The rights of people living with HIV, particularly their health rights, are routinely violated in the Republic of North Macedonia. An analysis of reported cases to NGOs working in this field reveals that approximately 90% of human rights violations of people living with HIV are related to their health rights, and the perpetrators are medical professionals. The health rights of people living with HIV are being violated either by disclosing their HIV status or, in this particular case, by refusing to provide them with health care.
During an examination at the Clinic for Infectious Diseases and Febrile Conditions – Skopje, the patient was advised to go to the University Clinic for Dermatology. Certain serious skin changes (pyoderma) indicated that the person needed to be admitted to the Clinic for Dermatology right away, at which point a specialized doctor was contacted by the Clinic for Infectious Diseases and Febrile Conditions, and an appointment was scheduled. In the presence of the patient, the doctor was starting the administrative procedure for patient admission at the Clinic’s reception desk, and he reminded the nurse that the patient has an immunodeficiency. The department nurse reacted angrily, questioning why the patient had not been admitted to the Clinic for Infectious Diseases instead, how he would stay with the other patients at the Dermatology Clinic, and how she would inform the other patients that one of the hospitalized patients has AIDS. The doctor informed the nurse that the patient has a dermatological condition and must be admitted to the Clinic for Dermatology. Furthermore, he stated that other patients cannot and are not permitted to know about his HIV status. Meanwhile, the patient needed to use the Clinic’s restroom. After exiting the toilet, he was met with a slew of inconveniences by the medical staff, such as remarks that others would now be unable to enter after him, that the toilet needed to be disinfected, and so on.
Even though the patient was aware that he should be admitted to the Dermatology Clinic, the doctor arrived after a long wait, informing the patient that he would still have to be admitted to the Clinic Infectious Diseases and that for “some” reason he could not be admitted to them. The patient believes that, despite the doctor’s good intentions and recognizing that he had a dermatological problem, the refusal to hospitalize him came from the nurse.
REAction and outcome
Because the patient chose not to pursue the violation in court, the Association for the Support of People Living with HIV “Stronger Together,” Skopje, decided to address the infringement of rights by writing to the director of the Clinic for Dermatology. The letter outlined the case while enumerating all domestic legislative rules concerning discrimination and patient rights. The Association demanded that measures be taken by the Clinic to sanction the violating behavior of the Clinic’s staff and prevent similar situations in the future. It also offered support in providing sensitization training to doctors and nurses, to prevent any future incidents of human rights violations in the Clinic. After a few days, the director of the Clinic for Dermatology called the Association’s executive director to inform them that they were aware of the situation before the Association sent a letter and that the nurse would be sanctioned. The Association has yet to receive written confirmation of any sanctions imposed on the nurse, and it intends to inquire whether the Clinic for Dermatology imposed any sanctions.
Relevant legal provisions
According to Article 5 paragraph 2 and Article 32 paragraph 4 of the Law on Protection of Rights of Patients, medical professionals are prohibited to discriminate against anyone based on their health condition. Such prohibition is also regulated in the Law on the Protection from and Preventing Discrimination.