L'éducation à l'antibiothérapie à domicile : alternative pragmatique et éthique de la gestion thérapeutique des IST chez les jeunes de la rue à Kinshasa
Leyka, Mukandu Basua Babintu
Baum, Prof Mylène
Santé (Montrouge, France) 2009 Oct-Dec; 19(4): 217-25
All healthcare providers decide in someone else's place, for someone else. In doing so, they take their place in a long long tradition, that of medical paternalism. Patients are treated as children, incapable of making decisions about themselves. How then are we supposed to deal with patients like the street children of the Democratic Republic of the Congo, who are not part of our health-care system, who refuse care and prescriptions? Their refusal of caregivers forces us to seek strategies to dispel the conflicts, adapt outselves to the situation (self-medication, drug sales outside of dispensaries, etc.), but especially to rethink the relation between caregivers and patients. This does not mean abandoning the authoritarian patriarchal model for total relativism; the use of drugs such as antibiotics is and must remain surrounded by all the precautions necessary to avoid the further development of resistance; it does mean training and informing. The task facing us is that of health education and promotion, a long and continuous process, centered on patients and integrated with their care, aimed at making them capable of managing their disease. This procedure is part of a pragmatic approach: beyond the asymmetry involved in any relationship of power, it is essential to establish informed confidence, to look for adhesion and not constraint. Only this pragmatism can incite young people with sexually transmitted diseases (STDs) to use modern medicine and comply with the dosage instructions. Effective treatment of STDs is, according to WHO, one of the most powerful weapons in the battle against AIDS transmission.
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Prise en charge des enfants de rue en République Démocratique du Congo: proposition d'une alternative éthique Leyka, Mukandu Basua Babintu; Baum, Mylène Botbol (2009-03)The goal of this study carried out on street children and care providers was to determine the opinions of the staff of these institutions -- foster homes -- and their degree of satisfaction. Out of twenty homes of the zone ...