Health workers under attack as lack of Covid-19 awareness is fuelling stigmaWhile the government response to the virus has not been up to the mark, it has also failed to ensure risk communication and make the public aware of the disease in a proper way, doctors say.
When Dr Bishow Bandhu Bagale and his wife, Dr Anita Bhandari, tested positive for the coronavirus last week, both decided to do what as medical professionals they should have done. The couple stayed in home isolation.
What, however, came as a shock to them was a group of people declared the area, where their house is in Bharatpur-4, Chitwan, an “infected zone”. A banner even read: “Caution, do not enter.” As though it was not enough, they even tried to put a poster on their house that read “danger”.
[Read our editorial: The cost of stigma]
Bagale is a senior superintendent at Ratnanagar Hospital and Bhandari works at Bharatpur Hospital in Chitwan district.
“I showed them the lock I had put in the gate from inside,” Bagale told the Post over the phone. “I had a hard time convincing them that we as doctors know the protocol and that we were not going to step out of the house.”
After a week in home isolation, the couple has now recovered.
Along with the Covid-19 spread in the country, stigmatisation too has been spreading fast, said Bagale.
On Saturday, a group of locals comprising representatives of the area development committees of Milan Chowk, Baneshwor in Kathmandu Metropolitan City Ward 31 demanded that health workers from a house in their locality be evicted. Health workers from Civil Hospital are using the house for quarantine.
“Our hospital is in the same ward and those people, who tried to attack our health workers, have to visit our hospital for services,” Dr Dirgha Raj RC, director at Civil Hospital, told the Post. “We sent a team of our hospital management to hold talks on Sunday.”
According to RC, after talks in the presence of political representatives and police, the locals admitted their mistake and agreed to let the health workers stay in the house.
In various countries and cities, doctors and nurses have been celebrated and applauded for working on the front lines during the pandemic, but health workers in Nepal are facing social stigmatisation.
Dr Radhika Thapaliya, a risk communication expert, said such social stigmatisation of health workers exposes the complete communication failure on the part of the authorities about the infection.
“State agencies have failed to disseminate right information regarding the pandemic,” Thapaliya told the Post. “Either people are being told that the virus will kill or they are being fed misinformation like it is similar to the flu and that home remedies can cure the disease.”
Nepal reported its first Covid-19 case in January. As of Sunday, according to the Health Ministry, 31,935 people have tested positive including 149 deaths.
So far 18,631 people have recovered.
The World Health Organization says that during the Covid-19 pandemic, more than ever, protecting the health and lives of health care providers on the front line is critical to enabling a better response.
“This unprecedented public health emergency has demonstrated that health facilities, medical transport, patients as well as health care workers and their families can–and–do become targets everywhere,” the UN health agency said in a statement last month. “This alarming trend reinforces the need for improved measures to protect health care from acts of violence.”
In the third week of June, the United Nations Country Team in Nepal, together with over 30 national and international organisations, collectively launched a campaign, calling for an end to stigma and discrimination against people, amidst the ongoing Covid-19 crisis.
The statement came in the wake of alarming accounts of stigmatisation against health workers, Covid-19 recovered people and their families and returnee migrant workers, among others.
In April-end, health workers, who had gone to Udayapur for contact tracing after the district reported a sudden surge in Covid-19 cases, were routinely turned away from hotels and restaurants and even denied food and lodging.
According to doctors, in big cities like Biratnagar, Birgunj and Chitwan, some health workers have been denied entry into their apartments and manhandled by mobs.
Dr Madan Upadhyay, former medical superintendent at Narayani Hospital in Birgunj said that several nurses and paramedics serving at Narayani Hospital in Birgunj were reluctant to go home after duty, due to fear of stigma and humiliation.
According to Upadhyay, who was recently transferred to the Health Ministry, Narayani Hospital was even vandalised by the mob.
Over 70 health workers of Narayani Hospital have tested positive for Covid-19 and some infected health workers have been serving the infected people.
According to the Ministry of Health, over 500 health workers including 140 doctors have been infected as of now.
Dr Mukti Ram Shrestha, former chairman of Nepal Medical Association, an umbrella organisation of medical doctors, said social stigmatisation of health workers not only exposes the lack of communication and awareness but also shows towards what the Nepali society is heading.
“If people are losing their conscience and mob mentality rules the roost then it is clear that the society is not going towards the right direction,” Shrestha told the Post. “I am afraid if this continues, if health workers are stigmatised and assaulted, they will be left with no option than to resign and stop treating.”
According to a Lancet research, frontline healthcare providers are at increased risk of reporting Covid-19 positive compared with the general community.
Doctors say there is a need to spread awareness among the members of the public that health workers are at increased risk of contracting the virus, but if they are stigmatised, the communities will ultimately suffer.
“Health workers are being attacked, humiliated and intimidated due to fear that since they are infected, they will jeopardise the lives of others in society,” said Dr Lochan Karki, chairman of Nepal Medical Association. “People are forgetting that they themselves could get infected and others could turn against them. There has been an erosion in humanity and this is a danger sign in itself for our society.”
The association is planning an emergency meeting of its office bearers to discuss the growing attacks on health workers.
The World Health Organisation last month emphasised the need for risk communication in the wake of increasing attacks on health workers across the world amid the Covid-19 pandemic.
“These attacks on health care speak to the importance of adequate risk communication at all levels of society to reduce fear, stigma and—ultimately—violence,” it said. “How we communicate about Covid-19 is critical in supporting people to take effective action to combat the disease and protect health care.”
Meanwhile, the Ministry of Health has said that it has taken attacks on health workers seriously and that it will take steps to address the situation.
“Health care workers are forced to live under constant psychological threats of getting infected, attacked and humiliated by the mob,” Dr Sameer Kumar Adhikari, joint spokesperson for the Health Ministry, told the Post.
“It will be very difficult to provide health care services if such attacks don’t stop. We will take some decisions for the safety of health workers.”
According to doctors working in the field of risk communication, a pandemic requires clear, unhindered and accurate flow of information—to the public, to doctors, nurses and health workers and to institutions that are providing services.
“Those who believed that the disease would kill us attacked health workers or stigmatised them out of fear that they would spread the infection in the society,” said Thapaliya.
“Others, who believe that the infection is like any other flu or regular infection are making light of the disease and even not wearing masks. Both are the result of communication failure.”