The COVID-19 pandemic continues to assault the world. Among the countries, the Kingdom of Eswatini, with which Taiwan has diplomatic relations, has had more than a hundred confirmed cases as of the end of April 2020, including frontline medical care providers.
The need to prevent hospital infections from turning into a community spread is high. Taipei Medical University Hospital (TMUH), which has a permanent presence in Eswatini, received a call for support from the Eswatini Ministry of Health.
Within 2 weeks, TMUH had put together the “Taiwan We Go” disease prevention and medical care team. The team comprised Dr. Li-Yuan Chen, Department of Infectious Disease; Dr. Kevin Shu-Leung Lai , Critical Care Medicine and Pulmonary Medicine; Lee Hsin-yu , Respiratory Therapy Department head; and Yu-Hsuan Lin , RN, Intensive Care.
On May 1, 2020, the team headed to Eswatini to begin the two-month disease prevention mission.
The team leader Dr. Li-Yuan Chen stated, “Eswatini is not large in area, and has a population of only around 1 million, but there is an unequal distribution of medical care resources between rural and urban areas. The country also is less experienced in responding to epidemics. For example, hand disinfectant and other sterilizing supplies were in insufficient supply and could become a threat to disease prevention.”
Most confirmed cases in Eswatini were young or asymptomatic. However, some medical care providers were also numbered among the infections. Prior experience has shown that, if ground is lost in the hospitals, the large-scale social spread may follow. The top priority for the “Taiwan We Go” team was to stop the healthcare-associated infection.
After two months, the TMUH’s “Taiwan We Go” team to the Kingdom of Eswatini has completed the epidemic prevention and counseling mission, and an achievement presentation was held on July 22, 2020, to share the team’s medical assistance to Eswatini. Counselor Ms. Lindiwe Cynthia T. Kunene from the Embassy of the Kingdom of Eswatini and Deputy Director-General Ms. Abby Lee of the Ministry of Foreign Affairs Department of West Asian and African Affairs were invited to the event.
The team planned pathways for local hospitals responsible for epidemic care and established intensive and respiratory care to reduce the risk of local nosocomial infection. Pathways were established for 75% of the hospitals nationwide. These included Mbabane Government Hospital, Hlatikulu Government Hospital, Mankayane Government Hospital, Piggs Peak Government Hospital, Raleigh Fitkin Memorial Hospital and Psychiatric Referral Government Hospital), and 100% of designated epidemic hospitals (Lubombo Referral Hospital, and Mavuso Exhibition and Trade Centre).
In addition, multiple discussions and exchanges with international health agencies were held, including all levels of Eswatini health agencies and experts from the U.S. The team also designed more than 10 types of teaching materials on improving personnel awareness of the disease, use of self-protection equipment, and adjusting respirator settings, totaling 43 lectures. Additionally, seminars were arranged to teach more than 500 participants across Eswatini, helping the spread of knowledge and expertise at the national level.
The “Taiwan We Go” Team also taught front line clinical practice for critical care. They assisted with the assessment and treatment of severe respiratory failure in COVID-19 patients, performed endotracheal intubation and other related invasive treatments.
Although the local medical equipment is relatively inadequate, the “Taiwan We Go” Team managed to use the limited resources for teaching and training. As nurse Yu-Hsuan Lin said, “To rapidly improve the foundation of the personnel within two months is a challenge not only to the teaching plan but also to local medical care.” Therefore, the team members constantly encouraged each other to build the confidence of the local medical staff, fight the epidemic together, establish local critical care, and strengthen the safety and effectiveness of epidemic prevention work, successfully passing on Taiwan’s epidemic prevention experience to Eswatini to help the country fight the epidemic.