Apart from medicines, the elderly, who are more vulnerable to COVID-19 also require extra psychological care to help them recover successfully, writes Goan noted author,
Damodar Mauzo
The COVID-19 situation in India is yet to get under control, though the optimistic official reports say that it is on the decline. The number of COVID-related deaths in India, as on October 31, 2020, is over 1,21,000. To date, officially the total caseload of the affected ones has reached eighty lakh. In all possibility, there is under-reporting as far as the deaths are concerned. Nevertheless, it is an accepted fact that the most vulnerable age group is 65 and above. In Goa itself, the last day of October witnessed two deaths, both senior citizens of 75 and 65 of age, taking the total count to 604.
A WHO report states that the highest mortality is among people over 80 years of age. The latest data from the Union Health Ministry of India has confirmed international trends that the virus affects the elderly people disproportionately and fatally.
Goa is not different from the rest of the states. In this tiny state, we have lost 604 souls to the coronavirus so far. Obviously, most of them have been elders. The aged people in Goa, like elsewhere, are living in distress, at times in panic, in view of the rumours about the deadly virus and of the callous attitude of the public health services. To add to that, they are apprehensive of their kin who, if they prove positive, would prefer to isolate themselves. In such a situation, there is an emerging need to pay greater attention to ageing-related issues and to promote holistic policies and programmes for dealing with the ageing society.
Though we boast of higher literacy rate and greater health awareness, Goa began with an absolute disadvantage – it didn’t have a testing facility in the state, nor a trained microbiologist for RNA extraction. The government health machinery was not prepared for the contingency. Also, the authorities remained oblivious to the fact that with most of the state’s population being tourist, migrant, and other transient people, it was more prone than most other parts of the country to the fast-spreading COVID-19. At last, towards the end of March, the government of Goa designated the 60-bed ESI hospital in Margao Town of South Goa as a COVID-19 facility to admit infected patients
I was very happy when I read about the yeoman services provided by the master warrior, Edwin Gomes and his team of dedicated staff that took such good care of the COVID positive patients, especially the elders. That the state remained in Green Zone for a considerable time was because of the heroism demonstrated by the likes of Gomes. What elderly patients need is not only the medicines but also a word of reassurance which injects confidence and positivity among them, that pulls them through the virus. This is exactly what Gomes and his team offered them. A July 10, 2020 report tells us that Gomes has hugged almost 190 patients as a parting gesture while being discharged during the last three months. As Goa’s first active case to be cured, Edgar Remedios, put it so aptly: “It was not just the medicine – it is also the manner in which Gomes puts you at ease, which is part of his healing potion.”
He also went on to share how Gomes helped him overcome his anxiety. “Dr Gomes is the one who resurrected me. To put me at ease, he himself would take an anxiety tablet with me, because he was also under stress. He just calmed my nerves. I have great gratitude for him,” said Remedios. Many patients who were then treated and cured also spoke of him in glowing terms.
This brought back some memories I have. It was in 1991 that I had my first heart attack. It was severe, with doctors counting on 48 hours to see the light of hope. I survived the myo-cardiac infarct mainly because the doctors attending on me provided excellent medical care to me. It was there that I met Gomes for the first time. We did not know each other then, though he hailed from my neighbouring village Nuvem. He did not know me as a writer and I did not know him as a gold medallist doctor. I remember having asked him whether after the initial training at Hospicio, he would go for private practice. He replied in the negative. He said, he wanted to serve the people by working in the public hospital. He had also expressed his desire to improve upon his medical skills through experience at the hospital. His ambition was to become a professor of medicine. I was happy that he not only achieved his aim but has also gone on to be the Head of the Department of Medicine since 2012.
Many people compliment me for my positive approach in times of critical ailments. I have gained this attitude because of my proximity to people like Gomes who have added meaning and purpose to my life. After I had the second heart attack, I went to see Gomes at the GMC. He saw the reports and told me point blank: “You are sitting on a time bomb. You leave for Mumbai for further investigations and treatment, as fast as today.” The words sounded crude then. But it served the purpose. I rushed to Mumbai in time for the bypass surgery. Ever since then I have been following his advice even when I feel slight discomfort. His words of consolation serve me as a booster dose. Every time I went to him for my annual check up, he paid personal attention. The readers might gather the impression that he was kind only to me. He was, but so he was to all others, especially the elders.
Soon after the pandemic broke out, I was stunned to read the abrupt way in which the HoD of Medicine at the GMC, Gomes was asked to hand over the charge to his colleague and take over the COVID-19 designated ESI hospital in Margao as nodal-officer-in-charge. I was a bit surprised. But I convinced myself that the move was in the interest of the public health. And indeed it was. Gomes led three teams of medical professionals, including junior consultant doctors, nurses and support staff all of whom worked tirelessly to successfully combat the situation. Goa felt overwhelmingly proud of this son of the soil when even the national media took cognizance of his contribution at that crucial time. Gomes also won plaudits when Goa’s first seven COVID cases were cured and discharged. The state of Goa had the privilege of being declared a Green Zone. When Gomes returned home after almost a hundred days of uninterrupted service at the ESI hospital, he was given a hero’s welcome by residents of the housing complex he lives in.
Gomes was quick to share the honours with his close associates, Nidhi Prabhu, Harshal Mamlekar, Geetali Velip, and Masood Mujawar, who helped the recovery of the 333 patients. He said that he and his team were burnt out following the same routine, day in and day out. “We slept a few hours every day, ” he said. “It tired us out, but it was good. Who said we are not willing to go back? We will go back.” But it was surprising that he was not called back immediately when other doctors from his team were asked to rejoin the GMC after testing negative.
I thought of all those aged COVID positive patients who were treated despite meagre amenities to deal with. As I keep interacting with my friends, I realise that they little trust the public health services. And to add to their misery, the private treatment is beyond them. Is this the reason why the death toll in Goa is proportionally higher than the rest of India? According to one national report the average deaths-per-million (DPM) in India is 120. In such case Goa’s 1.5 million ought to have been 180, whereas it is 600. The Goan media reports that GMC is ill-equipped to handle the large number of patients. Would it not be appropriate to hand over the charge of the COVID patients to Gomes?
Though the Government keeps on assuring that the COVID figures are on the decline, we all know how much to trust the figures. The much awaited Covidshield vaccine continues to be a distant dream. As per the Serum Institute, we may have to wait till the end of 2021 to get it administered. The COVID tested population of Goa stands at 20 per cent as on October 31. When the rest of the world is forewarning us of the second wave, are we geared up to meet the present challenge?
Those between 10 and 60 are comparatively safe to move about even if they are asymptomatic. But it is risky for the elders who are highly susceptible to the virus. Therefore we need to have the immediate measures on hand.
I strongly feel that a special ward needs to be set up to take special care of the older COVID patients under the supervision of Edwin Gomes. The elderly patients who are more vulnerable need extra psychological comfort as also medical care. Gomes, who has an excellent track record, can prove to be of great advantage to the GMC. The elders with medical conditions, such as chronic respiratory disease, heart, liver and kidney disease, neurological conditions, diabetes, hypertension and/or cancer, are particularly susceptible to infections during this period. The Union Health Ministry along with the Department of Geriatric Medicine, AIIMS, Delhi has prepared a list of Do’s and Don’ts for the senior citizens. Medical and para-medical staff are directed to take note of their pills, tablets, drinks, injections, and ointments. Some patients suffer from sleeplessness or loss of memory. Some can’t hear while others can’t see or recognise. How can the medical staff take care of their varied distress, when as it is they complain of being overburdened? Once detected COVID-positive, the patients are kept in isolation. They may get the COVID-related treatment. But their other medicines for pre-existing ailments can get sidelined. That makes them face discomfort and often brings misery, which factors may add to the overall death toll.
Therefore, to take special care of the aged, GMC must have a special ward with a limited capacity of 20 to 30 senior citizens, who need to be dealt with extra care and tenderness. Doctors like Gomes have a way with the old, who are anxious, fearful and nervous. Only genuine solace can help
them recover faster.
