Social work and infectious diseases
Working with people who live with infectious diseases such as HIV/AIDS, Hepatitis C, Tuberculosis or are affected by a current pandemic situation of SARS-CoV-2 requires a well-equipped ‘toolbox’ of skills and knowledge. In the example of HIV/AIDS and the UNAIDS’s global elimination goal of 2030, Stöver et al. (2017: 141) define three levels of social work with infectious diseases: a) as direct practice with specific, vulnerable target groups, b) as part of individual casework, and c) as part of social group work. In the face of rapidly changing pandemic situation, responsive and adaptive social work practice is especially important in relation to the sustainable development goals. Two factors are outlined:
- a successful cooperation with neighbouring countries and international support;
- maintenance and long-term adaptation of effective crisis responses in the post-pandemic world (United Nations Department of Economic and Social Affairs, 2020).
A recent study of infectious diseases and their prevention among people who inject drugs in Kazakhstan, Kyrgyzstan, and Tajikistan (InBeAIDS, 2020), show that HIV/AIDS continue to spread marking the region among the highest number of prevalence rates in the world (Altice et al., 2016). The InBeAIDS (2020) study provides a number of useful implementation and policy strategies for strengthening the role of social work and NGOs in the region:
- Development of testing policy for easier access to voluntary and rapid testing
- Reducing stigma through multi-dimensional engagement of ‘Trust Points’ and increasing financial support for social workers and medical staff
- Transferring the established trust with local NGOs to between local government and people
- Encouraging ‘friendly accounts’ to help battle ‘self-stigmatization’ and related mental health
- Training more social workers and medical staff to increase provision of accessible and quick professional help
- Ensuring protection of rights, dignity, and security of citizens with stigmatized diseases
Similar to Central Asia, social work with infectious diseases among marginalized populations is also greatly implemented by NGOs (Xu et al., 2005). The role of NGOs in PR China has similar goals to achieve, mainly increasing a better collaboration with the government, while in the meantime developing independent voluntary social work sector that is especially needed in China due to the small state sector responsible for a large population. Given its longer history of social work education in comparison to social work practice, China demonstrated a remarkable readiness during the initial stages of the COVID-19 pandemic by making social work knowledge available to public through broadcast and popular media platforms like ‘TikTok’ (Yuan et al., 2020). As a result, a prompt mobilization of ‘public education’ during a global pandemic situation can be deemed relevant internationally, given the practicality of approach in utilization of media channels to continue training and education of both professionals and the general public to be better equipped in uncertain times (Yuan et al., 2020).
Meanwhile, in Kazakhstan, professionalization of social work with regard to HIV/AIDS also requires further work. There are several factors that inhibit its development. Even if the vacancy of a social work specialist is present in a medical institution, the functions of a specialist are not always transparent. Oftentimes, the job is performed by specialists with medical educational background and therefore, medicalization of people living with HIV and drug addiction prevails. Another factor is the vulnerability of the profession itself due to its young history in the country. The first social work services began20 years ago, but the profession has not yet received a sustainability in the country. The first doctoral program in social work was opened in 2006 at Al-Farabi Kazakh National University in collaboration with the D. Brown School of Social Work in Missouri, USA. Currently, there are no faculties and departments of social work, instead it is often adjacent to neighbouring disciplines such as sociology or pedagogy. This makes it difficult to develop separate, specialized technologies for maintenance of a separate curriculum (e.g. for working with people who live with HIV/AIDS). The third factor is that one of the most serious barriers is the low salaries of social work professionals working in governmental institutions for social support. This factor impedes the awareness of families, children, and clients about the possibilities of social support from the state. What is often reflected in participant accounts from studies undertaken in the country (e.g. InBeAIDS, 2020), is that they do not know where their social protection centers are located in the city or they don’t know what kind of rights they have, or what kind of help is available. This often coincides with self-stigmatization in that many people living with infectious ‘social diseases’ are shy of their status with HIV and do not seek professional intervention because they are afraid of exclusion and open discrimination (see also
Sultan & Mažeikienė, 2019). This often translates into low levels of trust in state institutions and specialists.
Summarizing from the InBeAIDS and CADAP studies (see also Michels et al., 2017), our collaborative, international work suggests following services to people from key populations that social workers could provide:
- Implementation of case management. In Kyrgyzstan, specific steps and actions of a social worker in the process of social support are regulated and specified. The activities of social workers are carried out on the basis of case management. Depending on the needs of key groups and their specific needs, a social support program is developed. The end result of social support is to improve the quality of life of clients. Social support involves compliance with such principles of work such a s an individual approach, comprehensiveness, confidentiality, voluntariness, tolerance, and interdisciplinarity.
- An interdisciplinary approach and teamwork can help to increase the efficiency and quality of the services provided. This approach defines emergency intervention, diagnostics and discussion of the case, the coordination of the actions of experts, responsibility and activity aimed at solving problems and the effectiveness of work algorithms. Much attention is paid to establishing contact between specialists and clients.
- According to social and outreach workers, the technology of social work with key population groups should be focused on person-centered and strength-based approach and risk reduction.
- The fight against stigma. Social workers can play an important role in changing public opinion, establishing tolerance for HIV-positive people in society, as well as mobilizing and encouraging people involved. This can be carried out with the help of high-quality information campaigns targeted at different target groups, involving the media, demonstrating good practices in integrating people living with HIV, as well as individual and group social work to develop public potential
- The protection of the rights and interests of citizens is an important area, which can be manifested in different ways: developing policies, lobbying, raising public awareness, public education, conducting campaigns, creating alliances, etc. Social workers provide advisory assistance to clients in case of loss of documents, restoration, and other paperwork. They play an important role in establishing connections and carrying an intermediary function between the client and the relevant authorities.
- The provision of social services and humanitarian assistance (providing material assistance, providing services of crisis centers, shelters for victims of violence), assistance in finding employment (vocational training, retraining and advanced training of unemployed citizens, providing information about employment opportunities, employment).
- InBeAIDS (2020). Prevention of infectious diseases and treatment of HIV/AIDS and hepatitis among injecting drug users in Central Asia and the contribution of social work to the services for drug using people (InBeAIDS). Report: Frankfurt am Main and Bishkek.
- Michels, I. I., Keizer, B., Trautmann, F., Stöver, H., & Robelló, E. (2017). Improvement of Treatment of Drug use Disorders in Central Asia the contribution of the EU Central Asia Drug Action Programme (CADAP). Journal of Addiction Medicine and Therapy, 5(1), 1–14. www.who.int/whr/2008/en/index.html
- Stöver, H., Deimel, D., & Hösselbarth, S. (2017). Social work and support of people who use drugs in Germany. In Getting to Zero: Global Social Work Responds to HIV (pp. 101–126)
- Sultan, A., & Mažeikienė, N. (2019). Living with HIV in post-Soviet states: Rejecting individual stigma through social activism. International Social Work. https://doi.org/10.1177/0020872819858746
- United Nations Department of Economic and Social Affairs. (2020). Achieving SDGs in the wake of COVID-19: Scenarios for policymakers. In Sustainable Development Outlook. https://doi.org/10.18356/7a3ee84a-en
- Xu, H., Zeng, Y., & Anderson, A. F. (2005). Chinese NGOs in action against HIV/AIDS. Cell Research, 15(11–12), 914–918. https://doi.org/10.1038/sj.cr.7290368
- Yuan, Y., He, X., & Duan, W. (2020). A reflection on the current China social work education in the combat with COVID-19. Social Work Education, 00(00), 1–8. https://doi.org/10.1080/02615479.2020.1821637