Stigma: Medic takes battle to the workplace

By Kiundu Waweru

You have been waiting in agony for hours at the hospital’s casualty department. Finally, your name is called and it is time to see the doctor. And as the doctors and nurses, in their reassuring white uniforms fuss over you, you sigh in relief and surrender to them — body and soul — secure in the knowledge that all will be well.

With their healing powers, health workers may seem like demigods to patients. They relieve excruciating pain instantaneously and ease obstructed breathing like magic. With all their knowledge and experience, patients should be forgiven for thinking medics never fall sick.

But Phyllis Kisabei, a senior nurse at Kenyatta National Hospital (KNH), remembers the day she walked into a Voluntary Counselling and Testing (VCT) centre ten years ago. She just had an urge to be tested and she was confident the test would show she was HIV negative.

"But the results shocked me. I was declared HIV positive. I slept for three days straight expecting to succumb to the deadly disease in my sleep. On the third day, I woke up and pinched myself to make sure I was alive," she told the Sunday Magazine.

Kisabei, left was awarded the 2009, CEO Award.

She realised there was no way out but to move on or perish. Kisabei busied herself learning anything and everything she could about HIV and Aids.

In her quest to learn more, she came across an article in The Standard about a woman who had disclosed her HIV status.

"Her story and confidence inspired me and I was happy that I could still live a normal live. I went back to my job at the KNH where I was a general nurse," says the mother of four aged between 10 and 21.

Cases of stigma

One day, while Kisabei and a colleague were attending to an HIV positive patient, the other nurse expressed her fear that the patient might infect her.

"Stigma then was high and people did not understand the disease. The sad fact is even my colleagues in the medical fraternity were succumbing to the disease mostly because of ignorance," she says.

Kisabei decided to take action and in 2001 she started a support group for KNH health workers.

"I met a lot of resistance and suspicion but I would encourage people by sharing my story," she says.

Indeed, the same year, Kisabei had vowed to disclose her status to the patients and affected staff so as they could identify with her and open up. But it was not going to be easy as stigma was a live wire in the hospital and no one was about to open himself or herself to wagging fingers and discrimination.

"People who would be seen at the Comprehensive Care Centre (CCC) would be stigmatised. We had been branded ‘watu wa ukimwi’ (the Aids people). Today, even though the support group is a success with 60 active members, 35 of them still fear to be seen. We meet discreetly and privately with them," says the woman who announced her status to the public on national television.

Most of the people who are afraid to come out openly and join the support group are senior staff.

Kisabei went on to touch the lives of patients and fellow workers. Today she is a senior nursing officer in charge of the CCC and the HIV and Aids unit at KNH as well as the head of VCT and Patient Support Centre.

Initially she worked alone, but now the hospital administration fully supports her. She has spearheaded the formation of youth, staff and adult support groups where survivors share personal experiences and challenges.

With so many hats to wear, Kisabei is a very busy woman. She is up and about by 5am. As a diabetic, the first thing she does is inject herself with insulin. By 7am, she is at the hospital, serving the affected and infected patients and staff.

"People who come to the CCC feel dejected. My job is to put a smile in their face. Another role is to supervise the nurses at the CCC, VCT and Patient Support Centre," she says.

She also ensures there are enough supplies and liaises with the management, community and donors.

Kisabei says HIV and Aids is not the issue; prejudice, ignorance and discrimination is the disease.

According to her, 80 per cent of infected people don’t know their status.

"In Kenya, 250,000 people are on anti-retroviral treatment (ARVs) but another 240,000 HIV positive people have no access to the lifesaving drugs. And for every two people on ARVS, five more are getting infected," she says.

At this juncture of the interview, a man comes into her office for some advice. When he leaves, Kisabei says: "He is a peer educator. He and six others were star patients who would help us with other HIV positive patients. They now work with us full time with funding from donors."

Touching lives

Another man who has been touched positively by Kisabei is Mathew Omito, a security guard at KNH. "When I tested positive, Kisabei took time off her busy schedule to support and counsel me. Her moral and psychosocial support made me stronger and my life has changed because of her," he says.

Kisabei also counselled Omito’s wife as KNH has facilities for spouse support, and she overcame her denial. According to Omito, when married couples get infected with HIV, the man is blamed for ‘bringing it’.

Involving the men

Because studies have shown that men do not get involved in support groups, don’t disclose their status even to their spouses and, due to their ‘polygamous’ nature, are at risk of infecting multiple partners, Omito is planning to start a support group for men to overcome these challenges. He has attended several workshops, much to Kisabei’s delight as she has been trying to bring men on board.

"I am a firm supporter of the programmes Kisabei has initiated. Everyone one can see the positive impact. Earlier, we were losing one staff member a month to HIV and Aids. This year only two have succumbed, thanks to Kisabei’s campaign," says KNH Assistant Chief Nurse, Mlale Ojanje.

She adds that there has also been reduced stigma as sharing and disclosing ones’ status help while ignorance and stupidity kill.