Confidentiality - Standing at the Door.
Part 1
The continuum of treatment and care of the HIV positive patient requires its Health Care professionals to undertake an immense task such as the assurance of Clinic's capacity and capability, patient comfort ability, stigma & discrimination, rites of privacy and respect of the individual.

Regrettably, here in the Caribbean the epidemic is now the second highest per capita in the world. Governments in our region are developing their National Strategic Plan and HIV/AIDS policies necessary for each country. Trinidad & Tobago must now implement new strategic approaches and revolutionize its systems towards treatment for persons living with HIV/AIDS (PLWHAs) and prevention for those who have not yet been infected.

Though, prevention is most important to combat the fight against HIV/AIDS and should never be overlooked, my greatest consideration regards the national approach to patient treatment and the methods that are used to ensure comfort ability, confidentiality and easy accessibility for its citizens.

Our Medical Research Foundation has its hands full. As what is to date the leading facility to serve the general public for Treatment & Medication, I understand that there maybe limited funding resources, interested and qualified personnel and availability of medication subsidised by the government. Yet the staff at MRF are doing their best concerning the present conditions, however, from my observation as a person who requires their services, I see where there is the need for improvement, especially with respect to their patients' confidentiality, well being and emotional security.

Logistically, MRF is easily accessible and they provide some of the better HIV/AIDS services in Trinidad though their challenges need to be reformed, upgraded and reconstructed. Its layout and entrance design is too open to the public's view; in this day and age it does not provide for those who are physically challenged and require the use of wheelchairs; and the way the nurses' offices and the patients' waiting area are set up. The patients waiting room for persons who have appointments or accessing MRF's services are exposed in full frontal view to the public, due to the designated area. The waiting area is a fully, glass enclosed veranda at the front of the building and entrance. The nurses' offices do not provide privacy nor protect their clients' confidentiality. I have overheard closed roomed conversations between nurses and patients, whilst waiting amongst other patrons and individuals such as family members, husbands, wives, lovers and additional MRF personnel including security officers.

Will someone please tell me, -“Why is it the responsibility of their security officers to ask a patient's name upon arrival when the relevant personnel is away from their desk, handle patients files or even deliver medication?” This regularly happens when the relevant personnel is away from their desk and integrated assistance to the Pharmacist. Oh no, not good, this is not good for me at all. You cannot imagine the thoughts that run through my head or the thoughts of other persons subjected (seeking or supporting) to these conditions.

Alarmingly, the pharmacist is conspicuously located right in the front of the building for all to see and if you don't move fast enough she will stand in all her glory with your lifeline in her hands or basket, depending on your need.

Seeing that the office is no bigger than a telephone booth, can't it be relocated to a more appropriate and more humane friendly area? And is there a problem with the Pharmacy providing plastic bags or some sort of concealment when dispensing medication, in consideration of the given circumstances of the individual?

To add insult to injury, vendors regularly visit the MRF to ply their wares and converse with staff. Noticeably, in front of patients. Patients' confidentiality is being broken and it is also insensitive to the patients whom are having a difficult time. Failure to broaden or objectively view these aspects of confidentiality, treatment and medication may result in a negative impact.

My concerns are more towards the common man and the fears they already manage as persons living with HIV/AIDS. The role of such agencies even operating under limited circumstances should really consider these challenges for their patients. My concerns are not meant to be a critical attack of this organisation. I am fortunate to have had this opportunity to voice what I experienced during each visit and the many questions I ask myself every time I leave the building.

Falleyne - Trinidad (47)

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