Healthcare during Covid-19

Gino Contaldi, Tafelsig

The coronavirus pandemic has no doubt caused major disruptions in countries all over the world.

It has adversely affected educational, legal, economic, entertainment, business and especially healthcare systems and sectors.

The tremendous efforts by healthcare policymakers, managers, nurses, doctors, allied medical professionals and all other healthcare workers who screen, perform tests and treat those diagnosed with Covid-19, are indeed greatly appreciated and acknowledged.

The lack of staffing currently seems to be the biggest challenge in the public healthcare system.

It is, however, of concern that at primary healthcare level, patients with other medical conditions seem to be overlooked.

Even at some community health centres, also known as day hospitals, patients only receive more repeats of previously prescribed medication, whereas they are actually due for follow-up consultation, which involves them being clinically examined and possibly being given or referred for new treatment.

Needless to say, this may cause chronic patients with hypertension and diabetes for example, to develop disabling and potentially life-threatening conditions such as stroke and gangrene.

Those with other medical ailments may even die without being diagnosed and treated due to the lack of access to clinical examination.

Amid the crisis brought about by the Covid-19 pandemic, can no alternative or middle ground be found by the province and the City of Cape Town’s public health authorities?

Surely no one wants to have a situation in which there is a sharp increase in preventable deaths from medical conditions other than coronavirus infection, due to such factors?

Monique Johnstone, spokesperson, provincial Department of Health (Klipfontein and Mitchell’s Plain Substructure), responds:

The primary health care platform provides a critical first line of defence and response to keep people safe and healthy and to reduce the pressure on hospitals.

Primary health care services help to diagnose, trace and slow down the spread of the virus, while providing other essential health services to communities such as emergency care, immunisations, reproductive health services (family planning), maternal and child health care, HIV/ Aids, TB, mental health, and the treatment for chronic diseases.

Primary health care platforms had to relook at the way they were doing business during the pandemic, including the roles of staff while ensuring a collaborative approach in support to the response to the pandemic.

The Mitchell’s Plain Community Health Centre (MPCHC) outpatient department’s operating time was adjusted to be responsive to the patients’ needs.

The facility adjusted staff’s working hours to allow for early patient screening and faster directing of patients to their health access points.

All walk-in patients were channelled to the designated “see and treat” area outside the main facility, for clinical assessment and management.

Since mid-July community wellness outreaches have been taking place in the Klipfontein and Mitchell’s Plain areas, providing non-Covid-19 healthcare services.

Community health workers have continued with their door-to-door visits, screening and referrals.

The provincial Department of Health in conjunction with Aviro Health have developed an automated chatbot application system via the WhatsApp platform, which confirms delivery of chronic medication to our patients’ homes.

It also allows high-risk chronic patients to confirm an existing appointment before accessing services at their attending healthcare facility, which means they do not have to wait in long queues when going to a facility.

The department wanted a system that would respond to high-risk chronic patient queries timeously and to give people peace of mind that their medication will be delivered to their homes.

The system also allows our high-risk healthcare workers the opportunity to assist patients with their queries without placing their lives in danger as well.

Not only has the chatbot been of value in helping communities receive their medication, but it has also been an easy way for patients to manage their health without increased risk of contracting Covid-19.

Our data shows people with comorbidities such as diabetes, hypertension, TB, HIV/ Aids, cancer, chronic lung disease and heart disease are at higher risk of becoming severely ill with Covid-19.

These people or their family members are invited to join the chatbot to confirm their medication delivery by adding the number 087 240 6122 to their mobile phones and send a message saying “hi” to start the WhatsApp Chatbot conversation.

If clients are concerned about their health, then they are encouraged to contact their nearest healthcare facility for assistance.