From an HIV clinic in Lagos, Nigeria to a mobile measles vaccination unit in London, England, Joan Abohweyere had been on the front lines of public health emergencies before.
But Covid-19 was something different, a virus that upended the world and posed a once in a lifetime challenge for health care professionals. Abohweyere, the chief of paediatrics at Lakeridge Health in Durham Region, was suddenly faced with a rush of pressing decisions.
“It’s been challenging. It’s been tough,” she said.
As the pandemic started surging into Canada, she was plunged into a series of crucial meetings. The stark images of overwhelmed hospitals in Italy were a fearful example of what could happen in the worst-case scenarios. She and her colleagues needed to plan for a potential surge in cases that could strain hospitals beyond their limits.
“It was hours of work and quite intense.”
Processes and plans had to be quickly developed to mitigate the threats: how to properly manage, isolate and treat patients; how to protect physicians, nurses and support staff. They needed to ensure a sufficient supply of personal protective equipment (PPE). What would happen if a woman in labour was displaying covid symptoms? Doctors would need to consider how to protect the baby, even though they were unsure as to whether the mother was actually carrying the coronavirus.
In her own mind, she wondered what she would do if faced with a “code pink”, a child in need of immediate resuscitation. Several layers of PPE would need to be donned before administering urgent, lifesaving care.
“Getting into all that when a child is in distress, that sense of a tug between the natural response to get in there and resuscitate, but in the age of Covid, you’ve got to get into that gown first. It’s a challenge for paediatrics when every second counts.”
Paediatrics was not Joan Abohweyere’s first career choice. Nor could she have predicted the life path that brought her from a small town in Nigeria where she was born the ninth of ten children to her position as a senior physician in a Canadian hospital system. Neither of her parents progressed beyond grade school but they insisted that every single one of their children go to post-secondary education.
“Everyone was encouraged, really pushed, to go to school. There were no options.”
Abohweyere was interested in engineering, but her mother directed her towards medicine, following in the footsteps of an older sister who was a nurse. Her father worked as clerical staff person in the teaching hospital at the University of Ibadan, Nigeria’s foremost institute of higher learning.
Ibadan was where she got her medical degree and did her residency in paediatrics. Later she spent time practising in London. Having married a Canadian, she moved to this country in 2010, doing a fellowship in paediatrics at the Hospital for Sick Children before joining Lakeridge Health in 2014.
“I’m thinking of writing a memoir. My family has come a long way from humble beginnings.”
Now, the early months of 2020 were testing all of her experience, education and skills. As it turned out, the surge they feared never came. They saw some children who tested positive for Covid-19, but none were serious enough to require admission to hospital.
But the medical staff did not know it at the time. They had to maintain strict infection protection protocols, wearing uncomfortable PPE throughout the day in all interactions with patients. Fearful of infecting family, they would change clothes in the garage upon returning home, then go upstairs and shower before coming in contact with loved ones. But the worry never went away.
“Everyone gets strained. It’s been tedious in that way.”
When a physician reported a fever or cough, they would have to stay away from work as a precaution, even before being tested for the coronavirus. Abohweyere, as a senior doctor, sometimes had to cover weekend or evening shifts for colleagues who were forced to isolate. In the end, no doctors on her team were infected with Covid-19.
She is full of praise not only for her fellow physicians, but for the nursing staff, the lab and x-ray technicians and the non-medical support staff, some of whom never got the bonus pay that was provided for select frontline workers.
“They’ve all been doing incredible work. Everyone has been at risk, everyone. I think there has been a lack of recognition of health care workers involved in this.”
But even as Ontario is showing signs of having passed the first wave of the pandemic, Abohweyere fears for what may happen in the fall and winter. Even in normal times, it is a busy season for paediatricians when they see many children coming to hospital with influenza, Respiratory Syncitial Virus (RSV) or other respiratory illnesses. Now she wonders whether they may have patients with multiple infections, including the coronavirus.
“I’m much more worried about (the second wave) because it’s going to impact paediatrics significantly. That’s why all the work we’ve done regarding guidelines and PPE is really important, so we can apply them because that second wave is going to come.
“With everybody pulling together as a society we’re in a better place than we would have been if we hadn’t done the necessary work. Has it been hard? Yes. But we’re in a better place for it.”
Joan has continued her advocacy here in Canada. She is an Executive Board member of the Pediatricians Alliance of Ontario (PAO); and has served on its advisory board since 2014
She has also served as an OMA delegate to council.
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