American-born and Norway-based Physician, Parvathi Rau Bains, shares her experience of working with elderly people more prone to COVID-19 during a time when the proper safety measures were not yet in-place to protect either providers or patients.
1. Tell us a bit about your personal history that led to your current work.
I am an American doctor who completed my residency at a competitive program in Internal Medicine at Indiana University. I moved to Norway in 2011 and received a temporary license based on my background. Unfortunately, this was not enough to begin working in Norway. I began taking Norwegian language classes at a public institution, which was essentially tailored for students who were well-rounded with a high educational background. I struggled with Norwegian, in the sense that it was difficult to practice outside of class, since everyone automatically switched to English once they heard my accent. Long story short, I became licensed in 2014 and began working as a physician in Norway. My current work is in a short-term care facility in Lillestrøm. There, I am a kommunal lege, which means I work in the public sector in primary health care and most of my patients are elderly. I enjoy my job immensely, and it allows me to have a good work-life balance.
2. Do you relate to WGH's Five Asks for Gender-Responsive Global Health Security in your work and how so?
My colleagues at work are mostly (approx. 95%) women. My boss is also a woman and her superior is a woman. I think that, in Norway, women have a better chance of getting a higher education, which makes them well-equipped to handle global situations such as COVID-19.
3. Has your work changed during the COVID-19 pandemic?
My work has changed immensely, in the sense that COVID-19 has become fundamental to all I do. We have a low threshold to test our patients. My post (50 bed unit) was actually emptied of patients in March because we were supposed to be a center for palliative care of COVID-19 patients who were too sick to be actively treated at the hospital. The idea was that those patients would receive palliative care at my institute. Luckily, that hasn't happened.
4. What are the challenges in Norway for your sector due to the pandemic?
The crisis was the expectant rise of COVID-19 across a fragile population who is more prone to getting the infection and being harmed by it. The reaction at work was to try and make-do with the slim resources we had. We had to freshen up on palliative care guidelines and had a challenging time keeping families of patients informed. Fortunately, there were few cases at my institution.
5. In your opinion, what strategies from the Norwegian Institute of Public Health (NIPH) or other government bodies might be helpful to combat the challenges of COVID-19 in your work?
Norway had a very quick response to the outbreak and handled it well. Other countries that did not that take the virus as seriously have suffered increasing numbers of COVID-19 patients and high morbidity. Good communication is the key to everything. I do wish that, during the earlier phases, we could have had a more direct line to physicians at the hospital when questions arose. I felt that NIPH guidelines were often confusing in the beginning, but that became better over time.
In addition, NIPH has also made several sets of guidelines in terms of palliative care and has been updating them frequently. We have to evaluate each patient that comes in as if they are infected and then evaluate their need to be admitted. We also have to decide whether patients were candidates for artificial respiratory treatment (getting intubated and connected to a machine in order to help with difficult breathing due to respiratory issues). In addition to the immediate evaluations, we must ask patients’ loved ones to answer tough questions regarding extensive treatments, CPR, etc.
Our future challenges with COVID-19 are to get people vaccinated in a fair manner and get them to actually take the vaccine. I believe that the elderly (65 years and older) should be vaccinated first, as they are more likely to die from the disease.
7. What lessons have you learned both from COVID-19 and throughout your career that you might like to share with other women?
My private sphere has been somewhat affected in terms of my job becoming more demanding. This often spills over into my private life, where my family is affected and I am less likely to participate in even minor social arrangements for fear of contracting the disease and spreading it to my patients. I have learned in this process that health care workers are not always equally valued or given the respect we deserve. While this is not true for Norway, it is more obvious in the United States (US). Several close friends who are physicians in the US continue to suffer from a lack of PPE; it astounds me that such a global power would be careless with the people dedicated to healing others.
COVID-19, or similar situations, will arise again in the future. It is important that we are, by then, better prepared in cases where we have not been thus far. As a health care provider, it is important to let leadership know where they might have made mistakes and not simply to accept things as a part of your job. We have every right to be safe.
The WGH Norway COVID 50/50 Taskforce serves as a national hub for COVID-19 and gender equity actions and activities. This ad-hoc taskforce is in support of the WGH Global's #COVID5050 Campaign, which introduced the Five Asks for Gender-Responsive Global Health Security in 2020 to help confront power and privilege. Both of which undermine global health by preventing women from contributing equally to the fight against challenges like COVID-19.