Friday 25 July 2008

Are you a 'case'?

For some reason which I've never fully understood, Indonesia was persuaded that people living with HIV (PLHIV) needed 'case managers'. I think it originated from the US paradigm that was then being pushed by one of our donors. Anyway, now we're stuck with them. We didn't even bother to change the name, calling them 'manajer kasus' (I'm sure even those who don't know Indonesian can work that out!).

In the US, with a huge variety of services available that patients may have difficulty in navigating, perhaps this task is needed. But here, where services are very limited, many of the 'case managers' I have met have been confused about what they are supposed to do - and many end up as 'gofers', both for hospital staff and for PLHIV.

But what upset many of us right from the start was that the name is totally unacceptable to empowered people. As one of my PLHIV colleagues insisted at a meeting with staff from the Ministry of Health today, she is most unhappy to be considered just as a 'case' and she certainly doesn't appreciate the idea that she should be 'managed'.

Sad that her point of view, widely supported by PLHIV here, seems to be ignored by a rather arrogant health service. I wonder why patients in the US put up with this?

Babé

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