Tackling COVID-19 stigma in Ghana
A woman following Covid-19 handwashing protocols.
July 2020: Prof Crick Lund, King’s College London and Dr. Benedict Weobong, King’s College London/School of Public Health University of Ghana, on behalf of Ghana Somubi Dwumadie (Ghana Participation Programme)
The COVID-19 pandemic has dominated headlines globally since the first case was reported in Wuhan, China in late 2019. The pandemic has had a devastating effect on the economy – globally and in Ghana. At the time of writing there were approximately 27,060 cases confirmed, and 145 deaths attributed to the disease in Ghana.
Perhaps equally as devastating has been the “infodemic” attached to COVID-19. The term infodemic refers to the overwhelming volume of information (some accurate and most inaccurate), that accompanies an epidemic. World Health Organization Director General Dr Tedros Adhanom Ghebreyesus has been quoted as saying: “we are not just fighting an epidemic, we are fighting an infodemic”.
Unfortunately, the global infodemic has included a great deal of falsehoods and misinformation. Misinformation comes in many forms, from conspiracy theories about the cause of the illness, to mistaken views of effective treatments, to stigma associated with the illness.
The term “stigma” means literally to mark someone with a negative sign or label. Stigma takes many forms and is generally used to ostracize and exclude people from a socially defined group. For example, stigma is common against people with illnesses, such as HIV or mental illness and people with disabilities. With the advent of COVID-19, people who are infected by the virus have also been stigmatized.
There have been several recent examples of stigma associated with COVID-19 reported in Ghana:
People who have been treated for COVID-19, recovered and been discharged from hospital are not well received when they return to their families and communities.
There have been instances where some communities attempted to prevent the Ministry of Health from locating a COVID-19 isolation Centre in their community.
In some Health Centres, COVID-19 patients are not welcome by some health professionals.
There are reports of a pregnant woman who was abandoned in a hospital in Western Region because she was found to have been contact traced before her time for delivery. She had to be moved to another hospital to deliver safely with treatment and support.
Some nurses and health professionals are also recently victims of stigma because they attend to COVID-19 patients.
People with disabilities, including people with mental health disabilities who are infected with COVID-19 are often at risk of double stigma.
What are the best strategies for overcoming stigma against people living with COVID-19? Fortunately, we have the benefit of many years of research on strategies to overcome stigma against other health conditions. For example, there is a great deal of evidence of what works to overcome stigma against mental illness.
First, accurate information about the condition is vital. It is essential that the Ministry of Health and the Ghana Health Service provide accurate timely information on the causes of COVID-19, proven strategies for prevention (such as washing hands, wearing face masks and avoiding overcrowded places), and how to treat the illness if you are infected. It is also vital that the public inform themselves and learn to distinguish accurate scientific information from hearsay.
Second, caring and accepting attitudes towards people infected by COVID-19 are highly effective ways of overcoming stigma. Imagine yourself in someone else’s shoes, if they had been infected. In addition to suffering from the physical symptoms, they are likely to be worried about their future health, the threat to their life and the reality of social isolation, with associated loneliness. Showing solidarity and caring, even while maintaining physical distance, can make all the difference to an infected person’s quality of life.
Finally, the most effective intervention for reducing stigma is actually to meet someone who has experienced that condition. In the case of COVID-19, it is important for those who have recovered to share their stories – to explain the symptoms, and to help inform the general public about how to stay safe. Key leaders in Ghanaian society who have been infected and recovered need to share their stories, to demystify COVID-19, and strengthen social solidarity. And the media needs to present a balanced, factual account, not overly dramatising the situation.
To conclude, further research is required about how to overcome stigma against COVID-19, particularly as this illness is likely to influence our healthcare systems and society for many years to come.