Covid-19: fear or stigma? Tales of two worlds

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Stigmatizing

Stigmatization and discrimination against survivors of COVID-19 and their relatives have been widespread and a huge barrier affecting response to the pandemic.

This stigma and discrimination have been highly fuelled by misconceptions, confusions and fear of contracting the virus even from patients who have recovered and their families.

There are widespread misconceptions and fear of people who have recovered from Covid-19, as they are believed to pose a health risk to others. Survivors of Covid-19 are widely avoided and stigmatized.

Stigma and discrimination against survivors of Covid-19 and their families including children, remain a common belief and fear that those who have recovered remain infectious.

People who present symptoms of Covid-19, as well as those who have tested for it whether or not the result is positive, are frequently stigmatized.

Due to this, many people shy away from testing, calling for an ambulance when the need be, or even visit a health facility when they are ill, for fear of being associated with the condition.

This issue was frequently highlighted during the weekly briefings from the Ministry of Health, where survivors including influencers were brought in to share their testimonies of the double burden they faced as stigmatized survivors of Covid-19.

Psychologists were also brought in to counsel survivors as well as their immediate families and the society as a whole.

In the wake of the fear and uncertainty that emerge during a pandemic, stigma and discrimination quickly follow, exposing people to violence, harassment and isolation, and hampering the delivery and uptake of essential health services and public health measures to control the pandemic.

The stigma that arises during a pandemic can exacerbate existing inequalities including those related to race, socioeconomic status, occupation, gender, immigration status and sexual orientation. The presence of stigma specific to certain health conditions has been observed in the HIV pandemic, the outbreaks of Ebola virus and Zika virus, and now the COVID-19 pandemic.

According to the UNAIDS, the anticipation of stigma during a pandemic can interfere with the adoption of preventive measures, timely testing and adherence to treatment. Many forms of stigma and discrimination have surfaced since the identification of COVID-19. Xenophobia has been directed at people thought to be responsible for “bringing” COVID-19 into countries.

People who have recovered from COVID-19, essential workers such as health-care staff, and populations facing pre-existing stigma and discrimination.

Since the covid-19 pandemic was first reported in Ghana in March 2020, several measures including lockdowns, institution of preventive protocols such as social distancing, wearing of facemasks and ban on social gatherings were put in place to serve as guide for citizens to adhere to. Despite all the preventive measures, Ghana is among countries that have recorded high number of cases.

Globally, as of June 18, there have been 178,118,597 confirmed cases of COVID-19 including 3,864,180 deaths by the WHO and a total of 2,412,226,768 vaccine doses had been administered within same time.

In Ghana, as at June 24, according to the Ghana Health Service, a total of 95,642 confirmed cases with 93,288 recoveries have been recorded. A total of 795 deaths, 1,559 active cases and 166 new cases have also been recorded.

In all, 852,047 vaccines have been administered as at May 7, 2021 according to the Ghana Health Service COVID-19 official website when the first batch of 600,000 Astrazeneca vaccines were received by the country under the COVAX facility to mark the beginning of final roll out in March 202 Globally, as of June 18, there have been 178,118,597 confirmed cases of COVID-19 including 3,864,180 deaths by the WHO and a total of 2,412,226,768 vaccine doses had been administered within same time.

In Ghana, as at June 24, according to the Ghana Health Service, a total of 95,642 confirmed cases with 93,288 recoveries have been recorded. A total of 795 deaths, 1,559 active cases and 166 new cases have also been recorded.

In all, 852,047 vaccines have been administered Vaccines Administered as at May 7, 2021 according to the Ghana Health Service COVID-19 official website when the first batch of 600,000 Astrazeneca vaccines were received by the country under the COVAX facility to mark the beginning of final roll out in March 2021.

The concern for stigma and discrimination of those who contracted the diseases has become a huge worry to government and its agencies both national and international as it has the potential to derail containment efforts.

There have been unpleasant reports of people infected with covid-19 being stigmatiszed in their communities to the extent that landlords eject tenants who had contracted the virus from their homes while people refuse to sell to them simply because they have recovered from the disease or lost a relative or a friend to the disease.

Fear is defined as an unpleasant emotion or feeling caused by a threat of danger, pain, or harm, which is real or imagined whiles stigma involves negative attitudes or discrimination against someone based on health condition and many others.

While fear could be genuine, stigma on the other hand, could be associated with a lack of knowledge. Considering the hospitable nature of Ghanaians and one’s attitude towards each other, it becomes difficult to accept the fact that people are being stigmatized for having contracted the virus through no fault of theirs.

Perhaps, they are stigmatizing either out of fear or lack of knowledge about the mode of contracting the virus and the fact that the disease is new, makes its dynamics very difficult to grasp with.

In boosting public confidence and the understanding of the COVID-19 preventive protocols and the vaccination, and to ensure that Ghanaians are convinced of the safety of the vaccines, President Nana Addo Dankwa Akufo-Addo, his wife, the Vice President Dr Mohammud Bawumia and his spouse, took their first jab on March 1st followed by other top government officials, parliamentarians as well as leaders of the various political parties and institutions as well as the media to convince the general public, yet, some people were still skeptical.

Some prominent people including some members of parliament who contracted the virus, and recovered had their relatives, neighbours, and well-wishers visiting them to congratulate them for surviving the deadly disease especially when some of their contemporaries had succumbed to it.

In another instance, a farmer at Fankyenebra, a small farming community near Begoro in Eastern Region contracted the virus, admitted for two weeks at a local district hospital, on the day of discharge, some health workers followed him to his house in a kind of welcome party to sensitize the community to accept him and not to discriminate against him.

But his woes begun after the health officials who accompanied him to the house had left, everybody in the house immediately went to their rooms with their families, leaving him, his wife and children to their fate. The next day, the landlord called his wife and asked her to tell the husband to relocate to their family house since the other tenants in the house were not comfortable.

Three days later, as usual, his wife a porridge seller prepared the food for sale by the roadside, it was as if the entire community had travelled, nobody bought the porridge popularly known as “Koko” and eventually, the family fed on the Koko for their breakfast, lunch and supper, she painfully narrated, As I write this piece, the innocent woman’s Koko business has collapsed just because her husband contracted COVID-19.

Ironically, this woman is not ready to take the vaccine due to the many misconceptions and conspiracy theories about the vaccine. To her, her religion, which she did not disclose, abhorred vaccines and any form of injection and so in spite of the negative effects she has suffered from the COVID-19, she and her family were not ready to take any vaccine when made available to them.

This two scenarios present the tales of two worlds in the fight against a common enemy covid-19 and must be given the needed attention to ensure that each section of the public irrespective of class, creed, status and whatever inclination, we fight the enemy with one front of understanding.

A study conducted by Edumedia, a non-governmental organization in some communities in the Eastern Region on ‘What causes Stigma’ showed that people stigmatize based on fear for lack of knowledge about the disease and its mode of transmission and not to discriminate or cause pain to people who have been infected.

According to the Executive Director of Edumedia, Mr Kofi Amparbeng, most of the people interviewed in various communities made it clear that they shun the company of people infected and their families because of fear of contracting the disease. For the fact that they shared everything in common with such people, especially bathroom and toilet.

He said for the fact that high profile people like Ministers and other high ranking officials who contracted the diseases were not stigmatized and the ordinary persons were, gives ample evidence that stigmatization was not wide spread but rather depending on one’s location and one’s status.

He called for the need to have tailored made education to address specific individual problems to ensure a holistic approach to suppress the virus.

Dr Matshidiso Moeti, WHO Africa Director recently cautioned in a virtual news conference that the “threat of a third wave” of covid-19 in Africa is real and rising calling for strengthening of all measures adopted by African government’s including Ghana to prevent a their wave at all cost.

She said “whiles many countries outside Africa have vaccinated a greater percentage of their highly-priority groups population, African countries are unable to even fulfill with purchase of the second dose for their high-risk groups”, she said.

According to experts, COVID-19 is not going to leave us any time soon, therefore, as a people, we have to adjust to the protocols as a new normal way of living, and that calls for concerted efforts of educating people especially in the rural areas and less privileged communities as to how to go about the new life in order not to contract the virus and also not to stigmatize people who have been infected or discriminate against them.

According to Dr Patrick Kuma-Aboagye Director General of the GHS Stigmatisation should not be given a place in the fight against covid-19 and that people only have to stay safe by abiding by the protocols and hat hiding for fear of being stigmatiszed rather posed public health threats.

For those stigmatizing and discriminating against others for having contracting the virus, we cannot blame them so much for their act but find a way of making people understand the issues in the context of their situation and background.

My close shave with COVID on two occasions gives me the conviction that people’s conditions such as their educational and economic background as well as the environment in which they find themselves in come to play when dealing with issues such as COVID-19, it might be fear of losing their livelihoods and even death that drives the reported cases of stigma.

Adapting evidence-based interventions from other pandemics like HIV response to reduce stigma and discrimination and integrating them into the global COVID-19 response is critical.

Immediate action will reduce the negative impact of COVID-19 on public health and safety and will strengthen our collective ability to control the pandemic by removing critical barriers to seeking care, testing, and adherence to guidelines on physical distancing and use of PPE.

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