The Covid-19 pandemic brought the world to a standstill, testing the limits of humanity and strengthening the resolve of those on the frontlines uniting in the face of adversity.

In South Africa, doctors, nurses, and paramedics, among other healthcare workers, found themselves not only battling an unprecedented health crisis but also contending with the emotional weight that came with their vital roles.

Sharing his experience, Dr Dawood Bobat, 76, who is a general practitioner, said both he and colleagues of a similar age group found themselves in a predicament because experts warned that they should rather stay at home.

“But we had patients that relied and depended on us. I can’t think of anyone who sat back and locked himself up in the house.”

He said members of the KZN Doctors Health Coalition immediately sat down and discussed what they could do when the pandemic hit SA.

“We started a helpline where doctors volunteered to answer calls and allay the fears of patients and answer questions about what was wrong with them.”

During the pandemic, Bobat said doctors were fearful, not for themselves but for their families. “Although we were prepping ourselves and wearing masks and gloves, you could slip up and carry the virus home and one of your family members could die.”

Recalling his interactions with patients, Bobat said the most horrific experience at medical facilities was the shortage of beds. “Imagine an elder man, the breadwinner of the family, who can’t breathe, sitting in the car while his wife and children cry. They all want to get in, but there’s a queue, and there are no beds.”

Bobat said there was a doctor in Chatsworth who, with the assistance of charitable donations, found an open space and erected a tent with beds. “She did a magnificent job of treating patients there.”

The role of helplines and community support

Family practitioner Dr Prithy Ramlachan said he recalls the helplessness that was felt when the pandemic hit, and the first case was identified in the country. “Suddenly, people just started dying and we didn’t know what to do.”

He said they gathered information from experts and set up a process where information could be disseminated to practitioners and patients throughout the country.

“People were fearful, ‘Am I going to die? Am I next?’ because some young family member of theirs had died from Covid,” he said.

The 72-year-old said he contracted Covid twice and was off for three weeks in the first instance, and in turn, his wife became ill with Covid on a ventilator for six weeks.

“While I was sick with Covid at home, I could still help with the helpline. I could still have Zoom meetings with my colleagues and describe what was happening to me so that they could understand,” he said.

Ramlachan recalled how doctors worked almost 18 hours at a time and had to go out at night with an oxygen supply and a drip. “The family practitioners were going out to the patients, to the houses because every hospital was full. We had to manage them at home; there was no other choice.”

He said there were times that some doctors and nurses working in the high care ward filled with Covid patients could not even go and urinate.

“You had to completely disrobe, go to the toilet, and then put the PPE back on. So we had to make a plan and we said, guys, let’s put a diaper on,” said Ramlachan.

Ramlachan said looking back at the lengths that doctors and other healthcare workers had to go through, “We should really be proud.”

The emotional toll of the Covid pandemic

A nurse, who requested to remain anonymous, said the pandemic was a challenging time for healthcare workers, filled with both struggles and moments of resilience.

“The bad times included overwhelming patient loads, lack of resources, and emotional exhaustion from seeing so many lives lost. Many had to work long hours, risking their own health and their families.”

The pandemic tested healthcare workers like never before, pushing them to their physical, emotional, and mental limits, she said.

“Hospitals were overwhelmed with critically ill patients, and resources such as ventilators, ICU beds, and personal protective equipment (PPE) were often in short supply. Many healthcare workers had to work long shifts, sometimes without proper rest, food, or even time to grieve the loss of their patients and colleagues.”

She said the emotional toll was immense and watching patients die alone without their families due to strict isolation protocols was heartbreaking.

However, she said there were also good moments, such as strong teamwork, innovation in patient care, and deep appreciation from communities.

“I know of colleagues who went beyond their duty, staying in hospitals for weeks to avoid exposing their families. Despite the hardships, the experience highlighted the dedication and compassion of healthcare workers worldwide.

“The pandemic was a time of both immense suffering and incredible heroism. It showed the true dedication of healthcare workers, who risked everything to save lives. While the trauma of those days still lingers, the experience reinforced the importance of teamwork, compassion, and preparedness for future crises,” said the nurse.

Resilience and teamwork

Paramedic Kelly Pillay reflected that serving as a medic during the pandemic was both an honour and a profound challenge. Pillay said while it was a time of uncertainty, exhaustion, and sacrifice, it was also one of resilience, teamwork, and unwavering dedication to saving lives.

She said every shift meant facing the unknown shortages of supplies, overwhelmed hospitals, and the heartbreaking reality of losing patients despite their best efforts.

“The emotional toll was heavy, as we witnessed families torn apart, colleagues falling ill, and an ever-growing burden on the healthcare system,” she said.

However, she said amidst the chaos, there were moments of hope with patients recovering, communities showing their gratitude, and fellow healthcare workers supporting each other like family.

“The pandemic tested our limits but also reaffirmed the purpose of our calling. It reminded us why we chose this path to serve, to heal, and to stand on the frontlines in times of crisis.

“While the scars of this experience will remain, so will the lessons of perseverance, compassion, and the unbreakable spirit of those who answered the call to care,” said Pillay.

The aftermath of the Covid pandemic

Another paramedic, Loshnie Frank, said when Covid began in the country, the medics who she worked with were very afraid along with everyone else.

She said what drove the fear was not knowing who had contracted the virus as some did not show symptoms but were positive, as well as how quickly people were getting sick.

“On the many calls I went out on, it was a learning experience for me as well and it thereafter began a teaching experience to patients and my family,” she said.

Frank, who had contracted Covid three times, said she was one of the lucky ones who did not experience the harsh symptoms.

“The sad part for me after going out on so many Covid calls was eventually most patients became regulars just needing us to comfort them and explain the different stages they would have to go through to get better.

“I’ve lost many Covid patients, and it was difficult knowing I saw them a couple of days back and then finding out suddenly they are gone. I had to keep myself mentally and physically strong constantly so I could be able to help as many as I could,” Frank said.

IPSS Medical Rescue’s Samantha Meyrick said so many paramedics walked away from their careers or came close to it.

Medics who are from the communities they serve sometimes had to try to save their own family and friends, Meyrick said.

“I remember comforting a nurse who was crying because she felt like she couldn’t do anything more than watch her patients die,” she said.

Meyrick recalled how one of their ambulances was forced to park on the side of a highway with a patient who had suffered a heart attack. “We had nowhere to take him because the hospitals were full.”

She said due to an overwhelming volume of calls, they had to inform callers that they would experience significant wait times, potentially spanning hours.

“People were so desperate for help; we had people from all over KZN phoning us to try to get an ambulance for their family, and so many people refused to believe it was that bad,” said Meyrick.

Conclusion

As the world attempts to recover from the ravages of the Covid-19 pandemic, healthcare workers are grappling with profound challenges that echo the experiences of soldiers returning from conflict zones, according to Dr Rinesh Chetty.

Chetty, a prominent figure in the medical community, has warned that moral injury, compassion fatigue, and burnout now plague many in the profession, creating a toxic environment that jeopardises the future of healthcare delivery.

Moral injury stems from situations where healthcare workers believe they have compromised their ethical standards due to external pressures, he said.

He said during the height of the pandemic, doctors were often forced to make heart-wrenching decisions, prioritising ICU beds, delaying essential surgeries, or working without adequate protective gear.

“These experiences have generated deep feelings of guilt and helplessness among professionals who felt betrayed by the very systems meant to support them.”

Compassion fatigue is another by-product of the pandemic, he said, marking a deep emotional and physical exhaustion from prolonged exposure to patient suffering.

“Healthcare workers have become detached. They witness mass casualties and patient isolation and often feel powerless to change the outcomes,” he stated, outlining how the emotional burden has impeded their ability to connect with patients.

He said the concept of burnout has also taken on new dimensions since the pandemic, characterised by chronic exhaustion, cynicism, and diminished accomplishments.

“It manifests as overwhelming fatigue, cynicism, and a decreased sense of accomplishment. The increased workload, staff shortages, and administrative burdens during and after Covid-19 have driven many healthcare workers into burnout, making it difficult for them to engage meaningfully in their profession.”

These challenges create a dangerous vicious cycle that threatens both their well-being and the future of healthcare, he stated.

“Breaking this cycle requires a multifaceted approach, combining institutional support, mental health resources, and individual resilience strategies. Without meaningful intervention, the healthcare system risks losing its most valuable asset — the well-being of its doctors and nurses,” said Chetty.

Chetty added that the healthcare systems globally were already stretched pre-pandemic, and the Covid global emergency medical response required all healthcare workers to band together and work as one global force to hold the virus at bay. However, he said many of these memories of what healthcare workers did for the three years have been lost.

Chetty said once all the dust had settled, loved ones and colleagues buried and mourned for, the borders opened up, and lockdowns were released, there has been a worldwide exponential increase of mistrust in the healthcare system.

“Violent abuse of healthcare workers and a failure in grappling with medical error litigation are crippling the already strained healthcare budget and delivery. The current crisis of unemployed doctors and the serious lack of staff to man hospitals after hours is clear evidence of such,” said Chetty.

He said many senior healthcare workers are struggling, and most are leaving the profession following the pandemic and the aftermath.

“This further compounds staff shortages, worsening work conditions, and negatively impacts service delivery. A vicious cycle that was always a problem pre-pandemic but now it is cycling faster than ever before,” he stated.

Chetty warned that the noble profession of delivering healthcare services is at risk and has never been more difficult to perform.

“Defensive medicine is costing everyone. If this continues, there will be no healthcare workers to deliver any services. The fact that many local hospitals have no doctors on call after hours, and there are so few obstetricians to deliver babies in the country these days is testament to that already happening.”

karen.singh@inl.co.za