Lugaliki: The brave doctor who gave it all for her patients

Dr Doreen Adisa Lugaliki’s last update on her Facebook page was her usual poses in lovely dresses on April 11, then the next posts after that are her colleagues typing “rest in peace, my friend” and her patients recalling the last moments they had with her.

The doctor, in her late 30s, succumbed to the new coronavirus disease barely 48 hours after she was admitted to Aga Khan Hospital early Friday.

Dr Elizabeth Wala of AMREF wrote: “My heart is shattered. Go well, my friend.”

Another medic, gynaecologist Nelly Bosire, wrote that she would hide under a rock until “Dr Adisa Lugaliki wakes up and says it was a bad joke”.

CONDOLENCE MESSAGES

Messages of condolence continued to pour in on social media from Kenyans following her demise. Dr Lugaliki was known fondly to her friends as “Kadoreen”. She becomes the first doctor in Kenya to succumb to Covid-19 and the third healthcare worker after two other nurses.

The death of Dr Lugaliki cements the fear in the medical fraternity about their safety as they attend to patients. Some 361 healthcare workers have tested positive for the virus, which has since infected 9,448 people after 473 more people tested positive yesterday.

The disease has also killed 181 people so far, after eight more patients succumbed on Friday.

While it is not clear whether Ms Lugaliki’s exposure was due to the lack of personal protective gear, the medical fraternity has expressed their displeasure at how the county and national governments have handled healthcare workers.

Dr Chibanzi Mwachonda, the secretary-general of the doctors’ union posted on his Twitter account: “Frontline healthworkers need utmost protection, their Occupational Safety & Welfare is now an irreducible minimum!!”

Mr George Gibore, who is the secretary-general Kenya Union of Clinical Officers (KUCO), said clinical officers and nurses who are often the first to have contact with the patients are the most affected.

In April, healthcare workers asked for protective gear, as well as insurance and “hazard pay” to protect themselves should they die in the line of duty. The workers had lamented about lack of protective equipment.

In response, President Uhuru Kenyatta instructed that part of the Sh5 billion that came from Treasury should be used to create a “welfare package” to cushion healthcare workers against any negative consequences of the virus. He said he recognised “the critical importance of health, mental and emotional needs of our frontline medical doctors, nurses and other medical professionals”.

PROTECTIVE EQUIPMENT

The money was released just last week. Personal protective equipment like face masks, gloves and gowns, help keep nurses and doctors safe when they’re treating patients with infectious diseases like Covid-19.

The Centers for Disease Control and Prevention (CDC) recommends that healthcare workers should wear N95 masks, which filter out airborne particles and tiny droplets that may have been coughed up by patients.

Dr Joshua Santarpia, who studies biological aerosols at the University of Nebraska Medical Center in the United States, found out that when a person stands by the bed of a patient, it does not matter whether the patient is speaking or not.

The particles the patient emits as they breathe will be inhaled in by someone that is a metre-and-a-half away from them, at the foot of their bed.

Should these particles contain the virus causing the Covid-19 (SARS-CoV-2), the healthcare provider will be infected.

The World Health Organization’s technical guidance on how the virus is transmitted directs that protections against airborne transmission are especially important for health-care workers when they do medical procedures which might be anticipated to produce smaller respiratory droplets that could then be inhaled.

Health Cabinet secretary Mutahi Kagwe led the country in observing a moment of silence in honour of Dr Lugaliki, noting the government will ensure all healthcare workers have protective gear.

Lukoye Atwoli, a professor of psychiatry, told the Nation of “morale injury” amongst healthcare workers when they have anxiety out of choosing who gets to use scarce resources such as ventilators, and who does not.  “There are no guidelines to help them with this decision of choosing who dies and who lives, and then there is no support after that,” he said.

The Kenya Medical Association has reported of increased drug abuse and depression amongst doctors during the pandemic.