In the fight against COVID-19, we have many frontline personnel and some of these are the doctors behind the Ministry of Health’s 719 call center where members of the public can call to get accurate information on health matters. In this two part interview, we spoke to the team lead Dr. Momanyi and here is what he had to say.
Please tell us your name and what you do
My name is Lazarus Momanyi. I’m a Medical Doctor currently working with the Ministry of Health at the National Aids and STI Control Program NASCOP but in my other role I’m at the Ministry of Health 719 call center where I’m the team lead.
Where is the call center located?
We are located at Baobab House Call Center which is next to the Safaricom Headquarters in Westlands, Nairobi.
Are you an on-ground doctor too or concentrating on Line 719?
My core role is working at the Ministry of Health at NASCOP which supports HIV and STI services in the country. I still do that, but during this time some of us have been given additional roles because as you know, the Ministry of Health has had to redirect a lot of it’s efforts towards containing the COVID-19 pandemic in the country. So, I’m still at NASCOP but at this time specifically, my other role is supporting the call center.
Are all the call center operators from the medical field?
Yes. We have a total of 47 staff manning the call center and all are qualified medical doctors who have received special training on COVID-19 and how to manage all the aspects of the pandemic.
How busy is the call center?
The call center runs on a 24-hour basis, so we have 3 shifts of doctors who work from 8am to 2pm, 2pm to 8pm, and then 8pm to 8am to ensure 24-hour coverage. Initially when we begun we used to get an average of up-to 200 calls per day, but over the weeks as more information is made available to the public, and as counties are putting up systems to handle their cases internally, the number of calls have reduced and now we’re seeing an average of around 100 calls received per day.
There is usually a whole spectrum of respiratory complaints. How do you filter them?
Part of the training that the doctors have received is what we call customer care. When a caller calls in, we establish rapport and then they’re able to give additional information. If someone says they’re coughing, we’ll want to know whether they have a fever and for how long they’ve had this symptom.
There is the tool that has been established by the Ministry of Health. It is called a Case Definition – a list of symptoms and indicators that can point to whether a case is COVID-19 or not. Case Definition keeps on changing. For example, in the past, you had to have travelled from a COVID-19 country. But now we have community transmission, so the Case Definition has changed.
We use this Case Definition to do triage. Triage is basically determining whether it is a suspected case or not after taking medical history. This is Telemedicine so it is not like we are able to examine or listen to the chest and look at the throat. So, we really rely on digging in narrowing down because some callers might have unrelated symptoms.
At the end of the call we make a determination whether this is a likely case or not. Each county has established what we call a Rapid Response Team (RRT) and this is where we refer suspect cases. This is a team composed of doctors, clinicians and lab technicians. They’re the first responders for each county and we have a list of all of them.
Other than referring a suspected case by calling, we also document the symptoms in writing and submit them so that RRP can take it up, go take a sample, or go pick the patient.
Have you encountered paranoid and panic callers and how are you dealing with them? Like I know, if I venture out, I come back obsessing over a simple irritated nose because of masks.
We’ve come across several cases where right from the onset we can hear even from their tone of voice and the way they’re speaking that they’re coming from a point of anxiety. This is totally understandable because remember with COVID-19, people have been watching TV and reading newspapers about people dying in developed countries.
So, when we had the first case reported, we had a lot of callers coming in with a lot of anxiety though when they describe their symptoms we can clearly see that theirs is not a case of COVID-19. Some of them even have pre-conditions like asthma and they mistake an asthmatic attack for COVID-19.
What we usually do for such cases is to use medical facts to first of all re-assure the caller that from the history and symptoms, they do not have COVID-19. And then we also advise them on how they can seek help from the nearest health center.
For the ones we can see are really anxious and they need more of psycho-social support, we have a team of psycho-social counselors which is supported by the Red Cross though some of them are from the Ministry. So, we’re able to transfer them to those specialists who are able to approach it from a psycho-social angle and address the anxiety issues they have.
You transfer from the call center or give a number to call?
Yes. From the same call we tell them to hang on and transfer them to someone who help them further. They do not have to disconnect and call a different number.
How far is Safaricom coming through for you as doctors at the call centers in all this?
Safaricom has been a very supportive partner. Remember even where we are seated as a call center is courtesy of their kindness.
Even before the medical doctors came in, they had already trained their call center experts. They’ve been very supportive and especially with the huge reach throughout the country, they were willing to share their platform. They have supported even some joint calls which we’ve been having to understand the issues coming through the callers and how best they can be addressed.
More than supportive I’d say.
You’re probably working long hours. How are you keeping in touch with your loved ones?
It is tough during this period because some doctors are now having to do night shifts for example. This means that they’re not able to be there with their families in the night time and for some this is new. It is something that we’ve been able to adapt to over time and also explain to our families for them to understand why we have to be away.
We’re also up and down and so we also have our own anxieties about possible infection and possible infection of our families. The pressure has been real because COVID-19 was not our core business so we’re running between the pandemic and also ensuring our other work goes on.
But we’ve able to adjust and the Ministry of Health along with Safaricom have been of great support as we do our work.
It has been tough, but we keep going. We’ll get through it.