The COVID-19 pandemic has been challenging, and it has put significant pressure on our healthcare system. Nevertheless, our healthcare workers continue to devote their time and energy to contain this pandemic. We are humbled by their immense sacrifices, invaluable dedication, commitment and unwavering efforts in managing COVID-19, oftentimes risking their own lives, for the benefit of the nation.
ARROW’s Shamala Chandrasekaran speaks to Dr Zaiton Yahaya on her experience as a frontliner during this global health crisis. Dr Zaiton is the State Family Medicine Specialist (FMS) of Sabah, East Malaysia. She heads the Sandakan Health Clinic and is one of 36 healthcare professionals working in government health clinics across Sabah. Dr Zaiton is also the founder and president of the Sabah AIDS Awareness Group Association (SAGA) and recipient of the Tun Dr Siti Hasmah Award in 2019 for her outstanding work to end AIDS.
As the country pledges to stay home through a movement control order (MCO) to flatten the curve of the COVID-19 pandemic in Malaysia, Dr Zaiton and her counterparts work tirelessly, putting their own health at risk every day in order to safeguard the community. With the MCO lasting months, concerns on its impact on women and girls, and their vulnerabilities, have been raised. In these times of crisis, gender inequalities are unfortunately compounded and amplified.
A majority of my front liners are women. Those who are married, especially the ones with children including babies who are still being breastfed, are feeling the pressure the most. They are not just physically stressed but mentally as well, giving their very best in balancing the current demand at work and their primary role as caretakers at home where they have the responsibility of taking care of their families and children including babies as young as six months old. Now that childcare centres and nurseries are closed, some of my staff are in dire need of support with childcare. They have no one to care for their young children at home and they are left with no other choice but to leave their children with either neighbours or relatives. Some of their husbands are also in the healthcare sector but for some, their husbands are not ready to take on the caretaker role. This is even harder when they work during the weekends too. They are emotionally affected that they cannot be there for their children during this time of crisis like some mothers who are at home attending to their children’s needs during MCO. For example, one of my staff said she feels terrible seeing her school-going child missing out on the e-learning system the Education Ministry has introduced during this crisis. She is mostly in the clinic and is not able to support her child’s participation in the e-learning activities as compared to other classmates. It made her feel like a less competent mother.
This further adds to the mental pressure they are already feeling with the extended hours of work in the current COVID-19 situation. Also, the allowance for extended hours of work including working during weekends is not automatic and for most of my team members, it is not accessible. Some of them are constantly in fear of bringing the virus home to their families, especially those with babies and breastfeeding mothers. At one point, we faced a shortage of PPEs and this further added to the fear. Thankfully, I approached a few individuals for public support and several groups came forward to donate PPEs to my team. It is another challenge altogether to wear PPEs for long hours in uncomfortable conditions under the tents performing screenings. Thankfully, the situation has now slowed down a little for us.
The Ministry of Health has introduced a survey for healthcare workers and the general public to assess their current mental health status, in order to link those in need of mental health support with health services during this crisis. Most staff who took the survey scored high, indicating that their mental health is significantly affected, which can’t be ignored. I am waiting for more details to take the necessary steps to support the staff concerned.
Basically, they are burdened by prevention and care responsibilities at work and are at a higher risk of contracting the virus, being responsible as the main caregiver for the family and finally being subjected to emotional and physical stress.
MCO has made access to healthcare services a huge challenge especially for my patients who are from rural areas as far as Beluran (130km), Tongod (170km) and also Terusan Sugut (150km) who need to take a boat and hired vehicle to reach our clinic. They are not able to come to my clinic for services due to the MCO. So, we have the medication sent to the nearest clinic or hospital for them to fetch. I encourage them to go to the nearest community clinic run by nurses in their districts to continue contraception and maternal care. The police at the roadblocks require my patients to have a memo from the community clinic if they want to travel across districts to meet me for a referral, which is quite challenging due to the distance and also the queue … they have to wait at roadblocks for interrogations.
I also felt bad for a woman who had to come into the quarantine centre with her months-old baby and a toddler as her husband tested positive for COVID19. They came to the quarantine centre in a hurry and these places are unequipped. Some families didn’t bring enough clothes to last the 14-day quarantine and didn’t have enough milk and diapers for their babies. I have managed to secure some donations from the public and hypermarkets to meet these needs.
Some of my patients have difficulties in making ends meet as their husbands are daily wage earners and during the current MCO period they are not able to go to work. Hence, there is no income for the family to even put food on the table. If women had equal opportunity for education, equal job opportunities without being expected to automatically take on the role of the caretaker, the situation may have turned out differently for these families.
So far there are no reported cases of domestic violence but I believe there are. We hope that those affected will reach out by going to the nearest clinic or be brave enough to reach out to us via text messages or over the phone but the network in rural areas is not good.
I must say that the current COVID-19 crisis has made gender inequality more visible through its impacts, including those demonstrated in the examples I have shared. Women are definitely disproportionately affected, especially the healthcare workers who are struggling to balance work and home duties during this crisis. A gender sensitive response is critical for effective response to the crisis, taking into account every woman’s health and wellbeing including physical and mental health.
Women make important contributions as leaders, frontline responders and caring for their families and children especially during crisis and emergency situations like this. Because the health, economic and social impacts are intensified for them during this crisis, we must look into the gendered impact of this pandemic to further strengthen our response to this disease outbreak. And to reduce the gender inequality, women must be given equal access to education, job opportunities and more importantly they must have the right to choose and voice out their opinions and needs. From the SRHR perspective, it is a woman’s right to decide how many children she wants and when she wants to have them, spacing is important. Access to contraception is a right to health that a woman must be able to choose.