A large number of them arrive at the hospital already in a serious condition and many of them are in advanced stages of covid-19.Over the last month the emergency services at the Vladimir Ilich Lenin Teaching Hospital in the province of Holguin have assisted an average of 400 patients daily. This number includes respiratory cases, suspected and confirmed cases of covid-19, but also people with other diseases and clinical, surgical or maternal pathologies. Of these, between 15 and 30 patients end up in the observation wards. A large number of them arrive at the hospital already in a serious condition and many of them are in advanced stages of covid-19.
To treat them, an average of 30 to 40 doctors work in the emergency services of the Vladimir Ilyich Lenin Hospital. Among them, who can be of any specialty, is José Antonio Méndez Mora, a first degree specialist in Internal Medicine and acting head of the Emergency Department.
August has been the worst month of the pandemic in his province and the most exhausting of his life. "Some patients are in the state of care, others in better condition, but the last two months have been dominated by patients arriving in serious condition. They come in with pneumonia in the inflammatory phase and cardiorespiratory arrest, and we have to end up performing cardiopulmonary resuscitation on them."
With a brother at home who is a medical student and a pregnant wife who is also a doctor, Méndez Mora's day-to-day life is "quite overloaded. We work all the time. You have a start time, but not a finish one. As long as there is a patient to see or a life to save, the entire medical and nursing teams are there. The 24-hour medical shifts are very exhausting.
In the last 15 days, Holguin has reported more than 10,000 autochthonous cases, presenting one of the most complex epidemiological situations in the country. This year, the province has accumulated 38,000 positive cases, for a total of more than 43,000 diagnosed cases since the beginning of the pandemic.
Until July of this year, the Lenin Hospital had not received any suspected or confirmed cases of covid-19. But "after we thought we were going to take a breather, since we had months with the epidemiological situation quite under control, both in the country and in the province, the situation began to get more complicated".
The hospital then began to receive patients, both suspected and confirmed ones, "since the other two in the province exceeded their capacities. There was nowhere to admit patients. In addition, we had to take on all the other specialties that until then had been treated at the Lucía Iñiguez Landín Clinical Surgical Hospital. In other words, the hospital has a large white zone that does not attend respiratory cases, but in the midst of this situation we had to convert a large part of the hospital into a red zone for the direct attention of patients suffering from covid-19".
But despite not having received patients positive to the coronavirus in his own hospital in the first year of the pandemic, Méndez Mora was the head of the team that diagnosed the first case of this disease in the province: an Italian foreigner who was staying at a hotel in Guardalavaca with his partner. He still remembers that morning in March 2020 when the deputy director called him to her office. He was asked to go to an isolation center to treat suspected and confirmed foreigners from Holguin and Las Tunas provinces. That same day at two o'clock in the afternoon he was already there.
However, he does not hesitate to affirm that "August was and will be, by far, the most complex in Holguin's health system. A month where the large number of patients exceeded the capacities of our health system, hospitals and isolation centers. The large number of patients diagnosed daily exceeded all expectations. Primary health care also exceeded the number of patients they could treat in their different on-call units and the situation became quite complex.
"The figures," he says, "never reflected the objective reality of the province, since very many patients have even gone undiagnosed. We did not have all the necessary resources to reach all the patients who had respiratory symptoms in order to perform an antigen or PCR test".
In addition to the lack of resources, there was the oxygen crisis, which "became very tense. The hospital made a great effort together with the Arm Forces to try to supply vital services, such as neonatology and intensive care, where there could be no shortage at any time. By means of the oxygen balloons that came in through the Army plants, they reached the most needy patients, critical cases and premature children".
It is a situation that -he points out- has been easing in recent days, since the start-up of OxiCuba's oxygen plant. "Today the availability has a different face. Those were the days when we had to take one oxygen balloon for four patients and invent and innovate, having to take a rubber band out of a serum and connect four more rubber bands to give it to four patients with one balloon. Then imported oxygen concentrators entered the hospital and by just connecting them to the outlet you already had production for one patient".
Of those difficult moments, he recalls the cases in which a person has arrived at the emergency room in respiratory distress, "and you have to look for oxygen in some little corner of the hospital and then try to save his life".
"It is very painful to tell a family member that someone has died from covid-19. It affects us psychologically. When it is a young patient it hurts even more. We don't get used to seeing a patient die. Doctors are made to save lives, not to watch people die."
"But the most gratifying thing is when you see the patient recover and get up from the stretcher and walk out. The happiest moment is when you give the discharge," does not hesitate to say the young doctor from Holguin who is expecting the birth of his first child in the coming weeks. "I'm going to be a father soon, a little boy, healthy and strong, God willing. My greatest blessing is to be able to be a father".
Tired? Méndez Mora wouldn't say they are tired, but "exhausted. Exhaustion is inherent when we are in such a difficult situation and there is no rest, there is no Sunday, we arrive home late at night".
The acting head of the Vladimir Ilyich Lenin Emergency Department has been working at the hospital for about five years, since 2016 to be precise. He has done so as a resident in the specialty of internal medicine, as a graduate and as a student when he was doing his rotations there. "The Lenin is my second home. I'm almost more time at the hospital than I am at my own home." / Translated by Porta Holguin, from a CubaDebate report.
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