KENYA: A Nurse on a Personal Mission
Florence Chessa is a nurse on a mission.
Her goal is to save her fellow health workers from preventable HIV deaths – and she is starting in Busia District Hospital in Kenya, where she works.
One of the things that makes this fifty-year-old nurse special? Like many of her patients, she is also living with HIV.
I recently met Florence during a trip to Kenya’s Western Province, where the Foundation is part of APHIA Plus – a five-year, USAID-funded project that includes HIV care and treatment and prevention of mother-to-child transmission (PMTCT).
HIV stigma among health workers was identified as one of the bottlenecks hampering effective delivery of services. This stigma was even felt among health workers personally, many of whom would not get tested for HIV, or had trouble accepting their own status.
This was causing health workers to die from the very disease they were successfully treating in their patients.
Florence recounted to me how she and her colleagues took action to address this problem, and to help save lives:
“We were losing colleagues, spouses, and friends to HIV fast.
Meanwhile, we were treating HIV-positive patients, seeing them recover from worse conditions, and move on with their lives.
However, it was almost taboo to talk about HIV and AIDS in ourselves as health workers. Whenever we heard a colleague or a colleague’s spouse was very sick, we would befriend them and talk them into doing an HIV test and seeking treatment.
Because of stigma, some just wasted away gradually and died. Before long, we as nurses were meeting three times a week, talking about what we could do.
One day in 2007, we decided to act.
We approached hospital management and asked if we could hold a staff meeting. We hung posters everywhere and mobilized all staff. When the staff came, we dropped the news on them and told them we are HIV-positive. It was so quiet, you could have heard a pin drop.
Everyone lent us their ears as we shared with them our personal experiences. We recounted to them how we had lost medical doctors, nurses, and other colleagues to the very same illness we were treating in our patients.
After the meeting, a long queue of people formed – with the head of the hospital at the front of the line – all of whom wanted to know their HIV status. We continued with our regular meetings until late 2010, when we registered the support group for health workers.”
That same year, Florence attended a training of all health workers in Kenya’s Western and Nyanza Provinces on stigma reduction. Today, her group conducts regular outreach to other health facilities and prisons in Kenya, where HIV stigma remains high.
Florence understands well the stigma associated with HIV. She told me about her own difficulties accepting her HIV status:
“My own journey with HIV has been thorny and trying. I started suspecting I had HIV in 1999, after my son Amos was born. Being a health worker, I tested myself in 2000.
When results showed I was HIV-positive, I brushed it off and continued to live in denial. I kept on treating myself for infections, and thought that I would be HIV-negative one day.
By 2007, however, my health was deteriorating fast. People pointed at me when I was out walking. Not only was I losing weight, but my flesh told the tale of how ill I actually was. When my sister eventually commented how much she hated seeing me in such a state, it pained me to the bone. I went and locked myself in my room and cried.
Because the pain was too much to bear, I decided to disclose my HIV status to her. She then took me to a nursing home in Tanaka, where I spent one torturous month. After I was discharged, I talked to my friends in Kapsabet Hospital, where I went and took a test to determine my immunity levels and enrolled for treatment.
I was afraid to face my colleagues in Busia now that I knew I was HIV-positive – yet I knew we had been treating HIV patients and seen them grow stronger and stronger. Kapsabet is far away and expensive to travel to regularly. I had to bite the bullet and ask them to transfer me to Busia district hospital three months later.
Although some of my colleagues mistreated me because of my status, the management received me well and even offered me light duties after staying out of work for six months.
However, some of our colleagues, who are all trained health workers, feared infection and refused to take tea with us – and when they did, they would insist that the cups be sterilized in boiling water.”
Despite these initial difficulties, the Busia support group for health workers living with HIV continues to promote dialogue on HIV and to fight discrimination. It has grown to 24 members, and is openly recognized at the hospital.
Through APHIA Plus, the Foundation is helping the group extend its outreach, and help other health facilities start similar programs to combat stigma among healthcare workers.
But our efforts depend on courageous people like Florence, whose advocacy has helped change attitudes and break down taboos about HIV among her fellow health professionals.
“We always thought there was something we could do to change the situation, and it is rewarding to see the fruit of what we built painfully over time. It is now more bearable for HIV-positive health workers, as other health workers are more accepting of us.
They know anyone can get HIV, and this has opened doors for others who discover their HIV-positive status to open up and join the group.”
Eric Kilongi is the Foundation’s Senior Communications Officer for Africa, based in Nairobi, Kenya.