My experience with a Covid-19 patient

My young sister, Ms Rachael Nasolo, quickly bought a pulse oximeter to enable us monitor his oxygen levels since he didn’t exhibit any serious symptoms other than mild cough.
The oximeter read 93 before 9pm on Thursday, Ms Nasolo told me. Normal oxygen levels are supposed to be 95 and above, but because Dad was an octogenarian with underlying illnesses, the levels didn’t worry us as much.

The next morning, I was told, he ate breakfast and did normal tasks. He was examined again. His oxygen level had dropped to 67. This was alarming!
 So, every family member was informed and we agreed that he needed to be taken to a medical facility to get oxygen. We knew how overwhelmed the hospitals were so each family member was tasked to do a search.

My health contacts didn’t help much. My sister contacted a doctor, who said he could admit Dad to his medical facility in Kasangati Township, more than 20 kilometres away from the city centre, at a friendly bill of around Shs400,000 per day. It was a hoax; my sister could neither find the doctor nor the oxygen he claimed he had. He didn’t pick up Ms Nasolo’s repeated calls.
Dad’s oxygen levels dropped further. He was fatigued. I didn’t have transport to reach them so I worked on my phone.

 A photojournalist I was with called Mulago National Referral Hospital Deputy Director, Dr Rosemary Byanyima, to help out. Dr Byanyima asked me about the patient’s oxygen levels and I told her.
“Take him to Namboole,” she said on the phone.
Mandela National Stadium (Namboole) was turned into a treatment centre for Covid-19 patients with mild symptoms. I called my sister to drive the patient to Namboole. She told me that Dad was badly off, but her car had developed a mechanical problem on the way. 

I froze.
She, however, said her husband had sent an ambulance to pick him up. He was eventually delivered at China-Uganda Friendship Hospital, Naguru, where his personal doctor had found an empty bed and services were free. We all breathed a sigh of relief. The hospital admitted him and he was put on oxygen.

Given the strict guidelines for treating a Covid-19 patient, it was decided that only those who had contact with Dad – that was his caretaker and my sister – look after him. It was another tough night for me.
On Friday morning, news from the hospital wasn’t good. Dad had consumed more than five oxygen cylinders, but, his health wasn’t stabilising. 
The doctors said the situation would normalise, but it didn’t.

His caretaker said he literally spent a night awake because of the state he was in. My sister said what worried them the most was getting a constant supply of oxygen. 
The overwhelming situation at the hospital required the caretakers to do some medical tasks. For instance, the caretaker was supposed to monitor the oxygen cylinder gauge and alert the medics before the pointer reaches the red zone. The caretaker would also fill the humidifier bottle connected to the oxygen cylinder with water.
Caretakers with patients with diabetes and hypertension had to learn to use an oximeter and a glucometer, then keep data for the doctor’s analysis. 

A caretaker would also keep contacts of good gentlemen, who deliver oxygen cylinders, to alert them when a cylinder was used up.
On Friday night, a caretaker told me Dad’s situation was so bad that he consumed oxygen from cylinders at a rate faster than expected and they needed to get fresh supply at a time when the supplier was unavailable.
He had to pick the cylinder of Dad’s neighbour, who had partially recovered and whose cannula oxygen tube had been removed.

When that cylinder was about to be drained early in the morning, the caretaker tried to call the oxygen supplier, but the phone was switched off.
I decided to jump on a boda boda despite the presidential ban on public transport. The boda boda rider didn’t go far as security personnel had laid an ambush near Nakawa. I disembarked and walked via the Industrial Area to the hospital. I found Dad in a terrible situation, but a filled oxygen cylinder had been found.

Struggling for breath
Dad was struggling to catch his breath despite being on an oxygen cannula. The caretaker said his condition had improved in the morning, but had a worse  turn as soon as he saw his neighbour, a Covid-19 patient, die.
“His pressure shot up and he got breathing complications,” the caretaker told me. The body of the woman remained on the bed for two to three hours until a specialised team disinfected the area, put the body in a bag before wheeling it away.

That traumatised Dad. He was so afraid that he demanded that we hold his hands.
Doctors converged around and pleaded with him not to get worried, telling him he was going to survive. His oxygen levels had dropped to 30. Breakfast was postponed until his oxygen level rose at least to 50. It took nearly an hour for his oxygen level to reach 47.
No sooner had my sister removed the oxygen mask and given him a second spoonful of food than the situation deteriorated again. He sounded like something had blocked his lungs pipe (trachea).

Doctors rushed into the room and immediately put his oxygen mask back on. They measured the oxygen levels and they were disappointingly low. That was his last meal.
It took another hour or so to stabilise him. Doctors converging around him checked his blood pressure, heartbeat and other vitals before they administered drugs through his cannula.
He kept weakening gradually, but could talk. All his talk was about God. 
“God is good all the time,” he said. At one point, he signalled me to come closer to him and said, “Now, it is God to decide.” He had given up.

He now needed help to do everything. It was an embarrassing situation and we had to hold a sheet as a divider to cover him from his neighbour and their caretakers from viewing his private endeavours.
We turned him to lie on his belly and that appeared to give him some relief with his breathing. My sister, neighbours and I felt relieved. The other patient in the room was now comfortable to talk about how worried she was when she heard Dad breathing badly.
We had a chat with her as she consoled us that he was on the recovery path.

“I was worse than him. Now, see how I am. He will be fine. He just needs not to get worried about those who die. I have seen like six or seven people die in this room, but didn’t think about it, that is how I survived,” she said. She had been bedridden for two weeks.
At around 4pm as we were contemplating feeding him, his breathing condition deteriorated. We summoned the doctors and they rushed in, converging around him. They did the same examinations.

He was put on a drip and given about three injections through the cannula in quick succession.
After several minutes, the doctor fixed his eyes on the monitor and looked puzzled.
“The drug is supposed to help clear his lungs, but it isn’t responding well. I am worried about his kidney,” the doctor told me.

I too noticed the changes. He tried to talk to me, but he was inaudible. The doctor later informed my sister that it would be better to take him to the Intensive Care Unit. Unfortunately, China-Uganda Friendship Hospital didn’t have one. My brother-in-law mobilised for an ambulance and an ICU bed in Jinja District while another relative made a call to Mulago National Referral Hospital.
With the guidance of doctors, it was decided that he should be referred to Mulago hospital.
When the ambulance arrived, he had to be taken off from the oxygen supply in order to be carried to the parking yard. Although we did it very fast, those 15 metres were traumatic.

When we got into the ambulance, the driver discovered that he needed a key to open the oxygen cylinder. Dad struggled to breath. Medics had to run back to his ward and pick up a cylinder and fix it to his mask tube as they looked for someone with a cylinder key.
I was in a very confined area and I could barely hold the mask onto Dad’s mouth with one hand as well as keep my body firm on the ground. The ambulance operator was taking ages to fix the ambulance cylinder nozzle. Finally, he fixed it and he drove us to Mulago.

Armed with a referral letter, I was optimistic that things would be better at the referral hospital.
We arrived at Mulago hospital parking yard in about 10 minutes. Dad was still breathing.
We found half a dozen patients on stretchers waiting to be admitted to the hospital. The ambulance handed over a referral form to the medics.
“Who told you to bring a patient here? We don’t have vacant beds,” the medic declined to receive the form.
My heart sank.

I walked back to the ambulance a deflated person. We made some calls and relatives with good contacts at Mulago arrived to persuade doctors just to come to the ambulance to have a look at Dad.
They didn’t.
I went back to the ambulance. I noticed Dad wasn’t breathing so I went back seeking help to have him resuscitated, if it was possible. The medics didn’t shift.
Later, a medic came and asked for a torch. She examined him and confirmed what she had in mind.
He had already gone.

We shut the ambulance’s door and I sat next to Dad as we headed to the City Mortuary for a post-mortem and burial preparation later on.
On Sunday, a handful of people buried him at Banda village in Wakiso District in accordance with the Covid-19 standard operating procedures.
Rest in peace Dad.