Since the SARS epidemic hit Taiwan more than a month ago, it has claimed more than 50 lives. In particular, the serious negligence in Taipei Municipal Hoping Hospital has caused the loss of medical workers and brought disaster to its neighbors.
In this wave of virus infections, the medical personnel responsible for emergency aid are facing a toilsome task and long hours of work. Not only are their lives threatened, but they have also suffered great mental and physical pressure. Therefore, how to allocate manpower is the priority.
Manpower allocation usually goes from the near to the distant. In other words, local medical workers will first be recruited before people from outside are recruited. This is to avoid the possibility that their unfamiliarity with local disaster-relief systems might instead create counter effects.
Now the hospitals treating suspected SARS patients -- such as National Taiwan University Hospital, Chang Gung Memorial Hospital and Taipei County Sanchung Hospital -- as well as the public-health nurses and social workers responsible for implementing home quarantine, all face manpower shortages. We should immediately resolve the problem by systematically allocating the personnel and having them work in shifts. Otherwise, even if the rescuers do not come down with SARS, they might suffer from serious occupational trauma.
SARS will not only pose a serious threat to individual lives, but also have negative effects on the psychology, property, autonomy and welfare of families, communities and organizations. Therefore, during the period of emergency rescue, apart from saving lives and containing the epidemic, social and psychological reconstruction is also of great urgency.
After being ordered to undergo quarantine, suspected SARS patients will instantly have such psychological reactions as shame, indignation, terror, fear of being labeled and worries about negative influences on friends and families. When being quarantined, they will complain of boredom and loneliness. When SARS symptoms develop, they will have great anxiety, panic, pain, sadness and even despair.
Social and psychological support for these patients is as important as medical treatment. We advise that psychologists and social workers care for the patients' individual and family conditions, social relations and inconveniences they face in daily life. This kind of help is conducive to fighting the epidemic.
One can well imagine the difficulty of medical personnel's work as they are exposed to great danger when saving people. They are forbidden from contacting their relatives and friends outside the hospital and even prohibited from interacting with their colleagues. Amid the uncertainty given that donning masks and protective garb is no guarantee of safety, they even have fears when taking off the masks for food. Combating the virus alone, they are most afraid of being sacrificed and betrayed.
Providing these medical workers with updated information and adequate protective gear and equipment is the basic requirement. Moreover, psychologists and social workers should be dispatched to show concern for the medical staff regularly on the phone. Time slots should also be available for the medical workers to express their thoughts.
At the same time, convenient and comfortable chatting rooms should be offered inside hospitals, allowing medical workers to comfort each other. To calm down their minds, necessary assistance should also be provided to their families. Only after offering them support and sufficient rest can we expect them to save people's lives.
Due to restrictions on access to outside resources, suspected SARS patients put under home quarantine could not get the necessities of life, such as books, music, films, work, learning opportunities as well as visits by friends and relatives. Worried about being labeled and not knowing whether they can weather the storm, they might suffer from insomnia, anxiety and fractured interpersonal relationships.
At this time, apart from providing food for quarantined people, we should also collect publications and recreational appliances from the public. Mobilize their friends, relatives and volunteers to relieve their boredom and loneliness through Web sites and phones.
The government may also integrate non-governmental resources and set up exclusive phone and computer lines for professional counselors and volunteers to offer greetings, information and psychological counseling, and even help resolve their inconveniences in daily life. Only in this way can we effectively implement the quarantine measure.
After the crisis is gradually defused comes the "recovery phase." We must not ignore the rescuers' post-trauma pressure and survivors' grief. With the experience acquired from the 921 earthquake three years ago, we have learned to provide psychological treatment to the rescuers and victims.
Personal alienation, which everyone is worried about, should be a temporary phenomenon. As long as the epidemic eases and masks are taken off, communities will gradually return to a normal life. Those who deserve more concern, however, are the epidemic survivors, homeless people, foreign laborers and solitary old people who are suspected of being the transmission sources. Their shame, helplessness and self-condemnation resulting from the labeling will remain for a while. They will even develop such symptoms as withdrawal, suppression and self-injury.
If society does not accept them, it will be harder to heal their wounds. As for the relatives of the deceased health-care workers, the harm caused is especially grave. Bestowing the title of anti-SARS heroes or heroines to the physicians and nurses is often used to gloss over society's collective negligence and bureaucratic blunders. This is unfair to them. Discovering the truth and showing social and psychological support are what they really need.
Lin Wan-i is a professor in the social work department at National Taiwan University.
Translated by Jackie Lin
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