Workplace Stigma Against TB Survivors On The Rise In Zimbabwe

Documented cases of discrimination against TB patients and survivors in the workplace environment, have  been increasing over the years been reported in most settings in Zimbabwe with some employers going to the extent of dismissing survivors under unclear circumstances.

By Kudakwashe Pembere recently in Kwekwe

This was revealed during the presentation of the Community Rights and Gender Assessment findings in Kwekwe on Wednesday by Jointed Hands Welfare Organization (JHWO) director Dr Donald Tobaiwa.

He said they learned from the assessment that a lot of former miners were dismissed without getting any compensation.

A third of the respondents reported experiencing TB associated stigma and discrimination from family members , communities, co-workers and healthcare workers. 166 respondents (20.6 percent) of the TB patients experienced stigma at one time because of their TB status be it at the health facility, at home or at the workplace.

“The majority of ex-miners who were part of the focus group discussions highlighted that they lost their jobs and couldn’t get any form of compensation upon falling ill with TB. The employers dismissed them and families stigmatized them as being HIV positive since TB is generally associated with being HIV positive,” Dr Tobaiwa.

He also said there are structural barriers that have seen TB patients unfairly dismissed from work.

“Some of the structural barriers are to do with availability of information to legal recourse in case of any gaps or challenges.

“Those are some of the things that came through. And those can be as a result of lack of adequate information in communities to know that suppose you are fired at work, and indirectly you were a TB patient, and you were not really productive but you are indirectly fired not because you are TB patient but you are not generating any productivity.
“Those are some of the things that need to get to the communities to know there is legal aid support, there is legal recourse around related issues. So some of the barriers are as a result of lack of information and awareness,” he said.

He also said they noticed self-stigma, perceived stigma, and enacted stigma affecting access to treatment.

“Access to services was affected by long distances to facilities. It was affected by healthcare worker attitudes.

“It was affected by stigma and discrimination in quite a number of forms such as enacted stigma, self-stigma from individuals themselves, perceived stigma which came into the picture that was talked about,” Dr Tobaiwa said.

Dr Tobaiwa also said others ended up hopeless due to the stigma.

“There are some real extreme situations on stigma to an extent that it also affected the quality of life and eventually in some instances we have some quotations from focus discussions that also had people ending up giving up on themselves because there was no support mechanism because it all started as a result of stigma,” he said.

He also noted that a stigma assessment similar to the one done for the HIV sector should be done not only for TB but other diseases.

“But as a country, it is still equally important that we do a deep-dive stigma assessment for the country. Unlike the community rights and gender which focusses on all the four pieces but not really in-depth. But for stigma, it might be prudent and it is important that the country does a TB Stigma (assessment).

“We are aware that ZNNP+ and other partners facilitated the HIV Stigma, and it is important that we also get down and understand the stigma with regards TB. So those are some of the issues,” Dr Tobaiwa said.

Dr Tobaiwa explained that the study looked at community, gender and rights aspects.

“By community aspects, we are looking at those barriers that are affecting access to services from the community perspective. These can be community norms, socio-cultural dynamics, it can be the community related cultural interface.

“Then we also look at the Gender dynamics. Here, we are looking at the different roles and responsibilities that are in the communities and how they affect access to services. We are also looking at the rights aspect.

“And when we are looking at the rights aspect, we are looking at the legal environmental assessment. So when we are looking at the legal, environmental assessment, we are looking at issues that are policy in nature, affecting access to health services. So when we are looking at the community rights assessment, we are also looking into stigma and discrimination, structural barriers, interventions that affect communities’ access to services,” he said.

The study had 995 participants.

“Key Informant Interviews (n=148), Focus Group Discussions (n=41), and review of literature while quantitative data were gathered through questionnaires (n=806),” said Dr Tobaiwa.

Meanwhile, Acting Deputy Director for TB in the Ministry of Health and Child Care Dr Fungai Kavenga said Zimbabwe reduced the incidence of all forms of TB by 80 percent from 242/100000 in 2015 to 48/100 000 by the year 2026. Zimbabwe also seeks to have reduced mortality of all forms of TB by 80% from 40/100 000 in 2015 to 8/100 000.

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