Attacks on doctors and nurses occur regularly — usually instigated by family members or acquaintances frustrated

To be a health care worker in the best of times includes days of stress, sorrow, frustration, triumph, joy and reflection — not always in that order. This past year was all of that on warp speed, as the World Health Organization declared a global pandemic on March 11, 2020.

To mark the one year anniversary of that declaration, we’ve photographed and interviewed nine healthcare workers from around the globe, serving very different communities but all with the same goal: conquering COVID-19. We especially wanted to know: What has surprised them most over the past year? And how have they managed to cope with all the stress?

Emergency medical officer Dr. Storm Bissict, 35, photographed outside the ER entrance of Netcare Christiaan Barnard Memorial Hospital, Cape Town, South Africa, on the morning of January 19. To escape the stresses of her job during a pandemic, she dives into the ocean.
Charlie Shoemaker for NPR
Diving For Solace
A colleague of Dr. Storm Bissict’s was the first serious case of COVID her hospital had seen of one of their own staff. His health deteriorated to the point that he needed a tube inserted to help him breathe — intubation, often the last line of defense for COVID patients.

“We both knew full well what the chances of survival post intubation were at that point,” she says. Before they started the intubation, her colleague — a husband and father of two — asked Bissict to pass along messages to his family. Then he turned to her and asked, “What if this is it?”

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It’s that single moment of intubation that Bissict finds the hardest to deal with — what she calls “those moments of breathlessness when there is no other alternative but to be sedated and connected to the ventilator.”

Some of these patients are aware of what is happening but unable to communicate, she says. “They often just don’t have the breath to form the words.” Others, perhaps the luckier ones, says Bissict, are delirious from too little oxygen. Either way, she says, the moment of fear when they’re not able to breathe is always there.

Bissict’s colleague recovered and after three months in the hospital, they wheeled him out the door. He’s now back at work.

Many who get that sick aren’t as fortunate, says Bissict. And dealing with the amount of loss the staff sees every day is tough. She says the word “heroes” doesn’t even begin to define the people she works with.

“From exhaustion (physical and mental), the fear of falling ill (or more so taking it home to loved ones), to the illness and sometimes death of colleagues. It’s a day-to-day, shift-to-shift struggle. Relentless. We have all repeatedly cycled through the stages of grief — denial, anger, bargaining, depression and acceptance. At this stage a great deal [of medical workers] seems to be stuck on the anger phase.

“Yet, despite this, they still arrive.”

Dr. Storm Bissict, 35, dives in False Bay along the coast of Cape Town. It’s her way of decompressing from her hectic pandemic days.
Charlie Shoemaker for NPR
Free diving is how Bissict escapes the stress, and she finds herself struggling if a few days pass without a dive. The ocean is “my solace, my therapy,” she says, leaving her “centered, calmer, more at peace with myself and the chaos of the world above.”

“It’s the crackling of the kelp and seabed, the gentle pushing of the surge, the colors, the light. There’s a rhythm to the ocean. And an order.”

Bissict has also rediscovered yoga to “quiet the mind” and reconnect her with her breath.

“Funny how a disease that steals breath led me along a path of rediscovering it,” she says.

-Photographs and interview by Charlie Shoemaker

Jamil Ahmad Digoo, 47, an ambulance driver in Srinagar, Kashmir, prays in the Malkhah cemetery in Srinagar, where he has buried patients who died of COVID-19. Speaking of one of the women he buried, he says: “Even now, every night, in my prayers, I apologize to God and this lady in case I might not have accorded her the respect she otherwise deserved.”
Showkat Nanda for NPR
An Ambulance Driver With An Unexpected Mission
What has shocked ambulance driver Jamil Ahmad Digoo about the past year was not the grim scenes he has often been faced with as part of his job. It’s the “self-centered” way so many people have acted when asked to help others.

“I witnessed brothers running away from brothers and sons running away from fathers. Such was the fear of the pandemic.”

He made a decision early on in the pandemic to do whatever needed to get people they help they needed. “I left all my fears and came to the forefront to help people — from carrying COVID positive patients and dead bodies [in his ambulance] to helping dig graves for the dead.”

Ambulance driver Jamil Ahmad Digoo says he was shocked to see “brother running from brother” in fear during the pandemic — and resolved to do all he could to help others. The support of his family, he says, has helped him cope.
Showkat Nanda for NPR
What has gotten him through? Digoo says the “single most important thing” was his family. “My kids would tell me that they were proud of me. My wife always said that God would always protect me because whatever I was doing was for His creation. This attitude of my family always gave me the courage to keep myself going through the toughest time of my life.”

Despite it all, Digoo is positive about 2021. “I think humanity saw enough in the year 2020 and I am hopeful that God will end this difficult time for us. I am sure the year 2021 will be a year of prosperity and good health.”

-Photographs and interview by Showkat Nanda

Dr. Seemin Jamali is executive director of Jinnah Postgraduate Medical Centreo, the largest hospital in Karachi, Pakistan. She went through chemo during the pandemic — and kept working: “I didn’t want to stay home. I didn’t want to live a life that was useless.”
Betsy Joles for NPR
Pushing Through Chemo And COVID
To say the last year has been tough for Dr. Seemin Jamali, the executive director of Jinnah Postgraduate Medical Centre, would be a serious understatement.

First, her work: The hospital she runs is one of the largest in Pakistan, overseeing projects and teams in the hospital and working in the emergency room.

Attacks on doctors and nurses occur regularly — usually instigated by family members or acquaintances frustrated by a patient’s diagnosis or death. It happened before the pandemic, and now it’s happening as a result of the pandemic.

Dr. Seemin Jamali says that attacks on doctors and nurses occur regularly — usually instigated by family members or acquaintances frustrated by a patient’s diagnosis or death. It happened before the pandemic, and now it’s happening as a result of the pandemic.
Betsy Joles for NPR
“That is what I saw in the ward – how they [family members] tried to drag the dead body out of the ward. They broke the ward, they beat people with sticks and bashed all the glass. And this is what happens in normal times also.” She attributes it to the feeling among relatives of an injured or deceased person: “They need to put the blame on somebody.”

As frustration and anger increased while COVID raged, so did the violence. One of the biggest issues, she says, is how the hospital should handle the dead from COVID while still respecting different communities’ rituals. Some relatives of patients who had died became angry at not getting the body back by a certain time. Jamali says operating procedures have changed over how they handle the bodies, so things have improved.

Every culture and religion has its own way of carrying out burials or death rituals, she explains, so certain communities were agitated by not being able to enter the ward before the person died or collect their bodies in a timely fashion afterward.

Add in her personal life: At one point last year, Dr. Seemin Jamali and her husband, an orthopedic surgeon, were both sick in different wards of the hospital: He had COVID, she had colon cancer. She also lost some family members and colleagues to COVID.

The hardships in both her personal and work life have made Jamali all the more determined to get up every day and do her job, even though she is at an extra high risk if infected because of her cancer treatments; although she does spend less time in the emergency room since her illness. “I didn’t want to stay home. I didn’t want to live a life that was useless. I wanted to make my life worthwhile. There are so many people who benefit from my being here so it’s worth it.”

She is very thankful for the help she received along the way. Jamali’s sisters came from the U.S. to help and she is so grateful to them. “The last three months of chemotherapy were really bad. And I pushed myself to go to work. They left their work, their family, their kids and came here to help me. There are no words to repay them for anything for the rest of my life.”

-Photographs and interview by Betsy Joles

Ofelia Pérez Ruiz, 39, is a midwife in San Cristobal de las Casas, Chiapas, Mexico. She has lobbied — unsuccessfully — for protective equipment for midwives.
Janet Jarman for NPR
A Midwife Delivers
As a midwife during a pandemic, Ofelia Pérez Ruiz has learned to listen to her conscience. And that’s been a complicated matter. She not only supports her patients through the exceptional stresses of pregnancy in the COVID era, she’s been worried about keeping her own two children safe and cared for family members ill with the coronavirus.

“[M]y conscience said that I have to attend births, regardless of the fact that it could put my family or myself at risk,” says Ruiz, a spokesperson for the Nich Ixim midwife movement of Chiapas, Mexico.

Her burdens would have been easier with proper protective equipment. She spent a great deal of time trying to get the government to recognize midwives as frontline workers and provide resources to keep them safe.

Midwife Petrona Hernández Díaz performs a pandemic prenatal checkup on Ana Laura Gómez Hernández.
Janet Jarman for NPR
“We wanted them to support us with protection supplies and to give attention to the midwives and give recognition and respect to their work. Nobody responded, but midwifery continues, with or without support from anyone.”

As the pandemic year progressed, Ruiz moved her appointments to virtual and lived in a haze of anxiety, stress and insomnia while family, friends and colleagues died around her.

Eventually, she came to the realization she would have to learn to live with COVID for her patients’ sake: “We had to keep going, since the virus came to stay with us.”

Ruiz’s motto is to move forward. “I will keep taking care of the pregnant women and their births, since it’s my job as a midwife,” she says. “Midwifery continues, with or without support from anyone.”
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