Botswana government sent the country on a tail spin last week when it changed its COVID-19 public health response from being transparent to a relatively opaque approach.
Coordinator of the COVID-19 Task Force Dr Kereng Masupu revealed that unlike South Africa, Botswana will not stratify its COVID-19 data, but will instead aggregate it to hide demographic variables that may compromise patients’ right to privacy.
Dr Masupu said they had resorted to masking data to protect patients from the disease stigma. Although not in so many words, Dr Masupu’s approach is being supported by some local social scientists who say Stigma might be a threat multiplier because it prevents those with a disease from seeking care, engenders fear of those who have disease, causes prejudice against groups or communities, and has, in some cases, led to violence against the stigmatized group.
Dr Sophie Moagi, a clinical psychologist in Gaborone says “Stigmatization is yet another mechanism of social isolation caused by epidemic disease outbreaks—and itself a cause of mental illness. Individuals and communities often turn against each other or against others, resulting in fear, mistrust, and ostracization. The most obvious targets of stigmatization are those who have the disease. In some cases stigmatization can lead to patients avoiding the healthcare system for fear of being ostracized. This has been a significant problem with AIDS, where people living with HIV or AIDS avoided testing and treatment due to the stigma associated with the disease. First, stigma can present major barriers against health care seeking, thereby reducing early detection and treatment and furthering the spread of disease. Social marginalization often leads to poverty and neglect, thereby increasing the susceptibility of the community to the entry and amplification of infectious diseases. Finally, potentially stigmatized populations may distrust health authorities and resist cooperation during a public health emergency.”
Dr Sethunya Mosime, senior Sociology lecturer at the University Of Botswana says “Stigma is not limited to the person suffering from the disease but extends to one’s family members, too. We know from the history of diseases such as TB and HIV that stigma undermines efforts to prevent the spread of the illness, and does more harm to sick people and society. Stigma and fear can severely impede efforts to manage the spread of an outbreak of a disease. Community trust is strongly influenced by the degree to which officials and health care providers have addressed local health needs prior to epidemic emergencies. Only when these conditions are pre-established is it realistic to expect affected populations to cooperate with programs such as contact tracing and to distinguish isolation measures from the historical spectre of quarantines. Hospitals and isolation centres should be seen as treatment zones to be sought rather than places of death to avoid. Without clear and reliable information, the unknown risks of infection can exacerbate stigmatization and create undue alarm.”