Monday 15 June 2015

When a name simply put may serve to shame and have a likelihood to stoke discrimination & Stigma; lessons informing Public health and HIV Social Justice Policies

A woman, hair-stylist, skilled and experienced after doing this kind of work for many years both in Africa and USA, found herself being avoided by friends in Oakland, CA in 2014. From February to September her business on one of the most frequented areas in a corner next to Oakland Museum, witnessed a boycott. She was transformed by the community into a label. “Ebola!” This became her name. The name had its accompanying attributes in form of societal reward or punishment. There seemed to be a universal consensus among many to punish Africans. Other Africans also faced degrees of stigmatization. In the case of Jessica, her hair grooming enterprise became an instant loss. From the darling of hairdressing in Oakland to a social outcast. She came from Senegal. She had come to live in USA where she is a mother and a law abiding citizen. Few took time to understand what Ebola was. Mostly negative perspectives, prejudices and biases were the order of the day until there was effort to establish dialogue around this issue. 

A man in his late 30’s  had worked as a homecare provider for 1 year at a Senior Living apartment in a secluded corner in San Francisco, CA. He enjoyed his work, gave the right measure of unconditional regard towards his charges and followed instructions set by his bosses. In August 2014, he was shocked when he was told by one of the charges he was about to serve not to touch anything because “Africans bring Ebola to USA. It is all over T.V.” 

In Public Health, socially correct language needs to be used especially where there is likely to be confusion. Take for example: one of the forms of transmission of HIV is from “mother-to-child.” It is true, this happens but it is socially correct to say: “Perinatal Transmission.” It is an objective approach that takes blame away from a subjective situation motherhood. It gives perspective to mothership as acollective role: at the zygote level, birthing, nursing, caring and loving in their true light. It also shows clearly the point when there is likely to be vulnerability to infections so good care measures can be taken. The name “Perinatal Transmission” falls well under the characteristics that are used by the international classification of Diseases: defining the infection or disease; understanding causes; plotting rate of infections (morbidity); recording rate of deaths (mortality) and; rate of disability.

Motherhood has the following attributes:  key facilitator in the exchange of eggs during fertilization; implantation; gestation which is normally carried to term; birthing; bonding; caring; role training and supportiveness. Motherhood should not be made out to appear dangerous by some statements that on the surface may be thought to be harmless. Scientific evidence shows that the foetus in the womb from gestation to full term is not exposed to HIV but this vulnerability to HIV infection is during the 'passage' in the birth canal. In other words during delivery. That is why all measures are done to protect both the mother (who may be positive and child, by starting ART in the period before actual child birth). As I end this short article, I want to share with you what I learnt from the International Journal of Cardiology Volume 8, issue 3, July 1985. In it the authors are discouraging the eponymous trend and give their reasons. Why do we have to correct some of the names, especially in Scientific Nomenclature, that were passed down to us? Why have we all of a sudden grown a discontent with some names? Why don't we keep Fallopian Tubes (that highway that brings the egg in females from one place to another) and instead use Uterine Tube? There are reasons given such as: helping health service providers understand illnesses and reducing a fear/ cringe factor among sufferers. 

The latter is one of the reasons why I personally want the term “Perinatal Transmission” and not “Mother-to-Child Transmission.”