Case Study 8.5 HIV and stigma
Jemila, a Health Extension Practitioner who is working at one of the Health Posts in Gambella Regional State, attends Ato Ojul’s family. When she visited Ato Ojul’s family she found that W/ro Hawa, the wife of Ato Ojul, is very depressed and tearful. Jemila tried to reassure her but Hawa was not willing to tell her the reason why she was depressed and crying. Later in the course of their discussion, Hawa told Jemila that she is HIV positive and that she is worried what will happen to her because of the stigmatising effect of HIV. If people in the wider community find out that she is HIV positive she fears that she will be an outcast and treated badly.
This is a complicated situation for Jemila to cope with, but there are some ethical principles that she can use to help her. Firstly, Hawa is her patient and must not be harmed by anything that Jemila does now or in the future. She must reassure Hawa about total confidentiality and establish a situation of trust between the two of them. Hawa’s status is safe with Jemila and she can get treatment for her HIV without anyone else being aware.
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- What steps could Jemila take to address a stigmatising illness such as the HIV that has infected Hawa?
- In the short term it is important that trust is established and that Hawa knows that she can rely on Jemila to support her without her problem becoming widely known. In the longer term Jemila can put in place a series of community-based educational activities designed to reduce stigma about diseases such as HIV. When the correct facts about HIV are known by the community they should be able to accept Hawa and not fear or reject her.
8.7 Reproductive healthcare
One of the primary healthcare services that Health Extension Practitioners are expected to provide is reproductive healthcare. During this part of your work it is essential to develop trust with each individual and with the community as a whole. This service requires appropriate levels of care, confidentiality and truth-telling– possibly more than any other part of the health services. However, you may face conflicting situations and ethical issues that hinder you from providing appropriate reproductive healthcare service
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