Larrey, who invented the modern medical concept of triage, as well as the battlefield predecessor to the ambulance.

Astonished at the role Larrey’s advances played in keeping his troops alive, Napoleon said “someday, you medical people will have more lives to answer for than even we generals.” As we take on Covid-19 over 200 years later, the day Napoleon predicted has clearly arrived. This is the doctors’ moment.