Traditional healers, health workers and stigma
When traditional healers first heard about HIV/AIDS, it was sometime much later than other health workers. In addition, their training/practice is based on cultural beliefs which encourage sharing problems and support of the sick in a holistic manner. This might explain why their reactions towards the disease and patients with HIV/AIDS are less judgmental than may be expected. Compared to other health workers, they accept AIDS patients easily.
In Uganda, following training by THETA (Traditional and Modern Health Practitioners Together Against AIDS), they initiated patient support groups, supported their clients through counselling to disclose their HIV status. Some of them decided to take an HIV test and shared their results with colleagues and family members. Two areas of "stigma" or is it inadequate knowledge of the HIV disease, that we have noted in our interaction with traditional healers (THs) are the common practice of giving "stronger treatments" for people with HIV/AIDS (PWHA) with the underlying potential risk of toxicity based on the belief that their disease is complicated, their bodies weak and therefore they need stronger concoctions. This is not limited to THs, health workers will not hesitate to prescribe a third line drug even where a first line medicine would have been sufficient. The liberal use of otherwise unknown drug regimens
in PWHAs is not rare. In other patients, there is a tendency to be cautious which is not the case in PWHAs. Could this be an underlying attitude of "after all this person has AIDS any way?"
The second area is that of confidentiality. Many health workers including traditional healers do not see why the information about a positive HIV test should remain confidential. Many will inform the uninfected/untested sexual partner about their partner's HIV status without seeking patient's permission. They justify this action as a Public Health duty to those who may not be infected yet!
Many health workers will not take an HIV test. Their reasons range from "I know what to do when I begin to develop HIV-related problems". "What is the point of a diagnosis whose care package is merely palliative". This is an indication of the level of stigma in the health care workplace. Even when colleagues begin to suffer from AIDS-related opportunistic infections, they resort to self -treatment, they pretend there is nothing wrong, and they live in denial to the very end. It remains a challenge how to provide support to health workers through existing counselling services. This situation continues to propagate stigma in the health care setting.
HIV-infected traditional healers who have been counselled find it easier to cope including sharing their results with others. I know of several who first learnt of their HIV infection while participating in AIDS training activities. They informed colleagues about the kind of herbal treatments they use to keep themselves free of opportunistic diseases. This may have been a form of advertisement of their products but it also pointed to reduction of stigma with increased understanding of the HIV disease.
Many health workers will tell you that those who open up about their HIV status have nothing to lose especially with regard to social standing and status or they are prepared to take the risk.
This shows that even in a country like Uganda that has been acclaimed to have succeeded in reducing the spread of HIV still has a major battle to fight. If having HIV infection is still a kind of crime among colleagues, clients and peers.
Donna Kabatesi, Uganda
Traditional and Modern Health Practitioners Together Against AIDS (THETA)
Email msftheta@imul.com
(Source: Stigma-AIDS eforum, April 2001. To join email Join-stigma-aids@eforums.healthdev.org)
In Uganda, following training by THETA (Traditional and Modern Health Practitioners Together Against AIDS), they initiated patient support groups, supported their clients through counselling to disclose their HIV status. Some of them decided to take an HIV test and shared their results with colleagues and family members. Two areas of "stigma" or is it inadequate knowledge of the HIV disease, that we have noted in our interaction with traditional healers (THs) are the common practice of giving "stronger treatments" for people with HIV/AIDS (PWHA) with the underlying potential risk of toxicity based on the belief that their disease is complicated, their bodies weak and therefore they need stronger concoctions. This is not limited to THs, health workers will not hesitate to prescribe a third line drug even where a first line medicine would have been sufficient. The liberal use of otherwise unknown drug regimens
in PWHAs is not rare. In other patients, there is a tendency to be cautious which is not the case in PWHAs. Could this be an underlying attitude of "after all this person has AIDS any way?"
The second area is that of confidentiality. Many health workers including traditional healers do not see why the information about a positive HIV test should remain confidential. Many will inform the uninfected/untested sexual partner about their partner's HIV status without seeking patient's permission. They justify this action as a Public Health duty to those who may not be infected yet!
Many health workers will not take an HIV test. Their reasons range from "I know what to do when I begin to develop HIV-related problems". "What is the point of a diagnosis whose care package is merely palliative". This is an indication of the level of stigma in the health care workplace. Even when colleagues begin to suffer from AIDS-related opportunistic infections, they resort to self -treatment, they pretend there is nothing wrong, and they live in denial to the very end. It remains a challenge how to provide support to health workers through existing counselling services. This situation continues to propagate stigma in the health care setting.
HIV-infected traditional healers who have been counselled find it easier to cope including sharing their results with others. I know of several who first learnt of their HIV infection while participating in AIDS training activities. They informed colleagues about the kind of herbal treatments they use to keep themselves free of opportunistic diseases. This may have been a form of advertisement of their products but it also pointed to reduction of stigma with increased understanding of the HIV disease.
Many health workers will tell you that those who open up about their HIV status have nothing to lose especially with regard to social standing and status or they are prepared to take the risk.
This shows that even in a country like Uganda that has been acclaimed to have succeeded in reducing the spread of HIV still has a major battle to fight. If having HIV infection is still a kind of crime among colleagues, clients and peers.
Donna Kabatesi, Uganda
Traditional and Modern Health Practitioners Together Against AIDS (THETA)
Email msftheta@imul.com
(Source: Stigma-AIDS eforum, April 2001. To join email Join-stigma-aids@eforums.healthdev.org)
posted by AIDS-Care-Watch at 1:05 pm
0 Comments:
Post a Comment
<< Home