In Gabon, the stigma against people with mental COVID-19 is such that health care providers need to be discrete when they visit in homes, and left to put themselves in danger. “We team with our combinations on the inside rather than on the front porch,” says a biologist of Libreville. “The Gabonese are panicked at the idea that people should come home.”
22 may 2020 22: 20
Sub-saharan africa: stigma, a hindrance to the fight against the virus
Camille Malplat – Agence France-Presse
LIBREVILLE — The sick were removed by their owners, nurses abandoned by their spouses, the names of case contacts disposed in the pasture on the social networks: in sub-saharan Africa, the battle against the COVID-19 also passes through the fight against the stigma.
“The coronavirus is not a disease to be ashamed”, hammer the authorities across the continent, where people suspected of having contracted are pointing the finger at work, in their neighborhood and into their home.
A month ago, Fatou, a Senegalese in their twenties who prefers not to give his real name, had this bitter experience: after having been in contact with a sick person, the young woman — who is immediately confined in his room, was put under the ban of his neighborhood.
“Messages have been circulating on social networks, with my name, my name and my address,” says the girl who doesn’t even want you to write in what city of Senegal, she lives. And then the young people of the district have started spreading lies, saying that it “had contracted the virus by sleeping with blanks”, she says.
Fatou, who has never left his room before being tested negative, then still had to spend two weeks in isolation in a hotel while she does have symptoms : the doctors who followed him had received “anonymous calls”, she says. This has at least allowed to blow, “far from the popular speech”.
At 5000 km, Gabon, Jocelyn — also an assumed name —, a biologist who is testing the suspected cases in Libreville, subjected to “such discrimination every day.”
With his team, he tries to stay discreet when they visit in homes, and left to put themselves in danger. “We team with our combinations on the inside rather than on the front porch”, he says.
“The Gabonese are panicked at the idea that people should come home”, so we try to arrange testing “elsewhere, in places neutral”, he says.
Because the situation can quickly escalate. In the neighbouring country, the Cameroon, the second person tested positive has been evicted by its owner, testifies to the teacher Yap Boum, an epidemiologist in Yaoundé.
Stigma is not unique to Africa and has been observed elsewhere, nuance-t-il, adding : “But it is true that here, we live in community, we know our neighbors.”
Some even prefer to stay hidden. “Many people died, because they had delayed their support for fear of stigma,” says the professor, also the director of the research center of Doctors without borders in Africa. “It is necessary to take into account the psychological strand if we want to win this battle,” says the researcher.
And especially for caregivers. “They are doubly stigmatised,” says Yap Boum. At work, where the staff of the other services refuse sometimes their “speak or use the same toilet as them,” and, at home, where they are sometimes “seen as a plague-stricken”.
Caregivers made the difference
Nurses in cameroon have been left by their husbands, forced out of their homes, as they worked in units coronavirus, provides the psychiatrist Laure Menguene Mviena, in charge of the psychological response to the COVID-19 Yaounde.
“There is an urgent need to accompany them psychologically, because, if they are exhausted mentally and physically, how are we going to do to treat the others?”, is concerned about it.
The rejection may turn to outright hostility, as in the democratic Republic of the Congo : teams struggling against the spread of the coronavirus have been assaulted by residents in Kinshasa.
“This resistance movement may cause paralysis of the activities of surveillance, including active case-finding”, have regretted it with the health authorities. Similar acts had already disrupted the fight against the latest Ebola outbreak, declared in August 2018: several health workers had even been killed, including a cameroonian doctor WHO.
To raise the awareness of the population, the authorities must solve a difficult equation by adopting, on one hand, a firm tone in order to apply the gestures barriers and, on the other, doing everything to avoid psychosis, which is causing the stigma. It is necessary to “communicate more” and recalled “that the mortality rate remains low for us, less important than in Europe,” says the psychiatrist. In sub-saharan Africa has not suffered, for a time, that approximately 1400 died of the coronavirus.
Yet, the curse that strikes some patients may continue after healing.
This is the case of Roselyn Nyambura, a Kenyan who, after his release from the hospital, continued “to be mocked and dévisagée” by her neighbors, she says. Some even going so far as to be called “Corona”.
It is necessary to make “witness individuals restored to the television,” offers the professor Boom, or “distribute to the heal of the documents certifying that they are” not “more danger” than other citizens, “a bit like after Ebola”.
No study has as yet demonstrated scientifically that a patient cured was immune, even temporarily, against the coronavirus.
The Ebola epidemic, which was very badly hit West Africa in 2014, showed the authorities that the answer could not be that sanitary.
In Nigeria, the government has released a number of spots prevention hammering that the coronavirus was not a synonym for “death penalty”, that “stigma was a bad thing”.
But, the message still sometimes finds it difficult to pass. In Somalia, wearing a mask of protection is not easy : Mohamed Sharif, driver in Mogadishu, is obliged to equip it with a cache-to-nose to work. But he noticed that people avoided or even fled in his presence.
Some people think that “if you wear the mask, you have necessarily the virus”, he points out, admitting that he sometimes “to remove to prevent this humiliation”.