Zimbabwe: Covid-19 Stigma - Guilt and Shame Will Not Work

25 January 2021

Features, Health & Society Editor

When Charles Bungu, a 40-year old banker (not real name) tested positive for Covid-19, he immediately went into self-isolation as he had mild symptoms.

His absence from work after everyone at their branch had been tested was confirmation to his workers that he had tested positive for Covid-19.

Day in, day out, some of his workmates checked on him through calls and Whatsapp messages, with others wanting to know more about his condition, how he felt, if he thought he had infected anyone at work, among other issues.

Others wanted to know where he got infected.

"I just respectfully answered all the questions," said Charles. "I did not know where I got it and at this point I had no reason to hide information from anyone."

When he tested negative and returned to work before the second lockdown, the work environment was different and rather "hostile".

"Workmates avoided me," said Charles. "People I usually sat with stopped doing so even if we were sitting a metre apart in our canteen. Some avoided talking to me and complained about me using the same toilets with them.

"They treated me like I was still Covid-19 positive. This affected me psychologically."

After talking to the human resources department, Charles received professional counselling. His team, too, was also counselled.

"Things changed after the counselling, but many are still not comfortable around me," he said. "Even at home, my wife and children are being stigmatised by neighbours."

What Charles went through is a drop in the ocean with regards to what Covid-19 survivors and caregivers of Covid-19 patients are experiencing, not just in Zimbabwe, but around the globe.

This stigma is an indication of the way society behaves and responds in pandemics and sort of goes back to the first days of HIV and Aids where people were stigmatised.

Having thought communities' reactions had changed given knowledge on HIV and how stigma was tackled, it seems many are going round in circles when it comes to Covid-19 stigma.

Covid-19 stigma is like the same script with HIV, but with different lines.

According to a Covid-19 stigma guide developed by the World Health Organisation (WHO), United Nations Children's Fund (Unicef) and the International Federation of Red Cross and Red Crescent Societies, social stigma in the context of health is the negative association between a person or group of people who share certain characteristics and a specific disease.

"In an outbreak, this may mean people are labelled, stereotyped, discriminated against, treated separately, and/or experience loss of status because of a perceived link with a disease," reads the guidelines.

"Such treatment can negatively affect those with the disease, as well as their caregivers, family, friends and communities. People who don't have the disease, but share other characteristics with this group may also suffer from stigma."

The Covid-19 outbreak has provoked social stigma and discriminatory behaviours against people of certain ethnic backgrounds, as well as anyone perceived to have been in contact with the virus.

Responding to a question I asked during an HIV Research for Prevention (HIVR4P) Virtual Journalist Fellows Session titled: "COVID vaccines and treatments" last Tuesday, Director of United States-based National Programmes for the Black AIDS Institute, Rob Newells, said stigma around Covid-19 was a lot like the HIV epidemic.

"People want to know how you got it if you tested positive for Covid-19," he said. "If some test positive, they are keeping it a secret until when they recover.

"They do not tell people because it becomes about 'what risky activity did you take and participate in, in order to get infected with Covid?' You should have known better."

Newells said questions that also come are "were you stuck in a room with people that were not wearing masks or did you go out to restaurants and night clubs and bars, church services and weddings when you knew you could have stayed at home?"

Newells said he hoped the guilt and shame around how one got Covid-19 was not preventing people from getting tested.

"I do not think it is because people see Covid-19 differently than they saw HIV," he said. "I think people recognize their own risk for the most part.

"But, I think when we are messaging, guilt and shame do not work. We have to meet people where they are, the harm reduction options are masks, social distancing, limiting the number of people at gatherings, outdoor rather than indoor.

"We give people all of this stuff, we do not tell you, you have to get a vaccination or you are going to get Covid-19. We do not guilt and shame them because of how they got Covid-19 because they got together to watch election results together."

Newells said in the United States, 13 members of his pastor's family all tested positive for Covid-19 after gathering to watch the just-ended election results.

"They did not tell anyone for two weeks until after everyone had recovered," he said. "That's not healthy because you do not get the support that you need. I think the messaging really has to be less on the guilt and shame and more on meeting people where they are."

Community Working Group on Health (CWGH) executive director, Itai Rusike, told The Herald that the Covid-19 health response must prevent stigma and discrimination, include psychological care, ensure safe and quality care, including sexual and reproductive health-care.

"Zimbabwe must ensure that women and girls have access to Gender Based Violence (GBV) prevention and response services, including GBV survivor services such as temporary shelter, safe housing, financial support," he said.

"Health workers must be prioritised both in access to care and specific economic and social support."

Rusike said Covid-19 will disproportionately affect women and girls, vulnerable and marginalised people, such as people living in poverty, people who are malnourished, elderly people, people with disabilities, prisoners and people with existing health conditions.

"We must work to balance fighting this pandemic while maintaining essential health services," he said. "Lessons can be learned from the TB, HIV and malaria responses, such as health education on prevention, contact tracing, preventing stigma and discrimination, the role of communities, women's organisations and civil society, and addressing challenges of isolation."

Additionally, Rusike noted that community health workers can be activated for awareness raising, prevention and early detection.

This, he said, can be done through engaging in improving awareness and understanding of Covid-19 within communities, including the benefits of a vaccine.

There is also need to engage in improving health literacy of population on the ground on Covid-19, added Rusike.

He pointed out why it was critical to engage in effective campaigns to tackle misinformation and mistrust around Covid-19 as a disease. This, he said, can be done by undertaking campaigns to counteract misinformation on vaccine hesitancy and conspiracies.

Having worked in the HIV field which was one of the casualties of stigma, chairperson of the Zimbabwe Women Living with HIV National Forum, Catherine Murombedzi, knows too well the impact of stigma.

Sharing her thoughts with The Herald, she said there was need to emphasise that no one is safe as everyone is at risk of Covid-19.

"Unlike in the HIV message, where people called for behaviour change, those who were ill to go on treatment, Covid-19 is an infectious disease that is passed in a different way," said Murombedzi.

"People should know that you do not have to stigmatise anyone who is affected and infected by Covid-19. No one is safe."

Murombedzi suggested that the Covid-19 messaging should focus on risk perception, to show that no one was safe.

"When one is not safe, everyone is not safe," she said. "That is what I feel the messaging should be. Until everyone is safe, then we can be sure. Our messaging should be 'let us care and love those who are fighting and battling Covid-19.'

"Safety for one, safety for all," said Murombedzi.

With stigma clearly affecting reintegration of those once affected into society, more needs to be done to change attitudes as no one is safe from Covid-19.

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[email protected], Twitter : @RoselyneSachiti

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