When the first case of coronavirus was confirmed in Nigeria, health professionals across the country braced for the task ahead. Doctor Tope Ademola* was one of the 22 doctors who volunteered at the first isolation centre set up at Onikan Stadium. The Lagos state government lodged them in a hotel and transported them to and from the isolation center. Due to numerous healthcare problems in Nigeria ranging from budget limitations and lack of adequate infrastructure to poor governance, many Nigerians working in the health sector have relocated to the US, UK and Canada. According<\/a> to the Nigerian Medical Association, of the 75,000 doctors registered in the country, about 40,000 practice outside Nigeria.<\/p>\r\n\r\n\r\n\r\n \u201cThe major factor that contributes to burnout is shortage of manpower,\u201d says Nurse Mabel Okeke*, who works in surgery at General Hospital, Marina. Her ward is big and she and her colleagues are required to move around frequently. She told me that if a partner she is supposed to have a shift with calls in sick, the probability that there will be a replacement is very low. \u201cOn those occasions, we find ourselves working alone,\u201d she said. *Names with asterisks have been changed to protect the identity of the person quoted.<\/p>\r\n","protected":false},"excerpt":{"rendered":" By Kemi Falodun When the first case of coronavirus was confirmed in Nigeria, health professionals across the country braced for the task ahead. Doctor Tope Ademola* was one of the 22 doctors who volunteered at the first isolation centre set up at Onikan Stadium. The Lagos state government lodged them in a hotel and […]<\/p>\n","protected":false},"author":3,"featured_media":6097,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19,65],"tags":[129,128,72],"class_list":{"0":"post-6088","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-societe","8":"category-west-africa","9":"tag-burnout","10":"tag-healthcare","11":"tag-nigeria"},"_links":{"self":[{"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/posts\/6088","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/comments?post=6088"}],"version-history":[{"count":10,"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/posts\/6088\/revisions"}],"predecessor-version":[{"id":6616,"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/posts\/6088\/revisions\/6616"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/media\/6097"}],"wp:attachment":[{"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/media?parent=6088"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/categories?post=6088"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sahelien.com\/en\/wp-json\/wp\/v2\/tags?post=6088"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Dr. Ademola is an emergency physician at Onikan Health Centre, a small state government hospital on Lagos Island. At the gate of the hospital, I washed my hands and the security guard let me into the quiet compound. With his cheery wave, chatty voice and a mask strapped on his face, it was hard to sense a hint of fatigue on the doctor. But he was quite drained, he told me, having worked all morning and throughout the previous day. There was a time, though, that neither the mask nor his merry demeanor could conceal his exhaustion.
\u201cIn the beginning, the working conditions were good,\u201d he said, recalling the early days of the pandemic in Nigeria. The government split the health workers into units and then, after a little while, someone in his group contracted the virus. The health worker was isolated at a place specifically set up for Lagos state staff working at Onikan Stadium, and his absence meant more working hours for the remaining four people in the group. \u201cAfter a while, resources got scarce, we were rationing PPE and N95 masks,\u201d Dr. Ademola explained. By mid-June, having worked for over three months, he felt his energy edging off and he sank into lethargy.
Burnout syndrome is a global phenomenon. It usually begins with chronic stress, characterized by loss of energy and enthusiasm for the future. This study<\/a> on prevalence, impact and preventative strategies of burnout shows that \u201cdepersonalization and a sense of low personal accomplishment that leads to decreased effectiveness at work\u201d are also some of the signs that a person is sinking. The mental health of medical practitioners is an issue of growing concern as it significantly contributes to the quality of care they are able to provide for their patients. The paper also reveals that \u201cphysicians in specialties at the front line of care access such as family medicine, general internal medicine, and emergency medicine seem to be at greatest risk.\u201d<\/p>\r\n\r\n\r\n\r\n![\"\"](\"https:\/\/sahelien.com\/en\/wp-content\/uploads\/sites\/2\/2021\/02\/RTS37H4Y-1-1024x683.jpg\")
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Though she does not attend to Covid-19 patients, she said there has been an increase in the workload since the start of the pandemic because some people in her facility went to volunteer at the isolation center. \u201cWith or without pandemic, burnout is common among health workers, especially those working in federal hospitals,\u201d Okeke explained.
Burnout happens in stages and it sometimes ends with the strain punishing one\u2019s body. The first time Okeke was burnt out, she said it felt like her head was not on her body. She\u2019d been working several shifts alone. She started feeling lightheaded, dizzy. People were talking to her and she could see their mouth moving, but could barely hear what they were saying. She was at a patient\u2019s bedside, attending to her, when she fell. The patient called for help and she was taken to the emergency unit.
Last December was immensely busy for a lot of health workers, Dr. Ademola told me. Some doctors were away for various reasons so the ones available were short on hands, taking up more responsibilities. \u201cYou don\u2019t realize you\u2019re burnt out until you actually are,\u201d he said, and he ended up spending a month recovering. \u201cYou are not as motivated as you used to be. You are a lot more irritable.\u201d There was a time he snapped at a patient, and he knew that something was wrong.
In light of the pandemic, the mental health of health workers has been gaining more attention in the media. Centers for Diseases Control and Prevention published this article<\/a> about how health practitioners can cope with stress and build resilience. Not much has been done, specifically in Nigeria, to proactively alleviate their situation. One study<\/a> of health professionals during the Covid-19 outbreak published in the Journal of Diabetes & Metabolic Disorders<\/em> concludes that \u201chealth care workers face aggravated psychological pressure and even mental illness.\u201d The authors recommend that policymakers and managers should \u201cadopt the supportive, encouragement & motivational, protective, and training & educational interventions, especially through information and communication platforms.\u201d
Although burnout has been shown to be higher in physicians, with approximately<\/a> one in three physicians experiencing burnout at any given time, the issue also occurs in all kinds of professions. Amanda Iheme, a psychotherapist and founder of ND\u1ecaD\u1eca, a private practice, attests to this. She has often attended to people in different careers who are burnt out, \u201cespecially during these past few months with the lockdown and Covid-19 pandemic.\u201d As a mental health professional herself, she has also experienced burnout. \u201cLast year was the worst in the past three years due to the increase in demand for mental health care,\u201d she said.
\u201cOnce you are burnt out, you need to take a break,\u201d Iheme added. \u201cYou will feel like there is so much to do and you cannot take a break because it will all fall apart, it won\u2019t. A day off to focus on yourself and rest your mind will help the work be better,\u201d she said. Okeke says recovering made her become a better nurse. After the episode, she learnt to pace herself and re-strategize better. She has since not experienced any serious issues.
\u201c2020 was a terrible year for my personal relationships,\u201d Dr. Ademola admitted. He could barely keep in touch with his friends and family. To help him and his colleagues get through the stress, Lagos State Government provided psychological intervention for health professionals. They organized virtual therapy sessions and followed up on individuals.
There are no easy solutions to health care issues in Nigeria, especially for mental health. To avoid burnout, Iheme recommends paying attention to one\u2019s diet, exercise and sleep. \u201cWhen taking a break, try to not focus on other responsibilities like family, our even household chores if you have the luxury to do so. Sometimes, we say we are taking a break but end up doing work outside of our professional jobs,\u201d she said.
Though he\u2019s not eager to leave Nigeria, Dr. Ademola is considering switching from clinical medicine to public health. \u201cMedicine is not the problem. I love medicine. But clinical medicine is stressful.\u201d Nurse Okeke shares other sentiments, asserting that the remuneration in Nigeria is insufficient for the amount of work they do. \u201cWe are poorly paid. The country is not working. No sector is spared, including the health sector. Basic equipment is not available and we have to improvise a lot of times,\u201d she said.
She plans to relocate outside of Nigeria in the near future, and doesn\u2019t blame others for feeling the same way. \u201cI will not talk anyone interested out of it because I plan to leave too.\u201d<\/p>\r\n\r\n\r\n\r\n