Around the world, humanitarian workers struggle with the toll COVID-19 is taking on both physical and mental health. In Papua New Guinea, the International Committee of the Red Cross is working to equip communities with the tools to face these unprecedented challenges.

For 30 years now, Felix Soal has dedicated his life to patient care at the Mendi General Hospital in Southern Highlands, Papua New Guinea. During his long career in healthcare, Mr Soal has seen many of the challenges that come with the territory – outbreaks of tribal fighting remain common in the highlands. But nothing comes close to what COVID-19 has unleashed around the world in recent months. Trained to stay calm under pressure, Mr Soal said the stress of dealing with an unknown virus at such a large scale has taken a toll on health-care workers, causing many to feel anxious, irritable, and frustrated.

To address these mental health concerns among frontline responders, the International Committee of the Red Cross (ICRC) held four training workshops in various provinces to help close to 60 participants deal with the unprecedented situation. For many participants, this is the only exposure to mental health awareness training that they’ve had.

The mental health impact of COVID-19 occurs against a backdrop of tribal fighting in the highlands. With a history going back hundreds of years, the human toll from tribal fighting has become increasingly grave in recent times due to an influx of modern weapons. Rather than pitched fights between groups of warriors, the targeting of women and children, hospitals, and schools has become a tragic and worrying trend. In this way, the global threat of pandemic places an additional, complicating mental health burden on communities already affected by violence.

As a participant at one of the ICRC workshops, Mr Soal shared his fears that surfaced soon after the pandemic hit Papua New Guinea. “In the beginning, it was the fear of the unknown,” he said. “I was worried about taking the virus home and infecting my family. Our relatives stopped visiting us as they were apprehensive too.” He paused. “I felt discriminated against.”

This stigmatisation has been one of the biggest stressors for many medical personnel, as was revealed from feedback after the workshop. “In some cases, stigmatisation was already an unfortunate reality for them – both from their families and communities,” shared ICRC delegate Charlotte Blackman, who led the ICRC workshops. “One participant said her husband told her ‘not to come home’ if she continued working in the hospital.”

Citing discussions held during the workshop, she added, “the sources of stress include fear of getting infected, fear of transmitting the disease to their loved ones, fear of stigmatisation, the potential death of their colleagues or patients or the exhaustion of their work.”

Around the world, COVID-19 threatens both physical and mental health. In Papua New Guinea, where health facilities can be remote and difficult to access, the pandemic only makes a tough situation worse. The pandemic brings uncertainty with sudden or unexpected loss of lives and livelihoods, on top of the toll on communities left by tribal fighting. It all adds up. Anxiety, sadness, hopelessness, insomnia, fatigue, irritability, and anger are just some of the ways the threat of pandemic can leave a mark on the mental health of communities.

To strengthen their coping mechanisms, the participants were encouraged to follow only credible sources of information related to COVID-19, helping to avoid the anxiety that rumours could bring. “We also taught them to identify any change in their emotional reactions, including uncertainty, fear, anxiety, denial, minimalisation, hopelessness and helplessness, anger, and aggression,” Ms Blackman said.

Admitting that adapting to “the new normal” would take time, Mr Soal said the methods and tips shared during the workshop would not only help health-care workers protect themselves and their families, but also avoid the stressors related to the pandemic. “The experts from Red Cross clarified my doubts about COVID-19 and reinforced the importance of staying physically and psychologically fit during these times. If we take adequate care, we can beat this.”

According to Ms Blackman, people with existing mental health conditions might experience an increase in psychological distress and risk their trauma symptoms being aggravated during isolation. “Their treatment may be disrupted, and their careers could come under additional strain. We will continue to help the best way possible.” Across the highlands, the ICRC plans to continue coaching and supervising trained personnel to ensure they have the support they need. “We are also working at the community level and using information aids like videos and other tools,” she says.

Meanwhile, back at Mendi General Hospital, Mr Soal emphasises the importance of a well-being plan and deep breathing techniques, helpful during times of crisis like this one. “Peer support is critical,” he said. “It will be challenging to practice social distancing, frequent washing of hands with soap and avoiding crowds when our ancestors have conducted all cultural activities without using such measures. But if we embrace the changes and support each other, we will make it to the other side.”

“I signed up to help our people,” he said. “And I must do it.”

Reuben Tabel is an ICRC spokesperson in Mount Hagen, Papua New Guinea.

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