Magic Bullets: Stigma and discrimination kills faster

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It was a brisk business day for Madam Nura Seidu (not real name) until she all of a sudden started hearing someone clapping hands and shouting “AIDS woman, I want to buy your AIDS, sell to me”.

It was in front of her shop located in the Central Business District of Wa and echoes of the shouts hit Madam Nura like a thunderbolt not because she was not familiar with such actions from someone but because of the location.

Quickly, she managed to peep outside her shop and alas, it was her former neighbour, Madam Niama Shaibu (not real name) – a nightmare she thought she had escaped from months ago had just resurfaced in a more ugly fashion especially during this COVId-19 period.

Madam Niama’s decision to extend her constant attacks of HIV and AIDS stigmatization on Nura to her shop, a public place, was the last straw that broke the camel’s back.

Experience of stigma petty
Madam Niama and her husband were tenants at Madam Nura’s late father’s house in Wa where she was residing few years ago. She, however, moved to her current abode recently due to frequent attacks and stigmatization on her by the accused.
The move was also to avoid the regular name calling and quarrels in the family house and also to protect her business from collapse due to the stigmatization.

The frequent passing by the shop to attack and embarrass her in front of her customers and the public was what prompted her to take action by reporting Madam Niama to her own husband, Shaibu.

Madam Nura was, however, shocked when Shaibu instead of advising the wife to stop what she was doing, rather sided with her and almost beat her (Madam Nura) up after reigning insults on her.

Shetu Issahaku (not real name), another resident of Wa equally passed through similar experience of stigmatization and violation of human dignity from a neighbour who labeled her as an HIV patient.

“It all started when I woke up one morning in September 2020 to sweep the compound where I reside together with my family, when Amatu who is residing in the same compound came out of her room and upon setting eyes on me, started insulting me and calling me names without any previous or current provocation between the two of us”, she narrated.

“I was confused but remained silent because she didn’t mention my name but after a while I decided to go into my room to prevent other tenants from coming out of their rooms to a scene”, she said.

“Look at you, woman. What do you gain from all the trade you’re doing? Can you step outside the house without wearing a dipper? I’m talking to you”, she narrated and added that her noise attracted people to gather in their compound regardless of covid-19 safety protocols.

Without a face mask on, my other fear was, should she be carrying the virus, I can also have it because she was not wearing a face mask and at the close range, I could be inhaling whatever that was coming out of her mouth.

“I was quiet and still trying to understand why she’s insulting me until she finally said ‘old AIDS person, wearing dippers”, she said and noted that at this point she couldn’t take it any longer and had to raise her dress just to confirm to the gathering that the accusation was false.

Impact on business
Both Madam Nura and Madam Shetu said the action of the accused persons have affected their dignity and self respect and that of their families as well as their relationship with their neighbours.

Again, it has also gravely affected their businesses which they depended on to cater for their families as their accusations against them spread among their customers.

“As a result of the quarrel and stigmatization against me, there has been low patronage of my goods and I’m beginning to lose profit on sales to enable me cater for myself and others under my care”, said Madam Nura.

“Her act is not only affecting my dignity and self respect including that of my husband in the neighborhood, but it is also seriously affecting my business”, Madam Shetu said.

Both victims disclosed that the stigma and discrimination against them had caused them their membership of some “SUSU” (Savings and Loans) associations they belonged to.

Complaint
Both Madam Nura and Madam Shetu were compelled to lay complaints of stigmatization and violation of personal dignity against Madam Niama and her husband Shaibu and Madam Amatu at the office of the Commission on Human Rights and Administrative Justice (CHRAJ).

Mr Sebastian K. Ziem, Deputy Chief Investigator in the Upper West Region, noted that HIV and AIDS related stigma and discrimination also contributed in destroying the identity of victims especially in this COVD-19 era ensuring a social distancing of a two-meter apart each other is one of required safety protocols spelt out by the World Health Organisation.

He noted that Article 17 of the 1992 Constitution protects all persons against discrimination, adding that, anybody who engaged in the act was in breach of the Constitution.

Again, Article 15 of the Constitution provided that the dignity of a person shall be inviolable, noting that stigma and discrimination constituted a violation of the rights and dignity of PLHIV, he said.

He said in 2020, the Commission received four complaints of HIV and AIDS related complaints including that of Madam Nura and Madam Shetu.

He said per their investigations, they established that the public had actually withdrawn from patronizing goods from shops operated by the two complainants.

Additionally, they lost their membership status of some savings associations they belonged to, thereby, bringing untold hardships upon them and their families.

According to the CHRAJ Deputy Chief Investigator said both cases have been solved as the accused persons have been made to tender in written apologies.

Stigma and discrimination
Mr Dramani Yakubu, the Upper West Region Technical Coordinator for the Ghana AIDS Commission (GAC) said stigma and discrimination generally referred to prejudice, negative attitudes and abuse directed at Persons Living with or perceived to be living with HIV and AIDS (PLHIV).

He explained that stigma involved negative attitude and beliefs about a person while discrimination involved unfair behaviour towards a person, noting for instance that, being perceived as a socially discredited person was stigma while being treated unjustly was discrimination.

“Hence, HIV and AIDS related stigma and discrimination involve negative attitudes, beliefs and unjust treatment against identified or suspected PLHIV”, Mr Yakubu said.

Why HIV related stigma and discrimination are entrenched
According to the Technical Coordinator of the GAC, stigma against PLHIV is rooted in and fueled by the historical and unfortunately still enduring perception among some people that HIV and AIDS were conditions of deviants including sexual promiscuity, prostitutes, gays and injection drug users.

This perception, he said was erroneous since it was established that HIV and AIDS was not a preserve of such perceived social deviants alone, adding that people including health care workers could get infected through needle injuries or even mother-to-child transmission.

Mr Yakubu disclosed that 72.3 per cent of new infections were occurring among the general population according to the National HIV and AIDS Strategic Plan (NSP) 2016-2020, indicating that HIV was a virus and anyone could become a victim.

Scale of stigma and discrimination amidst COVID-19
According to the 2014 Ghana Demographic Health Survey (DHS), 67.7 per cent of adults aged 15-49 responded no when asked whether they would buy vegetables from a shopkeeper or vendor they know was living with HIV.
This indicates high level of stigma and discrimination among PLHIV among the general population according to a UNAIDS 2017.

About 342,307 persons are currently living with HIV comprising 122,321 (36%) males and 219,986 (64% females) according to Ghana’s HIV Fact Sheet, 2019.

Regionally, the 2019 National Estimates and Projections indicated 0.72 per cent of the people in the Upper West Region were PLHIV out of which 214 were new infections.

Mr Yakubu pointed out that the high levels of stigma and discrimination manifests itself in all spheres of the Ghanaian society including schools, work places, churches and mosques, and healthcare facilities among others.

“PLHIV suffer human rights violations including differential treatment at healthcare facilities, shunned by family members, peers and the wider community, while those who faced poor treatment in educational and work settings often develop psychological problems”, he said.

HIV Related Stigma and the Law
Recognizing the magnitude and devastative effects of HIV and AIDS related stigma and discrimination in the country, the GAC spearheaded the passage into law, the GAC Act, 2016 (Act 938), thereby, criminalizing HIV related stigma and discrimination.

Section 28 (2) of the Act stated that; “A person shall not directly or indirectly discriminate against a person infected or affected by HIV or AIDS based on the actual or perceived HIV status of that person or of a close associate of that person”.

The Act also reaffirmed the same fundamental human rights enjoyed by Ghanaian citizens under the 1992 Constitution also for PLHIV and any attempt by any person or group of persons to violate these rights was not only immoral and unacceptable, but also constituted a crime punishable by law according to Mr Yakubu.

Effects of HIV and AIDS related Stigma and Discrimination

The Technical Coordinator of the GAC noted that HIV and AIDS related stigma and discrimination did not only violate the fundamental human rights of PLHIV or affected with HIV and AIDS, but also posed a significant barrier to the national response to the pandemic and even worse with COVID-19 pulling out its ugly head.

He pointed out that stigma negatively affected the health seeking behaviours of PLHIV, which in turn disrupted the achievement of desired healthcare outcomes.

“The crux of the matter is that, stigma kills faster than HIV. PLHIV in Ghana often don’t access life-saving antiretroviral treatment, they become unwell and they die”, said Mr Yakubu.

According to him, data from the GAC and the World Health Organisation (WHO) suggested that stigma and discrimination were the main reasons for people being reluctant to get tested, disclose their HIV status and take antiretroviral drugs.

He noted that the unwillingness to take HIV test on the part of the public meant that more people were diagnosed late, thereby, making treatment less effective and increasing the likelihood of transmission as well as causing early deaths among victims.

The situation has worsened now that COVID-19 is preventing more people from going out into the public for fear of contracting the virus.

“HIV related stigma creates barriers to HIV testing, treatment, care and support as well as frustrate the national effort to achieve universal coverage. With COVID-19 living with us with its own problems, let us show more love and entreat each other to be extremely careful,” Mr Yakubu lamented.

He said HIV positive persons were highly susceptible to the virus since it attached their immune system and urged them to feel free and walk into the health facility to facility to access their antiretroviral medications

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