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The pandemic two years on: ‘We’ve had to rethink every aspect of our work’

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In early 2020 few of us could have foreseen how a little-known new disease would change our lives. In a Q&A, Medair’s Senior Health and Nutrition Advisor Dr. Wendy Dyment reflects on the extraordinary challenge of keeping life-saving programmes running through a global pandemic, and how we must now rethink aid for a COVID world.

You’ve been a humanitarian for over 20 years.
How have the past two years been different?
The pandemic has led to a major step back globally in all areas of health and nutrition. Surveys show the impact is pretty much across the board: cancers have increased, gender-based violence has increased, global vaccination rates for major diseases have taken a step back. There has been a knock-on effect on vulnerability on many fronts, such as access to food, so the humanitarian needs that were already there before are now worse. And there will be need for greater responses to try to catch up.

We’ve had to rethink every aspect of our work. Our first question was how to keep providing life-saving services in a safe way, without adding to the problem by being super-spreaders? And secondly, how to respond to COVID itself?

In the beginning we had to devise all the guidelines ourselves, across multiple countries, before there were any available globally. Running the global COVID taskforce has meant a lot of extra time for me, I’d say a good 10 to 15% increase in workload on top of a very full schedule.

What kinds of new approaches has Medair adopted?
We’ve helped in different ways in different countries according to need – setting up an isolation centre in Bangladesh, or a phone support service in South Sudan, for example. That service is providing both psychosocial and practical support, as aloneness has been a huge issue amidst the pandemic. In Lebanon our team realised that because of the rising cost of transport people couldn’t get to the vaccination centres, so they came up with a Medair vaccination bus that is going out to reach people where they live.

We’ve had to opt for more remote support. The positive side of that has been seeing more creative thinking and innovative approaches, and communities and staff coming together in ways we probably would not have seen if we had been able to just do business as usual.

What has been the biggest challenge?
The misinformation. Public health information generally used to be accepted and shared without much pushback, which made protecting communities a lot easier. There is more lack of trust than there has ever been, which makes health workers’ job more complicated.

Also, in many places we’re working in the dark: we don’t know what the situation is because they aren’t testing and people don’t want to be tested, due to stigma. You aren’t going to see the true number of cases in the official statistics, so we have to look at other information. In one country there was a 10-fold increase in demand at graveyards that the gravediggers couldn’t keep up with. So we’ve been having to do a sort of detective work to figure out where our help is most needed.

With all the debates over how best to manage COVID, how can you be confident in your decisions? We do our own independent review of all the data and research. We have pretty high standards for where we will accept information from. It’s important to have multiple sources that we can triangulate and validate, from good, reliable journals with strong vetting organisations. We are fortunate to have a strong technical team, and I feel we can stand by our due diligence.

Unlike most crises we respond to, this one reached all of us. How have you personally been affected? I have an elderly mother who was isolated at a facility for a long while, so we weren’t able to do our daily family visits. She is in a vulnerable high-risk group, so we’re really trying to be careful. I’ve also lost a friend to the disease, and I know many other people who have. I feel fortunate that I have access to lots of services and tools because of where I live, but it has touched us all.

When do you foresee things getting back to normal?
There is no getting back to the way things were – we have to face that. Many Western countries are now getting the virus under control. But it’s still a global problem, not just a problem for poorer countries – because the more cases there are worldwide, the more the virus naturally mutates, creating the risk of a new variant. What we need to do now is integrate COVID measures across all our activities so that it becomes standard mode rather than crisis mode. There’s understandably a lot of COVID fatigue. But it’s not over yet, even though we wish it was. It’s a marathon, not a sprint.

What gives you hope amid the many challenges?
Information sharing has been fast and strong, and people have been willing to put aside any territorialism. In many places we have seen the innovative spirit and resilience of communities and staff coming together and trying to find new solutions and approaches, and people caring for their neighbours and the communities we serve.

This is a new disease; we didn’t know anything about it before. But look how far we’ve come. We have a long way to go, but there are a lot of silent heroes out there within Medair and beyond, really working hard behind the scenes despite the challenges. That’s what gives me hope – the people working hard quietly to help others.

Dr. Wendy Dyment is an American paediatrician trained in international health and tropical medicine, and has been working in humanitarian aid for over 20 years. She is the Health and Nutrition Advisor Team Lead for Medair’s Global Support Office.