Blame & Banishment - Médecins du Monde

Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia
Leaks in the system
“All that may come to my knowledge in the exercise of my profession, I will keep secret
and will never reveal.” Excerpt from the Hippocratic Oath
Recognition of the importance of keeping information about an individual’s health
confidential is as old as the Hippocratic Oath, and is one of the guiding principles in
medicine. Yet, often in the region, HIV patients, both adults and children, face situations in
which information on their status is shared beyond those who need to know.
One incident spells it out: “There was a case of a girl who didn’t know her diagnosis. She
found out when she saw ‘HIV’ written on the door of her hospital room. She wanted to
commit suicide as a result... When we went back to the hospital two or three months later,
we still saw ‘HIV’ written on doors.” 41
Fear of breaches in confidentiality sometimes leads to extreme measures. In some
countries, patients are not guaranteed the right to confidentiality of their medical records,
and employers may access the information. In these circumstances, the repercussions of
having contracted infectious diseases such as syphilis, HIV or tuberculosis may be so severe
that patients will avoid seeking care, or pay bribes to health-care workers in order to receive
testing or treatment without it being recorded. 42
When combined with widespread stigma, the inability to protect confidentiality affects
people’s lives beyond just their health. Even when social protection schemes are available
for families with HIV, there are numerous reports of people preferring to forgo HIV-specific
benefits or services for fear of the social ostracism that would result if their status became
known. As expressed by a social worker from Romania, “When people come to get their
subsidies they stand in the hallway and employees call out, ‘Let the AIDS patients come in.’ …
Out of the fifty-five birth families that we work with there are over twenty who refuse to take
subsidies for fear of breaches of confidentiality.” 41
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