In 1985 I take on the job of Director of Social Work Department at Princess Alexandra Hospital Brisbane. At this time, it is considered the largest hospital in the southern hemisphere with 1200 beds. When I go there, no social work structures exist within all the departments, to name a few: spinal unit, psychiatric, geriatric, psycho-geriatric, general medicine, surgical and immunology. Even though administering such a large-scale social work force for the hospital I have clinical workloads in the head and neck outpatient’s department and immunology ward.
The immunology ward is where the patients with HIV and AIDS are admitted for treatment. The patients often first come through outpatients and emergency department with severe conditions and symptoms that indicate HIV may have progressed to stage 3. This stage shows the immune system is severely damaged and is vulnerable to opportunistic infections.
I walk through the emergency department and notice that the patients with AIDS, have their beds in the corridors and not in the main emergency treating area. I question, why are their beds here? It becomes obvious to me that with this infection, staff are apprehensive, so little is known about this disease and lots of hype and myth abound. Patients are marginalized and not treated with the same considerations. The condition is shrouded by misunderstanding and fear. Studies suggest HIV is present before 1980 in Australia. Misunderstandings about the virus and its transmission plague the early years of HIV.
In 1983, the scientific community identified the virus that causes AIDS. They first named the virus human T-cell lymphotropic virus type III, or lymphadenopathy-associated virus (HTLV-III/LAV). Later, researchers change the name to human immunodeficiency virus. They also identify the leading methods of HIV transmission and learn that a person can’t contract HIV from casual contact, food, water, or air. As a way of allowing patients to feel comfortable and accepted when they visit my office, I always offer them a cup of tea or coffee and let them know where the toilet is. Some of the ways of ostracising people with Aids, is to make them use separate cookery and cutlery and disinfect toilet seats after their use.
With Professor Michael Whitby, Professor Ian Fraser, both immunologists at Princess Alexandra Hospital, Peter North, social worker, and lecturer at University of Queensland, who also sets up with others, Queensland Aids Council; we give talks to students, nurses, doctors, and allied health professionals. We also do talks on T.V. and radio to educate the general public to lessen stigma and exclusion.
There is an incident, where I need to organise for a patient to make an urgent will, he is about to have brain surgery in a few hours and will not have the surgery until his will is made. Neil Woodgate a solicitor in private practice and assisting the Queensland Aids Council makes a dash to the hospital to assist. The patient’s will is made, and surgery is successful. Neil continues to do pro bono work for all patients with AIDS and HIV who need wills and other legal issues sorted out and when they have no funds to cover these costs.
The fear about the AIDS epidemic for patients at first is - what is it, what can it do to them, and fear of the unknown. Patients with AIDS in the 1980s, feel the stigma. Fear of AIDS is all around them and they are treated as lepers used to be. I meet the most amazing people who are privilege to know, doing this work.
The public and even health care workers want answers about the disease and how to avoid catching AIDS. The realm of the unknown causes people and communities to panic. In these days there are few answers, so people start to speculate and as a result fear and rumours abound. Walls are put up between people and contribute to the problem rather than supporting a solution. The stigmatising happens on multiple levels, having a widely known serious disease and being in a disenfranchised group, such as being gay, a drug addict and/or someone in poverty. In reality, AIDS affects everyone, in every walk of life; it does not discriminate, as we have now experienced with Covid.
In the immunology ward itself we need to gown and mask up, use all the precautions for infectious disease protocol of washing our hands before and after seeing patients. There are no protocols for admission nor discharge of patients. I set and write up the protocols for these patients, so that they are humanly treated and not ostracised. So that they have the services for their full care both within the hospital and also when they go home. This was another ‘Labour of Love’.