HIV and Child Minders. My nanny didn’t disclose her positive HIV status. Should I be worried?
I have 3 friends that have come forward to ask advice about their respective nannies.
Friend 1: She gave birth to a baby boy. After spending a few months with her baby at home, it was time for her to go back to work. For that reason, she needed to start looking for someone that would look after the baby while she’s at work. She received a few recommendations. While interviewing one candidate, the lady started sharing some information. 1) She was HIV positive 2) She was undergoing traditional training called “Ukuthwasa”.
Realizing what it took for the candidate to share this information, my friend was very appreciative. But she was not sure what she was supposed to do next. Could she ask for more information? Is the candidate taking treatment? Is she adhering to treatment? To what extent can she be involved in her life?
Friend 2: Her nanny had been with her for some time. She noticed that her nanny had a bad cough that was not ending. She encouraged her to go to the clinic. When she came back, she blurted out that she had Aids. The nurse at the clinic had told her she had Aids. They immediately started her on treatment. But as my friend was listening to her nanny, she had a sense that she hadn’t fully comprehend the news. Judging by how she couldn’t differentiate between HIV and AIDS, I suspect she was still in shock.
My friend is asking what she should do next?
Friend 3: Her nanny left abruptly. While cleaning her room she found empty ARV containers. Should she be worried? Why did she leave abruptly? Does it have to do with her status? She had asked if there were any medical conditions, she should be aware of and she hadn’t mentioned anything. What should she do next?
I would like to ask the following questions:
- Is the potential child minder obligated to disclose their positive HIV status?
- Is the parent within her right to ask about the medical condition of potential child minder? Whether or not there are underlining medical conditions the family should be aware of?
- In a case of a positive HIV status, should the parent be concerned about the safety of her child? Are they justified?
Before I continue, I would like to remind everyone the intention of my work. A few months ago, a follower commented on one of our pictures of Facebook. “I’m so happy you found love. I’m so happy that you found Skhu, that he loved you so much he was willing to get infected with HIV. I so wish my siblings can also see this”.
Everyone was shocked. I wasn’t. Maybe its because I’ve been exposed to the stigma and ignorance that comes with HIV. Not from anyone else, but my own family. While others attacked this young lady for saying such a thing, I saw an opportunity to educate. Similarly to what I’m about to share today. I introduced this topic on social media, Facebook and Instagram, and it received mixed reviews. While others shared their own experiences, which I appreciated, some had an issue with the discussion itself.
Let us remember this, in our efforts to eliminate stigma that has been caused by HIV, it doesn’t mean we cannot talk about it. I always say, for as long as we still have new infections, we will continue bringing more awareness and education.
Firstly, I cannot dismiss how these parents are feeling. It wouldn’t be fair in my efforts to educate. I need to acknowledge their fears and concerns. It equips me better in my interventions. So, to dismiss a parent and tell them, “Arg, you’re overreacting” or “I can’t believe you even asked that” is not fair. The fact that they took the time to find counsel and seek guidance is enough to tell you they want to know more. They want to learn more. And I knew this was going to be an important lesson for everyone when one follower said, “I am here to learn and unlearn”. That’s the whole point. To learn and unlearn.
Let me be transparent. This is what these parents are thinking. How long has the caregiver known about their status. Are they conscious about it? Being conscious means if there’s an accident at home, they’re going to take all precautious to protect themselves and the child. Are they’re taking medication? If they’re not, what happens when their immune systems absorb opportunistic diseases like TB?
For the longest time in our house, it has always been Skhu and I. We didn’t account to anyone. We didn’t have any other responsibility but ourselves. During weekends, we wake up around 11am, no worries whatsoever. Two weeks ago, my 3-year niece joined us. She started school in Johannesburg. I cannot begin to explain how she changed our entire life. I have been particularly amazed by how a woman develops maternal instinct as soon as there’s a child. You don’t necessarily need to give birth to your own child, it’s just there. She sleeps in the own room but as soon as she wakes up at 2am, she calls after me. I need to stay in bed with her until she sleeps. Or she crawls into our tiny bed. I’m usually left awake for the rest of the night because I want to make sure she doesn’t fall off the bed. I haven’t had proper sleep in 2 weeks. I’m constantly worried about her safety. Another child might push her on the playground she breaks both her legs. I hold her so tight when we’re crossing the road, I’m afraid she’ll run off and get hit by a car. I have a mini heart attack every time she runs down the stairs. As a caregiver, I understand the need to protect a child at all costs. It’s natural.
I’m going to approach this topic in 3 ways.
1) What does the law say?
The South African constitution is clear:
· No employer can require that a job applicant have an HIV test before they are employed.
· An employee cannot be fired, retrenched or refused a job simply because they are HIV positive.
There are no exceptions to what the law says. All people living with HIV/AIDS have the same rights as any other person.
Can you ask about a medical condition of someone during an interview?
Employers cannot ask employees about their health or possible disabilities. However, your employer can ask about your health in two cases:
- If they suspect you may have a condition that could risk your safety in the workplace or ability to perform your job. For example, if you have a double storey house. Some nannies are also asked to perform duties around the house. The potential candidate walks in limping. Because there may be safety issue with the candidate and their ability to be mobile around the house, this may affect some areas of their job.
- If you, as the potential candidate, is asking for medical leave or accommodation for your disability. In these cases, you have already disclosed there is some medical condition. Your employer can ask about your health and even ask for proof of the extent and type of condition you have. A few friends on social media shared how they found out about their nannies’ HIV status this way. The nanny voluntarily disclosed their status because they wanted their clinic visits to be accommodated.
Using someone medical condition to prevent them from working or terminating their contract is against the law. Or asking this information in attempt to “know more about the candidate”, it’s unconstitutional. No matter how we may feel about it, it is against the law.
2) What about the safety of my child?
Safety should form part of your household regardless of HIV. It should form part of the candidate’s orientation. What should happen when the candidate or child gets injured? There should be a standard procedure.
She has a cough you don’t like, encourage her to get it checked out. We couldn’t automatically think its TB. Or assume its related to HIV.
What if they intentionally infect my child?
There’s a level of risk you take the minute you welcome someone to your home. We’ve heard of nannie’s kidnapping children and taking them over the border. We’ve seen videos of nannies beating up a child. We’ve seen children drowning in the presence of their nannies. Maybe it’s much better at school? The same things have happened in school. Remember when there was a kidnapping in Gauteng and a teacher was involved?
“But Nozi, how often does this happen?”, you may ask. But what are chances of that child being intentionally infected?
“I’m not willing to take that risk”, you may say. It’s taking a chance every day with the teachers that haven’t disclosed to you. It’s taking a chance with every family member that haven’t disclosed. It’s taking a chance every time you allow your child to play with others. What if there’s one infected from birth? What if they accidentally cut each other, share blood etc
3) She disclosed, what do I do next?
In addition to the standard precautions, what happens next is going to be guided by her. She doesn’t need to reveal any additional information than what she has already chosen to disclose. The kind of support you ought to give her is the same kind of support you would wish your employer to give to you.
I truly hope this has helped.