Concern has spread in recent weeks among patients with the human immunodeficiency virus (HIV) in the province of Santiago de Cuba. According to a new “guidance” from the Ministry of Public Health, care of HIV-positive people will no longer occur in a specialized clinic, but rather will be handled at the regular family clinics in their neighborhoods.
The measure has been greeted with alarm by those who say it will result in a decreased quality of medical care, and who fear the loss of privacy over their status. In an environment where prejudices and fears still prevail against people living with HIV, medical attention in the area where they live could cause neighbors and family members to reject them.
Several physicians who work in the family medical clinics, moreover, acknowledged in the meetings held to implement the new policy that they are not prepared to treat people with HIV. Until now, the monitoring and care of these patients has been in centralized clinics, handled by a medical doctor and a nurse specializing in the treatment of this virus.
However, the constant loss of medical personnel who leave to go on international missions, along with the apparent decrease in resources available for healthcare, have made it impossible to maintain the specialized clinics. A setback to which is added the recent cuts in the supplemental food received by seropositive people
The constant loss of medical personnel who leave to go on international missions has made it impossible to maintain the specialized clinics
Prior to this guidance, many patients were already complaining about violations of the code of ethics on the part of the physicians and public health personnel, who revealed their disease to other people. Now, fears about possible indiscretions are growing. Given the more local and neighborhood character of the clinics, the problem could worsen in the coming months.
Otto Reyes is one of the many HIV patients who claims to have been a victim of an indiscretion on the part of a nurse who treated him, who revealed his HIV status to a near neighbor. An experience similar to that of Damaris Rivaflecha and Dulca Maria Benitez, who were extremely disgusted by how information about their illness was publicly aired; as a result of such carelessness they decided not to return to the clinic.
The situation is more dramatic among very young patients. A young man, 18, who prefers anonymity, said that he fears that people in his area will learn about his illness when he has to start being treated at the nearest family clinic. For him, “It will be like starting from zero,” and he says he will feel like “they gave me the diagnosis all over again, people will look down on me and what I’m most afraid of is rejection.”
Lester Acosta, who also lives with the disease, told this newspaper he had suffered discrimination for being HIV positive, including within his own family. He, who has experienced it firsthand, wonders what will happen now with the end of the specialized clinics. “What will become of those who don’t want their condition to be publicly known?” he laments.