You work at a community health centre and Jihamad has approached your service. He contracted hep C over fifteen years ago in Kenya before he immigrated to Australia. He has been referred to a liver clinic and placed on a waiting list for treatment services. He was referred four months ago and still hasn’t received any treatment and has been afraid to contact anyone. He does not understand what cirrhosis means and explains that the doctor referred to stages, index scores and grades of inflammation and that the doctor was rude to him and he was scared to ask any questions. He is considering cancelling the treatment as he is frightened of what is might entail, has problems with accessing the clinic from the area where he lives and is afraid that his family will see the letter arriving from the hospital. Your service does not have resources relating to treatment of hepatitis C. How can you assist him?
Issues for discussion
- The scenario reflects the wider problem often relating to poor post-test counselling and the lack of information received by consumers which limits their options in relation to determining how to seek health care.
- Barriers (such as geographical, financial, waiting lists etc) towards access to liver clinics may affect consumers ability to access treatment services.
- Due to the limited number of liver clinics and limited access in particular areas, consumers often report problems in accessing treatment.
- The various physical side effects from treatment also impede access and adherence to treatment.
Client issues
- Support services, immediately and over a longer period should be available. Local support groups may be accessed to provide more information and direct experience relating to treatment as well as providing emotional support.
- Due to possible barriers/miscommunication and/or other issues Jihamad has not received adequate information relating to his health and therefore cannot make an informed decision about his options. Resources, support and information could be supplied through referring him to the local Hepatitis C Council and other culturally and linguistically diverse (CALD) organisations.
- Cultural issues may also affect his likelihood to access treatment or complain about the lack of information.
- Referral to a hep C friendly doctor may help clarify some issues and provide a clearer explanation of treatment services and possible outcomes.
Organisational issues
- Organise to order resources relating to hepatitis C treatment options and treatment services and other resources in different languages.
- Review service links to hep C treatment services and referral organisations.