Rashes, fatigue & stigma: How ambulance workers are coping with COVID-19 pandemic

Hospitals are the battleground against the COVID-19 pandemic. While the doctors and paramedical staff are leading the fight from the front, the foot soldiers of their army, ambulance workers, are bringing the battle, the contagion, to the battleground. However, adverse weather condition has started taking a toll on their body.

The ambulance workers are facing hardship in performing duties in the hottest month of the season. They are surviving heat strokes and have developed rashes on their bodies while donning PPE kits in 42-degree temperature for prolonged hours.

Hospitals are the battleground against the COVID-19 pandemic. While the doctors and paramedical staff are leading the fight from the front, the foot soldiers of their army, ambulance workers, are bringing the battle, the contagion, to the battleground. However, adverse weather condition has started taking a toll on their body.

The ambulance workers are facing hardship in performing duties in the hottest month of the season. They are surviving heat strokes and have developed rashes on their bodies while donning PPE kits in 42-degree temperature for prolonged hours.

Braj Kishore, a 26-year-old emergency medical technician (EMT) of the 108 ambulance service, is deployed at the Combined District Hospital in Ghaziabad. He survived a heatstroke on Thursday after completing a round of COVID-19 patients from Rajeev Colony. "Just after I reached the hospital with the patient, I started to feel nausea. I experienced a blackout for several moments and felt extremely week on my knees. It was like the whole energy has been drained from my body. I lay down on the ground and remained there for a good 20 minutes till I regained my consciousness completely," he recalled his experience.

Kishore has been deployed in ferrying the Covid patients since April. He equated the PPE kits to sacks. "It is just like a sack used to store grains. Though air condition system functions in the ambulance, its effect is negligible on the body. Air cannot cut through the material PPE is made of," he said.

Arvind Kumar, EMT in ambulances backed with advanced life support (ALS) system, is deployed at Dr Bhimrao Ambedkar Multispeciality hospital in Noida. He said that his duty involves ferrying the patients who are critically ill. The whole process takes up to four to six hours, and he experiences severe breathlessness inside the PPE suit. "I feel like throwing up inside the suit. The vision becomes hazy due to constant sweating, and the heat inside the suit makes it difficult to breathe at times," he said.

Besides, the workers have also developed red rashes on their bodies. 25-year-old Ram Gopal Yadav is deployed in COVID duty in the MMG Hospital of Ghaziabad since March when the first positive case arrived in the city. He has developed the rashes on his chest, stomach, and back. I have been ferrying the patients from their residence to the hospital or quarantine facilities and back to their home daily.

Yadav said that a single trip takes around four to six hours. "We have to wait for minimum an hour to receive the patient. Then, we have to wait again at the hospital from half an hour to an hour since the procedure takes time. Till, the time, the patient stays in the ambulance and we are not allowed to leave before the hospital staff receives the patient,"

The procedure takes a long time, and ambulance workers have to stay in PPEs for the whole time. "We keep drenching with sweat inside. It compromises our hygiene and causes rashes and constant itchiness. Besides, the cringy feeling of drooling in sweat, moving around in clothes drenched in sweat is disgusting," Yadav said.

Yadav told that he takes a bath after completing the duty, applies medicated talcum, and waits for the instruction to go on another trip.

Facing stigma for their nature of work

Apart from bearing challenging work conditions, the ambulance workers also face the stigma attached to their duty of ferrying the Covid patients. Two weeks ago, Yadav was granted two weeks vacation to visit his home in the Ghonsli Village of Sambal district, Uttar Pradesh. However, he cut short his trip and joined the duty within three days since his fellow village people were unwelcoming him.

"Someone did a mischief by posting my photo on Facebook and mentioned that I have received 15,000 Covid cases the day I reached home. The next day, my village head came and asked me to return to Ghaziabad as he feared that I'm a Covid carrier and may infect the whole village. I returned a day after since I was concerned for my family. They could have ostracized my family members had I not left the village," Yadav recalled his ordeal.

Naresh Pal, 32-year-old pilot (driver) of 108 ambulance in the MMG Hospital, Ghaziabad, said he always experiences weird and unwelcoming gazes of the people whenever he receives a patient. We have a protocol to wear PPE even when we receive a non-COVID patient. But people don't understand it. They speculate that we have arrived to receive a COVID patient. Our mere sight makes them run away. They click pictures, make videos, and gather a crowd who asks irrelevant questions. It bothers the patient and us greatly," he shared.

He also shared that ambulance workers receive similar apathy from the medical staff as well. Even doctors run away from us. It feels like we are untouchable," he said.

The ambulance service by the Uttar Pradesh government operates under the National Health Mission (NHM). The NHM provides three types of ambulances -- 108, 102, and ALS ambulances. While 108 is provided for emergency cases, 102 is reserved for pregnancy cases and cases involving children. The ALS ambulance ferries critically ill patients. Each ambulance is operated by a pair of pilots (driver) and an EMT.

Sandeep Kumar, program manager at the NHM informed 72 government ambulances are running in Ghaziabad and Noida. Of them, 26 are designated exclusively to service the COVID patients. While one 150 pilots and EMTs work in Ghaziabad, Noida ambulances are serviced by 120 pilots and EMTs.