Thursday, August 19, 2010
TB: Why you should not discriminate
Impact of Stigma and Discrimination
Tuberculosis is an infectious disease caused by bacteria that any person can get. It is not a hereditary disease or a curse of God. It can be completely cured by taking regular and complete treatment. Stigma and discrimination against people diseased with TB can occur in many settings at the workplace, health care facilities, or within the community. Its manifestation can be as dramatic as physical violence or as subtle as avoidance. However, it is totally unnecessary and primarily based on myths. Stigma is as old as history. Stigma and discrimination against people infected with TB can occur in many settings at the workplace, healthcare facilities, or within the community. Its manifestation can be as dramatic as physical violence or as subtle as avoidance. However, it is totally unnecessary and primarily based on myths. Beyond the economic consequences, stigma and discrimination against people with TB have a devastating social and psychological impact. Such attitudes obstruct health care providers in delivering effective treatment. Stigma often prevents people from seeking health care attention, which constitutes a direct public health threat to the community. Even when patients attend treatment, social disapproval of their family or community members decreases compliance with treatment. Proper adherence, however, is critical to avoid the development of multi-drug resistant TB (MDR-TB). Social isolation, experienced rejection, shame and blame due to TB diagnosis can lead to psychosomatic stress, loneliness and feelings of hopelessness.
Some of the causes of stigma & discriminationinclude:
•Lack of knowledge about TB transmission, diagnosis and treatment.
•Association with conditions already stigmatized particularly HIV/AIDS, poverty, malnutrition, migration and poor hygienic living conditions.
•People with TB are often seen as being responsible for becoming infected.
• People living with TB are seen as guilty of infecting others.
• Lack of protective equipment for health care workers.
• Lack of access to treatment.
TB related stigma and discrimination can be minimized!
It is important that employees and healthcare professionals understand the determinants and dynamics of stigma to ensure that they prevent the violation of human rights, that patients seek timely advice and achieve good treatment adherence. It is suggested that company management implement the following strategies to minimize TB related stigma and discrimination at the workplace:
•Provide a supportive work environment, where people can disclose their TB status without the threat of being stigmatized and risk losing their jobs. Have in place a policy that addresses this so that workers don’t lose their jobs because of being diagnosed as TB; rather such TB patients are provided proper care and access to DOTS services.
• Influence people’s attitudes through awareness about TB, to provide up to date information on TB epidemiology, diagnosis, transmission, treatment and address TB related stigma and discrimination. Increasing factual knowledge should be followed by experiential learning, which helps employees reflect their own attitude about TB and understand individuals affected by TB stigma and discrimination.
•Involve those with personal experience with TB and set up “Support Groups”. Such groups can encourage the exchange of experiences related to TB and address issues concerning social and workplace support.
• Initiate workplace campaigns to change attitudes. The aim of these campaigns is to provide accurate, up-to date information on TB (‘TB is curable’).
• Develop sustainability of TB anti-stigma campaigns through partnerships with private and public national and international companies.
• Respect confidentiality. Risks of disclosure might include negative responses, such as rejection, isolation and loss of employment. This can result in poor treatment adherence and/or the spread of TB to other employees.
•Link with existing HIV/AIDS anti-stigma workplace initiatives.
•Ensure occupational safety for health care staff and appropriate working conditions for all, e.g. ensuring good ventilation of premises and/ or applying air filtration. TB anti-stigma interventions should be in place in every company.
Source: Adapted from ICN Document: TB/MDR TB Related Stigma and Discrimination.