Kinana Rahal

Kinana Rahal, from Lebanon, has worked in roles across the profession and sees many parallels between the HIV and COVID-19 responses. This is her story...

As a teenager, I was greatly influenced by inequality and poverty. Seeing marginalized groups, especially handicapped people, children with disabilities and the elderly, was heartbreaking, so I chose a speciality that serves the well-being of these groups. Nursing was an entry point to this world and not the end.

After graduation, I nursed in the intensive care unit of a university hospital in Beirut. I searched for a speciality that would take me away from death and closed areas – to the community, my world. I decided to obtain my midwifery diploma, followed by a Master of Public Health.

I worked as a nurse and midwife at the hospital, established my own private delivery clinic, consulted as a midwife at a dispensary, and taught nurses and midwives at universities. With experience in both academia and reproductive health, I was recruited by the UN in 2008 as an Associate HIV/AIDS Training Officer and also as an HIV counsellor.

Fear and discrimination against people living with HIV were high in the community and among medical staff. Myths and misconceptions were dominant 25 years ago and some practices did not follow standards. For example, the file of a patient living with HIV was labelled so staff were aware of this, and the patient was put in a single room. If a staff member had a needle prick, we took the patient’s blood sample to test for HIV and hepatitis without their consent. I personally screened pregnant women for HIV without their consent. Much has improved due to NGOs’ efforts and mass media work, but more is needed to change the attitude of the medical and paramedical sector towards the HIV response. 

As an HIV trainer and counsellor, I understood that HIV was like any other chronic disease: no longer a death sentence, but still battling with stigma and discrimination. I understood HIV from its diverse dimensions: medical, psychological, social and mental. The first time I met a person living with HIV was a lesson in empathy, compassion and acceptance, and I felt that I passed the exam with distinction.

I am very proud of being a nurse. This profession has given me a significant tool for continuous reflection on life, health and death. Gratitude is my best lesson learned. I want to tell you about a mother who lost her baby two days after birth and after many attempts to get pregnant. The paediatrician called me to assist in delivering the news to the mother and assist her in her grieving – I am known for my skill in compassionately approaching such situations. Working with sick children has been my biggest challenge.

There are many similarities between the HIV and COVID-19 responses. Both are viruses and require a vaccine; ignorance leads to fear, anxiety and panic in communities and leadership; and both are linked to stigma and discrimination. For both, we need to enhance the sense of individual and collective responsibility and concern. Preventive measures are well known for both, but attitude and behaviour change are missing.

We must learn from the HIV response to better manage the COVID-19 response.

The impact of the COVID-19 pandemic on the professional and personal levels is huge. We had to create new ways to work. For example, I shifted to online training and sometimes online counselling. Fear, confinement and uncertainty increased our anxiety. In Lebanon, the breakdown of the medical system due to the economic collapse that coincided with the outbreak of the pandemic complicated the situation and amplified stress.

To young nurses, I say that nursing is not just a profession; it is a vocation and a mission. We should do it with passion and devotion. Otherwise, we may not be able to handle the stress.