Dr. Cassindra Alonzo-Ash makes Psychological First Aid her “Focal Point” on the healthcare frontline - PAHO/WHO | Pan American Health Organization

28th July 2021 — With first-hand social knowledge of both rural and urban communities in Guyana, Dr. Cassindra Alonzo-Ash is no stranger to the diverse cultural landscape of her country of birth. A graduate of the Latin America School of Medicine in Cuba, this 38-year-old medical practitioner has selflessly used her lived experiences to better understand the healthcare needs of citizens with her upbringing between the capital city of Georgetown and the administrative centre of Mabaruma – the latter, a quiet village nestled closely to the rainforest, bordered by the Aruka River. Particularly during the COVID-19 pandemic, this familiarity has further driven Dr. Alonzo-Ash’s desire to focus on broader healthcare needs as a Hotline Operator and Frontline Worker - such as developing coping mechanisms and leveraging mental health and psychosocial support (MHPSS) in various catchment areas across the country.

According to Alonzo-Ash, one of the greatest challenges for her and the volunteer-based hotline team was encountering triggers from informational overload en masse. “When we got our first cases and I was exposed to the hotline, there were lots of persons who would call in, panicking – from googling information or watching reports of the signs and symptoms on television, especially during March to May 2020,” she recalled. “I remember one young lady who called during one of my midnight-to-morning shifts who would have read information on Facebook and called the hotline after seeing those details because she incorrectly self-diagnosed for shortness of breath, which is one of the pervasive symptoms of COVID-19.” Consequently, there was a wider revelation happening parallel to the pandemic for the medical task force –members of the general public were also using the hotline as a guide to ask for help during periods of mental and emotional distress.

“At our Health and Emergency Operations Centre, we received many cases alluding to suicidal thoughts and depression,” she noted – a further indication that fine-tuning humanity-centered, supportive responses for high intensity and distressing circumstances was a necessary aid for the frontline workers who were serving the public.

As one of 40 Guyanese healthcare participants earmarked for this capacity-building training supported by PAHO and CDB in August 2020, Alonzo-Ash openly received this opportunity to advance her skill set. “The psychoanalytical skills I would have received throughout my academic years were geared towards coping mechanisms during times of stress and not necessarily disaster management, so for me, this specific MHPSS training opportunity became an added layer of assistance for those who are in need during a crisis,” she explained. Learning more about assessing security risks, providing basic and practical needs, anticipating emotional reactions and finding solutions via social support services also helped Dr. Alonzo-Ash to develop coping mechanisms to manage her team. As the Coordinator for the Focal Point of Aedes Borne Disease Programme in the Vector Control Services Department attached to Guyana’s Ministry of Health – one of 150 health facilities covered in the programme - she found that her unit was better equipped for real-time circumstances through the solutions-oriented exercises.

“We have field officers, senior operating inspectors, biologists, technicians in my department – and together with the staff and with the knowledge gained through the training, we were able to better allocate resources to be more equipped for the field,” she assessed.

With multiple team responsibilities such as assisting with sanitizing of buildings and hospitals and sometimes not having adequate resources such as Personal Protective Equipment (PPE), Dr. Alonzo-Ash held a greater appreciation for the training programme in helping the team to understand their responsibilities. “It’s the way you look, listen for and link the knowledge that they would have out on the field to create a functional synergy in a team environment. At the end of the day, they have to go home to their families. If they get sick, who will complete the task of sanitizing?” she rhetorically asked. “We have to take care of our own in order to take care of others, and our team members are willing and able to serve once we are able to provide the necessary tools and resources. When we did the training with some of the staff, they gained get a better understanding of COVID-19. If you want people to come out to work, then we have to provide sufficient information and support.”

As a member of the task force and first responder to the frontline of the COVID-19 pandemic, Alonzo-Ash truly understood the value of the Psychological First Aid (PFA) course, as she sought to deal with the emotional needs of herself and others with measured contiguity. “The training should be continuous because we don’t know what the future holds,” she surmised. In her view, the program should not just be exposed to the Ministry of Health, but to different departments and other key officials outside of the healthcare field.

“Teachers are also important vessels of information and should be exposed to this PAHO training - you can tailor this program so that children can understand, because they are also receptive and perceptive,” she opined.

With essential workers, community leaders, and other decision makers playing a key stakeholder role, Dr. Cassindra Alonzo-Ash believes that knowledge about COVID-19 combats and removes some of the stigma within the community, which ultimately provides multifunctional solutions to help Guyana to stand Stronger Together in the face of fast-changing adversity.

United States of America

Caribbean Subregional Program Coordination

Noncommunicable Diseases and Mental Health