By Gatonye Gathura
Kenya: Scholars are seeking to establish why women are being forced to undergo syphilis tests and coerced screening for HIV/Aids and cervical cancer, all on account of being pregnant.
The claims were first made about six years ago by the Federation of Women Lawyers in Kenya, then picked up last year by international human right bodies and currently by local and foreign scholars.
Evidence presented by three universities last month show a significant number of pregnant women attending antenatal clinics are being forced to test for the three conditions without their consent as the law requires.
Routine testing for HIV and screening for cervical cancer has been introduced in all public hospitals but a client must first be given all the relevant information and allowed to make an informed choice, including the option of saying no.
On the other hand, the testing for syphilis in women during the first trimester is mandatory in public health facilities but in the context of informed choice. Further, the law on syphilis requires a client or her partner or partners to be notified once the disease is diagnosed.
He should be provided with written instructions about the condition, appropriate education and counseling measures.
In line with the Bill of Rights in the Constitution, Health Cabinet Secretary James Macharia in October launched the National Patients’ Rights Charter. According to the Charter, a patient has the right to informed consent for diagnosis and treatment. The patient should also be allowed to make own decision willingly and free from duress.
The client also has the right to be treated with dignity and respect.
Evidence, however, paints a totally different picture, with pregnant women visiting public hospitals being coerced and threatened to make decisions they may not be well informed about.
“Some women indicated they were threatened and others were concerned with the harsh or judgmental attitudes of the medical staff attending to them on syphilis cases,” says a report published last week in the journal BMC Medical Ethics.
The audit was carried out by Dickens Omondi Aduda of the School of Public Health at Maseno University and Nhlanhla Mkhize of the School of Psychology, University of KwaZulu Natal, South Africa.
The duo, who had studied clients attending cervical cancer and antenatal clinics clinics in two public hospitals in Nyanza, paints a picture of a master-servant relationship between some health workers and their clients (pregnant women).
The authors say the harsh treatment was one reason some women opted to seek alternative care from traditional midwives who do not perform screening.
“It emerged that those out there who don’t know their status and don’t attend clinic were likely to influence others against screening,” the report read in part.
Two weeks ago, an international study by the American University of Beirut, Lebanon investigating whether pregnant women are being treated with dignity while being tested for HIV found that seven per cent had been forced to take the test.
The results published on March 17 in the Journal of the International AIDS Society, covered Kenya, Burkina Faso, Malawi and Uganda.
A group called Multi-country African Testing and Counselling for HIV oversaw it.
Dr Peter Cherutich of the National Aids and STDs Control Programme represented the Ministry of Health. On cancer screening, Omondi says the biggest fear among the women is the long period they have to wait to get the results, which creates anxiety.