Care of the Caregivers in Namibia
Stigma and discrimination can negatively affect the interactions of health care workers with HIV-infected clients or those perceived to be HIV positive. Uninformed staff in health care settings may perceive HIV-infected patients to be the biggest threat to their safety at work, and these workers’ attitudes can frighten those patients and limit access to and the utilization of HIV-related services. Sometimes workers may go as far as withholding health services from those believed or known to be HIV positive, or staff members may create a segregated area, which violates the patients’ fundamental human rights. As HIV-related prevention, care, and treatment are growing in Namibia, access to these life-saving services will be significantly influenced by the degree to which health facilities welcome and respect the rights of HIV-positive clients. Some in-depth, anonymous discussions, conducted by URC staff with MOHSS staff, revealed problems worth considering and addressing. For example, those who sustained needle-stick injuries and did not report them to their supervisors experienced symptoms including fear of stigmatization, uncontrollable crying, extreme fatigue, insomnia, headaches, and loss of appetite, among others. To reduce stigma and discrimination in health care settings, we need to address health care workers’ fears about becoming infected with HIV while on the job and their need to protect themselves through standards precautions. We also need to provide training to health care providers to help them come to terms with their fears and anxieties about their own sexuality and to overcome their prejudices.
Targeting 15–18 participants per session, we conducted two-day-long training workshops. Workshops were organized around four pillars:
- Theoretical training sessions on HIV/AIDS topics to transfer knowledge and fight myths and misconceptions
- Psychosocial support through interactive presentations and teaching relaxation techniques for stress management
- Implementation of a support structure
- Capacity building to ensure continuity
The program was rolled out to 12 of 13 regions with a focus on fighting stigma and discrimination in the work place, as well as ensuring a supportive environment for health care workers and their patients. In addition, the program yielded several accomplishments:
- To spearhead necessary interventions, those involved strengthened sub-committees for the workplace program
- The program trained 20 facilitators to ensure an easy transition and continuity of the program and trained 246 health care providers in ABC, de-stigmatization, stress management and bereavement. An additional 1,371 health care workers were exposed to related information through peers and leaflets.
- We trained 11 health care workers from six different regions as focal persons to spearhead the program in their respective workplaces
Since the program’s implementation at sites, the MOHSS recognized the importance of functional workplace support programs that cater to caregivers’ needs. As a direct response to this result, the MOHSS has taken an active role to ensure the workplace program is supported.
Workplace programs are underfunded. However, the availability of sufficient resources and technical assistance is key to ignite motivation among health care staff in taking better care of themselves and their clients. Also, stigma and discrimination still are not completely understood among health care workers; thus, efforts to address these issues are greatly needed.