Kenya: Need to reduce HIV risk among health workers
Nairobi (Alshahid) – The Kenyan government is working to reduce health workers’ risk of HIV infection but experts say there is a need for greater focus on providing health workers with proper safety equipment and education.
According to government statistics, an estimated 2.5 percent of new HIV infections annually are health-facility related. Poor medical waste disposal, needle stick injuries and unsafe blood transfusions are some of the factors that put medical workers at risk.
While most government health facilities adhere to safety guidelines, private practitioners in poor areas may not be so strict, and patients themselves may not be knowledgeable enough to question unsafe practices.
“In poor or rural set-ups, health workers often provide injections at home [but] do not have access to either PEP [post-exposure prophylaxis - a short course of antiretrovirals to prevent HIV infection after potential exposure to the virus] or proper medical waste disposal facilities,” said Andrew Suleh, medical superintendent at Mbagathi District Hospital in the capital, Nairobi.
Leonida Murunga, a self-employed community health worker in Nairobi’s Gomongo slum, said she frequently gives patients injections in their homes and assists in home births, but rarely has all the proper safety equipment.
“When I inject somebody, I just carry the needle and syringe in my bag and dispose of them in the latrine where I stay; I don’t have gloves because I can’t afford them… it is dangerous because I even don’t know the HIV status of many of my patients,” she told IRIN/PlusNews.
According to the UN World Health Organization nearly 10 percent of the world’s 35 million health workers are exposed to blood-borne diseases every year; 90 percent of the resulting infections occur in the developing world.
The Kenyan government has sought to reduce the risk of HIV infection in health facilities, improving the availability of PEP, medical waste disposal and gloves in government hospitals and clinics. The US government has also partnered with the government in improving general blood safety and the blood collection skills of Kenyan health workers.
Suleh said that in addition to ensuring proper provision of safety equipment and PEP, there was a need for health workers to receive regular re-education on safety measures. “Having these measures is one thing but adhering to them is another; [many] injuries that occur in healthcare settings… are out of carelessness,” he said.
However, Viviane Mutai, a nurse at Kenyatta National Hospital, Kenya’s largest referral facility, said despite knowledge of safety standards, occasional medical injuries were inevitable.
“We take care as health workers and even though the government has made strides in improving the safety conditions for health workers, people still prick themselves with needles and this causes a lot of fear among health workers,” she said.
About one year ago, Janet Mulindi*, a paediatric nurse at Pumwani Hospital, a government maternal hospital in Nairobi, accidentally pricked herself with a needle while treating an HIV-positive child.
“I was trying to put the cap on the needle after the injection and I pricked my finger. I was afraid because I knew the HIV status of both the child and the mother,” she told IRIN/PlusNews. “Even though I was given PEP I am still afraid and truly I am not that confident as before when handling children who are living with HIV… I went for HIV tests for the following six months just to be sure.”
Mutai said additional counselling was necessary to ensure that health workers did not – out of fear of infection – stigmatize patients known to be HIV-positive.
“The fear of accidentally coming into contact with such a patient’s blood does cause fear, which then leads to stigma, which at times might affect the way you handle such people,” she noted.
Mulindi said since her own accident, she had had to make a conscious effort not to stigmatize patients living with HIV. “You don’t want a patient to realize you are afraid of them… I still see those [HIV-positive children] as a potential danger to my health. This stops me from giving my all.” (IRIN/PLUSNEWS)