I heard the word “pandemic” during my early nursing studies but never reflected on what it could look like. Today, I am in that world, facing COVID-19 as a pandemic. It has spread in more than 200 developed and developing countries globally, and Pakistan, my home country, is one of those.
Pakistan has one of the highest youth populations and is seen as a low resource country because, since its inception, it has faced ethnic conflicts, terrorism, corruption, and political instability. As a result, the country is struggling to maintain its economy and resources. The majority of healthcare facilities lack human and material resources; availability, accessibility, and affordability of quality care services remain a challenge.
Here in Pakistan, people often move in and out of cities and the country to explore jobs, earn money, visit religious places, and perform pilgrimages. The first positive COVID-19 case was reported in late February 2020. Most of the initial COVID-19 positive cases had a travel history, which they held back. They might have had a fear of being stigmatized and isolated, and unfortunately, they began silently spreading the virus.
Pakistan’s government started its efforts in mid-January by reflecting upon its resources and compared it with the worsening situation of China. The action plan focused on designing emergency preparedness actions and strengthening collaboration between government and private sectors and the civil society. The first action announced by the government was to close the schools across the country. This was an immediate and effective effort to promote social distancing. The media is playing an active role in emphasizing this concept, which is not acknowledged much by Pakistani people because we like to be together. Outside of the government-generated helpline led by doctors and nurses, hospitals are developing their own online self-explanatory videos in their local language on prevention and management of COVID-19. In addition to this, healthcare professionals are leading live interactive sessions on social media.
Realizing we have a weak health system, the government led conversations with key officials from the health ministry and major tertiary care hospitals of the country to strategize actions for identifying and designing quarantine centers; ensuring the availability of personal protective equipment (PPE), testing kits, and ventilators; and effectively distributing and utilizing other related resources to ensure timely scrutiny and management of COVID-19 cases. Our government has released funds to purchase and import ventilators, testing kits, and PPEs in addition to our locally made PPEs.
Areas in all provinces have been instructed to set up quarantine centers. Outpatient departments are closed in all hospitals, but hospital management has arranged designated COVID-19 areas to screen, admit, and manage cases. Doctors, nurses, midwives, and other paramedic staff are being hired on an urgent basis. Train cabins have also been set up as temporary hospitals and quarantine centers.
Along with the health ministry, all other ministries are actively working 24 hours a day, 7 days a week to combat the deadly COVID-19 virus. The ministry of food security guided provinces to prepare food security plans and ensure the availability of sufficient basic food stock. The finance ministry was advised to revisit tax rates on food and other daily use items. Many Pakistanis are on daily wages, and they are only able to afford two simple meals per day. Because of this, the government has announced relief packages for the low socio-income group and has created an account in which the white-collar community is requested to provide funds. With this fund, a ration is distributed to families who are unable to afford what they need.
Despite our progress, Pakistan is facing many hardships related to the COVID-19 pandemic, like many other countries of the world. It was a very hard decision for the government to decide on a lockdown, but this action was taken to minimize community exposure across the country. Public places, including parks, restaurants, markets, educational institutions (colleges and universities), shrines, and religious places (mosques and churches), are closed. Policies have been created for airports and train stations to screen, identify, control, and manage suspected travelers and travel schedules within and outside the country.
Currently, all provinces are following the lockdown policies by closing all cities at 5:00 p.m. During the lockdown, only medical stores and milk shops are allowed to be open until 8:00 p.m. Citizens are strictly instructed to stay at home and are only allowed to move in case of an emergency. Breaking the rules during the lockdown is considered a crime and is punishable under the law.
As a Pakistani citizen, I understand that during this time, Pakistan is using innovative and collaborative actions to work effectively and achieve the desired goals. Together, we can be more productive to fight the battle against the deadly virus. Every one of us has a significant role to play, so let’s not wait and do it now.
Shahnaz Shahid Ali, MScN, BA, RN, RM, is a Senior Instructor at Aga Khan School of Nursing & Midwifery in Karachi, Pakistan. She is a member of Sigma’s Rho Delta Chapter at Aga Khan University.