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Healthcare worker collecting swab sample for COVID-19 testing in Srinagar. Photograph by Umer Asif for The Kashmir Walla.

On the morning of 19 August 2020, when 45-year-old ambulance driver Jameel Ahmad Digoo’s phone rang, he instinctively knew that it was going to be a long and painful day. The call was from Srinagar’s Shri Maharaja Hari Singh (SMHS) hospital. A patient suffering from COVID-19 had died that morning and the body needed to be taken for burial.

An employee of the Directorate of Health Services, Kashmir (DHSK), Mr. Digoo is solely responsible for the transportation of all dead bodies of patients who die of COVID-19 within the Srinagar city limits.

An hour later, Mr. Digoo was on his way to Srinagar’s Zadibal locality to deliver and oversee the burial of the day’s first COVID-19 causality. “This is how my days usually start since the first COVID-19 death took place in Srinagar city in late April,” he said.

As anticipated, Mr. Digoo’s shift ended after about 16 hours, during which he had delivered seven dead bodies, the last of them in the Baspora locality of Srinagar. It was the highest number of dead bodies he had ferried in a single day so far. “After such a stressful and emotional day I cannot even sit with my family to share my feelings,” said Mr. Digoo.

The stress and anxiety involved in working around COVID-19 patients is something that he just can’t leave behind at work. At home, Mr. Digoo is constantly afraid that he might already be a carrier of the infection, he often eats his dinner in silence–alone in a spacious room his family has kept for his daily self-isolation. “I have been in perpetual isolation [from my family] since April,” he said. “This is the price I know I have to pay every day to do what others fear to do.”

Moreover, Mr. Digoo is also aware of the other consequences of the job: social stigma.  

It pained Dr. Khurshid Ahmad Dar to see people who took a chance with their lives and with the lives of others around them by disregarding the guidelines for the prevention of the COVID-19 disease.

“Can you imagine almost every Covid-19 patient has at least four attendants with him? When we deny them entry inside the hospital buildings, they loiter in the lawn,” said Dr. Dar. “They eat food brought to them by other relatives inside the hospital and behave as if it is a picnic.”

A professor at the Chest Diseases (CD) Hospital in Srinagar, the sole COVID-19 exclusive facility in Kashmir, Dr. Dar is currently at the frontline of the fight against the deadly pandemic. On most days, after spending hours in a Personal Protective Equipment (PPE) without food or water, he has attempted to educate the attendants about basic precautionary measures like social distancing and wearing a mask. 

Dr. Dar has seen patients and attendants pick fights with hospital staff, particularly doctors after they are not allowed inside the hospital premises for not having worn a face mask. “By acting normally these attendants put our lives at risk too,” he said. 

“When these attendants go back into society or go home to get food etc. they [can] carry infection with them. In some cases, attendants change shifts, which is very dangerous. This way they [can] become spreaders without even realizing it,” he said.

Currently, most of the critical patients infected with coronavirus disease are under treatment at the Chest Diseases Hospital. “We (as doctors) are already stretched beyond our human capacity since March. We cannot afford such insensitivity at this critical juncture by the society,” said Dr. Dar. “A number of our resident doctors have not visited home for months at stretch. It takes an emotional toll too. Sometimes we too get emotional and react. But society should understand.”

Dr. Dar said that better communication and clear messaging about COVID-19, from the administration, could have helped the society to better understand the reality and the extent of the threat.

For a 30-year-old counsellor, Sania, who wished to be identified by her firstname, being at the frontline was akin to being trapped in a maze. She is posted at the COVID-19 isolation ward at the hospital in Srinagar.

“We have been misunderstood by all sides,” said Ms. Sania. “When we ask for proper gear, the administration thinks we are overreacting. When we tell people to take precautions, they too think we are overreacting. Ultimately we carry our anger and frustration home with us.”

She has vivid memories of her maiden visit inside the isolation ward, something that has left a lasting impression on her mind. “I could clearly see patients feeling ashamed for being there or for testing COVID-19 positive. They would hardly look you in the eye,” she said. “I realised how much we have stigmatized them. The society acts as if they are untouchable.”

What still haunted Ms. Sania is the sight of an 18-month old baby, who had tested positive in mid-April, crying for milk. Wearing a full PPE kit and aware of the circumstances, she had no means to help the child. She is still reminded of the baby’s shrieks piercing through the ward.

“It takes a huge mental toll on [health workers] like us. We see death and pain firsthand. Their faces and cries stay with us long after they are gone,” said Ms. Sania. However, she insisted that she had never been afraid to be among coronavirus patients. “I am not afraid for myself. But as infections increase, the quality of our PPE gear decreases. It feels like it can hardly protect us,” she said.

Last month, her father suffered a heart attack and a stunt was placed into his coronary arteries. “This makes him vulnerable to catching infection quickly now,” she said. “In order to help people, we are putting our own families at stake directly. That thought pains me the most.”

Ms. Sania felt that the overall approach of society and the stigma associated with the COVID-19 disease–even the frontline health workers helping the infected–is putting health workers in a dock.

The recent death of two prominent doctors due to the coronavirus has added to the anxiety of some health workers. “Everyone is scared and it is quite normal. When you lose someone you know, then only you feel how real the threat is,” said Dr. Yasir Hussain Wani, 30, a surgeon at the SMHS hospital. “But people must appreciate their sacrifice and help in the fight against COVID-19.”

As the rush of patients in hospitals across the Kashmir Valley has returned to the norm that was before the outbreak of the pandemic, doctors like Mr. Wani have now found it even more difficult to enforce social distancing protocols amid the growing footfall of the sick.

“Because of the lack of clear communication by the government, people are complacent towards Covid-19. They think the virus is gone as the lockdown is lifted,” said Farooq Ahmad, a health worker at the Sub-District Hospital (SDH) Pampore in south Kashmir’s Pulwama district.

Recently, five health workers at this hospital had tested positive for the disease. “You find most of the people visiting hospitals without masks. They don’t even maintain distance while consulting a doctor,” said Mr. Ahmad. “This attitude puts everyone’s life in danger.”

However, for 35-year-old psychotherapist Mudasir Aziz, who counsels patients with drug addiction and psychiatric ailments, to maintain a distance from her patients is not an option. “It is impossible to counsel a patient with psychosis or mania from a distance as we have to engage them to gain his/her trust. Without that, it cannot be done.”

Initially, Ms. Aziz tried to counsel some patients, struggling with drug addiction, over the phone but that didn’t work well as the patients were reluctant to engage in a conversation. “It is frustrating. You really want to help them, but you know visiting such patients is risky,” said Ms. Aziz. “I have to think of my old parents too.”

The lockdown has been lifted but confirmation of newer cases of the disease has steadily risen–on 22 August 2020, the Kashmir Valley reported 9 deaths and a total 567 of the 612 deaths due to COVID-19 in Jammu and Kashmir with 5,490 of the total of  6,973 active cases.

After having transported seven dead bodies in a day, Mr. Digoo was hopeful that the next day would be a bit better. As he had anticipated,  he was proven wrong. The day began with another phone call and another death at the SMHS hospital. Nothing had changed.

“I am living one day at a time without thinking much. The day I stop to think, I will not be able to do what I am doing,” Mr. Digoo said, thoughtfully. “So far I am not infected. And that is a reason enough to keep going.”

The cover story was originally published in our 24-30 August 2020 print edition.

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