Fiona Gracie
Head nurse, Chelsea and Westminster Hospital
London,
UK
Attitudes and Responsibilities of Health care professionals
It has been many years since a disease has come along that has caused
such a social reaction like HIV and AIDS has.
The stigmatising, marginalising and judging of those infected and
affected has been universal. They have been denied care – turned away from
hospitals and clinics.
They have been socially excluded – thrown out of workplace, homes and
communities. Extreme behaviour has happened recently in South Africa, which has
a high HIV incident; a woman was stoned to death when she revealed she was HIV
positive.
This behaviour has resulted in people not coming forward, not changing
their behaviour and the result is that the disease has spread further.
Why has HIV caused such fear?
1. The route of transmission. In
particular the association:
-
with sexual behaviour and we don’t talk about sex
-
with injecting drug use (IUDU). A behaviour which is socially
unacceptable and in many countries criminalised.
2. The disease itself. There is a fear of suffering, of having a
disease, which has frightening physical effects, as we have heard.
3. Social reaction. We fear being labelled and rejected if we are found
out to be HIV positive. That we will be thought to be IUDU’s or promiscuous.
That we would lose out jobs, social position and all we value like our family
and work.
Health care workers all over the world have had to face HIV infection
not only at work but also in our own lives.
We are members of a family and community so we may have members of our
family who may be at risk because of their behaviour or of the behaviour of
others; we live in a community with members at risk.
We as health care workers have to set an example. We have the resources
to be informed and are in the position to educate others.
By caring for those infected with HIV we encourage others to come
forward. Not only those who are HIV positive also those at risk.
We are then able to physically manage their disease and can educate them
and their families. Therefore we can reduce the risk of transmission and
facilitate the HIV positive person to be a contributing member of society.
I met a man in India who gave up hope when he was diagnosed with HIV. He
was thrown out of his village and had contemplated suicide. He then heard of a
clinic in Calcutta where he was told the doctors and nurses would help him. The
result was he was given hope. In three years not only had he started his own
business; he also employed 20 other workers. He was able to look after his
elderly parents and unmarried sisters. This is a good outcome.
HIV positive people and people at risk will not access health care if
they feel they will be treated badly. They need to be confident that they will
not be judged. They must know that confidentiality is ensured so others will not
find out about their status. If there is trust there is respect and then
education can take place.
Education is needed on how to prevent transmission and how to care for
themselves.
We have a duty of care to support those infected and to educate others.
To dispel the myths and teach all how
to avoid infection. We have a duty to ensure our knowledge is correct and up to
date. Knowledge is power. If we know the route of transmission we can protect
ourselves in our work and personal lives.
We cannot ignore HIV and think it will go away. We cannot believe that
it only affects certain people. If you believe this, the epidemic will get a big
hold before you wake up. South Africans thought that HIV was a white mans
disease. As you saw yesterday now in some areas 30% of the population are HIV
positive.
All of us in society have a role. We as health care workers have a big
part to play in the addressing of HIV. We must educate others and ourselves. And
very importantly we must care for those infected. This way we can meet the
challenge of HIV and prevent its spread. It can be done and has been done in
communities all over the world.
Remember people must trust us so they come forward because stigmatised
people go underground and an underground disease spreads.
I leave you with these words:
Don’t let your fear of HIV be a problem
We have nothing to fear but fear itself
Knowledge is power
Power to help ourselves
Help those in need
Help the community