By GOH Resource Development – Civic Dialogue
Trying everything possible to halt community transmission of COVID-19, Centers for Disease Control commander Shih-Chung Chen announced on May 14 that the COVID-19 alert would immediately be raised to Level 3 for Taipei and New Taipei City until May 28. Nationwide-related restrictions were expanded and reinforced to hold the line of community defense. On the following Monday and Tuesday, remote learning and a national Level 3 alert were also implemented.
Within a week, everyone’s life drastically changed and was converted online—voluntarily, or forcibly. To keep safe, we shopped, attended school, went to work, held meetings, and socialized online through our screens. Texts, voices, and conference calls became the main mediums of human interaction. Apparently, the world is shifting rapidly, though no one knows whether it’s heading toward a good or bad direction.
One thing is for sure, the COVID-19 is not a new challenge, but a belated trial. Some people are having a more difficult time due to a higher risk of infection than others. “Group-living in youth shelters is essentially clustering,” Wang Yueh-hao, CEO of the Garden of Hope Foundation, said. “Kids can’t go to school nor leave the shelters, and social workers stay with them 24 hours a day. In addition, 40% of the kids in all the shelters in Taiwan require special physical/mental care. When space is confined and emotional outlets are unavailable, it’s difficult to avoid interpersonal conflict, and physical/mental conditions deteriorate. These restrictions have made youth shelter management and operation extremely difficult during the COVID-19 alert.” she said worriedly.
At the end of June, the Centers for Disease Control extended Level 3 to July 12. Schools throughout the nation also paused until summer vacation, which caused difficulties for all the GOH shelters around Taiwan.
Challenges One After Another for Youth Shelters
How do you implement personnel segregation and flow control measures when short of independent spaces? Should shelters accommodate new children under the Level 3 alert? Do shelters have enough living spaces, software/hardware equipment, learning resources, and caretakers for remote learning? How do you stabilize kids’ emotions when they lack socializing and human interaction during their one to two months of staying inside? Usually in the background, social workers and dorm advisers stepped up to provide 24-hour companionship in the shelters and took on multiple roles in kids’ daily care, guidance and learning counseling, health care, environmental safety, and fighting against COVID-19. How did the team survive the repeatedly prolonged COVID-19 alert with insufficient backup as well as mounting pressure from increasing risk?
To cope with the inconsistency between each local government’s resources and policies, and to understanding the shelters need to constantly adjust their work model and review the required resources, GOH held the second “Youth shelters’ response to COVID-19 meeting” on June 18th to communicate the latest information between each city and cautiously control potential changes and risks. As the pandemic deteriorated, GOH offered vaccination leaves for shelter social workers and also allocated allowances for social workers who stayed in their posts and took the risk to fight against COVID on the front line. At the same time, GOH also re-examined the backup manpower capacity of the youth shelter system to see if it is able to meet the challenge.
Digital Divide of Remote Learning
GOH Hsiang-Jing Shelter in Taipei City was the first that got hit. “We only had 2 desktops and laptops each in the beginning of remote learning, but we had 13 kids. Schools know the kids live in the shelter, but only one kid’s school distributed a computer. We tried to get equipment from other shelters and headquarters, and some our colleagues brought their home computers over for kids,” Supervisor Kao said. “Later, we learned that some underprivileged families had received equipment from the Department of Education of Taipei City Government, which was a timely support for continued learning for kids in shelters and underprivileged families.” Improvising has become the norm for shelters during COVID-19.
Even from the earliest COVID measure, there were still things that were difficult to overcome. Kao said, “There was a new social worker that was supposed to be on-board. At first, we asked her to come after Level 3 lifted, but now with no end-date in sight and with mounting demand from kids in the shelter, we ended up asking her to report for duty to have sufficient manpower.” Kao added, “There was also a kid who couldn’t stay at the current residence and had an urgent shelter need. Therefore, with a negative COVID-19 test result, the kid was put in the shelter earlier.”
70% of Youth Require Special Physical and Mental Care
Every new member joining is a risk. Kao said, “To avoid cross-infection, authorities require personnel segregation and flow control to reduce infection risk. However, the Labor Standards Act requires dorm advisers to match shifts during rotation instead of having two independent shifts with separated duties on two floors. In reality, personnel flow control is not feasible.” There are not many options for shelters.
Even with all the efforts to maintain operations, Kao still worries about the future: “We don’t know what the pandemic will become and when it’ll end, and we’re also not sure how long the kids and the team can take it.” 70% of the kids in Hsiang-Jing Shelter require special care, but the pandemic prohibited them from going to doctors, and over 10 kids didn’t go out for a month. Interpersonal friction, relationship conflict, and mental/physical symptoms are more likely to occur due to living space being confined, which is what Kao worries about. “Four to five kids said they had gastroenteritis and stomachaches this week, but they can’t identify their physical condition after further inquiries.” Instead of being actually sick from confinement, Kao hopes kids were just pretending to be sick to get out for some air.
“It’s hard to follow a standard with all kinds of changes during COVID-19. We constantly reviewed current shift work manpower and COVID-19 measures to comply with the latest regulations and also modified our epidemic prevention plan according to shelters’ various needs.” She said the complexity of the information and real-time mobilization test the team’s adaptability, and the shelter faces different challenges every day.
Newborns during the Pandemic
Everyone is waiting for Level 3 to be lifted. . .
On the morning of May 28th, Chun-ju Xin Shelter of GOH in Taichung was expecting the 138th newborn. Even amid the turmoil, infants come into this world surrounded by love and happiness.
“The second week into the Level 3 alert, all people entering and exiting the hospital needed to pass PCR testing, and only one person could accompany a patient.” One girl learned about this news a day before her due date, and it messed up the plan Supervisor Wen of Chu-ju Xin Shelter had envisioned.
Who should accompany the girl if only one can go? “Social worker? Family? Chun-ju Xin Shelter serves people from all over Taiwan, and whether the girl’s family can travel to another region is also what we’ve been worried about.” Wen pondered over it again and again before making any decision.
Repeatedly going in-and-out of the hospital for prenatal exams, companions, and postpartum checkups inevitably increases infection risk as well as mental stress, not to mention this time she was to bring back a less-than-a-week-old newborn from the hospital. “We used to walk back teenage mothers and their babies from the hospital since it’s close to shelter. But it was raining that day, so I decided to drive. I waited outside of the hospital for the girl to finish the hospital discharge procedures,” she recalled that day.
“The girl took a shower after leaving the hospital, while I took care of the baby and organized and sanitized clothes and appliances brought back from the hospital. I gave her the baby after her shower. I didn’t go into the hospital, so I then went back to the shelter to continue other jobs after a simple sanitization and change of clothes.” Wen kept breaking down every step that was once familiar routine. “A week after birth, the mother and baby needed to go back to the hospital for postpartum checkups, to check for follow up jaundice, etc. Now every step sounds smooth…” In actuality, to deal with all emergencies, she rehearses each procedure in her mind under every circumstance over and over again.
No Room for Risk. Always Prepare for Worst.
“Always prepare for the worst in challenges,” she said. Before resources and circumstances became even more challenging, Wen already assigned tasks to herself, the social workers, and the dorm advisers. Before Centers for Disease Control announced the nationwide Level 3 alert, Crown Daisy Shelter started implementing Level 3 measures, such as sanitizing twice-a-day with sterilizer and sodium hypochlorite solution; large-scale sanitization during weekends; making sure staff, girls, and children do not overlap with the footprints of the epidemic survey; thinking about shift work that responded to the pandemic but also aligned with Labor Standards Act regulation. What if someone in the shelter was identified as a close contact case? How do you arrange the supporting manpower, space, and resources to ensure uninterrupted service?
“Once kids or staff were identified as a close contact case or COVID-positive, we needed to put them into a separate shelter…” Crown Daisy Shelter is located in a residential-commercial complex building in Taichung with an around 1,440 square-feet living area. “Because there is only one floor, there is no way to practice personnel segregation and flow control. In addition, home quarantine requires an individual bathroom, but Chun-ju Xin Shelter doesn’t have such conditions.” Wen continued, “We don’t have room for any risk.” Aside from the helplessness in her tone, behind the layers of deliberation is responsibility and the determination to guard the shelter.
Close Collaboration and Establishment of Mutual Trust During the Pandemic
There’s no effort taken in vain, all are for preparing for the next step. Earlier implementation of stricter epidemic prevention measures has granted Crown Daisy Shelter social workers, dorm advisers, and girls more time to adjust to the work model and daily routine. When asked whether more complicated and tighter shelter rules stifle girls and cause a tense relationship, she paused for just a short moment and replied, “After understanding the cause for these measures and requirements, they won’t be considered codes or restrictions. Every evening we watched the news and learned from the media with the girls to understand the current pandemic status and to stay connected with society.” Even with the fast-changing environment and regulations, Crown Daisy team still chooses to spend more time on communication, mutual understanding, and collaboration, rather than unilaterally forcing the measures onto the girls. She said, “That’s because with everything in the shelter, including sanitizing, cleaning, cooking, and laundry, social workers and dorm advisers do it with the girls.” This builds mutual trust and collaboration with the girls through the completion of every task.
Trust is the way to work and live with kids in shelters. Wen said that most of the girls staying in the shelters were traumatized from past experiences growing up and need more care, interaction, and companionship, physically and mentally. What she worries most about and wishes won’t happen is if social workers or dorm advisers who now accompany the girls need to self-quarantine. Can the backup manpower or team take over shelter operation promptly? Can they understand the kids’ physical and mental status? Who can be the backup under such high risk? Every question she asks is worrisome, but not one has a simple answer.
Obviously, she doesn’t have an answer yet. “Centers for Disease Control announced that young kids, elderly, disabled or physically/mentally troubled are not suitable to quarantine alone. Therefore, there should be a dedicated family member or caretaker to quarantine along with them 24 hours a day for 14 days, who can’t go out and can’t rotate with others.” Wen fell deep in her thoughts and then continued, “In fact, I don’t recommend changing caretakers at this moment, especially under [Level 3] alert. A sudden change of caretakers not only puts the caretaker under great pressure, but it is also difficult for kids to get used to a stranger.” Unsurprisingly, the one who sees the problem and raises questions is the one who is willing to stick around and stay in her post.
Vaccination is the Only Way Out for Permanent Epidemic Prevention
If COVID-19 doesn’t disappear naturally, then we need to actively contain it to overcome it. Vaccination is the only way out, otherwise it’ll be fighting a losing battle.
Centers for Disease Control announced on June 9th the allocation priority of the COVID-19 vaccine, and the 5th was residential long-term care institution residents and their caretakers; home/community long-term care institutions; disabled people and their caretakers; and other institutions, including corrective institutions, but youth and women shelters were not listed. Although the Department of Social Welfare from each region have one by one inquired shelters about their vaccination roster, some shelters didn’t receive further notice. By mid-June, staff of GOH Youth shelters in Taipei, Taichung, Kaohsiung, and Pingtung were the only ones vaccinated with a 1st dose.
“We were arranged to be vaccinated on June 16th at short notice. Among 8 social workers in the shelter, only 1 didn’t have side effects, and the others had multiple symptoms such as fever, chills, sore, insomnia.” Wen said there was backup from another shelter, but the backup also got sick. Therefore, Wen urgently contacted a vaccinated counselor for support. “Every day in the shelter is dealing with the unknown.” Wen forced a smile.
“Backup manpower needs to be trained.” Even in a changing environment, she remains flexible but also sticks to her principles—to protect the rights and interests of kids. “Replacement can be handed over through conference call or video, but the information needs to be clear and include software/hardware operation, status of each kid, and care giving details.” And in parallel, she maintains a daily safety check, fire inspection, security system checks, and electronic appliances check. She gave examples: “Checking the power plugs of electronic appliances, checking whether the freezer remains negative 18 degrees Celsius, documenting the temperature and humidity of each cabinet, preventing extension cord overloaded.” Day after day, shelter staff comply with regulations by conducting each check to ensure the safety of the kids.
New Daily Routine Brings Hope
No one knows when Level 3 will be lifted, but Chun-ju Xin Shelter staff is always using creativity for girls to learn in games and feel a sense of novelty towards life. Wen held handmade K.K. Phonetic Symbol cards in her hands and said shyly, “There’s usually no teaching aids or materials in the shelter, and we also don’t have enough money to buy them, so we either hand-make, or have staff bring a globe from home to make learning more interesting.”
“Everyone is trying hard to create a new routine in the shelter, which brings the team a sense of hope. We don’t have any alternative but to be confined in this space, but the team is trying to create a new way of life.” Chun-ju Xin Shelter takes care of the need of every child, and customizing the daily curriculum and schedule allow girls to decide when to take part or to be alone. “Staff are using creativity to bring new ideas to life, such as adopting a hairless animal—a turtle. Girls learn how to be caregivers in the process, and we lead girls in discussing animal adoption. We plan to host a vegetable growing contest in the summer for social workers, dorm advisers and girls to all participate in and have our usual greengrocer be our judge.” Wen relaxed her eyes and shoulders when speaking of it. She expects and believes new lives joining in will bring the shelter more vitality and hope.
Epilogue: Safety and Peace of Chun-ju Xin Shelter During the Pandemic
Wen sent over pictures one after another through the Internet. They not only paint a vivid picture of the lives in Crown Daisy Shelter, but also show affection between people and love toward the kids.