Former health minister blames contractors for stigmatising HIV room labels

Former health minister Kalumbi Shangula says the labelling of HIV treatment rooms started with contractors during the construction of health facilities, and that health officials often fail to remove them after handovers.

Shangula told The Namibian yesterday that it was never the policy of the Ministry of Health and Social Services to label rooms where treatment for HIV-AIDS and tuberculosis are provided because such labels can foster stigma and discrimination.

Shangula was responding to the views of the current minister of health and social services, Esperance Luvindao, during a visit to Epako Clinic in the Omaheke region recently, where she raised concerns about the labelling of rooms designated for HIV-AIDS services.

“The labelling of rooms specifically designated for HIV treatment leads to some patients defaulting on their treatment for fear of being identified,” Luvindao said.

Shangula said labels are often placed by contractors during the construction of health facilities, alongside other signs such as ‘Reception’ and ‘Toilet’, without awareness of the ministry’s internal policy.

“It is the responsibility of the heads of hospitals and health facilities to ensure that those offensive labels are removed. The minister was correct in enforcing compliance with the policy,” Shangula said.

He said by the time buildings are handed over, the labels are already in place, and in some cases, facility managers fail to remove them.

However, some HIV-AIDS activists warn that removing labels from clinic rooms providing HIV-AIDS services to reduce stigma could worsen patient access, increase queues and disrupt care for people living with HIV-AIDS.

Activists argue that while stigma must be addressed, it must not compromise service delivery and patient access to care, with some in agreement that some people with the virus might fear being spotted in public.

Walvis Bay-based HIV-AIDS activist Bernard Kamatoto says removing labels without broader system changes could create confusion and inefficiencies in already stretched health facilities.

“If you remove the labels, everyone will go to the same rooms and the same lines, and the queues will be longer,” Kamatoto says.

He says specialised HIV-AIDS services, while imperfect, provide structure and continuity of care, particularly for patients who require regular monitoring, follow-ups and medication.

“People on treatment need proper follow-ups and organised systems. If everything is mixed without proper planning, it becomes difficult for patients to get consistent care,” he says.

Kamatoto says stigma must be addressed, but warns that poorly planned changes could weaken already pressured health systems.

Long-time HIV-AIDS activist Jeremiah Shetunyenga from Onesi in the Omusati region, who has lived with HIV for 28 years, says stigma remains a major barrier to care, particularly for young people.

He stresses the importance of flexible service delivery models that protect patient privacy while maintaining proper follow-up systems. He says some patients are shy to access services because of fear of being seen entering certain clinic spaces, which affects treatment adherence.

He adds that any changes to clinic systems must ensure that proper records, follow-ups and continuity of care are maintained.

“Integration or change is fine, as long as records and follow-ups are done properly. People must still be monitored and supported,” he says.

Shetunyenga also points to the importance of community-based HIV-AIDS services, where patients can access treatment and community support, reducing pressure on clinics and lowering exposure to stigma.

HIV-AIDS activist Levy van Wyk says stigma linked to designated HIV-AIDS spaces remains a serious problem in many health facilities, but warns that changes must be carefully planned to avoid unintended harm.

Van Wyk gave examples of clinics where HIV-AIDS services and pharmacies are clearly designated, making it easy for community members to identify patients.

“The stigma is very deliberate because clinics are still designated as HIV clinics. Once you enter, people already assume your status,” Van Wyk says.

She says this exposes patients to discrimination, violates privacy and places some people, particularly women, at risk in their communities.

“People feel unsafe because their right to privacy is compromised. Once they are seen entering those spaces, everyone knows,” she says.

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