Shivers in the Spine: Historicizing Dilemmas and Hope During a Pandemic

Abstract

This chapter analyses dilemmas during the outbreak of epidemic and pandemic diseases within the construct of the practitioner-patient relationship. In the process, we examine the likely impact of the current pandemic on the interactions between health workers and patients, especially in less resourced settings. We also discuss the sociopolitical and economic implications of dilemmas resulting from pandemics. The dilemmas in a hospital setting are, in part, dependent on the relationship between health workers and patients. On COVID-19 in Africa, concerns were raised on the duration that African health systems, variously described as fragile, can withstand the pressure of the pandemic and its subsequent disruption of basic health services. In the context of an ongoing pandemic, we ask: What significant dilemmas have hospitals faced in past pandemics? How did they occur and what form did they take? With recourse to surveys and reports rooted in secondary and primary sources, we discuss the medical dilemmas within the hospital setting during the HIV/AIDS and Ebola epidemics in some countries of sub-Saharan Africa (SSA) in the late twentieth and twenty-first centuries. We demonstrate that the encounter between health workers and their patients was disrupted during the health crises of HIV/AIDS, Ebola, and COVID-19. Health workers found themselves in an uncertain state as they had to conform to new ethical guidelines like triage and were expected to provide adequate care to patients amid health care challenges. Patients were also left with options to take care of their own health. The sociopolitical and economic implications of dilemmas resulting from pandemics are inevitable.