Dubai: A 20-year-old Indian expatriate student who suffers from a severe phobia of syringes used in medical tests is struggling to renew her UAE visa. As a result, she is unable to travel back to the US to continue her education.

Denise Fernandes and her mother, Romona, have been frantically looking for ways to get Denise’s visa renewed for the past six months — since the time the visa had expired — but have not been successful as yet, they told Gulf News.

Romona, a single parent to Denise, described the last six months of her life as “a complete mess” as her trips back and forth to different health centres in Dubai, the residency department and Rashid Hospital have not brought her any closer to a solution.

She explained the origins of her daughter’s condition. Ten years ago, she was witness to her grandfather struggle for his life with an E-coli infection following a blood test. “The whole experience was traumatic for me,” said Denise. “I have since associated hospitals and needles with transmitting infections and [this fear] has worsened with time.”

Any attempt to get her to take a blood test sees Denise get into a state of severe anxiety, resulting in shortness of breath, chest pain and violent reactions. “I can’t control them,” she says. “It’s not something I want to do. I don’t want to hurt people but I feel like they are attacking me to infect me and it’s my only defence mechanism.”

But now, she has no choice but to undergo a blood test for her visa.

“It’s been such a long and tiresome journey,” says Romona. “I was looking for ways to get her exempted from the blood test just this one time.”

Romona says she did send her daughter to counselling sessions but had to discontinue as she could not afford them. “I never expected her case to be this severe.”

For the past few months, Romona has been hoping for an exemption and said she had been asked to get letters of approvals from Rashid Hospital and present them to the Residency Department. “After many visits to all concerned departments, I’m told that an exemption is not possible but as an alternative, a committee can be formed by doctors in Muhaisnah Health Centre and Rashid Hospital to sort out this issue.”

But six months on, she says the time has been “wasted with promises”.

Meanwhile, repeated visits to hospitals are only increasing Denise’s anxiety, Romona said. “We were told by the Head of Infectious Disease Department in Rashid Hospital that a finger test is possible, which Denise is fine with, but the kit doesn’t exist in the UAE any longer and they have been unable to order it. I have visited all health centres to be able to find it. Why would they give us hope for things that are not possible?”

On the issue of being sedated, Denise said, “It’s even more frightening that someone is doing something to me of which I would have no knowledge.

“I feel like I’m trapped,” she said. “I’m sure there are others who are also afraid of blood tests and have to go through this pressure. It’s not fair.”

Romona said she has sacrificed a lot to raise her child after her husband passed away and is now struggling to pay for her daughter’s education. “This is one of the reasons why Denise had to come back to Dubai [from the US, as she had to move from one university that was expensive to another that is less so] and so needed to get her visa again,” she said.

She can’t bear to see her child suffer any more. She fears losing her job and her daughter’s future and the fines due to the visa being delayed are piling up.

Official reaction

The Dubai Health Authority (DHA) said Denise and Romona Fernandes have been extended “ complete support”.

In a statement, DHA said: “We have presented the client with options, including non-needle method of sedation but she has refused this option. However, screening for infectious diseases is a federal procedure and we cannot make exemptions as we are simply following the due course of the federal law.”

DHA added that In certain cases, it forms a committee of experts to look into the best ways to assist the client but forming a committee in no ways means the patient will be exempted from the procedure. “This has been clearly explained to the client and her mother,” DHA said.

‘A type of anxiety disorder’

Dr Saliha Afridi, clinical psychologist and managing director at Lighthouse Arabia, described Denise’s case as a type of anxiety disorder called Specific Phobia from blood/injection/injury.

“Any disorder — phobias included — are on a spectrum of severity ranging from mild (minimal affects on life, work, and relationships) to severe. In Denise’s case, she has a severe case of Specific Phobia because it is significantly impacting her occupational and academic functioning.”

Causes

Dr Afridi said “some individuals are more biologically and genetically prone to have anxiety disorders following a stressor”. If an individual does not have the cognitive and psychological capacity to deal with some stressors, they may develop anxiety disorders. Environment can also create certain fears.

“In this case, the girl was 10 years old and may have lacked the cognitive, emotional, and psychological maturity to cope with the traumatic death of her grandfather. Witnessing the E-coli disease take course and visiting him at the hospital may not have been something that she was able to handle at such a young age. Continued avoidance of doctors reinforced her fear and phobia — which developed into a Specific Phobia Anxiety Disorder.”

Treatment

Parents must comfort children by explaining to them the process of visiting doctors or the necessity for immunisations, Dr Afridi said. “This will help the child cope and deal with the anxiety as they face it, which will help keep the anxiety under control and not develop into a full-fledged phobia.”

Denise needs psychotherapy and medication, Dr Afridi said. “Typically cognitive and behavioural approaches are used to treat phobias. We expose the patient to graded doses of the phobic situation [or object]. We may use emotive imagery or technology to make the patient imagine the anxiety provoking situation and help them learn ways to cope and decrease their anxiety.”