Dr Boniface Bongonyinge, Clinical Care Coordinator at Lira Infectious Disease Clinic in Uganda, talks about the value of differentiated service delivery and the importance of Zero Discrimination
Q: What does Zero Discrimination mean to you?
A: It’s so disheartening to watch someone being denied an opportunity or access to a critical service just because they are young or old, from a different ethnic group, pray at a different church, or worse still, just because of their health status or physical impairment. Zero discrimination would therefore mean accepting, treating, and serving everyone equally and fairly.
Q: How does discrimination effect your clients?
A: In the context of HIV, many fear discrimination or lack of confidentiality on the part of the health providers, and for others, there is a fear that they will be identified by community members at the health facility and therefore may go to a clinic far away or rather not access the service at all. Thus discrimination greatly affects access to HIV testing services. Even those who test positive either delay access to care and treatment or do not come back to the health facility at all. It contributes to poor retention and adherence when it comes to treatment and subsequently poor treatment outcomes.
Q: The right to dignity is important and can ensure that young people return for treatment. How do you work to promote dignity?
A: Services rendered to young people must be tailored to their needs and must be offered in a friendly manner by health workers who are trained in the provision of adolescent-friendly health services.
Q: How can we spread messages of awareness to the community about Zero Discrimination?
A: Actions speak louder than words. Zero discrimination starts with me, and subsequently awareness is spread, reducing the high level of ignorance, myths and unnecessary beliefs that have perpetuated discrimination to date. There must be a strong political will and citizens must make demands where necessary. This can be done through community dialogues, integration into school curriculums, tougher policies on discrimination, and stricter action taken against perpetrators of discrimination including jail time or have fines issued for those found guilty.
Q: Why is this important?
A: In the context of HIV, the young people suffer the most from the effects of discrimination. This is partly because they are more prone to this type of behaviour, especially in schools. Yet, many young people have not been taught how to handle discrimination. The result is a young person who may feel out of place and different to his or her peers. This can lead to isolation and poor adherence to medication and thus a poor viral load suppression and so forth. So if we want better outcomes for our young people living with HIV, we need to achieve zero discrimination. Young people need to feel safe, supported and must be able to participate and be heard in all areas of their life, especially when accessing health services and making decision about their own healthcare.
Q: What more can be done to achieve Zero Discrimination?
A: Awareness needs to be created at all levels, right from the grassroots to the top. It is not impossible, but will need a lot of transformation at personal and community levels to be able to achieve Zero Discrimination. Health providers too must be trained and must be aware of their own prejudices and sensitive to the needs of young people. Health service must be provided to all people fairly and equally irrespective of differences that exist between people or location, because health service remains a fundamental human right.
What does zero discrimination mean to you? Comment your thoughts below.
This interview was compiled by Jacquelyne Alesi, PATA’s communication correspondent in Uganda. Jacquelyne will be assisting in the compilation of stories from the voices of the PATA network. As a global youth advocate, she has represented young people on the National Forum of People Living with HIV Networks in Uganda, sits on the board of the Global Network of People Living with HIV (GNP+) and she is an Ambassador to The Coalition of Children affected by AIDS.