Born in 2020 series - Born during a pandemic

Tamuka case – Covid Baby

Last Month we had to crisis manage a pregnant teen who went into labour 4 hours past curfew time in Zimbabwe. The team got a distress HELP message from Tamuka via our WhatsApp support group (Ntombi Gateway). It was past most people’s bedtime, so responses came in slowly an hour later with some people asking if she was OK. When no response came, our senior staff member contacted her privately and discovered that she was in labour but could not determine which stage of labour she was in. A panic-stricken care giver was heard asking if our staff were coming to pick her up to take her to the hospital: A discussion among staff concluded that contacting emergency service would be the best course of action. A member of staff was allocated to be on-call to provide emotional support and to crisis manage the situation and to handover to Tamuka’s keyworker and the rest of the team in the morning.

According to United Nations Development Programme “COVID-19 pandemic is far more than a health crisis: it is affecting societies and econ­omies at their core” (UN, 2020). This is particularly true for individuals in developing countries who have struggled with the impact of Covid affecting them financially, mentally, physically, and politically. The government strategy to both stop the spread of Covid and to crush growing dissatisfaction of the current regime imposed an indefinite curfew four months after the outbreak. The curfew came with rigid restriction to movement between 6pm and 6am, restricted access to public transport and limited travel with evidence required for reason to travel. While it is understandable that authorities have a duty to safeguard public health and protective measures must be imposed. Time will tell if these systematic measures will combat the spread of Covid as current reports show a rise in of cases instead of plateau. However, the youth, elderly, the vulnerable are impacted daily. What happens in emergency cases? Will the hospital be staffed? Will their care needs be met? Will they afford to pay for a C-section if there are complications? Can they afford an ambulance service, which is among the authorised service allowed to operate during curfew times? Sadly Tamuka opted to wait until morning to go to the hospital where midwifes confirmed she was in labour and a few centimetres dilated.

Secondly Covid has presented many professionals with ethical dilemmas. Health and Social Care providers have a duty of care to support those in need. However, Covid has torn a lot of professionals between their well-being and duty of care. Reports of abandoned hospital wards due to nurse’s strike have left many fearful of attending local hospitals and increased anxiety. Similarly, prior to Covid Thula Trust provided Crisis Intervention which required face to face interaction with pregnant teenagers and their families. Adhering to social distancing measure means most of the support and outreach is delivered via the phone and social media platforms, staff are torn between providing hands-on support and protecting their own families. Is it selfish for nurses to request PPE or for Thula staff to go against their work ethics and ethos to protect themselves and families?

Covid is teaching us at Thula to change our strategies in terms of keeping staff safe and being available when needed by our beneficiaries. We have introduced an on-call system where a worker is available to manage any issues out of hours. We have adapting to the new normal of communicating via Social Media Platforms, but this can be challenging for most pregnant teens and teen mums who are dependent on their care-givers to top-up their phones. In this case Tamuka was fortunate to have a supportive care- giver who was with her throughout labour and delivery. Tamuka delivered a healthy baby girl, both mum and baby continue to strive.