With October, internationally
recognised as breast cancer awareness month and 1 December or World AIDS
quickly approaching, the Cayman Islands Cancer Society and the Cayman Aids
Foundation would like to take this opportunity to address the issue of
health/illness related stigma and discrimination in Cayman.
While the community has come a long
way in accepting awareness campaigns and educational programmes surrounding
cancer in general and breast cancer in particular, we still have a long way to
go in regards to cancer awareness and education and an even further distance to
cover when it come to HIV and AIDS.
From an early age we are taught
that sticks and stones break bones, but words can do no harm. Unfortunately we
quickly learn that sometimes the pain inflicted by words- or lack thereof – are
much deeper and slower to heal than physical scars. While we would like to
believe otherwise, the reality is that stigma and discrimination are as much a
part of our daily lives and perhaps even culture, here in Cayman as it is in
any other part of the world.
Our dialogue about how these
judgment based reactions are manifested usually covers race, class, nationality,
and at its most heated sexuality. Too often, however, we fail to acknowledge
that health based stigma and discrimination is equally as rampant and its
detrimental impact reaches much further than the person directly victimised by
it.
Health related stigma is not a new
phenomenon. The references to leprosy in the Bible not only illustrate how
society at the time organised itself to handle a perceived danger to others,
but the very language utilised in its description highlights the problem which
we still have today. “The person who has the leprous disease shall wear torn
clothes…and cry out ‘unclean, unclean.’ He shall remain unclean as long as he
has the disease….He shall live alone; his dwelling shall be outside the camp”
Lev 13:45 (NRSV).
Hansen’s disease, or leprosy, is
not nearly as feared and loathed today as it was back then and over the course
of time persons infected with TB, yellow fever, and cholera have all been met
with similar reactions. As science continues to make leaps and bounds in
helping human beings understand, diagnose, cure or treat illnesses, the reality
is that our attitude towards those diagnosed is still centuries behind. While
our outward practices may have changed in order to appear more humane and
acceptable to the civilised world, at our core we are still holding on to the
idea that particular illnesses manifest on those who are “unclean” or somehow
being “punished”. In other words, we attribute some level of moral fault or
blame on the patient for their current condition.
Take cancer, for example. It is
unthinkable to some young persons today that once upon a time patients who were
diagnosed with cancer were as readily shut off and made to live “outside the
camp”- literally and figuratively. It is probably even less conceivable that,
while the general perception of cancer and those persons who have been
diagnosed with or survived it has changed tremendously over the past two
decades, the shame and humiliation which some patients feel is still tangible.
It is not uncommon for survivors to report the loss of relationships, the
isolation and the death sentence that is handed down to them in a single look
from disclosing their illnesses. One need not search the Livestrong blog or You
Tube to hear these stories: our very own survivors will tell you what it was
like for them within our shores.
On the other hand, while our
treatment of persons living with HIV and AIDS has improved, we all know how
shameful some people’s treatment of those persons continues to be – even if we
fail to acknowledge it. There will always be another disease, illness or virus
that will come along and inherit the disdain of the last and with it another
set of persons who will suffer at the hands of a society so willing to stigmatise
and judge.
Like persons diagnosed with cancer
in years gone by, persons living with HIV and AIDS in Cayman have lost the
support of friends and family, their jobs, been denied treatment by certain
unscrupulous practitioners, and even
been denied mortgages on account of being unable to get life insurance. As a community,
we have stigmatised HIV and AIDS to the point where we have made it impossible
for persons living with the virus/ disease to feel comfortable enough to meet
on a regular basis to offer support to one another for fear of having their
status disclosed. Those who, at one point or another, have served as the human
face of the virus have quietly gone back to living a life of anonymity as the
burden of such status is simply too great to bear alone in such a small community.
We all lose when we fail to protect
the dignity and humanity of the person living with the illness, choosing
instead to treat said individual solely as a diagnosis to avoid and fear. In
our readiness to judge, criticise and ostracise we dissuade each other from
taking care of ourselves and seeking information and treatment. When it comes
to the spread of HIV and AIDS, stigma and discrimination is considered the
third phase of the pandemic as it plays a tremendous part in driving the
disease further underground. In Cayman and around the world people continue to
choose to live a life without knowing what their HIV status is rather than risk
the possibility of testing positive and being condemned to live a life on the
outskirts of their community.
Any community should strive to do
better. One that defines itself according to Christian principles should be
raising the bar, not struggling to locate it.
Cayman Islands Aids Foundation
Cayman Islands Cancer Society
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