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PATIENTS' SUFFERING

Virus stigmatisation could reverse health-care gains

Health facilities are increasingly recording low attendance for checks and treatments.

In Summary

• One of the hospital’s management said levels of patients have reduced drastically and asked its employees to understand the desperate situation.

• What this means is that people who ordinarily seek attention for non-communicable diseases, regular clinic appointments for maternal have dropped.

Nairobi City residents line up at the Kencom bus station for coronavirus screening on March 22, 2020.
Nairobi City residents line up at the Kencom bus station for coronavirus screening on March 22, 2020.
Image: WILFRED NYANGARESI

Recently, a gentleman with a breathing difficulty sought treatment at a health facility in western Kenya.

Instead of being attended to, medical personnel at the health facility took off. He later visited a second facility where he was diagnosed with pneumonia.

In another instance, a man who had been on quarantine was released to go home.

 

He received a rude welcome from people who had been his neighbours for over five years, avoiding him, talking on low tones that he could infect them coronavirus.

Both cases illustrate the level of fear and stigma associated with the pandemic.

Health facilities are increasingly recording low attendance for routine checks and treatments, perhaps, with specialists attributing to the fear of contracting the disease and being sent to forced quarantine should they exhibit the symptoms.

Social stigma in the context of health is the negative association between a person or group of people who share certain characteristics and a specific disease.

In an outbreak, this may mean people are labelled, stereotyped, discriminated against, treated separately, and/or experience loss of status because of a perceived link with a disease. 

Such treatment can negatively affect those with the disease, as well as their caregivers, family, friends and communities. People who don’t have the disease but share other characteristics with this group may also suffer from stigma.

The level of stigma associated with Covid-19 is based on three main factors; to start with, it is a disease that’s new and for which there are still many unknowns.

 

Secondly, we are often afraid of the unknown and finally, it is easy to associate that fear with ‘others’. Understandably, there is confusion, anxiety, and fear among the public. Unfortunately, these factors are also fuelling harmful stereotypes. 

During the Ebola crisis, in the three most affected countries – Sierra Leone, Liberia and Guinea – people began avoiding healthcare at all costs.

They were afraid of this mysterious new disease, but they were also fearful of doctors. With their sinister white protective overalls and association with sudden death, healthcare workers had become heavily stigmatised.

People didn’t want to go near them.

As a result, a 2017 analysis found that the pandemic led to a dramatic drop in the popularity of medical care.

The number of pregnant women seeking help with childbirth was down by 80%, vaccination rates plummeted and there were 40% fewer admissions of children with malaria.

Ironically, after an intense international effort to combat the pandemic, this collateral damage was more severe than the disease itself.

A similar scenario is currently being reported by medical doctors locally.

Recently, two leading hospitals in the city sent employees on compulsory leave on half salary.

One of the hospital’s management said levels of patients have reduced drastically and asked its employees to understand the desperate situation.

The decisions must have been made based on a drop in revenue in the facilities.

What this means is that people who ordinarily seek attention for non-communicable diseases, regular clinic appointments for maternal have dropped.

As a result, a large number are suffering in silence and could lead to fatal outcomes. 

Unfortunately for us, other diseases have not taken a break.

Which means we could be bracing for a more desperate situation than we are already in.

We must de-stigmatize the respiratory illness among Kenyans and health care workers and create models that give people the confidence that visiting a health facility is among the basic needs in these trying times.

 Dr Steve Adudans is the Executive Director Center for Public Health and Development