Tuesday, June 29, 2021

Salute to COVID-19 Medics and Caregivers

Salute to COVID-19 Medics and Caregivers

It’s June 9th, 2021 at the Lady Pohamba Private Hospital (LPPH) ground floor casualty reception. I am being discharged after a week at the facility fighting for my life having contracted COVID-19. Incidentally, it is the second discharge from the hospital in less than a month – see explanation elsewhere. But this one is phenomenal – it is a discharge after literally, as Psalm 23: 4 puts it, ‘walking through the valley of the shadow of death.....”

Now, I had intimated to myself that when I am finally discharged – (that is after I realised I actually might leave LPPH alive) -  I promised God I would pray for the staff in that hospital, specifically those dealing with COVID-19 patients if they would allow me to do so. So, I asked a senior sister if I could do it and she said ‘yes please doctor’. They gathered around and I prayed for them. But I am not sure if I was praying only or also just releasing my emotions for the past week. 

I am generally emotional – I tear easily but not the loud cries – just a sniffle here, a tear there. So, I don’t remember when I last cried continuously in front of people – I think it was when the soil was being put into my mother’s grave on April 16th, 2016. At that point, there was a finality and the brave me, who had just given a glowing tribute to mum, just realised – ‘its over – she is gone’. I had then sat down on one of the graves at the All Saints Church, Tigoni and just cried unashamedly. I remember one of mum’s close friends – Mrs Makundi - wife to an Anglican Bishop from Tanzania, sitting next to me and holding me calling me by my first name, ‘Perpetua’, as she always did, and just letting me cry. 

So, I prayed and cried. I thanked God for the dedication I had witnessed at LPPH from the first day of admission when I had to wait for hours to get a ‘real’ bed – (see Picture 1).  I prayed for their personal needs, I thanked God for the joy they spread in that hospital, for the unwavering and non-discriminatory dedication to each and every patient that came into their care.  I begged God to give them lots of energy, continued love, dedication to caring for COVID-19 patients and when I was done, we all said ‘Amen’ and the tearful goodbyes. On my second admission that I was being discharged from, I had been brought in a wheel chair, gasping for air, confused and wondering what was going on. But today, I left walking (Pic 8) and my son Tijara couldn’t have been happier, having almost carried me to the car as we had headed to LPPH a week previously.
Picture 1 - Waiting to get a 'real' bed. 

Yes – I miss that LPPH team and God knows, I will forever cherish (albeit having been ill) my experience at the facility thanks to them and what I learnt from the team – that every profession has it’s black sheep – and the medical field is not immune to this. And that is why, my week at LPPH was nothing but a new found realisation that there is a crop of medics who love what they do, despite the difficulties they endure, despite the dangers of COVID-19 – they still have room to give their patient the ultimate best care, laughter, peace, patience, dedication...And that is what I want to talk about before I discuss what it means to have COVID-19.

Admission to LPPH with COVID-19 
Now, I don’t exactly remember much about Day 1 and 2 at LPPH (with COVID-19) but these are my observations. First off, I had always wondered what it was like being admitted to hospital with COVID-19 – do the medics wear all that protective cover we see them with when they are testing you for COVID? How do they feed people with COVID, do they get any close to you – so many questions were answered in an instant. The medics put on protective gear, masks, gloves and above their uniform, another layer of protective disposable clothing but they treat you normally, just like any other patient and that to me made the difference between feeling instantly ‘safe’ or ‘unsafe’. I felt safe, cared for, appreciated.

Now, from when a patient is admitted, the team is running around, filling this form, creating a file, asking you those critical questions about your age, underlying conditions etc, trying to find out as much information as they can, placing those ecg electrodes (Pic 2 below) all over your body. On discharge if you don't remove them before leaving hospital, one has to find where they are across the body and remove them. (I had an interesting time during my first shower at home when I thought I had removed them all only to discover I had three more on me.) It’s an emergency – unlike other admissions – this one, I can almost bet, many patients are confused, out of breath and need oxygen. Because of lack of beds and space, they create some comfortable room – (Pic 1 above) – I was informed it was previously a medic’s office but it is now a receiving room as you are admitted while they search for space and a ‘real’ bed. I don’t remember much about what happened for a few hours but I remember being put on oxygen as I had reached a point where I could not breath on my own at all. It has always been a struggle getting my veins – not sure how they managed to get those that morning to put several medication going on at the same time but they did. Kudos.

Picture 2 - the little 'blue' things: ecg electrodes

When I came to, I had several drips of what I would later learn was to revive me, put some energy into my body as they treat one with a concoction of COVID-19 medicine. I remember conversations around me but it was like – for those who have gone through anaesthesia – it sounds distant like you are going to that kind of sleep and then wake up after an operation. 

Food? I remember someone talking about food but it was the last thing I wanted to see though I was hungry. Someone came to my bedside and requested that I take something small – I sat up with a struggle and not sure what I ate but it helped and just went back to sleep. Moving from my ‘bed’ to a wash room a few metres away was one of the greatest huddles I had to endure. So, they place you on a wheelchair and with an oxygen cylinder, they take you to that little room and if you are not able to do anything for yourself, they will lift you up and place you on the toilet sit. I have always had my pride about taking a dump in a basin whenever I have been in hospital for a procedure – I was determined to hold on to that little pride. So, I told the nurse I will try to use the toilet and she can wait outside. I did and then got back on my wheelchair and rang the bell for her to take me back to my bed. Now, even speaking one single word out of your mouth is a struggle – you are panting like you just finished a marathon. Back to bed, they put your drips back and you doze off to wonderland. As a diabetic, frequent visits to the washroom are normal – so, that was a pain for me having to ring the bell every so often for a nurse to take me to do what was previously something very normal. But they came, they took me to the washroom and back to bed without a complain and lots of smiles like it was such a normal process for them. Eventually I got a ‘real’ bed. 

Sleep is what you do most of the time those first few days – if you can – I had a neighbor who couldn’t especially at night and I felt sad for him. One of the tricks I use when I can’t sleep is drink a mug of cocoa with milk or just a mug of milk – there was no cocoa – so, I would request some milk and it would help me doze off and when I would come to, I would find a nurse next to my bed with a file, going through a list of something. I learnt she was checking to ensure I had gotten my relevant medication and had not missed anything and what I needed when – they were many types of medicines – so, it was crucial to ensure you got them all. Sometimes they would be checking on level of oxygen and many other critical things that happen to you. You see – the medication is so much and the timings very varied. I could be wrong but the tablets you put through your mouth for a single session cannot be less than 12 – and that is besides what you are getting through the drip a concoction of others plus that painful injection one to the stomach that I will explain about later (Picture 3). So, they ensure you get everything you require. Whereas I have no clue about names of most of them or their use, I decided they knew best what I needed and I rarely asked what a medication was for until about Day 3 when I started getting interested in things around me. But not all patients took in medication as it was prescribed. In a conversation I overheard, two nurses were discussing two male patients who had decided they would not take a certain tablet because they did not have that condition. They needed to get a doctor to prescribe an alternative. Only when I got home did I discover that I was on that medication too and just laughed away...Once in a while, you would also get a nurse check if you are feeling hungry and needed a snack, some tea or just chat away, wanting to know what I teach once they had established I was not a medic but an academic, asking questions, just ensuring you are comfortable. They simply made your stay bearable. Oh those angels.

Picture 3 - blood thinning medicine injector

Now, on Day 3, one of the nurses – a charming male nurse – (I forget his name sadly), came and told me – doctor, I want to move you to a better space. I had not complained about my 'space' but I assumed he had good reasons for the move. "You see where your bed is, this was previously like a reception – that’s why so, many gadgets here go on an alert every so often – and you see us coming into your space all the time". There was also a little problem with the Oxygen point next to my bed – something was loose and he wanted it sorted out, he said as it kept dropping a key oxygen bottle. “So, I will move you to that corner there (Pic 4) – it is spacious, you can dance, you can exercise and can have fun there and no one will disturb you,” – he explained. His humour lifted my spirits and in any case, I was convinced and knew he had my best interest at heart. So, he moved me and true to his word, there was some ‘privacy’, some 'space', less movement. I remained in the little corner to the day I was discharged.

Picture 4 - Little new corner 'room'

Again from Day 3, I decided I would try and walk slowly to the washroom. I was panting at every step but I decided I would try and not go to the washroom in a wheelchair.  However, someone would dedicatedly walk with me to and from my bed, all the while telling me how well I was improving on my breathing. Those nurses understand what it means to take those little steps of faith and they encourage you to keep doing it but to also get help if you need it. 

Now, besides the medication they dispense, these dedicated medics also clean you up. The first two days, I really couldn’t do much and asked that I clean up later which I tried to do when I would go to the washroom. But on Day 3, when they brought the warm water to clean up at 5 o’clock in the morning, I told the nurse I would do it right there – it was a milestone, believe you me. But she still came around to ensure I was fine. She asked to clean my back – I told her I would try and reach some parts of it – I did – I felt like I had won a jackpot. So, thereafter, I was able to clean myself up with my little white towel – a memento from my first trip to the hospital on May 19th for Procedure 1, 2, 3. 

I cannot remember all the names of those that came in and out of my ‘little room’ but some were a constant – so, I remember their names – there was Nurse Albertina,  Shatika, Impili, Israel, Hilya, Sacky, Edward and many others. There were cleaners, there were those that ensured you got your diabetic meals and extras if you wished. Then, there was one nurse who advised that I should keep Canderel sugar for diabetics if I got extra - “you might want to keep any extra of these ones if you get them to ensure you have enough when you need them for an extra cup of tea” and she was right. Incidentally, I have never liked sweeteners I never used to take them before – I preferred no sugar but in hospital, they taste ‘heavenly’ strangely. Then there was young Nurse Impili – she reminded me of some of my students. She had an interesting way of communicating and made me feel at home. One of those was that she kept loosing her pens – “I lost my pen again doc,”, she would lament.  I advised here to tie a string on it. But there was a day she came in the evening and informed me she had held on to both her red and black pens– it was a milestone. She made my evening and I also promised her a set when I got better. I will keep the promise. 

Then, there was a doctor who held forte for Dr Willie Bruwer, Specialist Physician & Pulmonologist the first two days of my admission. Dr Bruwer is the key doc taking care of all COVID-19 patients at LPPH. Not sure about his name but it was something like Dr Sakika – very serious with his work like everyone else. He insisted that one must sleep on their stomach – the lungs healed faster or something of the sort and trust me, for those used to sleeping on the side like me, that was a tough exercise but I tried when I could. Dr Bruwer resumed on Day 3. He came via my bed with a large team – he wore the light yellow disposable gown on top of his other clothing and fully masked like everyone else. I was just getting my mind functional, still registering that I needed ‘oxygen’ to breath, that I was still panting as I spoke and yet had been lying on my bed all along and that I walked like I was stepping on hot coal. I needed some advise from him - the previous night had been a tough one – I had a very painful left lower stomach pain and I could not sleep. Might the good doctor know what the problem was? He requested a sorna to be done and this did not happen all day due to what I was to learn was the load of similar and other procedures going on. At some point in the evening, someone from X-ray came with the machine to my bedside (if the mountain can’t come to you sort of thing...) and carried out the process. I tried to enquire what she was seeing but she insisted doc would give me the results when he visited the following day.

Day 4 – Dr Bruwer visited – this time with just one senior sister. “Now, what is causing the pain is an infection in your kidneys. This is normal for COVID patients and it might go away on its own but we will monitor it,” he explained. That was enough to make me feel ‘better’. But, we had struck a rapport with him previous day and we had a chat beyond my illness. “So, what do you do Dr?,” he asked. “I teach at NUST”, I responded. “What do you teach? I told him. He smiled. “No wonder you are so inquisitive”. We had a little more chat whereby I got to know roughly how many patients he saw in a day - shocking. I got to know what his anxieties were most – he, like all the senior sisters I spoke to, wished people could just get vaccinated and made it clear, it made a difference in the response my body had made to treatment. I asked him how he cleared his mind of all the misery surrounding him. “When I get home, I allow myself to enjoy the moments with my family, I sometimes read a book totally unrelated to my work, I find things to do that are different from my routine, but at the back of my mind, my patients really don’t leave my mind.”  I was tempted to tell him that I had some nose bleeding that morning, but I let it pass as I thought it was a one off. The last time I’d had nose bleeding was years ago. 

On day 5, when the good doctor visited, I still did not mention the nose bleeding though it had happened more severely that morning. I don’t know why but I assumed it is because my nostrils were dry. Big mistake! But I had a more urgent matter to negotiate on - one very painful procedure I was undergoing daily twice – 100mls of a medicine used to thin my blood. Blood clotting is common with COVID patients but this medicine is only administered through injections - to my stomach every morning and evening. I think for as long as I live, I will remember those injections. Due to the magnitude of the disease in the hospital, there were no 100ml injections – so, one got 40, 40, 20 – those are three painful injections. But there was a day even that was not available and I got it as 40, 40, 10, 10 or something like that – I just know they were four not three – that was a very painful day session. So, I asked the doc – “please look at my report this morning and tell me if I can go off one of the sessions of those injections,”. He looked at me, smiled, went through my file and said – “ I think we can get you off to once a day.” I screamed in jubilation and he laughed. “But no more negotiation,” he said. “Doc, I can’t promise you that,” – he left. The following day, he came – again with only one sister. He looked through my file and said: “You know, if you continue to improve like this, I might discharge you sooner than later,” It was the best news I’d heard. And true to his word, after getting the vital results from Pathcare’s blood work, (a process done every morning to check on the vital organs) and other procedures from the medics, he said he would discharge me that day or the following day. But first, he had to ensure that I got the Oxygen Concentrator machine that COVID patients get to go home with to assist with breathing process. One needs to be shown how to use it too. Besides helping with breathing at home away from medics, this machine (Pic 5) is being provided so as to release beds to accommodate the new cases of admissions daily. I still had to call a technician from the company that provided it to help with a loud noise and later, one of their Windhoek technician, a very able Justina come and show my son and a number of things, including, where the Nebuliser needed to be fixed to. This below has been a very helpful machine during this healing process.

Picture 5 - Oxygen Concentrator

And then there were the senior nurses – called sisters – they wear elegant grey outfits – some ranks on the shoulders, sometimes they wear all maroon – a top and a trouser - but generally, you can tell these are the ones that help to keep the team motivated, I could hear it as they chatted away. Unfortunately, I cannot remember their names as I did not come into contact with them as often as I did with the nurses. But they always passed by, we had a chat, they told me the challenges they were going through daily, the pains of watching patients pass on, the pain of knowing that people can get vaccinated but do not want to for reasons that do not make sense – they are frustrated but they go on, carry on, fight on. 

Then there is Wellington – the physiotherapist who makes you have a few minutes of ‘massage parlour’ experience. I had heard some sounds like a pillow being hit repeatedly – so, I asked a nurse what it was and she told me it was physiotherapy being done on patients as they got better. So, my turn happened on Day 3 – it was ‘heavenly’. Wellington first puts you through the electronic massager that takes care of your upper body up to the neck. He says it helps with releasing tension, breathing better etc. Then he does the full hand palm ‘beating’ all over the back and then puts you through the electric massager again. Its about 10-15 minutes of the best that can happen to you besides love from the medics. He then would take me for a walk to the farthest he could within the ward and this helped with the confidence to walk around again. That physiotherapy is something LPPH must be applauded for too.

Dedication to patients was evident for all but there is a patient I will call ‘Ms P’ who made me realise that the medics at LPPH have a heart of gold. I found ‘Ms P’ there – she was in the ‘next room’ – all we had were curtains between us. I had to pass via her bed to get to anywhere I needed to go. ‘Ms P’ was very sick and even as I left, she was still very sick. I pray for her daily. At some point, they moved her away to somewhere but brought her back after two days. ‘Ms P’ barely talked, sometimes sat on her bed for hours. I would wave at her as I passed by her bed but she would just look straight ahead. The nurses would ask her if she needed the bed to be placed in a way she would be comfortable and more often than not, she would answer in the negative. Would she want to lie down? Sometimes she would just be quiet and not answer. She did not move out of her bed – there was a catheter on her and everything else was done on her bed. She hardly ate – so, a nurse would come and talk to her – literary beg her to eat an item on her plate. Thankfully, she was on drip. They cleaned her and cared for her at her bed. The dedication the nurses had with ‘Ms P’ touched the inner core of my heart.

Unlike during procedure 1-3 when I had only one roommate, and a few specials such as earphones to ensure your calls or watching TV does not disturb the neighbour, a locker for my things etc, here, those 'specials' are not available because this is a makeshift COVID-19 ward which is in actual fact a casualty/emergency reception turned ward due to the massive infections. However, you get fantastic care and that is what matters. We are all in one large ward male and female together with curtains between us for privacy. You learn to accommodate cell phone ring tones – some that go on and on before the owner picks it, conversations of all sorts - mostly loud, some 'live chat/viewings' with family from outside and a few irritable behaviours you would avoid if you had a choice. You learn to be patient and pray you will be out of hospital sooner.

There is so much to say about the medics at LPPH but let me summarise in one sentence – they are angels sent from heaven and do what angels do – be kind, take good care of you, are respectful, do not discriminate, laugh with you, cry with you and they are just lovely human beings. 

Procedure 1, 2, 3
To get any procedures done, you need to test negative to COVID-19. I did my test on May 17th – it was negative. So, on May 19th, I went to LPPH  for two procedures – a 2nd one was done necessitated by what the doc saw in Procedure 1. Whereas the first two were routine, the third was to deal with pain I had endured for a long time – more than 4 years of daily pain and trying to figure our what exactly the problem was. Part of that pain had also started during 'Lockdown' in 2020.  While one key painful area had been dealt with through other procedures, there remained three that had yet to be resolved. Two of those will be done at a later stage in the next two or so years. However, procedure 3 had to be done then to deal with extreme pain that had reached a stage that required urgent attention. So, the procedures were done and May 21st, I was discharged in the morning. But I did not feel ok – so, I requested the doc to allow me to leave late in the afternoon. When my son Tijara came to pick me in the afternoon, I told him I wasn’t feeling too well but maybe it was the anaesthesia -  I’d had reaction to it previously in one of the procedures in a different hospital. 

I went home but nothing was ever the same again. I just never felt ok. 

Tested Positive for COVID-19 
On the day I was admitted to LPPH for the second time, I had an appointment with the surgeon to review Procedure 3. For about three days or so previously, my condition had not been ok. My son had tried giving me medication we had gotten from the chemist, some constant steaming to deal with a congested nose and anything he could think of. I was not eating but I held on to some strength hoping I would at least get to Friday June 4th, the day I was due for Procedure 3 review. COVID-19 was the last thing on my mind. Why? Because I had done my part. I barely removed my mask, my students had to wear them in class for the entire teaching period, I social distanced, I had vaccinated – both vaccinations – I had done my part, plain and simple. So, COVID-19? Nope, I told myself. I thought it was something amiss with Procedure 3. On this particular day, my son had literary almost carried me to the car. At the doctors' suites at LPPH, I could hardly walk to the doc’s clinic. One look at me and the doctor did not even review the procedure he had done  – he requested for a wheelchair and asked that I be taken to casualty and tested for COVID-19 first. In less than an hour, I was on drip and procedures were being done with half of me barely knowing what was going on around me - I believe that is how fast a person dies if urgent care is not provided. My son later told me being admitted to the hospital was relief for him – he had realized I was very sick and he did not know what else to do with me.

What does it mean to have COVID-19 that lands you in hospital? 
I had been writing a book chapter on Stigma towards those with COVID or their families that had been witnessed since March 2020 and so, 'COVID effects' never really left my mind. And then in April this year, I lost two dear friends simultaneously - Njeri Mwangi (here in Namibia) and Assistant Commissioner of Prisons in Kenya, Pauline Wanja. Those two deaths affected me enormously. Njeri was only 35, had a brilliant career in banking (Fraud section) and everything else going for her. She did her part but it still caught up with her. My former colleague and cadetmate in Kenya Correctional Services, Wanja - she too was very careful from all the information I received after her demise from our mutual friend and her colleague, Assistant Commissioner Olivia Onyango, (both of whom had visited Namibia in the last two years and we had had multiple interactions) but it still caught up with her. I watched her entire memorial and funeral service online and I cried so many times. She was to retire in two years time from a very successful career. Participating in Njeri's memorial and burial ceremony as a committee member and 'accidentally', as a director of ceremonies (for the first time ever) gave me some form of closure but I still have lots of 'why God, why nows' for both of them. Now, I assume different people have different experiences but those two deaths were at the back of my mind as I gasped for air at LPPH, the worst experience ever. I have a new-found respect for Oxygen – there is the Oxygen we breath daily and take for granted most of the time and there is the Oxygen you require between you and death. So, until I got COVID-19 and had to be admitted to hospital, panting, grabbing at the air I had been so freely breathing – I had no idea exactly what to expect when one got COVID-19 at individual level. And now, the words of George Floyd, “I can’t breathe” became a reality – but I had choices – he did not have. I would not wish COVID-19 on my worst enemy. 

What are the changes, disruptions, struggles on daily basis? 
Early in the semester when I realised I would have a procedure, I organised my teaching and assessments well to ensure by the time the procedure was done, I was done with teaching and recuperation would provide time to finish any pending marking. Unfortunately, the procedure was postponed several times and it was not until May 19th that it happened but I was still on course. But COVID-19 totally disrupted my life and not sure when that will ever be the same again. Besides being unable to do anything sitting down for a while, the mindset takes a while to start figuring out - 'where do I start with what'? Messages on several student 'whatsapp groups' on assignment this, marks for this do not help because you know you owe them anyway. Many of my students I believe were accommodative of my 'hospitalisation/ailment' but I guess some students would never imagine what it means to want to do something but one cannot. And none may have known that I was so sure that this semester, I would be ready with all my marking way before original June 11 closing date but one can never plan for their lives to the letter, COVID reminded me. 

As mentioned previously, walking a few meters from your bed to a washroom without panting is a miracle in itself. You have to consciously tell yourself – “today I will try and do a, b, c, d – God, please help me”. If you are able to do 'a' alone and maybe add 'b', you are grateful. 

Day 1 & 2 – I can hardly remember much but I know I could hardly stay out of the oxygen inhaler – you just can’t even if you wanted to. I learnt to monitor my progress on Day 3 from terminologies the nurses repeated. The first one was after they would take the blood pressure – done a minimum of four times a day. You learn to read the most important numbers – saturation. They have to be between 90 and 100 but the best is 95 to 100. On Day 4, those kind of numbers started becoming a constant – the feeling inside me was like of a little child promised a lollipop. The next important digits were at the main oxygen pump – not sure what they called them but the numbers are between 1 and 5. We are at 5 mostly – needing all the oxygen you require to breath. But over time, that is reduced slowly as they test how well your lungs can take it. When you get to 3, you are on your way to mending. The day Dr Brauwer told the Sister to reduce the oxygen to between 2 and 3, I knew I was on my way home soon. 

On medication, my opinion has always been that medics know what’s best for me once they know the allergies and diagnosis I have – so, I never question why this or that – just what it is going to do for me. There are lots of multivitamins – varied types, lots of COVID medication such as Combivir and some other combination. The medication that goes into your body should make you better – that’s just what I concluded. Then, four times a day, you are put on a nebuliser (Pic 6) This one has a combination of I think Combivir and Combvent medication which you breath in and there is lots of fumes around your face, like you are steaming your face. It helps clear the lungs. I was sent home with this too as I could now use it via the Oxygen Concentrator. The drip was a constant – some medication or the other. 

Picture 6 - Using a Nebuliser 

Let me say that during the day, it is not possible to sleep a straight two hours without a medication or a procedure being administered. So, I decided to befriend YouTube and watch things I had wanted to watch for a long time and had no time for them. For a Kenyan reading this – the story about award winning singer, Guardian Angel marrying a woman 20 years his senior had gotten me wondering what the hullabaloo was about – no one complains about the French leader. I decided to view a number of the couple's videos and realised the two have a special bond and relationship – let them be. I am very happy for them now that I understood where they had come from. I had time to watch Kenyan success singing couple’s Wahu Kagwi and Nameless recent videos – they are testing use of YouTube to tell their love story. My son previously played Rugby. Though I loved watching the game, it was not until he started playing and helped me understand a lot of things in the game that my greater love for the game developed. So, I had time to watch Springbok’s legend Tendai Mtawarira’s interview on The Open Side – if you haven’t please watch it – its a gem. I love watching House Renovations – Before and After and House  Hunter International – they give me ideas about the other love of my life – re-doing homes. I had time to listen to different churches/preachers from my usual ones, music and things I would not have time for during a busy teaching week. I was lying down most of the time – so, lots of time to listen or watch stuff that did not require me to take notes. Since Day 3 when I had decided I was leaving the hospital alive, I started also writing stuff to do, to accomplish on my phone’s Notebook, stories to complete for my blog which I had decided needed reviving so I could write what I wanted, when I wanted.

Getting the Oxygen Concentrator to go home with was not an easy matter. I almost did not leave the hospital but some negotiation done between my medical AID NMC, LPPH and the company selling it  saved the day. 

Now, remember that nose bleeding? When I was discharged, I woke up the following day with everything around me bloody and now, I had to call Dr Bruwer’s clinic to ask for help. It turned out that a medicine I take daily as part of my diabetic medication was the cause. I needed to stop it until further notice – and that was it. The nose bleeding stopped.

Other effects of COVID-19
I have always had a problem with appetite – COVID-19 killed it in total. I eat because I have to. While in hospital, when I did not feel like eating, I was provided with something called resources (Pic 7) – the Nestle one is more palatable but it’s been out of stock for a while. However, through major efforts, my wonderful landlady, Gachiku Kamau was able to get some for me when I got home for which I truly appreciate.

Picture 7 - Resources - a food supplement

Another major effect of COVID-19 was killing my taste buds – I pray it is temporary. I only got to know this when I was discharged.  Back in the hospital, I had kept adding salt and paper to my food, wondering why the food never had any. So, I get home and sleeping all day long started to become monotonous despite not being able to do much and permanently on the Oxygen Concentrator. But on day three - two things happened - I decided to surprise my son who had gone to take a breather out of the house on a long drive and back with making dinner but I also felt like I needed to prove to myself that I was still 'normal'. So, I wheeled the Oxygen Concentrator to somewhere near the kitchen and used an extension cable to keep it on. I had no energy to stand, let alone to make the dinner but I was determined. I got a chair, (something I don't remember doing in a long time while cooking) and prepared some chicken I had marinated all day (secretly in the fridge). I thank God my son loves cooking and is very creative with meals. He always left some exciting food ready in the fridge for when I would wish to eat. I knew it was going to be a daunting task but I was going to do it one way or another (I recalled the first walk to the washroom without an oxygen tank and decided I could do this). Now, while I have basic ingredients for an accompaniment, for chicken, it depends on what I am making and often like playing around with ideas. I finally settled for a simple coconut chicken stew and he would make the rest when he came. While cooking it, I kept tasting the stew and wondering what was not right as it tasted flat despite having marinated it and all other spices I had added to it. I decided to stop adding anything and wait for my son to come and tell me what I had not done right. When the young man came home, he was in shock that I had dared cook chapatis besides other dish. But on tasting the chicken, he screamed - ‘Mum!’ I asked him what had happened – “How much salt did you pour into this stew?” I knew there and then what had happened – my taste buds were affected by COVID. Now, when I get some energy and can cook something – I put little salt and my son does the rest. Hopefully, their use will return soon. That cooking session took a toll on me and couldn't do any more cooking in a while.

Whereas one does not realise this while in hospital, when I got home, I realised my energy was way below anything I could ever imagine. For more than two weeks at home, it was it’s a struggle doing normal things, moving a limb, typing this story took almost a week. The energy to do little things one was able to before is hard to come by. It does not matter what you take or do – energy loss is a reality.  But in week three, the energy is slowly coming back and I have decided to what I can besides marking that had to take a break and just do the little I can do with the little energy coming back. This is besides resting when I cannot do much and take one day at a time. 

When one is healing - the immune system being low, a sore throat here, a running nose there, dormant several cavities awakening and all manner of things happen. Taking short walks to exercise for Procedure 3 as well as COVID have not been the easiest but they get better every day. 

Keep Your Affairs in Order
I always update my WILL when there is need. I have had a WILL since 1989. But for some reason, going in for Procedure 1-3, I felt vulnerable and found myself redoing a few things on it in a notebook I carry around. My son is aware of what needs to be done immediately and what I would wish done if I went to meet my maker, including that I should be cremated and what he should do with the ashes. But, as I went into procedure 3, I asked a nurse who had been a constant since Day 1 to show my son a book he would need to read through incase I did not wake up. There is little anyone other than my son would understand much of the lingua in it but this time around, there was more info critical for him – and more of what he would need to do from the point of getting the info that I had gone to join my parents and my maker. I am glad I had put all that stuff in order as when COVID struck, that little booklet became more critical then than before. Those first two days, I was unsure I would leave LPPH alive. So, when I gained some consciousness at some point, I read through what I had written in the book, updated more information and now, clearly put a label on it – ‘For my Son Tijara’ - incase I passed away. It was a tough thing to do but even as I wrote it, I asked God to give me one more chance so that I could do three pending things – the most critical one was to see my son graduate. The other two are ‘private’.

Family and Friends
Family and friends are critical to the healing process. I have always known that I have a very supportive son who is also a good friend. I have no idea what I would have done without him these past few weeks or this past year since COVID struck and there was 'Lockdown' - the loneliness would have been insurmountable in 2020. His calls those first few days when I could not finish a sentence without panting broke my heart but it helped to hear him on the other end. So, it is critical to have family or a close friend you can chat with when need be. Though he could not see me in hospital but could only bring fresh change of clothes a few times and leave them at the reception, going to hospital for both Part 1 and 2 – only my son and my Head of Department, one colleague and my closest friend and auntie, Dr Rahab Muinga (back home in Kenya and who has been a constant daily) were aware. However, while in hospital, someone who knows me and works at LPPH saw me on Day 3 – and I believe she spread the word to a few friends who called. On return home, two friends here have been a constant – Mrs Sarah Ngonyi and Mrs Beatrice Mwangi (despite the pain of loosing her daughter to the same in April) checking on me throughout the day through calls and sending goodies that I missed or do not have the energy to make now (See picture 8 – mandazis (Kenyan 'form of fat cakes), kales, coriander) and Peter Wamburi – a former Kenya Welfare Association chair calls once in a while. A nurse friend, Rhoda Komen, who my son and I have nicknamed 'daktari Rhoda' has shown me a side of her that I had never seen since I was discharged from practical advise to physical assistance - nursing angels are everywhere. Those chats with friends helped especially first two weeks, to practice speaking without panting or coughing constantly. Besides our Human Sciences Faculty Dean, Prof Alinah Segobye and Acting Head of Department, Prof Admire Mare who check on me regularly, chats from most of my colleagues from my Journalism section checking on me regularly has been very helpful. Didn’t realise the importance of such simple actions until now.

Medical AID 
When emergencies such as these happen, one realises the importance of Medical AID, something not many people can afford to have and I will forever thank my employer, NUST for this facility. I hate to imagine what I would have gone through, healing from surgery, then getting COVID-19 and so much else that happened in between the various processes. It is times like this one realises how critical affordable healthcare for all in Africa is.

Picture 8 - Mandazis, kales, coriander

GRN and Vaccinations
Something many people may take for granted is the efforts the Namibian Government has made to ensure vaccines' availability in the country. In my own country Kenya, whereas many who wish have had their first shot, their second shot is not guaranteed any more. Access to vaccines has been easily necessitated in Namibia in key government and private hospitals. When my son and I got ours early May, the queues were short, now I hear they are quite long. Take advantage of this and do your part - the government has done its part. GET VACCINATED!

This narrative can go on and on as one can never say enough as I look at where I was and where I am today. When I returned home, my son telling me that everyday he woke up or went out and came back, he was scared he would call me and I would not respond. He had reached a point where he knew if I did not go to hospital, I was not going to make it out of the house alive. He started wondering what would happen next. He knew some basics about what he needed to do but that transition - he did not want to think about it. He was very relieved when I told him we needed to go to hospital. Decisions we make, lives we live affect our children, our loved ones but until they talk about it, sometimes we never truly understand unless it it too late - I thank God I went to hospital when I did.

For now, I wish to let those who have lost loved ones know - I may not 'feel' how you really feel but I know the pain of loosing a loved one more so when there is little you can do about it. I pray that God comforts you in a special way. For those sick in hospital, I know exactly what it means to have COVID - I pray you get well soonest. For all others, please Keep safe, use your God-given brain to make decisions about 'where to go', 'what to do' and 'what to let go'. And once again, most importantly, GET VACCINATED! The youth especially are resistant to this but I am glad my son and I were vaccinated as soon as we learnt we could do so. The medics made it clear that without the vaccination, there is a high possibility I would be chatting 'live' with my late parents and others who have gone before us due especially to the other underlying conditions I have. So, just get the vaccination done – you never know when it might come in handy.
Abbreviated version: https://www.namibian.com.na/103030/read/A-salute-to-Covid-19-caregivers

-Dr Wanja Njuguna, a COVID-19 survivor.