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CHECK Berlin #3

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ENGLISH Diversity

ENGLISH Diversity DIVERSITY AT ST. JOSEPH The Clinic for Infectious Diseases in the St. Joseph Hospital in Berlin-Tempelhof is one of the few inpatient facilities in Germany that specializes in the field of infection medicine. The station has now also been awarded the “Diversity Practice” seal of approval. This initiative of the Deutsche Aids-Hilfe (DAH, German AIDS Foundation) is awarded to medical practices and care facilities that welcome people with HIV and diverse sexual, linguistic and cultural backgrounds and ensure non-discriminatory healthcare. We spoke to chief physician Hartmut Stocker, M.D., M.B.A. What requirements do you have to meet in order to become a “Diversity Practice”? We have been working closely with the DAH since the beginning of the year joining their initiative „Let‘s Talk About Sex“. “Diversity Practice” wasn’t really intended for us, because it is a seal of approval especially for practices. But Inge Banczyk, the nursing manager of the day clinic, worked very hard so that we as a hospital were allowed to participate. We are now the second hospital in Germany to receive this award. It‘s all about learning how to use your language and attitude in approaching people to signal to them: We don’t judge you, we are open to your concerns. It’s easy to be careless with your language and say things that automatically give the recipient an image of “he doesn‘t want me there”. It is therefore extremely important to raise awareness of such issues. How does this kind of sensitization work? Does an expert come in and explain? The whole thing was web-based and there were many lectures, but I also had to solve a few tasks and do role-plays. The doctor becomes a nurse and vice versa. Or the doctor takes on the role of the patient, where different situations are played out. What kind of situations? For example, one man reports to the doctor that he has been in a monogamous relationship for the past two years. His partner is HIV-positive on therapy below the detection limit. The man says they have had unprotected sex for two years, but now he wants to be prescribed PrEP. As Dr. Hartmut Stocker, chief physician at the Clinic for Infectious Diseases in the St. Joseph Hospital in Berlin-Tempelhof © Manuel Tennert a doctor you ask yourself why? Doesn’t he want to be monogamous anymore? Does he no longer trust his partner to take his pills regularly? But of course the question is: do you even ask the patient such a question? The patient certainly has a reason, but is that my business? Should I address it? How can I address it without it being stupid and the patient feeling uncomfortable and leaving? Playing through something like this is great, of course, because you too have to confront your own uptightness and deal with it? This particular scenario is naturally less relevant to us than for general practitioners, because such questions do not necessarily arise here in the clinic. What are the topics that come up here in the hospital? We treat patients with infectious diseases, some of whom are seriously ill. The topics just mentioned do not necessarily appear at first. But these patients get healthier again at some point during their hospital stay. Of course we will advise on these issues then. Therefore we also see the great benefits of the workshops. It helped our entire team and was fun too, especially the role playing games were great. Does it ever happen that the colleagues on the ward may have been sensitized, but there may be difficulties, discrimination or stigmatization during admission at the emergency room? The duty to reduce discrimination and stigma runs through all areas of society. And the process is not one that has come to an end somewhere and at some point. As soon as you take your foot off the accelerator, the car slows down or moves backwards again. We definitely see it as our task to pass on our new findings to the other departments here in the hospital. Many people do not necessarily realize that this kind of awareness raising is important and justified. It‘s just not true that everything is already going well and that there are no difficulties. Even in health care facilities, people are being discriminated against based on their sexual identity or orientation, or simply because of their origin. Even if it happens without malicious intent, because there is insufficient awareness of it. Missteps happen everywhere, we have to make sure that they don‘t happen again. What diseases are treated here at St. Joseph Hospital? We treat all kinds of infectious diseases. Infections have always been around and are certainly the number one reason why people die. Bacteria and fungi live on and in us and they belong to us like the liver and the heart belong to us. The human part of humans makes up even a smaller part of the body than the part that the bacteria make up. There is a perfect interaction between them and us. So for most of the time there is love. You could say that we are a kind of shared apartment. At some point, for reasons that are not entirely clear, one of the roommates decides to claim the place for themself and get rid of their human habitat. Sometimes this is an end-of-life situation and it is inevitable. Most of the time, however, we infectiologists manage to fend off this attack from within and get the infection under control. The victory over infectious diseases as was proclaimed in the 1960s will never happen. And what we are currently experiencing also shows that new infectious diseases keep popping up and troubling us. We treat all possible infectious diseases here, dividing into HIV-associated and non-HIV-associated infectious diseases. They can be heart valve inflammations, brain inflammations, inflammations or infections of the bones. It’s always about giving the patient as few antibiotics as possible in order to impair the bacterial cosmos that lives on and in us as little as possible. Infectiology means, above all, the management of the entire disease process. An infection is always a systemic disease. If bacteria enter the bloodstream, I need to know which are they may target so I can treat, or at best, prevent an infection. So we are the ones who can read how an infection works. We then bring in other specialists who support us with the treatment. Many infections cannot be removed by antibiotics alone, but have to be operated on. When it comes to HIV-patients we are sad to find that far too many still get AIDS and become ill as a result. Despite antiretroviral therapy? We assume that around 2000 people in Berlin are HIV-positive without 36 CHECK | AUSGABE 3 CHECK | AUSGABE 3 37

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