Emotional reverberations during COVID-19 trying times in Manipur

Ranita Maibam, Ranjita Devi and Dr Elsa Sanatombi Devi
WHO Chief, Tedros Adhanom Ghebreyesus announced saying that the world must be prepared for Pandemic on 25th of February 2020. COVID-19 soon spread far and wide and developed countries started facing heavy death tolls. Chaos in health care, fear and anxiety among health care seems to be the menu on daily clinical experience.  Health care professionals are on the frontline risking their own lives in the midst of uncertainty. First cases appeared in India in January 2020 with stable abilities to contain them but soon COVID-19 travelled across the country but with careful implementation. Chaos between violators, community leaders and health care professionals building capacity to fine-tune the existing facilities and expand for the theoretical predictions of tall rise of infection mid-May. Soon corona arrived on 23rd of March to the state of Jewel and fear began so as to how spread can be contained. Quarantine facilities were created for the people who travelled back to state from various hotspot locations. Not having witnessed prior pandemics, the entire healthcare seems to be numbed at the arrival. Immediate family members were quarantine with all other returned during the last week of March.
Quarantine home Vs Home was not comparable. Inmates felt terrible in the initial stay not understanding what is the outcome or the fate that lies ahead of them. One of the inmate expressed saying, “it was scary, felt emotional and also had good experience at the end”. She felt “broken” inside of her as no family members were around. Gradually she drew up her emotional feelings and began to feel at ease as the frontline health care professionals began to involve them in various activities and also getting used to the inmates who lived daily in the same quarantine home.
Anger, denial and bargaining were the psychological traits exhibited. In two days’ time, nurses formed as a team to help people come out of their fears to the real-time quarantine space and left to manage 24 hours of the day. Social distancing, basic procedure that needs being at bedside, educating them, supplying food and managing the entire traffic within a school set up was a kind of improvisation. Help calls made to mentors made ease of managing people in quarantine. Anxiety and fear loped away as various established activities were planned for the inmates. Morning evening pranayama, Yoga, and physical exercises were live demonstrated and inmates maintaining social distance were fervently practised. Video conferencing of yoga practices from home when not even on duty in the morning hours by nurses made a great way to relax and be peaceful.
Drawing and imaging them through pencil and pen sketches moved the feelings of being isolated in a quarantine home. Their stories of experiences are featured in their drawings giving deep feelings of being saved from the dangerous virus the COVID-19.
Having all inmates and health care professionals on a social media platform allowed expression of feelings that each one wishes to express for which actions and strategies were implemented on individual basis. It was a kind of ease of info sharing with relevant videos and messages that motivated them to stay calm and composed. Soon the inmates started taking up self-responsibilities and communicating with each other within the quarantine home. There were people who do not speak Indian Languages and English was the medium for many. Individual counselling was possible as inmates could message or call when they need help that are very personal. Talking and sharing information made them feel at ease. The fourteen days seemed a year around. Hand hygiene, personal hygiene and tips for health maintenance were displayed at every possible walls and corridors for compliance. Practice sessions motivated all inmates to comply and make sure that their health and others’ health are taken care of. Diet planning and variety were induced to maintain their health and also to stay active.
Picture-1 Girl and bird in hand, themed- “Hope and freedom”
A pencil sketch of a girl emerging from water and a bird in her open palms typically picturizes a soul freed from danger. Experience of drowning in water tells you that you hand no branch to hold on. It suffocates and fears make you aspirate. This picture depicts freedom from the dangerous corona virus. The feeling of being not infected is a grace from God. A priceless gift at this pandemic time.
Picture 2: By Romen Singh themed - Everyone holds hands to fight the virus.
Another faded coloured sketches of hands put together to suppress and contain the spread of COVID-19, is fantasized to achieved this fight. Even being in quarantine and having experienced this isolation for the dreaded COVID-19, made these inmates feel the need that we all stand together for the virus to extinct from the land of Jewels. Nurses and doctors by their side made each one feel very comforted and they also  realized how nurses round the clock looked after their needs and keeping them safe as ever forgetting their needs and stigma by family and society. This compassionate care by the nurses makes it clear that role of health care is deeply appreciated and value of nursing becomes angelic.
Picture: 3 Ship sailing themed “En-route towards a new world”.
Life is not a bed of roses is well depicted in the sketch of an inmate who seems to sail through the pandemic times. This expresses the experiences that touches one’s emotions which leaves a positive impact when one survives or escapes from unknown danger. Pandemic shapes social evolution. From luxury to a normal limited space and facility creates sense of understanding one’s beginning. Pandemic recreated family time which are quite vulnerable as many are not used to sharing family time in this busy schedule.
Within a week time, people got used to and woke up from depressive feelings of lockdown to social activities running to help the poor and needy. Taking a signal from clapping and lighting to light up and motivate citizens at the frontline that made huge success in uniting the people of India made a way to applause our honourable PM
Modiji but instead he pleaded “Don’t need standing ovation, honour me by feeding the poor during COVID-19 crisis”. This movement made everyone feel the pinch of hunger and love for neighbours and strangers in need. This world has realized that helping and giving is the only source of joy. The joy of giving, the joy innovating, the joy of releasing tangles in health care are the success stories our next generation would read and learn in history.
Narrations from pandemic inmates at the quarantine home made remarkable impact on the journey of understanding. One of them recounts “Initial week was terrible feeling as entire family isolates themselves in their own room in a home”. This thought is reflected looking at how caged animals would feel and their freedom abandoned. This terrible feeling of being isolated and inhibition disappeared with rock singing by the health care professionals with social distancing at the quarantine home atmosphere just to lighten up the mood. This was amazing and made them feel at home.
Health promotional activities like laughing therapy, yoga, pranayama are very much into our system even after we returned home, says an inmate. They realized that health promotion and healthy living are the only ways by which people can avoid health issues and live a very enriching life.
We have come a long way in science & technology but nature and natural practices should not be forgotten. Winding up the quarantine care services and back to centres made life more challenging as community needs overwhelming service utilization as number of people visiting the community health centres increased for the fact that they prevent themselves going to hospitals. Remember there are increased number of pregnancies reported by women and also abuse and violence against them. Counselling couples and managing children with low feelings due to lock down and no school time is to be tackled carefully to reduce post pandemic impacts on health.
Philanthropic thoughts and feelings of CHOs are evident making thousands of mask spending from own pocket to make their people safe and comply. Community preparations are underway if COVID-19 returns to Manipur, our motherland. Webinars, hands own training, sharing views and ideas on ZOOM, and many social platforms made nurses and public completely aware so that we can mitigate. Sudden dip into technology and successively venturing home to home on safe stay, and health maintenance were the song every CHO sang for public indulgent.
Today, Manipur is free from COVID-19 and we remain committed. A strong nursing team with knowledgeable leaders with a fighting spirit could be the ideal way forward to fight future pandemics and also maintain the sustainable goals. This year, WHO theme on “Year of the nurse and midwives” clearly demonstrates that nursing empowerment is the solution to achieve the sustainable goals and investing in nursing could mean a world of health for the people.
It is high time to thin down the thick walls between health care professionals and form an interprofessional approach to care that would bring tremendous change in quality patient care.
(Maibam Ranita Devi is presently working at Ayushman Bharat Health & Wellness Centre, Awang Wabagai, Imphal West, Manipur as Community Health Officer.
She is a National Florence Nightingale Awardee 2019.
Loitongbam Ranjita Devi is presently working at Ayushman Bharat Health and Wellness Centre, Naorem Chaprou, Imphal West as CHO. She received appreciation certificate for organizing population-based screening of diabetes and conducting awareness programme under NPCDS,2018.
Dr Elsa Sanatombi Devi is a FAIMER Fellow, Professor and QMR at MCON, MAHE, Manipal and also faculty at FAIMER International institute, MAHE, Manipal. She coordinates the first IELTS center in India in collaboration with NHS, UK)