Tuesday, May 27, 2014

CONVICTED NURSE IS PROGRESS IN HIV/AIDS FIGHT



Last week Nurse Rose Namubiru was convicted of professional negligence for pricking a baby with a needle she had already pricked herself with. Namibiru is HIV-positive.

For anyone who is a parent this is a story that makes your blood run cold and cuddle in your veins.

I understand that medical practitioners prick themselves all the time in the course of their work, but there is a prescribed practice of what to do afterwards to prevent possible infection to the health worker or/and the patient. By her own admission Namubiru ignored this or forgot to observe these protocals and coupled with her HIV-status set the scene for the landmark case, whose conviction was passed down barely days after parliament passed the HIV Prevention & Control Bill 2010.

The new law provides a legal framework for the prevention and control of HIV, disclosure of sero-status to reduce transmission, provision of testing and counselling services and prescribing criminal penalties for intentional transmission of HIV.

The court passed judgement and there is very little else we can add to the argument.

However as is always in such like cases, the human rights element came up. Activists have been arguing that the arrest, trial and eventual conviction of Namubiru was clear case of discrimination of HIV-positive people in this country.

One can argue that hadn’t she been living with HIV the ensuing drama may not have happened and the whole incident may have been swept under the carpet, as has probably happened in numerous cases before.

It is no consolation to all the concerned parties, but its good events took the course they did because this single case cuts straight to the heart of the professionalism and ethical standards to which we hold our health workers.

The law is useful in maintaining order but more importantly there has to be a fear of social censure, that society will not look on and allow certain behaviour to pass. So for example you wouldn’t help yourself on the road side or walk around naked in public for fear of ridicule and be ostracised. This a more powerful means of controlling public behaviour than all the laws and enforcement agents that can be aligned against outlaws.

Which brings us around to the case by the human rights activists. It is clich├ęd by now but worth repeating, we exercise our rights and freedoms in as far as they do not infringe on the rights and freedoms of others. Which presupposes that in exercising our rights we should act responsibly.

That Namubiru was the victim of a with-hunt and what she was alleged to have done could be handled administratively by her peers is to dismiss the concerns of the family and the wider society as irrelevant.

In addition these claims deny the breakdown of our medical services, not only in infrastructure and inadequacy of health worker numbers but also in practice.

 One of the outcomes of this case is to put our medical service providers and workers on notice that the days of medical workers doing with us as they please without fear of scrutiny are over. It has also set a benchmark of how such cases of alleged malpractice or negligence can be handled, a useful precedence for society, which if anything advances the rights of the medical practitioners and their patients.

And to that extent the case against Namubiru was not a regression in the country’s pioneering efforts against HIV/AIDS.

In the more than 30 years since the struggle begun there has been a lot of progress, some setbacks but the trajectory has remained forward. We stigamtise the infected less than we do in the 1980s,  testing and counselling services are much more widespread, access to treatment is not only more widely available but cheaper and there is a greater understanding of HIV/AIDS than before. A lot still has to be done in those same areas.

We are looked up as a reference point on AIDS prevention, treatment and even research, especially in the context of a poor country. We are not perfect, but it is safe to say we learn at every turn.

It wold be ideal if progress was made in a straight upward line but that is not how life works.

The Namubiru case was not a cut-and-dried issue of criminal liability. It was bigger than the convicted nurse, the aggrieved parents or the wronged baby. It was a groundbreaking case which furthers the fight against the pandemic going in to the future not only in Uganda but globally as well.

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