Since the outbreak of the Covid-19 pandemic, there has been one loud, clear message from healthcare workers: stay home and let us keep you safe.

And while across the world and in Pakistan, people rush to return to their previous routines, it's the frontline workers who still put their lives on the line everyday. Not just their own lives, but those of their families and loved ones.

Here, they recount in their own words the struggle against an unknown enemy and answering their call of duty as they find themselves on the frontlines of an ongoing battle — one of the toughest in recent human history.

These are some of the stories of the thousands of healthcare workers across the country, who are risking it all to save lives. Dawn.com will keep updating this space with more stories as they come in.

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Dr Saima Kamal Moutasim, Karachi

Head of Covid-19 ICU, Dow University of Health Sciences

“Unless you have seen and managed a corona patient gasping for breath, seen young people die from it, worn a three-layer PPE for hours on end when you can't eat or even go to the washroom, you have no idea what corona is.

“When as a physician you feel helpless even after you have done everything to save a life but you can't, you realise it's real. It is very, very real,” says Dr Moutasim.

After waking early in the morning, she prepares for her long day ahead. Once at the hospital, there is no time to waste; she dons a three-layered PPE for 3-4 hours straight, managing the most critical patients before dealing with administrative issues.

But the day doesn’t end even after she has returned home in the evening. “At home l get calls from the hospital regarding patient management and administrative issues.

“The past two months have been draining, both mentally and physically, due to various issues, ranging from a lack of resources to the uncertainty of this disease and its circumstances.”

To protect herself and her loved ones, she wears a mask and gloves on her way to and from hospital and once home, she takes care to wash herself and her clothes. “You never know that you may be an asymptomatic carrier.”

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Dr Aftab Phul, Hyderabad

Focal person for Covid-19 isolation ward, Liaquat University Hospital

Dr Phul has not seen his family for the past nearly three weeks.

“Kaisay ho? Apna khayal rakhna (How are you? Please take care of yourself),” is the advice he gets from his mother every time he calls her, mostly around midnight, after ending long, draining shifts in which he manages the Covid-19 isolation ward.

“I have [physically] distanced myself from my family completely. I live in a separate rented house. A cook there who maintains a safe distance serves food to me and no one else visits me," he says.

“As doctors, we don’t get sentimental and are ready to face any kind of situation.”

The medic often encounters extreme attitudes towards the coronavirus, much about which still remains unknown. "Many educated people call us and tell us that it is a Western sort of conspiracy," he says.

But knowing full well the lethality of the virus, the safety of his staff is always at the back of Dr Phul's mind.

"Staff members working in the isolation wards face the threat of the virus directly. They are doing a great job without any incentive. Their colleagues are working other jobs in the same pay scale which are not as potentially dangerous or harmful as [being in] an isolation ward."

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Zakir Ali Mashoori, Hyderabad

Ambulance driver, Liaquat University Hospital

“Why would I get scared? It is my job and I have to do it,” says 21-year-old Mashoori matter-of-factly.

These days, he transports coronavirus patients to the isolation ward or drives LUH doctors for emergency duties.

"I have driven many patients and also transported some bodies to Tando Mohammad Khan," he says.

The only time he is concerned is when he thinks of his family. But with no alternative options, “I just wear the protective kit and then leave all thoughts behind,” he says.

“My parents tell me not to get too close to the patients and not to go on duty without wearing the kit. But what should I do? I have to be in the ambulance whenever needed because it is my duty.”

After returning home from a 14-hour-long shift, “I change my clothes, take a bath and then sit with my family for dinner.”

Despite being in close proximity to infected patients frequently, Mashoori has not been tested for the virus himself. “I didn’t get my test done. I am told that one should go for a test only if they show symptoms and Alhamdulillah I have no symptoms."

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Ashiq Husain, Lahore

Technician, Emergency Operation department, Children's Hospital Lahore

“We all feel a little scared due to the pandemic, but as health professionals we will have to take care of the public,” says Husain.

He wears complete protective gear while visiting the coronavirus wards set up at the hospital. But at home, he always has the nagging feeling that he could infect the family.

“I maintain a distance from the children and other family members when I get home after finishing duty,” says Husain. “I also avoid coming into contact with the elderly and children.”

It has become somewhat of a ritual after reaching home: change clothes immediately, use a homemade spray and sanitiser for disinfection and do not allow anyone to come too close.

Husain notes that even more at risk are the healthcare workers on the frontlines — the ward boys, the security guards and the nurses. They are the people who often come into contact with infected patients.

“We have been taking safety measures such as wearing PPE, maintaining social distancing and using hand sanitisers for the past two months.”

But is the general public that Husain hopes would realise the gravity of the disease. He wants them to observe precautions for their own good, and for the safety of others.

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Sadaf Noreen, Lahore

Nurse, Children's Hospital Lahore

Until a couple of months ago, it was routine for Noreen to get physically exhausted from the deluge of patients that she and her colleagues handled daily. But after the Covid-19 pandemic, the mental stress has taken precedence over the physical.

“The mortality rate has gone down and the number of patients coming in with other ailments and after traffic accidents has decreased while some surgeries have also been delayed, taking away some of the physical strain,” the nurse says.

Once the pandemic became a reality, the anxiety has become about avoiding contracting the virus while being on the frontlines and keeping others safe in the process.

“After getting home, I put away all my belongings from the hospital at a distance and meet my family only after bathing with warm water, taking steam and using a sanitiser,” she says.

Anything she has come into contact with before disinfecting herself — a door handle, a chair or a utensil — also gets cleaned.

For Noreen, the answer is simple: prevention is, after all, better than cure.

“People should realise that this disease will not only affect them but will also create problems for their loved ones and society at large.”

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Dr Bakhtawar Fatima, Lahore

Postgraduate trainee, Lady Willingdon Hospital

Dr Fatima was at her home on leave when Covid-19 cases suddenly began to swell in the country. When she returned to duty, it struck her: She might not be able to see her family again and, like many other healthcare workers in the country, might not survive the pandemic.

It is not herself that she is worried about, but her family. “It is very scary when you know you may cause harm to your family as my father is diabetic,” she says.

She and her colleagues have been performing their duties as they did before the pandemic, but the modus operandi has now changed. “We are being as careful as we can so that we may not be the carrier of Covid-19 to our patients and others.”

But working in the ‘red zone’ increases her burden of responsibilities, and the level of care she must take. After ending her shift, she puts away her safety kit in a closed bag and returns home to bathe and disinfect.

“I wash my clothes and place them in sunlight. I do not take anything home with me from work,” she says.

Dr Fatima wants the public to realise that hundreds of people have lost their lives in the country and this pandemic is “not a joke”.

“Wash your hands properly, take precautionary measures and do not put your family at risk,” she advises.

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Imran Khan, Swat

Ambulance driver, Saidu Group of Teaching Hospital

To save them from mental anguish, Imran Khan doesn't inform his family when called in to take a Covid-19 patient to the hospital or transport a victim's body to the graveyard.

"Initially, I was scared and confused and even hesitant to continue with my duties once the outbreak began. But I overcame the fear in my heart with my will to play a role in the battle against this pandemic.

"I am performing my duties without any expectations, just for the blessings of the Almighty."

Each time he clocks out, Khan performs an exhaustive ritual to disinfect himself before returning home to his family. "We are provided with personal protective equipment [while on duty] and I make sure to follow safety guidelines."

The one lesson he has learnt from the past few weeks is to not take the virus lightly.

"I have seen all types of Covid-19 patients; some are stable while some are in critical condition. Therefore, if I could say anything to the public, it would be this: Take special care and follow precautionary measures to avoid contracting the virus."

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Asad Iqbal, Swat

Lift operator, Saidu Group of Teaching Hospital

"Before leaving my house, I recite Ayatul Kursi and blow around me so that I am protected against the coronavirus," says Asad Iqbal.

"When a coronavirus patient comes to the hospital, I am the first person to receive them. It is my job to take them to the elevator, designated for such patients and transport them to the isolation ward on the third floor."

Iqbal says the patients who are in his care for a brief moment of time, always offer him their prayers. "Others run in the opposite direction when they hear of a coronavirus patient. But I take care of them, without fretting over their diagnosis."

While he feels lucky to be able to serve humanity during this time of crisis, Iqbal has kept the real nature of his job a secret from his family.

"I know that if I ever tell them about working at the isolation ward or being exposed to the virus while on duty, they will tell me to stop."

So with his lips sealed, Iqbal takes a shower, disinfects his clothes and spends some time basking in the sunlight before returning home.

"For people to call the virus a conspiracy is unfathomable. I see patients daily; sometimes I receive a patient and later find out he has died. People need to take it seriously, this isn't a joke."

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Dr Muhammad Arif, Swat

Works at Covid-19 isolation ward, Saidu Group of Teaching Hospital

"I chose this profession to serve humanity irrespective of caste, creed, colour and religion. So I am treating this period as my responsibility as a frontline healthcare worker," says Dr Muhammad Arif.

According to the young professional, his heart skips a beat every time he sees a critical coronavirus patient.

"They can't breathe properly and are in acute discomfort. Sometimes, the colour of their face changes due to shortness of breath."

"Some of us have taken to living at the quarantine centre where we have been assigned personal rooms, instead of returning home," he says.

Arif has also started providing medical consultations on the phone for non-coronavirus patients in his care.

"People need to avoid leaving their homes unnecessarily. Even if they have a health-related issue, they should stay at home and contact their doctor over the phone. I myself have made it a point to be available on the phone 24/7."

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Fazilat Akram, Swat

Nurse, Saidu Group of Teaching Hospital

"Since the coronavirus pandemic began, my life has become one of solitude," says Fazilat Akram, who has been working as a nurse for the past 14 years.

Recently, she was given the responsibility of overseeing the high dependency unit (HDU) for Covid-19 patients.

"Prior to the pandemic, I would sit down with my family members at the dinner table, where we would update each other about our lives.

"Now, after finishing up work, I go home and don't interact with anybody. I have told my children to maintain their distance.

"My children think I am strange, but this is what I have to do to protect the people I love."

She says that working all day and then limiting oneself to a single room is not an easy feat.

"It is tiresome, but I am constantly scared. At work, I fear contracting the virus and at home I fear passing it onto my children. The mental stress alone has robbed me of my sleep."

Akram has witnessed the deaths of eight Covid-19 patients so far, and she calls them "the saddest moments of her life".

"The elderly patients are in constant pain, unable to breathe and unable to sleep for a few moments of respite.

"When the first patient died, it broke my heart to see that the family was told to keep their distance. They didn't even take part in his funeral," she says.

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Ataullah, Swat

Nurse, Saidu Group of Teaching Hospital

"Ever since I have started working at the HDU for Covid-19 patients, I feel as though my friends and the people around me are hesitant to meet me," says Ataullah.

He has only recently started working at the facility as a nurse. "A while ago, I had a friend come to me asking to stay at my house for some time. But when he heard where I was working, he quickly retracted his request and hasn't met me since," he says.

Covid-19 patients with other ailments are the ones most at risk as they are in constant pain, he says. "We try our best to help them but we can't always save their lives.

"Only care and precautionary measures can do that," he says.

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Dr Raheem Khan

YDA Balochistan chapter spokesperson

"The biggest fear that doctors have at the moment is not that they will get infected with the virus; it is that they might infect others," says Young Doctors Association (YDA) Balochistan chapter spokesperson Dr Raheem Khan.

"Let me explain: doctors are working day and night, they are on call and are performing surgeries. We never know if the patient we are interacting with is corona positive or not," says Khan, who is also a medical officer at Civil Hospital, Quetta.

"So when you go home and sit down with your family or go and visit your friends, this fear is always playing up in the back of your head, the thought that 'what if I am transmitting the disease'."

According to Khan, hospitals are a major source of infection. "I have been living at a hostel for the past few weeks, I have stopped going home because, let's face it, we are a danger to our loved ones.

"This thing is constantly at the back of your mind: are you getting infected or are you a source?" he reiterates.

Khan's message to the people is simple — stay at home so that you are able to live longer.

"Just look at the current situation. Cases are increasing and we have to break the chain to stop human-to-human transmission. The tests being conducted right now don't illustrate even a small percentage of ground realities.

"Avoid crowds, avoid iftar parties. Only when you are alive can you enjoy these things. People will have to show a serious attitude towards this virus."

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Jamal Shah

All Pakistan Medical Staff Federation president

"Every single day, since the disease first emerged in Pakistan, has been of immense difficulty and worry for us, and the situation is only getting worse," says Jamal Shah, president of the All Pakistan Medical Staff Federation.

"The people of the nation still don't understand the gravity of the situation. I have seen frontline workers give up their lives while battling the coronavirus," says Shah, who also works as a senior paramedic at Civil Hospital, Quetta.

"On their behalf, I want to say only this: understand the current circumstances and their severity and stay at home."

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Edited by Adeel Ahmed and Sana Chaudhry

Header illustration by: Mushba Said