Massachusetts General Hospital Vincent Program in Global OB/GYN
Love in the Time of Covid
by Annekathryn Goodman, Arun Chaudhary, Violette Perrotte
“I wish it need not have happened in my time,” said Frodo. “So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.”
J.R.R. Tolkien – The Fellowship of the Ring (1954)
This is the one-year birthday issue of our MGH Global OB-Gyn Newsletter launched in April 2019 with a story about home births in the Rohingya Refugee camps of Southern Bangladesh. Our hope was to teach students, residents, and fellows about women’s sexual and reproductive health in the international space, share information and news, and network with each other. Our subscribers have become a global community of nearly 500, and we have shared stories about global women’s health from many parts of the world. In this issue, Carmela Berlin, the pharmacist on our MGH Disaster Response and Humanitarian Action team shares her experience providing care in typhoon-ravaged parts of the Philippines. She teaches us about communication and cultural competence. Implicit in her account is the importance of a multidisciplinary team to work closely with a community in crisis.
In the past 12 months, we have born witness to great tragedies: A fire devastated Paris’ beloved Notre Dame; the Amazon burned; it was a year of protests: Hong Kong, Algeria, Sudan, Nicaragua, Russia; it was a year of suppressive nationalism, and the unfolding tragedy of the Central American migrant exodus led to ongoing controversy and hardship at the border of the United States. Yet in the midst of chaos, there was also hope and inspiration in science, medicine, art, and the rising economic achievements of many low and middle-income countries.
We are now facing an extraordinary crisis with the COVID-19 pandemic – locally, nationally, and internationally. There has been so much suffering and loss. We face not only a medical but also global economic and social catastrophe. Yet, at the same time, a great love story is unfolding around us. From people singing on the balconies of a ravaged Italy to the courage and commitment of our medical providers, mayors, and governors, to the food baskets, love notes, and well wishes of patients, families, and neighbors, we have found new ways to connect. There has been laughter, dark humor, creative new musical ensembles through Zoom, and a new appreciation of zombie and apocalypse movies. To echo Gandalf, we have the power to find creative solutions to maintain community, care for the sick, and overcome this pandemic. When surrounded by such sadness, fear, and uncertainty, we are strengthened by the power of love. Love in the time of COVID.
Notes from the Field
The Power of Good Communication
By Carmela Berlin
Pic: MGH Global Disaster Response Team Alpha, Panay Island, Philippines (2013)
. Pic: Mobile medical clinic in the village of Gabuc, Panay Island, Philippines (2013)
The realization of my passion for disaster response came upon an unfortunate event that happened in my home country. In November 2013, the Philippines was hit by typhoon Haiyan, a category 5 deadly typhoon that killed hundreds and displaced thousands of people.
I was unfamiliar with what my role would be as a pharmacist on this deployment but felt compelled to give back to my community. I learned a lot on that deployment. One lesson stuck with me, the significance of good patient communication.
Our team was assigned to staff mobile medical clinics in the northern villages of the island of Panay. Every morning we rode on vans to the villages and outriggers when roads were impassable. The locals spoke the same dialect I grew up speaking. During our clinics, my colleagues were each partnered with a local to help with translation as they saw patients and I tended the pharmacy table.
The locals quickly became comfortable speaking to me when they learned that I spoke the dialect. The women, especially, lingered to chitchat excited to show off their English. I listened to their stories on how they coped during the storm. I heard their stories about the crops they had lost, even ones in storage, and the fruits! Filipinos love their fruit trees and are proud to own the ones that bear the sweetest, biggest, most beautiful looking fruits.
The conversation soon turned somber as they told me of their families sleeping on the ground under a makeshift shelter with roofs made of tin they recovered. They also told me of their concerns on how they would feed their families in the days ahead as their salvaged food was running out.
During my conversations and drug counseling, I learned that these women had all been complaining to the nurses and physicians of dizziness and headaches. Dizziness and headache were the direct translation but not what was meant in their dialect. What they wanted to relay was the desperation of their situation and the anxiety of how to live was making their heads spin and hurt.
Disasters affect women disproportionately. It brings more hardship to women’s existing vulnerability. During a disaster crisis, women often assume the role of caregiver in the family. Their responsibilities increase but their needs are not identified and addressed. There’s been a growing movement in disaster relief efforts of empowering women affected to increase resiliency.
As a pharmacist, I have opportunities to empower women in their caregiving role. I can advocate for their mental health support when needed so they can better function in their role. I can also help improve their health literacy by providing education on the proper administration of the medications they’re taking or administering to someone they’re caring for. Lastly, I can help educate the public on proper hygiene and sanitation for infection control and prevention, the importance of immunizations and the treatment of diseases associated with natural disasters such as diarrhea, measles, acute respiratory infections, pneumonia and malnutrition.
Working in the field with MGH disaster response team is an ever-learning experience. I have learned valuable life lessons that teach me to be more empathetic to the populations that suffer from disasters.
International Pharmaceutical Federation (FIP). Pharmacists supporting women and responsible use of medicines. The Hague, Netherlands: International Pharmaceutical Federation (FIP), 2018 UN Women-United Nations Entity for Gender Equality and the Empowerment of Women Crisis response and recovery
Carmela Berlin works as a pharmacist for the MGH North Shore Cancer Center. She has been an active member of the MGH Global Disaster Response Team since 2013. She first deployed with the MGH GDR team when her home country, the Philippines, in the aftermath of super typhoon Haiyan. Since then, she has deployed with the team to Texas, Northern Mariana Islands, Mozambique and the Bahamas.
The symposium for Gender-Based Violence in Disasters and Humanitarian Settings, initially planned to be held on June 9, 2020, has been postponed due to the ongoing Covid-19 pandemic. The new date for the event is to be determined.
Heartfelt thanks for funding support: Karen Johansen and Gardner Hendrie, Al and Diane Kaneb, Vincent Memorial Hospital and Vincent Club, Westwind Foundation, Bank of America Foundation, Wyss Foundation
Editors: Annekathryn Goodman, Adeline Boatin, Thomas Randall