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‘We have to choose between beard or emergency shifts during COVID-19’: Australian Sikh doctors

Dr Amandeep Singh Bamra, a Sikh doctor at work in an operating theatre using PAPR. Source: Supplied

A group of Sikh doctors has petitioned the federal and New South Wales governments to make powered air-purifying respirators or PAPR freely available for bearded healthcare workers who work in hospital emergency departments. They believe their campaign will help healthcare workers from other faiths too, who can't shave off full beards.

COVID-19 has thrown a unique challenge before bearded healthcare professionals across the world. Owing to their facial hair, they are unable to wear N95 masks (also called P2 masks) properly while performing emergency duties in hospitals.

An Australian WhatsApp group titled ‘Turbaned Sikh Doctors Group’ comprising nearly 40 healthcare workers, primarily doctors, has taken it upon themselves to convert this challenge into an opportunity to provide a solution to all male healthcare workers sporting full beards. 


Highlights:

  • Bearded healthcare workers don't feel safe with N95 or P2 masks: Turbaned Sikh Doctors Group
  • Sikh Youth Australia has requested federal and NSW health ministers for PAPR for bearded healthcare workers
  • 'I regret the unintended impact of this on our Sikh health staff', says NSW Parliamentary Secretary of Health

Satwant Calais, Sikh Youth Australia’s president was approached by some Sikh doctors with worries that melded their professional and religious concerns.

“The founders of this Whatsapp group are Sydney-based anaesthetists Dr Gurdial Singh and Dr Amarpal Saluja. They first noted that N95 masks, commonly used by healthcare professionals, don’t provide a proper seal around beards. They discussed this with me and we sent a submission to Federal Health Minister Greg Hunt and New South Wales Minister for Health and Medical Research Brad Hazzard,” says Mr Calais.

Mask
N95 masks don't provide a safe seal for faces with beards.
Unsplash

Dr Gurdial Singh says the solution to this lies in a specialised personal protective equipment (PPE) called powered air-purifying respirators (PAPR), which is what you’d see welders wear, complete with a transparent helmet and an air tube affixed to the nose with a mask.

“PAPR is highly effective in providing breathing safety in contaminated environments. Anaesthetists, ENT and dental surgeons must use it during the current coronavirus-impacted environment,” says Dr Singh.

Dr Amandeep Singh Bamra, an anaesthetist in regional New South Wales’ Bowral and District Hospital says that thanks to the PAPR kit provided by his hospital, he is ready to treat COVID-19 patients if the need arises.

“It will be helpful for the community if bearded healthcare workers can be provided PAPR. However, those who don’t get it, may feel left out when they see others using it, and that can be a challenge for any hospital administration. I feel supported by my hospital in that regard,” says Dr Bamra.

PAPR
Dr Bamra working with PAPR.
Supplied

Despite the confidence PAPR provides to healthcare workers in sensitive work environments, it has many downsides too.

“They are expensive (around $4,000 on average), in short supply because of the low production from the US and require specialised cleaning. They are also complex to don and doff, but they give us assurance,” Dr Singh adds.

While public hospitals are less likely to procure PAPR for a handful of bearded staff, private hospitals have also not supplied them to every staffer who needs them.

In a response to Mr Calais letter, the Parliamentary Secretary of Health, Natasha McLaren-Jones has said "I regret the unintended impact of this on our Sikh health staff, " adding, "NSW Health empathises with the difficult position for practising Sikh staff members who are required to use P2/N95 masks as part of their work."

The letter further states, "The CEC has advised that PAPR use is complex and is not recommended for routine use. PAPR does not align with recommended precautions per mode of spread due to the complexities of use, cleaning challenges and clinical appropriateness." 

PDF icon letter_from_nsw_health_ministers_office.pdf

SBS Punjabi has learnt that some healthcare workers with beards have been unable to perform emergency duties for this reason or have opted to buy their own PAPR so as to continue getting shifts in the emergency department.

“It is a peculiar situation. Sikhs can't shave off their beards for religious reasons. Being put off the emergency roster can mean a significant drop in income for healthcare professionals,” says Dr Pavitar Sunner, a Sydney-based orthopaedic surgeon and member of the Turbaned Sikh Doctors Group.

Earlier this year, two Canadian Sikh doctors, also brothers, Dr Sanjeet Singh Saluja and Dr Ranjeet Singh Saluja, made news as they shaved off their beards because their PPE wouldn’t fit over their beards.

In June, Sikh Youth Australia had submitted to the ministers that “future health policy needs to be developed in alignment with the Racial Discrimination Act and state-based employment legislation.”

Dr Sunner says that while this submission has been made by Sikh doctors, its benefits will be reaped by all communities.

Dr Pavitar Sunner.
Dr Pavitar Sunner.
Supplied

“Our colleagues from the Muslim, Jewish and Christian communities often sport full beards. If with Sikh Youth Australia’s help, we are given what we need, it’ll help bearded healthcare workers from every community,” says Dr Sunner.

They have since heard from the minister’s office and have been advised that those healthcare workers who can’t safely work with the available N95/P2 masks, will be rostered in areas where PAPR is not required.

"But that puts extra pressure on the non-bearded staff, which can harm the working relationship amongst workers in hospitals," explains Dr Sunner.

First page of the letter issued by Parliamentary Secretary of Health Natasha McLaren-Jones
First page of the letter issued by Parliamentary Secretary of Health Natasha McLaren-Jones regarding the issue of Sikh health professionals and PPE
Satwant Singh Calais

“New South Wales’ Parliamentary Secretary for Health has informed us the Clinical Excellence Commission would be pleased to meet us and discuss this issue further. They have also stated that PAPR use is complex and not recommended for routine use,” Mr Calais added.

Talking about beards, Dr Sunner explains that while men from other communities may like to have them, Sikh men must have them.

“This is why we need PPE that is culturally-appropriate because beards are indispensable for Sikhs,” he signs off.

Listen to this podcast in Punjabi by clicking the audio link in the picture at the top.

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