Online Reporter
Robin Muchetu, Health and Gender Editor
THE dusty streets of Dulivhadzimu in the border town of Beitbridge tell a story of desperation and hope together.
Desperation — as an over 2 000 strong force of women rely on sex work for a living, often crossing the border into South Africa to eke out a living from the same trade. Hope in the future as they are accessing health services for free from local organisations as they are affected by the disease many times.
About 420km away in the border town of Plumtree, nearby are Bulilima and Mangwe districts, where cross border transport operators commonly known as omalayitsha are “wreaking havoc” to say the least as their constant visits bringing in food and goods to villages also leaves young girls vulnerable to the disease.
Beitbridge and Plumtree towns both in Matabeleland South Province, are like Siamese twins, suffering the same fate, both located at ports of entry and also boasting of the highest levels of HIV in Zimbabwe.
They are also affected by teenage pregnancies, Gender-Based Violence (GBV), intergenerational sex and multiple concurrent partnerships and many other unfortunate circumstances.
According to the latest HIV estimates, the province has the highest HIV prevalence (total number of people with HIV) of 15 percent which compared with other provinces and the national rate, is the highest in the country.
The incidence rate, which comprises new infections at 0,2 percent while the number of people enrolled on Antiretroviral Therapy (ART) across the province is 98,4 percent.
A visit to Dulivhadzimu, in Beitbridge painted a picture of despair as both young and old women revelled that they are into sex work due to poverty.
Mr Edward Mlaudzi the Beitbridge District Aids Co-ordinator from the National Aids Council said the district is affected by an influx of sex workers from across the country.
“We have about 2 000 sex workers in the district, you find they come from Murewa, Mutare, Harare and many more selling their services. This is why we have organisations that are purely looking at issues to do with key and vulnerable populations like these.
NAC, the Ministry of Health and Child Care, North Star Alliance and other organisations are offering services in the district to this population,” he said.
He, however, said offering health services to sex workers has been met with various challenges as communities question why they must be assisted owing to the nature of their job.
“Some might say, why are we wasting time and resources offering services to key and vulnerable populations like these. If you ask them, they will tell you that their clients are people who work, who are in their homes (are married) and are like any other person. So, as NAC said, if we leave them out and say we do not want to offer any services to them, we find a married person will come and have unprotected sex here,” he said.
Added Mr Mlaudzi;” But because of the health education services that we are offering you find out that we are empowering the sex workers to ensure that these men who come and seek services of sex workers will have protected sex and in the end, we reduce new HIV infections.”
He said the positivity rate of sex workers is about five times higher than the general population leading to the need for HIV and general services for such key and vulnerable populations essential if the country is to reduce new HIV infections and end Aids by 2030.
“We are not working as NAC alone but as a team taking a multi sectoral approach to ensure that we offer the services to them,” he added.
A Wellness Centre located in Dulivhadzimu is the designated site where sex workers access health services very close to where they work.
HIV testing, treatment of Sexually Transmitted Infections, condom distribution, Antiretroviral Therapy, Pre-Exposure Prophylaxis and general health services and information are offered for free at the centre.
Ms Nyarai Shumba, the representative from North Star Alliance formed in 2009 in collaboration with the Ministry of Health and Child Care that is offering the health services at the Wellness Centre said they also target truck drivers who use the border town to various destinations.
“We also target the community that interacts with the sex workers because our services are for free. We also hold social change behaviour communication sessions, health education by peer educators and night outreaches. We conduct these with the Victim Friendly Units of the police where we go and observe what they will be doing in the hotspots,” she said.
While sex work is dominant in Beitbridge, Plumtree with its’ two districts, Bulilima and Mangwe is affected by a different problem — omalayitsha that target Adolescent Girls and Young Women (AGYW).
“They come especially during prominent holidays like Christmas and Easter Holidays and bayasirobha ngezimnandi (they lure us with nice things) and leave us pregnant, with HIV and STI’s,” said one young girl in Bulilima probably affected by the presence of omalayitsha.
Many like her suffer the same predicament and bear the brunt of being young, infected by HIV and usually without an education. The transporters often vanish back to South Africa where they have wives and leave the girls to suffer alone.
Mr John Moyo DAC for Mangwe District said the two districts’ characteristics are similar.
“Our districts have more than one family member that is based outside the country which creates spousal separation and a dependency from remittances. The situation in South Africa is becoming tougher by the day and remittances are drying up and that creates some vulnerabilities to HIV, especially adolescent girls and young women,” he said.
Mr Moyo said Mangwe District is peculiar in that it has the second highest HIV prevalence in the country at 16,8 percent while Bulilima has the highest in Zimbabwe with 18 percent.
Major concerns for Bulilima are the new HIV infections. Mangwe, on the other hand, has the highest incidence rate in the country standing at 0,27 percent while the national rate stands at 0,01 percent.
“So, you can appreciate the burden we have of HIV in our district. This is of major concern. We have two programmes to try and curb HIV incidence among the AGYW which is the Sista2Sista and Community Art Refill Groups (CARGS) which is aimed at promoting the last ‘95’ in the 95-95-95 targets which says people taking ART must be virally suppressed,” said Mr Moyo.
He said research has proved that when people take their ARVs correctly, their viral load reduces and increases the chance of not spreading the virus to the next person in the event of unprotected sex.
He added that sex workers are also a concern in border towns and are also being targeted in terms of services to prevent the spread of the virus. He said prolonged spousal separation, poverty, low risk perception, multiple concurrent partners and intergenerational sex are also fueling new HIV infections.
Just like Beitbridge, Plumtree experiences volumes of human traffic from people crossing the borders and also trade along the borders makes the rate of infection higher owing to the populations of people.
Child-headed families are a common sight in the border towns as parents move in search for better opportunities leaving children alone or with elderly grandparents as caregivers.
“There is limited control where children are left alone and HIV does not spare these children in many cases as they live alone and tend to do what they want,” he lamented.
Matabeleland South, like any other province, holds sports tournaments occasionally for recreation, but they have become a breeding ground for new HIV infections and young people take advantage and indulge in sexual activities after tournaments are over. Unwanted pregnancies, STI’s and HIV are all acquired during the sports; however, these cannot be banned vowing to irresponsible behaviours of some young people.
The NAC provincial leadership is calling for a province specific approach to dealing with HIV in the rainbow province as HIV scenarios are largely unique to themselves, while other interventions may be similar across the country.
@NyembeziMu
