The Prefecture of the Pontifical Household announced on Wednesday that as of Wednesday, 2 September, Pope Francis’s General Audience will once again take place “with the participation of the faithful.”
Following the hygiene directives issued by the competent authorities, the audiences for the month of September will be held in the Apostolic Palace’s San Damaso courtyard.
The statement says that attendance at these General Audiences “is open to anyone who wishes” to participate. It also notes that no ticket is necessary and that it begins at 9:30 am.
The Bronze Door under the right colonnade of St Peter’s Square will serve as the entrance to the Courtyard. People wishing to attend will be allowed to enter beginning at at 7:30 am.
Colombia’s President Ivan Duque has announced the imminent end of the blanket quarantine, at the beginning of the coming month.
He explained that Colombia will carefully start up a new phase, during which isolation will be specifically selective, with an emphasis on individual responsibility involving common sense.
Each region’s situation and plight will be individually monitored and assessed. This could lead to a graduated resumption of economic activity, while health measures will continue to be applied.
National air transport will be re-established, but the worst affected places will remain closed down.
Balancing lives and livelihoods
It’s a bold and controversial calculated risk.
So far, Colombia has over 540,000 confirmed cases of Covid-19 and more than 17,000 have already died from it.
Latin America remains the epicenter of the pandemic.
All of this must be balanced against the corrosive and rapidly worsening impact on economies.
The considerable gamble involves lives and livelihoods.
This week marks the launch of one of WHO/Europe’s new flagship initiatives: mental health. Mental health is a key public health concern in the WHO European Region – over 110 million people are living with some kind of mental health condition, accounting for over 10% of the population.
The 4 new flagships – mental health, digital health and innovation, behavioural and cultural insights, and immunization – represent identified priorities for WHO/Europe in the coming 5 years. The mental health flagship will bring together a broad coalition of mental health leaders, champions, service users and other partners to improve mental health policies and practices across the Region.
Mental health has been an essential programme within WHO’s agenda since its founding in 1948. But in light of the COVID-19 pandemic, a renewed focus on mental health is particularly important. Apart from the fear and uncertainty regarding infection itself, measures brought in to contain the spread of the virus, such as quarantine and lockdown, have been psychologically challenging. These compound social isolation for many and add to existing anxieties and stresses.
For frontline health-care workers and for those suffering from existing conditions, the pandemic has taken a significant toll on well-being. Furthermore, the socioeconomic fallout is exacerbating pressures on the population’s mental health. Precarious work conditions, unemployment and uncertainty with regard to the future are expected to contribute to a sharp increase in mental health conditions, just as they did in the wake of the global financial crisis a decade ago.
As the world begins to adjust to and recover from the initial impacts of the pandemic, renewed attention to the mental well-being of affected vulnerable populations and of the public at large will be crucial.
Supporting countries
Reform and development of the mental health system is an area of work for which many countries across the Region have been requesting help. WHO has responded with guidance, capacity-building and technical support.
Now, a more concerted effort is required to secure better mental health for all, both through intensified country support and intercountry initiatives at regional and global levels. By marking mental health as a fundamental element of the European Programme of Work, existing opportunities and evidence-based approaches for mental health promotion, protection and care can be seized, scaled up and sustained.
Poor mental health already claims the lives of 140 000 people per year by suicide in the Region. We urgently need to address long-standing gaps and deficiencies in mental health service delivery and financing, and to implement prevention and mitigation strategies to stem any worsening of the mental health situation across the Region.
What will the flagship do?
People with mental health conditions or psychosocial disabilities have long been stigmatized. One of the core components of the WHO mental health flagship will therefore involve challenging stigma and discrimination by improving mental health awareness and literacy among not only the public but also service providers and decision-makers.
Another key pillar of the new initiative will be enhancing access to person-centred, rights-based mental health care in communities. This will expedite progress towards universal health coverage for people with mental health conditions and make the case for a parity of esteem between mental and physical health.
The pandemic has shone a light on the fragility of existing institution-based systems and the need for community-based support and care (delivered through digital means where necessary or applicable). The mental health flagship will encourage efforts and investments to relocate care away from institutions and towards community services, including through the integration of mental health into primary health care and other priority programmes such as adolescent health and noncommunicable diseases.
Since mental health is an integral element of individual and collective well-being, protecting and promoting it during times of adversity and uncertainty is especially important, as is ensuring the availability and continuity of quality care for those living with mental health conditions. It is time to instigate long-awaited reforms to mental health services and deconstruct social stigma around mental ill health. Through collaboration with a strong coalition of partner organizations and citizens, WHO/Europe looks forward to building a more positive approach to and future for mental health across the Region.
Vatican News English Africa Service – Vatican City
“We stand with the truth that the Catholic Bishops so ably articulated,” reads a statement issued by the Evangelical Fellowship of Zimbabwe President, Bishop Never Muparutsa -the Presiding Bishop of the Pentecostal Assembly of Zimbabwe. Bishop Muparutsa referred to a “multi-layered crisis of … economic collapse, deepening poverty, food insecurity, corruption, and human rights abuses” in Zimbabwe. With all these happening, EFZ stands with the Catholic Bishops, Muparutsa explained.
“We stand with the truth that the Government is focused on things other than national democratic priorities,” said the EFZ head.
Speaking in an interview with Jayson Casper, of Christianity Today, Bishop Never Muparutsa said the Evangelical Fellowship of Zimbabwe had decided to side with the Catholic Bishops because Churches in Zimbabwe have in the past discussed ecumenical cooperation and unity. The Churches have pledged not to allow themselves be divided by politicians.
“We realised that when we are divided, politicians take advantage. We have not eradicated this completely; politicians still divide us for particular agendas. But we have all agreed that in national matters we must be united, in order to move society in a positive direction. The Church must be nonpartisan, but at the same time, be concerned about the well-being of the general population. We must be the voice of the weak and the voiceless. We must hold our government accountable when it comes to looking after the vulnerable. Sometimes this makes us look like we are pro-Opposition. But we have nothing to do with the Opposition because they are not in power. Our interactions instead are with those in power, because they bear the responsibility,” Bishop Muparutsa told Christianity Today.
Pastoral Letter condemned Government crackdown on dissent
The Zimbabwe Catholic Bishops’ Conference (ZCBC) on 15 August issued a strong Pastoral Letter that criticised the country’s heavy-handed clampdown on dissent. Many activists, political actors and journalists are still being held in prison after the 31 July protests. The Pastoral Letter also condemned corruption, widespread human rights abuses, and the Government’s handling of an economy in free fall.
Government’s attacks on Catholic Bishops
Zimbabwe’s Minister of Information, Publicity and Broadcasting Services, Senator Monica Mutsvangwa, responded to the Pastoral Letter with a personal attack on the Archbishop of Harare, Robert Christopher Ndlovu. The Government called the Archbishop “evil minded” and went on to cast aspersions on his integrity and that of the country’s Catholic Bishops as a whole.
While it comes naturally for Catholics and some civil society organisations to come to the defence of the Catholic Bishops, the voice of Zimbabwe’s Evangelical Churches speaks to a history of ecumenical unity.
We stand with Catholics because an insult to one is an insult to all
Bishop Muparutsa explained that the Catholic Bishops’ Pastoral Letter meant well.
“The Catholic (Bishops’ Pastoral) Letter was trying to provoke discussion, not give an insult. It pointed out problems like all of us were doing. But it received such a strong (Government) backlash. We felt that given the situation in the country if we just stand by and watch, we don’t know what will happen. We have journalists and activists in prison. There have been abductions with perpetrators unidentified, making us all vulnerable. So, this prompted us to stand with the Catholics, because an insult to one is an insult to all,” said Muparutsa.
Widespread disillusionment in Zimbabwe
Muparutsa also spoke of the disillusionment many Zimbabweans now find themselves in. When President Emmerson Mnangagwa assumed office in 2017, many were encouraged by his talk of the dawn of a new era.
“The former President (Rober Mugabe) left us with a system of mis-governance, human rights issues, and international sanctions. We were all very happy when (President Mnangagwa) was elected, hearing that he would turn over a new leaf. There was so much hope. Having been part of the system, we expected he would learn the lessons of the past and bring us back into the family of nations. But with the COVID-19 pandemic, problems began to multiply. We were already suffering, and our health situation became dire. The majority of our people live hand-to-mouth. But as workplaces closed due to the lockdown, there was civic upheaval because people were hungry,” said Bishop Muparutsa.
A feminist pianist who decided to convert to Orthodox Judaism to marry her Jewish partner has claimed her experiences over the last three years are a ‘far cry’ from those depicted in the Netflix miniseries Unorthodox.
Ivi Chin, 35, fron London, spoke to Glamour about what it’s really like to join the religion – which has been accused of misogyny and the oppression of women – after growing up in a secular household.
She suggests a lot of the scenes in the show are over-dramatised for effect, yet acknowledges that some of the customs, including not being allowed to handle her partner’s plate or sleep in the same bed as him when she is on her period, do in fact still apply.
Ivi Chin, 35, has spent the last three years converting to Judaism and claims accusations of misogyny concerning the Orthodox Judaism faith are unjust
religion in order to marry her partner. Pictured: a scene from the Netflix series Unorthodox” width=”634″ height=”356″ data-src=”https://i.dailymail.co.uk/1s/2020/08/25/15/32366010-8662567-image-a-1_1598366992949.jpg” />
Ivi suggests the portrayal of Orthodox Judaism is a ‘far cry’ from what she has experienced while converting to the religion in order to marry her partner. Pictured: a scene from the Netflix series Unorthodox
Conversion can take up to 10 years to complete, and those hoping to join are expected to immerse themselves in the faith, homes and communities of other Orthodox Jews.
Since starting her conversion three years ago, Ivi has been studying Judaism under the London Beth Din, which provide a central religious authority for Jewish communities in London and throughout the United Kingdom.
In her case, she has six rebbetzins – the wives of rabbis – whom she can rely upon and contact at any time to discuss her conversion.
But she says since the release of Unorthodox – which depicts the fictional journey of 19-year-old Esther Shapiro (Esty), a member of the ‘ultra-orthodox’ Satmar Haredi Jewish sect – she has had lots of people asking if her experiences have been similar to those in the show.
She said: ‘I have been asked, “Why would you want to join a community that treats women in this way?”, but the way Esty is treated is a far cry from my experience of Judaism which has given me huge unexpected joy and fulfilment.’
Instead, she remarked that all women in all societies face misogyny – like that depicted in Unorthodox – and insisted the ‘draconian’ treatment of women in the show was not what she had experienced.
By contrast, she suggests women are revered in the religion and claims Judaism is one of the ‘earliest champions’ of feminism.
Ivi said her favourite example of women’s importance in the Jewish community is through the Ayeshet Chayil (Woman of Valour) which is sung to them every Friday evening.
The self-professed feminist boasted that instead of getting one card a year as a show of appreciation, her man serenades her and brings her flowers every week.
Ivi acknowledged that while there are stark contrasts between her experience and that depicted in the Netflix show, there are also similarities.
In the programme the newlywed couple struggle to consummate their marriage and continue to try for months – something Ivi said was most likely put in for ‘fantastic drama’.
She noted that Jewish law forbids married couples from having sexual relations when there is ‘disharmony’ between them.
Ivi has six rebbetzins – the wives of rabbis – whom she can rely upon and contact at any time to discuss her conversion
Judaism also stipulates that men and women cannot have any sort of physical contact with each other when her period begins and for seven days after she stops bleeding.
For this reason, Ivi says most couples sleep on two single beds joined together, which can be easily separated when necessary.
The separation, according to Ivi, is designed to spark up the ‘honeymoon feeling’ once again.
Although many people assume the procedure is linked to periods being seen as ‘impure’, Ivi said it is actually treated as a time to work on the non-physical needs of your partner.
The women are not allowed to do certain chores such as serve their husbands food or pour a glass of water in front of him.
Another custom in the programme which Ivi said is adhered to in real life is Orthodox women only allowing their husband and female family members see their real hair.
In the show, Esty is forced to shave off her hair the night before her wedding – a tradition which dates back to medieval Hungary
Instead they wear scarves or wigs – something which is also worn on their wedding day.
In Unorthodox, Esty is forced to shave off her hair before her wedding – harking back to a former practice from medieval Hungary in which men would shave their future bride’s heads in order to repel feudal lords from bedding them before they were married – something Ivi said she had never seen in her experience.
And while phones and internet are banned in Unorthodox, Ivi only has to put down her luxury electrical items from sunset on Fridays to nightfall on Saturday.
During that time, the community gathers to eat meals together and do fun activities away from technology.
As she continues on her journey of converting to Judaism, Ivi acknowledged that the rules she must adhere to are not for everyone and may seem restrictive to people in the secular world.
She said: ‘A boundless life is analogous to a violin – when the strings of a violin are not bound, they are free yet purposeless. It is only when the strings are bound that they make beautiful music.’
Kohn, Kohn & Colapinto, LLP, The National Whistleblower Center, And Two European NGOs Dedicated To Whistleblower Rights Provide Finnish Officials Recommendations For Their Transposition Of The EU Whistleblower Directive
“Finland has the opportunity to modernize its anti-corruption laws and incentive whistleblowers to risk their careers by reporting violations of law. Whistleblowers are a key part of government transparency and accountability and they must be fully protected,” said Stephen M. Kohn, a partner in the whistleblower law firm of Kohn, Kohn & Colapinto, LLP.
Because the Directive sets forth the “common minimum standards” for whistleblower protection required by each European Union (“EU”) Member State, the Directive permits Member States, such as Finland, to extend protections beyond these minimum standards. When implementing the Directive each Member State has an opportunity to create robust whistleblower programs that protect whistleblowers, incentivize the reporting of crimes or regulatory violations, and enable law enforcement agencies to effectively combat corruption.
Although traditionally Finland has a decent record of supporting whistleblowers, even suspending investigations where necessary to protect whistleblowers, it is lacking a comprehensive whistleblower law. Therefore, in accordance with Kohn, Kohn & Colapinto, LLP’s recommendations, Finland should focus on harmonizing its current legal scheme with the new proposed whistleblower law, incentivizing credible whistleblowers to come forward, and creating clear rules for whistleblower disclosures.
Based on an expert review by Kohn, Kohn & Colapinto attorneys, specific recommendations for new whistleblower legislation include:
Expanding whistleblower protections to cover disclosures permitted under international anti-corruption treaties signed by Member States;
Narrowly interpreting a provision in the Directive that could result in retaliation against whistleblowers (Article 22);
Enacting whistleblower reward laws to combat financial frauds, money laundering, foreign bribery, ocean pollution tax evasion and other crimes; and
Adopting language and procedures that have proven effective in protecting whistleblowers when implementing Articles 6-7, 11, 14-16, 19-21, and 23-24 of the Directive.
The survey also found non-government school graduates were more likely than state school graduates to hold a bachelor’s degree, and to believe that school had prepared them for success at university.
Forty-eight per cent of respondents who attended an independent school said they held at least a bachelor’s degree, compared with 41 per cent of Catholic school graduates and 27 per cent of government school graduates.
But the gap was significantly narrower on the broader question of whether school had set people up for career success, with 55 per cent of government school graduates believing it had, compared with 60 per cent of Catholic school graduates and 63 per cent of independent school graduates.
The Australian Schools and the Common Good report, released on Wednesday, said it was widely held that since the 1980s, “the ideology of neoliberalism has redefined education policy and the subsequent educational purposes within Australian schooling”.
“Within this view, education’s main function is to improve social mobility and an individual’s economic or psychological wellbeing,” it said.
“Attachments and obligations to neighbour, community, city or nation are downplayed. Common good is understood as the sum of the private goods of discrete individuals.”
The report was commissioned by a group of six Christian school associations.
Co-author Dr Darren Iselin said the study also sought to analyse how education had influenced people’s personal relationships, ability to deal with problems in life and attitudes towards volunteering and giving.
“There’s an important conversation around privatisation and self-interest that has taken place [in society] and let’s face it, Christian schools and the non-government sector have been the beneficiaries of that, but we were really wanting to explore a more holistic narrative,” Dr Iselin said.
Just 22 per cent of Catholic school graduates and 20 per cent of independent school graduates grew up in religious families, compared with 13 per cent of government school graduates, the survey found.
This compared with 43 per cent of graduates from the six Christian school associations that commissioned the research.
“Whilst there can be an emphasis in [non-government] schools around an ethos of spiritual and religious values, that doesn’t necessarily mean that it translates to that in later life,” Dr Iselin said.
“Some of the selection processes around school choice certainly come down to providing that upward mobility.”
The report found a majority of graduates from all school sectors had donated to a charity or cause in the past year, but that volunteering rates were much lower.
It also found a significant gap in income and educational attainment between city and regional dwellers, although this gap was smallest among government school graduates.
These findings raise concerns about advantage and equity that “threaten social ties across the nation”, the report argued.
Communications officer Hella Ibrahim went to a mix of government and religious schools, including a Catholic primary and two private Islamic schools.
“While I really liked the school I completed VCE at, I don’t think it did set me up for success,” Ms Ibrahim said.
Instead it came down to the varying commitment levels of her teachers. She recalls one brilliant English literature teacher, who inspired her to high marks, and another teacher who didn’t even bother to check her homework, to the point that she stopped bothering to do it.
“Teacher attitudes matter,” Ms Ibrahim said.
With Hannah Schauder
Adam Carey is Education Editor. He joined The Age in 2007 and has previously covered state politics, transport, general news, the arts and food.
Schools in the Jewish-religious sector and Druze sector led in a number of fields in rankings released by the Education Ministry this week.The <a href="https://www.jpost.com/tags/education">Education</a> Ministry announced that there was a slight drop in the percentage of high school students that were eligible for a matriculation certificate (bagrut) in the 2019 school year.<div>69.7% of students earned a matriculation certificate compared to 69.9% in the previous year. In the Bedouin sector, the percentage of students eligible for a matriculation certificate fell 4%. In the haredi sector, the eligibility rose by 1.9%.</div><div>Some 71.8% of female students were eligible for a matriculation certificate, while only 67.2% of male students were eligible.</div><div>A number of <a href="https://www.jpost.com/tags/druze">Druze</a> towns lead the country in matriculation eligibility including Peki'in, with the highest rate (98.7%) in Israel, Hurfeish (97.1%) and Beit Jan (96.2%).</div><div>Ariel (97.7%), Kiryat Ekron (96.6%), Givat Shmuel (96.5%), Elkana (95.6%), Kaukab Abu al-Hija (94.5%), Tzura-Kadima (94.2%) and Ramat Hasharon (93.9%) were also in the top ten in Israel.</div><div>Modi'in Illit, a haredi city in the West Bank, had the lowest matriculation rate in Israel at only 4.7%, followed by Bnei Brak (95), Beitar Illi (15.9%), Rehasim (25.5%), Jisr az-Zarqa (31.5%), Tel Sheba (36.7%), Hazor HaHagalilit (37.1%), Segev Shalom (38.6%), Elad (39.6%) and Ofakim (47.4%).</div><template async="" id="4c4d856e0e6f4e3d808bbc1715e132f6"> cnxps.cmd.push(function () { cnxps({ playerId: '36af7c51-0caf-4741-9824-2c941fc6c17b' }).render('4c4d856e0e6f4e3d808bbc1715e132f6'); });</template><div>Some 46 high schools in Israel achieved 100% matriculation eligibility. Most of these schools were state Jewish-religious schools. Five of the schools were religious-ecclesiastical schools in the Arab sector and nine of the schools were general state schools.</div><div>A number of the schools that achieved 100% matriculation eligibility have acceptance requirements and charge thousands of shekels in tuition payments.</div><div>The Education Ministry also published a ranking of schools based on the percentage of students who earned an "outstanding" matriculation certificate, which means that they learnt five units of English and at least four units of Math with an average grade of 90. The students must also achieve excellence in a program for personal development and social-community involvement.</div><div>The Darchei Noam Jewish-religious school for girls led the list of schools concerning "outstanding" matriculation certificates and was joined by six additional Jewish-religious schools for girls in the top 17 schools in this regard.</div><div>The Al-Qasemi Academy in Baqa-El-Gharbia ranked in second place in this regard and was joined by four other schools in the Arab sector and one school in the Druze sector in the top 17. Four general state schools ranked within the top 17 as well.</div><div>On Tuesday, the Education Ministry published a list of 755 "outstanding" high schools based on a number of paramaters including special education, IDF enlistment, civil services, matriculation eligibility and improvement.</div><div>Some 48% of the schools on the list were Jewish-state schools, 32% were Jewish-religious schools, 7% were in the Arab sector, 3.5% were haredi schools, 2.3% were Druze schools and 2.3% were Bedouin schools.</div><div>Eight out of the top ten outstanding schools were Jewish-religious schools.</div><div>The outstanding schools were split into four levels, with teachers in each school receiving grants based on the level the school achieved ranging from NIS 3,119 to NIS 8,318.</div>
BANJUL –hunger – Africa is becoming a new COVID-19 epicentre. In the recent weeks, South Africa reported a 60% increase in natural deaths, suggesting a higher COVID death toll than reported. And the World Health Organization recently warned that cases are proliferating across Sub-Saharan Africa, including my country, The Gambia. Unless the European Union urgently rethinks its protectionist trade policies – beginning with the Common Agricultural Policy – a sharp uptick in food insecurity will turn the COVID-19 crisis into a catastrophe.
The CAP subsidizes European farmers to the tune of €42 billion ($50 billion) annually, thereby giving them an unfair advantage in foreign markets, such as Africa. As a report released by the NGO network Coordination SUD last year showed, such subsidies, together with the abolition of market-regulation mechanisms (such as milk quotas), have strengthened EU producers’ ability to export agricultural products at low prices to markets in the Global South.
Such policies distort markets, destabilize developing-country economies, and destroy livelihoods. For example, the CAP has devastated agricultural production in West Africa, particularly for wheat and milk powder. And the problem extends far beyond Africa: local industry and agriculture in Caribbean and Pacific countries have been undermined as well.
The EU’s protectionist policies mean that developing-country farmers, who have access to significantly less support, cannot compete with European imports. In fact, though 60% of Sub-Saharan Africans are smallholder farmers, a staggering 80% of local food needs are met by imports. EU subsidies to its own farmers, along with what the UN Food and Agriculture Organization describes as “unfair trade agreements,” have enabled EU farmers to undersell African farmers dramatically. This protectionist stifling of local producers partly explains why, even before the pandemic, half of Africa’s population faced food insecurity.
Last month, there was a glimmer of hope that the EU was finally rethinking the CAP, at least within Europe. One proposal that was put forward focused on helping small farmers in Europe by expanding community-supported agricultural (CSA) schemes, which directly connect farmers to consumers. Proposed reforms also reflected criticisms of industrial animal farming and trade in livestock over long distances – practices that facilitate the emergence and spread of viral infections similar to COVID-19.
But this approach once again remains inherently detrimental to African producers, who would continue to be subject to EU protectionism in the guise of “free trade.” It is precisely in regions like West Africa, where a large number of smallholder farmers are currently being crowded out of the market by protectionist policies, that CSA schemes would be particularly valuable.
What is needed from the EU is a fairer, more holistic approach that accounts for the effects of its policies on African farmers. In the meantime, European policymakers have shelved the proposals until at least the end of 2022, owing to the pandemic.
Making matters worse, to increase its own crisis stockpiles, the EU is preparing to limit food exports. This could directly constrain Africa’s food supply without supporting African farmers, compounding disruptions to global food-supply chains, while placing additional pressure on smallholder farmers.
The CAP is not the only EU policy that is devastating developing-country agriculture. Its 2019 ban on palm-oil imports, ostensibly implemented to prevent deforestation, is similarly misguided.
A blanket ban on palm oil – a common food product also used in biofuels – may simply shift demand to less efficient, more land-intensive agricultural products, such as sunflower and rapeseed oil, resulting in even higher rates of deforestation and greater environmental strain. (Some policy experts believe that this is the point: despite the guise of environmentalism, the ban is fundamentally a protectionist effort aimed at boosting the EU’s own oilseed industries.)
Whatever the motivation, there is no doubt that the ban devastates the livelihoods of smallholder farmers, who comprise 50% of palm-oil producers. Add to that the decline in overall demand caused by the COVID-19 crisis, and smallholder farmers in Malaysia – one of the world’s largest palm-oil producers – are facing a veritable “survival crisis,” despite the tremendous progress the country has made in ensuring sustainable production.
Again, there is some evidence that the EU is rethinking its approach. But the needed changes are far from guaranteed.
As the COVID-19 crisis escalates in Africa, the economic, social, and, eventually, political fallout will be significant. The harmful effects of poorly conceived policies and practices will intensify and multiply. And, in lieu of strong action, millions of people will go hungry.
If the EU really wants to help Africa, during the pandemic and beyond, it must urgently reform its trade policies to ensure a level playing field and enhance food security. We are all in this crisis together. We in West Africa hope that we will not be left alone in addressing it.
epa09525768 A hospital staff carries two fresh oxygen reserves at the Covid-19 section of National Institute of Pneumology 'Marius Nasta', in Bucharest, Romania, 15 October 2021. Romania registered on 15 October 365 coronavirus related deaths, the highest number of daily deaths since the beginning of the pandemic. About 18,000 patients are hospitalized, of which 1,729 in intensive care units, in the entire country. Romanian health authorities are overwhelmed by the outbreak of the fourth wave, as the number of infected people with SARS-CoV-2 are rising from one day to another. EPA/ROBERT GHEMENT
Rehabilitation needed by every two out of three COVID-19 patients recovering from intensive care – The story of Samantha
The first thing you notice about Samantha, a Community National Health Service (NHS) Physiotherapist in Bournemouth in the United Kingdom of Great Britain and Northern Ireland, is her beaming smile, energy and passion for her work. Her outstanding professionalism and capabilities mean that it takes most people she meets a while to notice her disability. Four years ago, Samantha fell 50 m off the side of a mountain in Austria while sledding, sustaining a brain injury and multiple fractures to her spine. Months of rehabilitation were needed for her physical, cognitive and speech difficulties which earned her huge gains, but limitations with her right arm movements are permanent. She says, “I have adapted and deliver the same high standard of care anyone else could.”
Samantha delivers rehabilitation to individuals that experienced injury, surgery, illness, or a fall. Many of Samantha’s current patients are recovering from COVID-19. Data from the United Kingdom’s chartered Society of Physiotherapy shows that 62% of COVID-19 patients who were in intensive care will need rehabilitation once they return home. After the acute rehabilitation phase in hospital, rehabilitation may continue in long-term care or at home.
Rehabilitation is key to improving the functioning and quality of life of a person affected by COVID-19 while reducing potential long-term disability. WHO’s Regional Office for Europe has published “Support for Rehabilitation Self-Management after COVID-19 related illness” which advises on exercises and activities to empower and facilitate recovery after discharge from hospital, which Samantha says is an “extremely useful resource for the provision of rehabilitation services to people recovering from COVID-19”.
To ensure patient needs are met and the continuation of vital rehabilitation services in the community, infection prevention and control measures have been implemented. Samantha says, “Before entering a patient’s home, I clean my hands, then put on my apron, then my mask, eye protection, and finally my gloves. The use of each type of personal protective equipment is based on the risk of exposure to body fluids, which I conduct every time I see a patient. I’ve been vigorously washing my hands.”
As for many with disabilities, Samantha has found adhering to infection prevention and control measures difficult. “I couldn’t fit the medical mask myself as I can’t lift my arm to the back of my head to tie the knot needed to secure it in place. I had to ask for masks with elastic ties I can fit with just one hand. I also have to tie the aprons at the side rather than at the back as I can’t reach and it’s a struggle to put the gloves on. All of this takes time, so I have to allow myself more time in my planning.” Samantha finds the WHO issued COVID-19 guidance for those with disability useful to prevent and mitigate the risk of COVID-19 and elaborates, “It helps me as a rehabilitation professional with disability to do my job properly.”
Samantha describes an elderly patient suspected to have COVID-19 which she treated. “Burt is an elderly gentleman with dementia who was referred because he was finding it difficult to walk, felt like he had a lot of mucus in his lungs, and had a temperature. He was already having daily visits from his primary health doctor and carers were visiting him three times a day to help with personal care.” Burt did not want to go to hospital for treatment, so his family and the medical team jointly decided to care for him at home. Samantha provided a walker and advised his family on exercises Burt could follow to clear his chest secretions and maintain his mobility. She also facilitated the installation of a downstairs hospital bed and commode. Burt recovered, thanks to the efforts and services of the community team and his family.
“No one ever questions my ability to do my job because of my disability. Most people don’t even notice,” says Samantha. “Once I have explained what I’ve been through and overcome, they are usually in shock and awe. My patients trust and work so much harder with me because I’ve been through it myself. I love being a rehabilitation professional and having a positive impact on someone’s life.” Samantha’s passion to overcome challenges from disability isn’t just limited to her professional life. Samantha has found ways to ski, rock climb and swim. Her ultimate goal is to climb Mount Everest, the highest point in the world!