Patient confidentiality and the chance COVID-19 offers to redesign our world
Updated: Sep 23, 2020
I shouldn't, but I blame the reality shows and the lifestyle pages. Patient Zero Brenda Ivy Cherotich and Brian Orinda showed up this week and we lost the plot in our own opinions. There are reasons why patient confidentiality is a central principle of health care and some of us demonstrated why we all should respect it.
An online and offline storm followed the televised discussion between the President, Brenda Cherotich and Brian Orinda. The various stages of her journey to recovery, age, profession, intimate relationships and even her body suddenly became available for closer scrutiny and casual debate. The hashtag #TwitterDCI and the refrain “this Government always lies to us” feebly attempted to give the conversations some respectability. This was not the only bridge we erred in crossing this week. As maps of people being traced for having been in contact with affected persons began to circulate, we started advising each other to avoid these areas. While possibly intending to keep us safe, these advisories merely informed the need to flee these areas and increased our levels of panic and anxiety. Sharing personal photos and information without the expressed consent of that person is an abuse of their privacy. Posting inflammatory and controversial messages that negatively target someone’s identity in an online community humiliates, degrades and belittles them. In most cases, the main intention is to cause the target to withdraw, limit conversation and leave platforms altogether. It is designed to crush their freedom of expression. Although not exclusive to women, women bear a disproportionate set of attacks not just in Kenya but globally. It is for this reason that platforms like Twitter enforce a hateful conduct policy and users cannot promote violence, directly attack or threaten other people based on their identity, including whether they have a serious disease. Health-workers have known and been bound by this code since 300 before Jesus was born. 2,320 years later, the rest of us are still catching up. From the Hippocratic Oath and code of ethics that guides all health-workers, the Kenya Health Patient Charter, Public Health Act and the Constitution, we have rights as patients to be protected even during the pandemic COVID-19. Described in that original Greek oath, our names, precise location, relationships and our health conditions are “holy secrets”. Tracking down people in a pandemic who are possibly infected is not a public responsibility. It is the obligation of Government health teams and epidemiologists. For the rest of us, we have a right to know how many are affected and their general locations, what is being done to keep us safe and what precautions and remedies we need to take. The pre-occupation with COVID-19 being a disease out there, Europe, Nairobi, anywhere but where we live, directly endangers us. As Kilimanian Kevin Doyle reminds us, only self-isolation, physical distancing, cleanliness and other prevention techniques keeps us safe. Fleeing areas does not stop the virus, it spreads it. People transmit COVID-19 not geographical areas. There is another reason some of us lost the plot this week. What we put our attention on, grows and becomes us. The pandemic is frightening for most and life-changing for us all. Rather than seek relevance through incessant, unverified and scary shares, we must consciously choose to share insightful and life-affirming information. There is one thing that COVID-19 has revealed that is not getting enough attention. We live in a discriminatory, exclusionary and broken system. There is an opportunity to redesign patient healthcare and police the public and detain accused persons. Can we rethink and invest in informal settlement homes and services and protect the daily wage-earner and the unemployed? If we had a functional social protection programme and hadn’t run down our Strategic Food Reserves, we could have gone into lockdown must sooner. For the first time in our history, we have seen a serious attempt to digitise education and bring as many students online. The danger of poverty and our gross inequalities just revealed itself, does this crisis give us an opportunity to redesign our households, neighbourhoods, the country and the world? Obsessed with minor details, some of us may have missed the significance of compassionately welcoming our Patient Zero, now Brenda Cherotich, back to full health. By intentionally acting on the bigger picture, we may also strategically miss the moment to create a country that is stronger than this small, nasty bug that currently threatens us. #StayHome #StaySafe and wash your hands after reading this article. This article was first published in the Saturday Standard, April 4, 2020