“We don't just work a lot. We work all the time.” An interview with a nurse from Toretsk city

The article was published on nv.ua on 10 December 2020.

Svitlana Panarina, a nurse from the therapeutic department of the central city hospital in Toretsk, Donetsk region, talks about the challenges she and her colleagues are facing in connection with the coronavirus pandemic.

Ahead of the Human Rights Day celebrated on 10 December, NV media and the UN Human Rights Monitoring Mission in Ukraine are publishing a series of stories about how the pandemic has disproportionately affected people in vulnerable situations and why it is important to put human rights at front and center of the COVID-19 response.

Therapeutic nurse Svitlana Panarina has been working in the central city hospital of Toretsk, Donetsk region for three years. She first came to work at this hospital back in 1983 but then worked for some time in Europe, in another country. Later she returned to her homeland.

Thanks to the hospital's management, the staff was prepared for the coronavirus pandemic both professionally and mentally, says Svitlana Panarina. For example, the head of the therapeutic department conducted training for the staff and did everything possible to prepare workers for new challenges. However, doctors still faced a number of difficulties: irregular work hours, overwork, lack of material support and lack of psychological support.

In an interview with NV Svitlana Panarina talks about the work of the central city hospital in Toretsk during the pandemic, the dynamics of coronavirus infection and her working days.

About working hours during the pandemic

We didn't just work a lot. We started to work all the time. This is not an office building, when at 5 pm you can just go leaving some tasks for tomorrow lying at the laptop. We are devoted to this work because the health and lives of people are at stake.

There are a lot of shortcomings, both general and local. But in total, as far as our hospital is concerned, I am proud of the team. The efficiency is at the highest level yet sometimes it is not possible not just to eat or perform the necessary hygiene procedures but simply to have a water. Everything in the mouth dries up. It is very difficult. According to the Labor Code, we have the right to a break and rest after four hours of work, but in fact we get no rest and that is not regulated in any way.

There was a moment when there were only four of us left - three nurses and one doctor. The rest fell ill and were on sick leave. It was impossible to provide assistance with those resources. We were short of oxygen concentrators. The patients were simply suffocating but we could not help. They told us that the hospital could simply be closed because of that.

Our hospital changed its leadership two months ago. The new leader did everything to help us and also sent staff from other departments to assist us. I believe we got out of this situation with dignity. Today we can already talk about a decrease in the level of cases.

Yes, we have an urgent need for psychological help. However, such help is completely absent. We cope only by supporting each other and rejoicing when we have the opportunity to help someone and when patients leave us healthy. This is the only way to cope at the emotional level.

I'm not afraid. I am genuinely happy when I see that we have managed to do something to save lives. After all, there is nothing more valuable in the world but life and, secondly, health. This is the joy of being needed. Therefore, there is no fear.

Women account for 90% of our staff. Men are only doctors and technicians, the rest are mostly women. There were both tears and emotions over this time. Nevertheless, no one deserted anywhere and left. All remained.

Of course, the pandemic also brought us a kind of positive experience. First, at least slightly, but the level of supplies has grown. Yes, we have not yet reached the point of exercising our right to overalls, but still at least something.

In addition, it seems to me that we have become even more professional: we learn, we gain experience. We have all become more humane and kinder.

About the treatment of patients with coronavirus

To date, we have deployed an infectious diseases department, where there are about 40 people with confirmed coronavirus. However, people with pneumonia are admitted to the therapy department that we serve. In fact, these are the people with symptoms of coronavirus, who come to us and several days later a PCR test can be made.

We are in contact with patients with coronavirus without being financially supported. The decree on the additional payment of 300% of the salary to physicians [decree of the Cabinet of Ministers of Ukraine dated 04.24.2020 No. 331, which is valid from 05.05.2020, but applied from 01.04.2020] applies only to the infectious diseases departments.

As reported by the UN Human Rights Monitoring Mission in Ukraine, apart from the lack of healthy and safe working conditions for frontline medical workers involved in the COVID-19 response, healthcare workers also raise concerns about fair remuneration for their jobs as average salaries in the health sector were significantly below average salaries for less qualified work. They further complained about the inconsistent approach and discrimination in payment of COVID-19-related and other temporary bonuses introduced by the Government for healthcare staff. Only a small percentage of COVID-19 infections among healthcare workers were recognised as work-related, which negatively affected the right to social protection and compensation.

As for medical care, for some time they would not give us protective masks at all or they would but of dubious quality. It was not clear who and where had bought them. Moreover, when I asked to show me at least some quality certificate, I was refused in a rude, even threatening manner. But today we have everything - masks and disinfectants. Everything is modest, but it is there.

About 60% of the medical staff contracted coronavirus over this time. These are either those with Covid-19 confirmed by a PCR test or those who were sick with pneumonia even with a negative test. Many people have the disease while remaining on their feet but the symptoms of coronavirus are still notable. This is how we work. If  any of our health workers dies from the coronavirus, some compensation is provided. However, we have no medical insurance.

In my opinion, there is also a violation of the rights of patients, not just doctors. If initially a preliminary diagnosis was made on the basis of symptoms, not only of test results, the patients would receive the minimum number of medicines that the government gives for the treatment of coronavirus. Otherwise, the treatment of pneumonia costs patients UAH 10-40K.

Coronavirus infection is a very specific disease. Many approaches in the treatment of viral diseases and pneumonia do not work here.

About support from the outside

Unfortunately, trade union organizations have remained in the post-Soviet form and they are just an appendage of the leadership. It’s hard for me to say what else they do other than collecting union fees. We did not hear from them a single word, no action towards out interests. I believe that such organizations should be completely separate from the enterprise itself and be in complete opposition to management in order to be able to help their employees.

They could teach people to defend their rights. They could help people cope with fear, prove their participation or non-participation in something. The staff should have a lawyer who would help people cope with difficulties at the legal level. Because without all this, if some nurse says that she should not work in such conditions – for example, without masks or without gloves – she is simply told: “Shut your mouth. If you don't like it, go away".

In such small towns as ours, the problem of employment was very topical especially for women. Because basically the main area that provided jobs was the mining industry, which is now dying. And now, when we are also a front-line city closed by checkpoints, we have no opportunity to find a job anywhere. We do not have a railway to be able to get a job in another city. Therefore, people have to endure a lot. They are afraid to defend their rights so as not to lose that minimum and means of living that their salary gives them.

You can complain everywhere but no one hears you. For example, I had a conflict situation with one of my colleagues, when, as I believe, the law was violated, instructions were violated, and criminal instructions were given. I complained to the prosecutor's office, to the civil-military administration, and wrote a memo addressed to the head physician. And I received replies that accused me of saying that I do not perceive the problem correctly and should improve my legal knowledge.

UN Human Rights Mission in Ukraine urges the Government to improve standards of work of all healthcare staff by ensuring, equally for women and men, decent pay, safe and healthy conditions of work, and access to social security including the recognition of COVID-19 as a work-related illness and adequate compensation for it. It is also important to establish effective dialogue between trade unions of healthcare workers, and national and local authorities.

The most important thing that could be done to change something is to remove the corruption component that unfortunately remained in our hospital as well.

Another important point is the health of doctors. This is the backbone of our fight against the pandemic. Therefore, physicians must be protected both legally and financially, and have psychological and emotional support.

Now the whole world has understood who health workers are. We come to this world with help of health workers, and we leave this world being attended by that same health workers. Therefore, it seems to me that this is the most basic among the basics – the support of doctors and care for their health.

I would like to help our health workers remember their dignity, teach them to defend their rights. I want to see our people without fear in their eyes.