COVID-19: Stigma the next battlefront

ALTHOUGH coronavirus (COVID-19) cases in Zimbabwe recently shot up to 34, the five recoveries recorded so far offered a glimmer of hope that with the right approach and strategies, the disease could be contained and defeated. However, the stigma that has slowly crept in may be the “disease” that could take longer to defeat, with almost all the cases having experienced some form of ostracisation since testing positive.

The World Health Organisation ( WHO), which is spearheading the global effort to contain the pandemic and minimise its damage, has since indicated the need to show “compassion and kindness” towards the infected.

“Be empathetic to all those who are affected, in and from any country. People who are affected by COVID-19 have not done anything wrong, and they deserve our support, compassion and kindness,” reads the WHO guide on COVID-19 in part.

Titled Mental Health and Pyschosocial Considerations during the COVID-19 Outbreak, the guide further noted that in order to minimise stigma, those infected with the virus should not be referred to as “COVID-19 cases” or “COVID-19 families” as they were simply people being treated of the disease and their lives would go on beyond their infection and treatment.

In light of this, the Zimbabwe government could be fuelling stigmatisation by violating this provision in its COVID-19 updates where the infected are referred to as case numbers.

The stigma manifested in more virulent form, with one of the recovered patients, Saul Sakudya of Ruwa, and his family having been forced to remain in “selfisolation” even after receiving a clean bill of health following their recuperation.

This, however, did not stop people in his neighbourhood from rechristening his street “Corona Road”, while friends and relatives have kept their distance post-recovery.

A partner with the Amalgamated Social Work Practitioners (ASWP), Robert Mapurisa, said it was important to consider families of those that would have been infected as they would also be stigmatised, with people avoiding their homes because of fear.

“So, as we are going to deal with issues of stigma focusing on the victim, we also need to consider the family members,” he said. “At school, if fellow pupils know that a parent to one of their classmates was once infected with COVID-19, it can lead to some form of stigma, so we need to extend our hand to these families.”

When Zimbabwe’s first COVID-19 patient, the late broadcaster Zororo Makamba, was taken to Wilkins Infectious Diseases Hospital in Harare after testing positive, he experienced the stigmatisation that had become associated with the novel condition, according to his elder brother, Tawanda Makamba.

“Remember this is a critical patient, nurses would only visit him after two hours because they were afraid of handling his situation,” Makamba told local media.

“We had to phone from home, calling the nurse station to tell them that Zororo was in distress and that his oxygen was finished because they were not going to check on him.”

Tariro Mufute, a Zimbabwean social worker based in Hong Kong, said information campaigns were essential to help people understand COVID-19.

“We need to educate communities (and) if possible have face-to-face sessions because fear often spreads faster than the virus itself,” she said. “This may also help and can dispel misconceptions and fear.”

In Sakudya’s situation, the nurses also kept him at arm’s length when he was first admitted, but he remained magnanimous as he understood their situation. “These nurses had no protective clothing so I said no, I think they are right because even if it was me, I was also going to run away,” he said.

This has led observers to believe that in some cases, it was not so much a matter of stigmatisation, but genuine fear given the lack of personal protective equipment (PPE), which has been grossly inadequate, with the government waiting on donors for succour.

Two weeks ago, a physiotherapist identified as Zenzele was accused of allegedly violating quarantine measures after testing positive for COVID-19 and roaming around Bulawayo, exposing others to possible infection.

Identified as case number 15, she became a target of stigmatisation after she was described in the media as some form of renegade, with one headline screaming: Beware of this patient! COVID-19 positive woman gallivanting around town.

In a letter responding to the accusations, the woman said she was shocked to learn of her results on social media before the rapid response team that had tested her had communicated the information to her.

“I expressed my displeasure at getting my results via social media for which they apologised, noting that their laboratory in Bulawayo had sent the results to Harare before informing the local rapid response team,” she said.

“I found that to be dysfunctional and unethical. However, I focused on the way forward. I was told to self-isolate as my symptoms were mild and a doctor would get in touch with me to assist with my case.”

Zenzele expressed concern at the high level of stigmatisation, which she said affected her deeply and was likely to have far-reaching implications.

“We are all at risk of contracting the COVID-19 virus and moreso, health workers who, despite the risk, continue to offer their services to the ailing. All over the world, we witness standing ovations for health workers who stand in the line of fire against this virus, but in Zimbabwe, we get accused of endangering lives by gallivanting the streets,” she said.

“Now, instead of focusing on my health, I am fighting tooth and nail to rectify the false allegations against me so that if and when I do heal, I am able to continue to practise as a health professional without the dark cloud that such allegations present to my career and livelihood.”

It becomes essential, therefore, to ensure that as part of the campaign against COVID-19, people are made aware of the need to avoid stigma in dealing with those that may be infected.

It also speaks to the need to train even health officials dealing with these cases because stigmatising the infected may lead to stress, which can consequently open the door to other health challenges.

Stigmatising the infected may have far-reaching consequences. In that particular state, they need more comfort and acceptance given the fear that is associated with the disease, which has killed four people here at home and several thousands in other parts of the world.

Mapurisa, the social worker with ASWP, discouraged society from stigmatising people infected with COVID-19, and those that have recovered.

“People should be conscientised on what exactly is COVID-19 and how it is transmitted. There was a time when HIV was at its peak, and there was a lot of stigmatisation because of how the virus was transmitted through sex. So when it comes to COVID-19 people need to know how it is spread, and the fact that it can infect anyone, including doctors,” he said.

“Those that are infected need our support. Quarantine should not be mistaken to mean that the particular person is no longer a part of us, and we should be afraid of them. It is just a question of containing it because it is very contagious.”

Healthcare workers in COVID-19 centres are also likely to fall prey to stigmatisation as they regularly come into contact with the infected, according to WHO.

“Some healthcare workers may, unfortunately, experience avoidance by their family or community owing to stigma or fear. This can make an already challenging situation far more difficult. If possible, staying connected with your loved ones, including through digital methods, is one way to maintain contact. Turn to your colleagues, your manager or other trusted persons for social support — your colleagues may be having similar experiences to you,” a WHO statement reads.

As the world battles to flatten the respiratory virus’ curve, successfully dealing with stigma will help ensure the peace and mental health of survivors in the post-COVID-19 era.