“I Carry the Trauma and Can Vividly Remember”: Mental Health Impacts of the COVID-19 Pandemic on Frontline Health Care Workers in South Africa

Abstract

We know from research that pandemics and disease outbreaks expose HCWs to an increased risk of short and long-term psychosocial and occupational impacts. We conducted qualitative research among 44 frontline health care workers (FHCWs) practicing in seven South African hospitals and clinics. FHCWs were interviewed on their experiences of working during the first-wave of the COVID-19 pandemic and its perceived impact on their wellness. In this study, FHCWs included the non-medical and medical professionals in direct contact with COVID-19 patients, providing health care and treatment services during the COVID-19 pandemic. Most of the FHCWs reported stressful and traumatic experiences relating to being exposed to a deadly virus and working in an emotionally taxing environment. They reported depression, anxiety, traumatic stress symptoms, demoralization, sleep difficulties, poor functioning, increased irritability and fear of being infected or dying from COVID-19. The mental health impacts of COVID-19 on HCWs were also associated with increased poor physical wellbeing, including fatigue, burnout, headache, and chest-pains. FHCWs reported professional commitment and their faith as critical intrinsic motivators that fostered adaptive coping while working on the frontline during the first-wave of the COVID-19 pandemic. Many alluded to gaps in workplace psychosocial support which they perceived as crucial for coping mentally. The findings point to a need to prioritize interventions to promote mental wellness among FHCWs to ensure the delivery of quality healthcare to patients during pandemics or deadly disease outbreaks.

The mental health toll among healthcare workers during the COVID-19 Pandemic in Malawi

“…Studies focused on specific countries within sub-Saharan Africa, such as Zimbabwe 7 , Malawi 8 , 9 , South Africa 10 , 11 , Nigeria 12 , 13 , and Uganda 14 , consistently report high levels of psychological distress, anxiety, depression, and PTSD among healthcare workers. For instance, Chingono, et al 7 found that over 53% of healthcare workers in Zimbabwe experienced moderate to severe psychological distress.…”

“…For example, Dawood, Tomita and Ramlall 11 found that healthcare workers in South Africa's KwaZulu-Natal Province felt unheard and unsupported by their employers and the government, leading to feelings of burnout, anxiety, and depression. Similarly, Mahlangu, et al 10 reported that healthcare workers in South Africa experienced memories of traumatic experiences, such as witnessing patient deaths and fearing for their safety. In Nigeria, Kwaghe, et al 13 highlighted the role of stigma and lack of support from communities and employers in exacerbating the psychological impact of the pandemic on healthcare workers.…”

Impact of the CoViD-19 pandemic on consultation-liaison activity: changes in everyday clinical practice and work-related factors associated with the psychiatrist’s need for seeking help

“…Among first-line workers, extraordinary levels of stress were reported from the very beginning of the pandemic, possibly due to increased case numbers and working hours (Greenberg et al, 2020). High rates of psychiatric symptoms, namely Post-Traumatic Stress Disorders (PTSD) symptoms, among front-line health care workers were reported in China (Lai et al, 2020), Italy (Rossi et al, 2020;Sani et al, 2022), Oman (Alshekaili et al, 2020), United States (Norman et al, 2021;Peccoralo, 2022) and South Africa (Mahlangu et al, 2023). A study carried out in Italy showed that frontline workers had higher prevalence of insomnia, depression, anxiety, obsessivecompulsive symptoms, non-specific chronic and acute traumatic stress, as well as more adaptive coping strategies, when compared with second-line workers (Sani et al 2022).…”