The project “Challenges for health care workers during the COVID-19 pandemic” is part of a larger mixed-methods study I am conducting with my colleague Galateja Jordakieva and Maren Jeleff at the Medical University of Vienna, in which we assess risk factors and working conditions of health care workers in public hospitals.
The study was conducted against the background that health workers have a threefold increased risk for getting infected with Covid-19, compared with the general population (Nguyen et al. 2020), and that they are more likely to experience psychosocial distress (Lai et al. 2020), including stigmatization (Bagcchi 2020). Up to now there are only few studies that investigate the occupational situation and resilience strategies of health care workers during the current Covid-19 pandemic.
Galateja’s quantitative clinical study is focusing on the exposure of neglected groups of health care workers (cleaners, service personnel) by assessing the potential risk factors for Covid-19, plus analyzing the serum prevalence of SARC-CoV-19-IgG antibodies.
In the qualitative part I am leading, we were interested to understand the general challenges of working in such a crisis, the coping strategies, and the gendered implications. To get an in-depth understanding our team used an explorative approach, conducting so-called semi-structured interviews (with open-ended questions) with health workers (nurses, doctors, medical technicians, cleaners, and service personnel) who were in contact with Covid-19 patients. The in-depth interviews lasted between 30-60 minutes and took place at the workplace of our study participants. We have already conducted over 30 interviews, but the analysis is still ongoing.
The project was funded by the Vienna Science and Technology Fund in the framework of rapid funding called “Vienne Researches Corona”. The project underwent expedited peer-review and we were able to start the project in the record time of two months after application.
The first step in any kind of research, whether clinical-quantitative or social science & qualitative is the application for ethical clearance at one’s research institution. Our university’s ethical committee offered a special expeditated review for Covid-19 research and with their support, we were able to get our study approved within a few weeks. However, we also needed the approval of each federal state and for time constraints decided to confine our study to Vienna.
We contacted health workers from different hospitals, largely working by word of mouth and so-called snowball sampling. While most health care workers were extremely eager to talk to us, we found that especially cleaners and service personnel were difficult to reach. Even though we guaranteed them confidentiality, some were still afraid to talk openly. Clinical staff was easier to reach and more at ease to talk with us. We did, however, experience challenges as staff were frequently overworked and exhausted. We tried to keep the interview time as short as possible, especially when health workers were on duty or when they had some precious time after a night shift. The participants showed a remarkable interest in our study and we are extremely grateful for their dedication and time.
There are quite some media reports on the occupational situation of health care workers, their challenges in working many hours on end without breaks, packed into their protective gears, profoundly sweating, not able to drink or use the toilet; and their mental challenges with distressed patients, who fight for their lives, and overwhelmed relatives who are not able to visit their loved ones in times of greatest need. As noted above, however, there are still only a few in-depth studies that document these challenges in a structured and systematic way.
Health care workers are one of our most precious resources when it comes to fighting a pandemic. Yet, they often seem to be forgotten in their day-to-day struggle.
Prof. Ruth Kutalek is a Medical Anthropologist and Associate Professor at the Department of Social- and Preventive Medicine, Center for Public Health, Medical University of Vienna. Her research currently focuses on anthropological perspectives of infectious diseases, especially community perspectives on Ebola, Lassa fever, and measles, including the involvement of health workers in epidemics. She has also done work on vaccine hesitancy and migration of health workers from the Global South; as well as the environment, health and vulnerabilities; medical ethics, and ethnopharmacology. She has conducted research in several countries in West and East Africa and supported the WHO in missions in Liberia and Sierra Leone (Ebola) and in Nigeria (Lassa fever). Prof. Kutalek is also engaged in the development of curricula in various settings, specifically in introducing aspects of diversity, culture & health in the curriculum for undergraduate medical studies. She has published widely and is a reviewer for several journals in the social sciences, public health, and tropical medicine.