When Susan Kimani found out that she was HIV positive in 2002, she only disclosed her status to her husband. She is a nurse by profession and from watching how her colleagues treated HIV positive patients, she decided to keep her status secret.
“I feared I would be subjected to the high degree of stigma by my fellow nurses as I observed them sideline patients by neglecting them to a corner and offering them minimal nursing care,” Susan remembers the dark days and attributes this trend to a lack of knowledge by her colleagues.
"My husband supported me and urged me to carry on because he knew me as a strong woman," says Susan who is in a discordant relationship.
“In 2007, I went public about my status because I wanted to encourage my colleagues who were having a tough time declaring their status and thus avoided taking drugs in public for fear of raising suspicion,” Susan remembers.
For nine years, her immunity status was good and the amount of virus in her blood known as viral load was manageable and only began using ARVs in 2010.
That she has gone public about her status and is the focal point in HIV and Aids, Susan terms HIV as a condition that she is passionate to discuss both within the hospital precincts, in her community, in church and with her friends and relatives alike.
She is now part of a group that has chosen to wear their hearts on their sleeves. Fighting for acceptance first from their colleagues, and spreading it out to the community, is their key goal. This group comprises health workers whose HIV status unites them as they work towards a common goal of zero stigma and full-circle social support.
Made up of nurses, clinical offices, nutritionists, laboratory technicians, subordinate staff and other cadres of health workers, this group began in 2008 initially drawing membership from other counties that were formerly in the Central Province and their 80 members are spread out in Kirinyaga, Nyeri, Kiambu, Nyandarua and Thika.
And as Kenya joins the globe in marking World Aids Day on Monday, the Central Province Network of Medics Living with HIV (Cenemeh) can only look back and celebrate for having slowly, though not completely, conquered what they call dark days in the health fraternity.
Themed, ‘Closing the gap in HIV prevention and treatment,’ this year, the globally observed day centres on providing information to curb further spread of a disease that has the world fighting to establish proper prevention and treatment regimes.
Seeking to spread out to other regional chapters with the same goal, Cenemeh meet once at their members’ houses or in hotels to share experiences on living with HIV and discuss ways to live an even longer and healthier life as health workers.
Susan is one the founding members of this group that has taken over the role as a health promoter and Trainer of Trainers at Kiambu District Hospital.
But the knowledge to form this group, according to Susan, stemmed from a need to create an avenue where the HIV positive health workers got the same level of counselling and Antiretroviral Therapy that they provided to their clients.
“We realised that health workers who were diagnosed with HIV travelled to hospitals as far as Nakuru, Nyeri and even took loans to get treatment in private hospitals for fear of their colleagues knowing that they are HIV positive,” Susan remembers what she now describes as dark days in the health fraternity.
Through the years, Susan has encouraged dozens of HIV positive health workers to enroll for treatment within the health facilities they work in and this has led to an outcome of better health in members of the group, both physically and psychologically.
“In 2011 alone, we lost eleven health workers because they defaulted on treatment despite understanding the implications of such decisions,” Susan says calling for more concrete intra-hospital support groups that encourage health workers to discuss their health challenges beyond HIV.
Agatha Akinyi, a 50-year old nurse is a member of the group, which she considers family because they work within an environment that encourages them to stick together.
This mother of two was transferred to this hospital from one of the former provincial hospitals, and describes her experience at her former work station as lonely because she could not interact with medics with her condition.
“We face similar challenges and it was important for me to find out whether there were others in my situation even as we serve our patients,” she says.
Her co-workers have been her source of strength even during a period where she was being treated for herpes zoster, an opportunistic infection.
Herpes zoster is a painful skin rash with blisters affecting the area of skin supplied by the nerve and is caused by a virus called the varicella-zoster virus.
Susan points out that the risk of transmission from the healthcare workers to patients is extremely low, especially when the universal precautions already in place are followed.
“We wear gloves during all procedures and are careful to dispose syringes and needles appropriately immediately after use,” she points out.
In fact, she makes a light moment when she says healthcare workers who know their HIV status whether positive or negative, are more careful and keen on standard practices to protect themselves from infection.
Last year, Susan was part of the team that called for improved ventilation of sections of the hospital in order to prevent transmission of respiratory disease like Tuberculosis.
“I contracted TB last year while serving a client in one of our clinics and was made worse due to my suppressed immunity,” Susan said.
After six months of drugs on anti-TB medication, Susan is now a promoter of open spaces and infection control for all health workers in the hospital.
Susan also found a new passion arising from her experience serving patients in the hospital.
“Hearing impaired persons have multiple challenges when communicating with us and it becomes worse if they are on ARVs and we cannot counsel them on when and how to use these drugs,” she notes.
As she approaches the final of her three-month sign-language course at the Kenya Institute of Special Education, Susan is optimistic that she will serve more deaf clients at the hospital and thus ensure better devotion to their medication.
The group members say an increase in the number of clients who confide in them has increased after they disclose their HIV status to them.
“They are more comfortable dealing with us here at the hospital because we also get to share experiences even as we serve as resource persons,” Susan notes.
However, as Kenya joins the globe in marking World Aids Day, these health workers seek more interactive sessions with key partners including the Ministry of Health to improve training of health workers on how to deal with colleagues who are HIV positive, and also increase community awareness to understand that health workers are also affected and require social capital.
Other challenges include the lack of funds for this group of health workers with a passion to create awareness and carry out intensive training countrywide, beginning with their counties.
Susan and her colleagues will on Monday be at Afya House observing World Aids Day at a forum organised by the Aids Control Unit at the Ministry of Health.
For those who would like to get in touch with Susan and her colleagues for support and information, their contacts are:
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