“How can I help you?” Pause. “Have you travelled out of the country recently?” Pause. “Please stay on the line. I am connecting you to a doctor."

The young woman reassuring someone on the other end of the line is Sadia Saleem, a call agent at the Sehat Tahaffuz (meaning health protection in Urdu) 1166 helpline centre in Islamabad, Pakistan.

Originally set up for parents and caregivers to get support and information about polio and other vaccines supported by UNICEF and partners, the helpline is now being inundated with tens of thousands of calls every day about coronavirus (COVID-19).

As part of its emergency response to the COVID-19 outbreak, the government has expanded the centre to help people get information on how to stay safe and connect them to a doctor when required.

“It’s stressful work, but I feel proud that I’m serving the people during this challenging time.”

A vital support system during a difficult time

“I received a phone call from a 75-year-old man this morning. He was so scared and confused because of the coronavirus situation. He asked if sunbathing could help him stay protected from the virus,” said Sadia. [It can't.] “I explained to him the symptoms of the virus and the preventive measures. He seemed relieved and thanked me.”

Sadia is one of 250 call agents currently staffing the helpline which operates in shifts, from 8:00 am to midnight every day, seven days a week.  

More than 80 per cent of calls received every day at the helpline are related to basic information on COVID-19, such as symptoms.

“I’ve been working for the 1166 helpline since its inception. It’s stressful work, but I feel proud that I’m serving the people during this challenging time,” said Sadia. “In addition to receiving reliable information such as the symptoms of coronavirus and the contact information for the testing facility, I think most people feel some comfort just speaking with someone from the health system.”

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Dr. Rabia Basri is one of the doctors stationed at the helpline centre, responding to critical calls with expert medical guidance. [© UNICEF Pakistan/2020/Sharmin]

70,000 calls a day

“Initially, we were receiving about 1,000 calls a day. During the National Polio Immunization Campaign in February 2020 for example, people were calling to report missed children, clarify doubts about vaccines and lodge complaints when health and vaccine services were not working,” said Huma Shaukat, a Helpline Liaison Officer.

However, since the outbreak of COVID-19, the amount of calls has increased dramatically, to about 50,000 to 70,000 calls a day.

The number of calls grew to such an extent that the government stepped in to assign additional resources. The Prime Minister’s Office extended support to recruit an additional 165 agents and the National Institute of Health assigned 10 more doctors to the technical team.

Dr. Rabia Basri is one of the doctors working at the helpline. “Every day I receive about 40 calls, some last as long as 20 minutes,” said Dr. Rabia. “These are difficult times for everyone. I often advise people about personal hygiene and physical distancing, and if they are having symptoms, help connect them with a hospital for the coronavirus test and further medical support.”

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Daniyal Kiyani is a newly recruited helpline agent committed to helping people during this difficult time of COVID-19. [© UNICEF Pakistan/2020/Sharmin]

Managing the helpline

At the helpline centre, television screens mounted on the wall display real-time information about incoming calls and graph representing the number of calls.

All call agents undergo a comprehensive training on COVID-19 by the National Institute of Health where they learn about the virus. These trainings are then followed by sessions on the helpline technology and interpersonal communication.

“The training and commitment of the call agents are very important. Otherwise the helpline will not work,” said Huma. 

Many precautions are in place to make it a healthy work environment for agents and prevent the spread of COVID-19 – including checking individual temperatures at the entrance of the helpline building, providing masks to all agents and ensuring a supply of hand sanitizer. 

With the spread of the COVID-19 pandemic, all polio vaccination campaigns have been temporarily suspended until June 2020 in Pakistan. However, plans are in place to reach all children with the life-saving polio vaccine as soon as possible.

Pakistan is one of three remaining polio-endemic countries in the world, along with Afghanistan and Nigeria. However, since the launch of the Pakistan’s Polio Eradication Programme in 1994, there has been a massive decline in polio cases in Pakistan from approximately 20,000 every year in the early 1990s to less than 150 cases in 2019.