As a Kuwaiti citizen pursuing a medical specialization in Canada, I have seen how the COVID-19 pandemic has ravaged two countries and have been forced to make difficult personal decisions.
Deciding to leave Kuwait for Canada pre-COVID two years ago to specialize in Internal Medicine was hard but I had big dreams and ambitions. With my two children in tow, I left my husband and family behind. My 2- and 5-year-old boys are my anchors to the shore and would keep me grounded and motivated during my training. There was no way I could leave them in Kuwait.
While I anticipated the separation to be difficult, I had no idea just how complicated the situation would become because of this pandemic – travelling to Kuwait and back, worrying about the health of my family, and simultaneously continuing my intensive training.
COVID-19 has exposed cracks in both health systems: in Canada, COVID has ravaged long-term care homes and shelters; in Kuwait, it is immigrants who work and live in crowded, poor conditions.
I was four weeks into my rotation at St. Michael’s Hospital when COVID-19 broke out, spreading uncertainty among residents and staff and fears of the pandemic’s potential impact.
My worries were constant as I had no family support for my children if I had to self-isolate or, worse, if they became infected. Border closures left me with no option but to remain here and wait and see.
The Kuwaiti embassy in Canada offered a solution with a voluntary evacuation of its citizens with all expenses paid by the government. Even though I was preparing to apply for a fellowship program, I felt I had no choice but to go home. My site director and program director were supportive and agreed that I could do two months of electives in Kuwait and, if I couldn’t return to Canada in time, temporarily halt my training. That proved to be wise as returning to Canada was as nerve-racking as deciding to go to Kuwait.
Fatema and her children travelling back to Kuwait.
When I arrived in Kuwait in early May, I was immediately struck by the strict and extensive pandemic restrictions. At the airport, passengers had their temperatures checked and were swabbed for COVID in a room full of nurses and doctors donned in personal protective equipment. We were then taken to a room where personal data was collected and tracking bracelets connected to our smartphones were distributed. Anyone leaving their residence would face serious charges. While all of this was overwhelming, I was happy my home country was taking the pandemic seriously.
An early obstacle was getting out of the airport safely. I asked my family to drop off my car at the airport and leave but it was painful to see them after months away and just wave at them from afar.
Two levels of care were established – those testing positive and symptomatic were taken to one of the major hospitals designated for COVID; those testing positive but with no symptoms would be taken to sanatoriums, remodelled beach chalets far from the city that could accommodate many with all meals and services provided by the government. Those who, like me, tested negative and could safely isolate at home were allowed to do so.
Though my quarantine period was strange – living with my loved ones but isolated from the world and anxious about what was to come – I was lucky enough to spend two happy weeks with my children playing, cooking and creating new activities. A rare treat since even during vacations, we would be so busy visiting family that I don’t get much time to just be with them. I knew that would end with the quarantine so I enjoyed every moment I had with them.
My training schedule and routine after quarantine would be relatively simple. The subspecialty elective I had chosen would keep me away from direct contact with patients, meaning I did not need to isolate from my family since I would wear full personal protective equipment at work and wash and change before coming into contact with my family. And since my husband was teaching online, he was able to take care of the children while I was away.
Once I was allowed to enter hospitals, the hectic pace became obvious. COVID units were expanded and cases were rapidly increasing despite the extreme lockdown measures that had been in place for three weeks.
Hospitals across the city designated COVID units. Those with newer extensions moved positive cases into a separate building. Three major field hospitals were opened in May for patients needing minimal oxygen.
Much like in Canada, many frontline healthcare workers were eligible for extra stipends as the workload increased and vacation time was refused. Follow-up of patients was done on the telephone.
The lockdowns, however, were stricter than those in Canada. Grocery shopping required a booked appointment and was limited to 30 minutes. All restaurants and non-essential shops stopped deliveries. Leaving your house for medical reasons required submitting a request and receiving permission, though healthcare workers and certain essential sectors were exempt during curfews.
Once the total lockdown was lifted in early June and replaced by a partial curfew, it was time to face yet another difficult decision – returning to Canada with or without my children.
With ministries working at half capacity and rules changing week to week, finding information on travel exemptions for Kuwaitis to leave the country proved to be complicated. After waiting 10 anxious days, I was granted an exemption and booked my ticket to Canada, a relatively easy task with many immigrants leaving the country and daily flights to many destinations.
The exemption letter allowed me to travel with my immediate family. However, after long and excruciating consideration, I decided that it was safer for my children to stay with their father and our families in Kuwait rather than to expose them to the same risks we faced before leaving.
And now that I have returned, I face the most difficult part of my training – to be separated from my children with so much uncertainty around when I can return to Kuwait or bring them safely back to Canada.
Fatema Almousawi is an internal medicine resident.
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I loved this story Fatema. We know so well how things are going here, but rarely get to see how other countries are handling the pandemic to contain the disease locally, but also to prevent re-introduction as much as possible.
I also definitely appreciate your honesty about the pain you feel either having your kids with you, or leaving them behind in Kuwait. They are lucky to have such engaged parents, and the good news is that they will thrive knowing that they are loved, and in the grand scheme of their lives this will be a small blip. It will be harder on you likely! Time passes quickly when you are busy, thank goodness.
Thank you for choosing Canada for your training. We are better as a health system for having you here. And please keep telling us about your journey! It is good for all of us.
Be well.
Darren Larsen, MD, CCFP, MPLc
Chief Medical Officer, OntarioMD
Lecturer, DFCM and IHPME (DLSPH), University of Toronto