"I Carry the Trauma and Can Vividly Remember": Mental Health Impacts of the COVID-19 Pandemic on Frontline Health Care Workers in South Africa

Pinky Mahlangu; Yandisa Sikweyiya; Andrew Gibbs; Nwabisa Shai; Mercilene Machisa

doi:10.3390/ijerph20032365

"I Carry the Trauma and Can Vividly Remember": Mental Health Impacts of the COVID-19 Pandemic on Frontline Health Care Workers in South Africa

Int J Environ Res Public Health. 2023 Jan 29;20(3):2365. doi: 10.3390/ijerph20032365.

Authors

Pinky Mahlangu^{1

2}, Yandisa Sikweyiya^{1

2}, Andrew Gibbs^{1

3

4

5}, Nwabisa Shai^{1

2}, Mercilene Machisa^{1

2}

Affiliations

¹ Gender and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa.
² Faculty of Health Sciences, School of Public Health, University of Witwatersrand, Johannesburg 2193, South Africa.
³ Department of Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter EX2 4QG, UK.
⁴ Institute of Global Health, University College London, London WC1E 6BT, UK.
⁵ Centre for Rural Health, University of KwaZulu-Natal, Durban 4041, South Africa.

Abstract

We know from research that pandemics and disease outbreaks expose HCWs to an increased risk of short and long-term psychosocial and occupational impacts. We conducted qualitative research among 44 frontline health care workers (FHCWs) practicing in seven South African hospitals and clinics. FHCWs were interviewed on their experiences of working during the first-wave of the COVID-19 pandemic and its perceived impact on their wellness. In this study, FHCWs included the non-medical and medical professionals in direct contact with COVID-19 patients, providing health care and treatment services during the COVID-19 pandemic. Most of the FHCWs reported stressful and traumatic experiences relating to being exposed to a deadly virus and working in an emotionally taxing environment. They reported depression, anxiety, traumatic stress symptoms, demoralization, sleep difficulties, poor functioning, increased irritability and fear of being infected or dying from COVID-19. The mental health impacts of COVID-19 on HCWs were also associated with increased poor physical wellbeing, including fatigue, burnout, headache, and chest-pains. FHCWs reported professional commitment and their faith as critical intrinsic motivators that fostered adaptive coping while working on the frontline during the first-wave of the COVID-19 pandemic. Many alluded to gaps in workplace psychosocial support which they perceived as crucial for coping mentally. The findings point to a need to prioritize interventions to promote mental wellness among FHCWs to ensure the delivery of quality healthcare to patients during pandemics or deadly disease outbreaks.

Keywords: COVID-19 impacts; South Africa; frontline health care workers; mental health; pandemic.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Health Personnel / psychology
Humans
Mental Health
Pandemics
SARS-CoV-2
South Africa / epidemiology

Grants and funding

This research was funded by the South African Medical Research Council. The support of the DST- NRF Centre of Excellence in Human Development towards this research is also hereby acknowledged, grant number [ACC2020-COVIDHD-4]. Opinions expressed and conclusions arrived at are those of the authors and are not necessarily to be attributed to the funders.