Tuesday, September 22, 2009

Papua New Guinea: The stigma of cholera

Leah Peter with her list of questions about cholera

An ongoing cholera outbreak is killing a growing number of people in Papua New Guinea and making scores more ill. But the disease is also having a severe effect on survivors.

This is the first known outbreak of cholera the country has ever experienced, and the government, the World Health Organization (WHO) and aid workers are struggling to raise awareness about the disease. Few people have ever heard of cholera, leaving infected people shunned and stigmatised.

One is Leah Peter, 25, from the Boundary Road settlement in Lae, the provincial capital of northern Morobe Province, which has experienced most of the cholera cases.

A few weeks ago, she woke up feeling weak and within a few hours was rushed to Angau Hospital in Lae by a friend.

"They put two drips into me and told me I had cholera. I didn't know what it was. My face had sunk in, my body was tiny," Peter told IRIN.

"When I looked through the tent flaps [of the hospital's cholera treatment centre], I saw people covering their mouths and noses and crossing to the other side of the street. I thought, 'What's this disease I have? I must be going to die from something really terrible,'" she said.

Peter survived her battle with cholera but when she returned to the settlement, the villagers ran away in fear.

"Everyone [ran away] - my nephews, cousins, friends. Only my friend, Monica Telba, stayed," said Peter. Her boss also told her not to return to her cleaning job. However, after two days of anger and depression, she resolved to fight for her rights.

Peter returned to the cholera centre and spoke to Karin Lind, the Médecins Sans Frontières (MSF) doctor who had treated her.

"She told me about the stigma she was experiencing. I called her boss to explain about the disease, and that Leah was not contagious, but it didn't work. I thought we could find her something to do here at the hospital. But she had another plan," said Lind.

Educating the community

The authorities still did not know the origin of the cholera outbreak, first reported in two coastal villages in Morobe Province. They suspect the highly contagious disease was brought in by Southeast Asian workers at a logging operation in the area, or aboard a fishing vessel.

Peter decided to run an awareness programme in her settlement to educate people about cholera.

"Rich people live a luxury life. They can buy good food, drink good water. They have education. They know about cholera and how to protect themselves. They don't have to be scared of it," she said.

"In settlements, we are poor and we live with germs. We don't know anything about cholera, so we get sick. That's not right."

Lind helped Peter develop the educational material for her programme, including information sheets about cholera.

"Leah came to me with a list of questions people had about cholera like, 'How do you get cholera?', 'What is the safest water to drink?', 'What food is safe to eat?', and 'What can I do to protect my family?'"

Monica Telba is also helping with the education project. "People in the community believe if you argue with someone, you get the cholera germ. But they are wrong," she said.

While virtually illiterate, between them Peter and Telba speak five of the languages spoken in their settlement, an advantage many outsiders lack. Besides distributing the information sheets, they plan to talk to people individually.

"You can give them a sheet of paper and tell them to read it," said Telba. "But they won't understand. And with radio it's in one ear and out the other. You have to take the time to sit and talk."

Fighting the stigma

Educating communities is the only way to overcome the stigma associated with cholera, said Sister Gatsia Muwete, senior nurse at Angau Hospital's cholera treatment centre.

"You can't blame people like Leah's boss, really. They've never heard about cholera before. We've had people who've died at the side of the road because no one wanted to take them to hospital.

"Nurses here at the hospital don't want to have [physical] contact with the nurses working in the cholera centre and avoid us. Of course, we are holding information courses on cholera to educate them," she said.

However, even educating health workers is a challenge.

"Only three nurses attended the information session today. But we'll get there," said Lind.

Disclaimer:This material comes to you via IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs. The opinions expressed do not necessarily reflect those of the United Nations or its Member States.
Photo: Copyright IRIN

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