an interview with Dr Giulia Manfredini Cornali
Globally, women are always supporting and providing care for others.
Once again, at the core center of this pandemic, nothing is different; health professionals were the first ones to show up and will be the last ones to be able to slow down, most of them are women.
In the 210 countries and territories around the world coping with this unprecedented health disaster, health care professionals have been the real heroes on the frontline of COVID-19.
Among them, women constitute 70% of medical and support staff, 85% of nurses, and half of the doctors in OECD countries are women.
They save lives, they perform quality health work under pressure of the pandemic risks, whilst self-isolating to avoid spreading of the virus to their own families and friends.
Italy has been flagellated by COVID-19. According to Worldometers, on April 24, 2020, Italy is in third place of the most affected countries, with more than 189.000 cases out of the 2.7 million worldwide cases, and over 25.000 deaths out of the more than 191.000 deaths in the world. The globe was shocked in solidarity and sadness from the devastation of this virus in this much-loved country.
SIE Vice President of Advocacy, Rita Nogueira Ramos interviewed her friend and fellow Soroptimist, Dr Giulia Manfredini Cornali, Head of the Endocrinology Unit at the Massa-Carrara Hospital in Northern Tuscany, Italy on the impact of COVID-19 not only in Italy, but worldwide.
Rita: Could we have done something different to avoid this unprecedented global disaster?
Giulia: My personal belief is that our government and even scientists underestimated the COVID-19 infection and we lost precious weeks to get prepared. I clearly remember many virologists and medical experts re-assuring our population and politicians through the media that COVID-19 virus would not have affected our lives more than a normal flu. By looking at the news from China we should have started producing more Individual Protection Devices (like masks, clothing, gloves) and medical equipment for assisted breathing and preparing for a greater number of Intensive Care Unit beds.
Misinformation and fake news have been a problem for our society for quite a while, but COVID-19 has made everything worse. Especially in the beginning, it was unclear whom to listen to or what behaviour we had to follow. Soroptimist International Europe Italy has been very active in this sense, providing fact-checked news and information to the population.
I would have liked to see more women involved in the Italian Government and in the regional task forces, but it was not our case, I am sure better decisions would have been taken. Finally, I have always been a strong believer of the value of the European Union, but I must admit that as a European citizen I felt truly abandoned. A European task force, with a common trans-border response, should have been enacted since the beginning of January. Especially because COVID-19 knows no borders. Post-SARS the EU created the European Centre for Disease Prevention and Control, an agency founded just for situations like this one. Its absence was deafening.
Rita – Hospitals have been overloaded for almost two months with such a massive and sudden influx of patients, with life and death decisions having to be taken on the spot, missing materials and proper conditions, how does the medical professional feel?
Giulia – Most of my colleagues and nurses working in COVID-19 hospitals and home-assisted COVID-19 facilities are particularly stressed and worried. As you said, most of them are women and they decided to leave their homes, stay separate from their families for fear of bringing the infection to their relatives. Some of them have not seen their kids and partners for several weeks. When they are working not only do they treat and cure patients in critical conditions but also take care of the psychological burden of those men and women who, because of the illness, are secluded from their homes and their beloved ones. There are wonderful reports of nurses and doctors connecting patients with their families with tablets, cellphones, making video calls… but there are also so many sad reports of personnel holding the hand of a patient before he or she dies without seeing loved ones again. We will be all changed after these experiences.
Rita – Do you think it is still possible to guarantee quality healthcare to this and to other health situations?
Giulia – Even though the healthcare personnel has been overwhelmed at work, I am sure that we gave the best we could in terms of medical assistance and psychological support. Obviously, the number of doctors and nurses was clearly inadequate not only because of the load of the pandemic but also for the unwise restrictions and cuts applied to our staff in the past years. Many of us have been obliged to stay at work endless hours. Massive investment, especially in training and hiring new personnel, is needed.
SI Italy, National Emergency Project Covid19
Rita – When having to work endless hours, tirelessly in tension to respond to all situations, do you feel like Superwoman? Facing the cruelty of so many human losses, which might cause mental burden, and being apart from your beloved ones for days, risking yourselves to be infected, how do you think the medical health care professionals, in particular women who are always in so many fronts, support these extreme circumstances?
Giulia – Doctors and nurses are used to dealing with these problems and from my experience, we give our best in the most critical situations. At the end of this COVID-19 emergency I know we will be very tired and many of us will be frustrated for the human losses we could not avoid. We, women, are strong but will be anyway changed forever.
Rita – How do you protect yourself and your family from infection? I know that you are very active as a Soroptimist and immediately taught to make protective masks, but at home and when out to the hospital, how do you prevent the propagation and protect yourself?
Giulia – I am using extreme care when I am at work and in public when there are people around me, keeping a safe distance and wearing protective masks. At home, we use the same cleaning standards we already had but we wash our hands more often. We are happy to know that our dog is safe, and COVID-19 will not affect her!
Rita – As a woman, (you are not only a doctor), but a caregiver, a volunteer, a Soroptimist, with a wide range of responsibilities and a very intense agenda, too many people expecting so many different responses from you. As far as you can see, are women around the world being properly taken care of under the circumstances of COVID-19?
Giulia – Although the virus seems to statistically affect men more than women, there are sociological and medical aspects to take into consideration when looking at women’s experiences during the COVID-19 pandemic. For example, women are traditionally those who are in charge of family organization and care. This can translate itself into greater risk of exposure during grocery and supply shopping but in general a heavier familial workload. Just think, in big cities in Italy average waiting times to enter the grocery store are around 40 minutes, in direct sunlight, and it can be a great burden both physically and timewise. Workwise, it is more probable for women to be unemployed due to the economic recession caused by the lockdown. Furthermore, at least in Italy, but probably also in other countries, most medical staff is made up of women and we know that medical personnel is the most exposed category to the virus (12% in Italy). Worth mentioning are also the harsh, complicated, and stressful conditions under which many women are experiencing labour and childbirth – totally alone without their partners or families.
Rita – What are the main concerns you have been witnessing in your hospital, your neighbourhood and what actions are missing by the governments to target these problems? Should women be now at the heart of concern?
Giulia – Our main concern, right now, is to get back on our feet. We are each doing our part, the government has been consulting constantly with scientists and experts and the community has come together to support hospitals. I am particularly concerned about the mental health of our patients but also of our community. Loneliness seems to be the most common feeling during these hard times of lockdown. I constantly hold in my thoughts the elderly population, whether men or women, who find themselves alone and scared, with truly little contact with the outside (technology is not their forte, in most cases). We also must support to the best of our efforts those patients either affected by serious non-COVID-19 medical issues who have a hard time accessing medical care or must do so without familial support. The community is trying its best to support these groups and I know the Italian government, civil society and religious groups have started psychological phone support services in these hard times. Soroptimist International Italy has also activated a free nutritional assistance service managed by nutritionist biologists from Soroptimist Italy to help people in this period of forced isolation and direct them towards a healthy and conscious diet. And we know that women often take care of family nutrition.
Many Italian SI Clubs have promoted crowdfunding actions for women in need, providing food and help for critical situations. SI Italy has also launched a national campaign, with great financial support from the Clubs, for the purchasing, production and distribution of professional masks especially to front-liners and citizens at risk (Healthcare personnel, grocery stores workers, other professionally exposed workers). This was very useful because some front-liners, most of them women, were not given enough – if any – protective devices.
Rita – I have been reading that hospitals and municipalities are facing a dramatic increase of domestic violence against women and children due to confinement and isolation, being sometimes unable to cry for help. Do you confirm this problem with COVID-19? Can you describe the situations coming to your knowledge?
Giulia – It is quite frightening. We have seen an increase in violence against women, as forced confinement is exasperating already harmful situations. I am also thinking about how difficult it must be for women living in situations of domestic violence to have the courage to pick up the phone and ask for help, or even the space to do so, for that matter. Living in close quarters can often mean no possible way to contact help. Soroptimist Italy has set up an online platform “COVID-19 Free Psychological Assistance” managed by 50 trained Soroptimists professionals, working online and by phone.
Children have also been suffering strongly, the lack of social exposure is harming them deeply. School was a refuge for many of them – I am especially conscious of those situations where familial support is weak and children benefit deeply from school care. I am proud to say that Soroptimist Italy has set up “Soroptimist Net Lead,” a free online learning platform on YouTube for secondary education as a support in these lockdown days. There is also a proliferation of Italian Soroptimist online groups where users can meet virtually to talk about various cultural subjects.
Rita – Do hospitals have gender capacity to effectively mobilize a response in case of violence? In particular, the special kind of health support, evaluation, gathering evidence, psychological and social work. Is there enough prepared personnel on the ground to address violence and coordinate with shelters and justice measures for perpetrators?
Giulia – Yes, I must say we have a very responsive system to deal with situations of violence from a medical point of view, for the past fifteen years both hospitals and family clinics have trained personnel to a specific protocol (Codice Rosa) to follow in cases of violence. There are coordination measures with shelters and the justice system, but many sectors are underfunded and much still needs to be done. Soroptimist Italy has tried to push this agenda forward by creating “rooms only for you” (Stanza tutta per sè) in Police stations, where women may have private and protected conversations in a safe space regarding their experiences. We supported the creation of numerous “protected listening rooms” (Stanza Protetta di ascolto) in courts, so that women and children may deposit evidence in a separate space and do not have to get into contact with those who have harmed them.
Rita – What do you think Soroptimists can do to advocate for the mitigation of the key risks of violence against women children and domestic violence during this period?
Giulia – A good communication strategy is necessary. Many women find refuge only in social media or on TV shows and direct or indirect messages of support are crucial. Every woman everywhere needs to know what to do in case of violence. This year Italy almost had no possibility to celebrate International Women’s Day on the streets, as the COVID-19 had already forced us into lockdown, but we did not let our guards down. We fight and must continue fighting for women’s rights every day and make it public knowledge that domestic violence is not acceptable. It is not the norm. Soroptimist International will keep standing up with women, enhancing their value and their role in our world. Certainly, the massive importance of women in the workforce is finally being recognized. I sincerely hope that at the end of this emergency, women will continue to know their worth and how valuable they are to our societies.