adminRoselyne Sachiti Features Editor
Labour migration, a historical phenomenon across the Southern African region, has always come with unique dynamics, challenges and opportunities across social, economic and political spectrums.The emergence of HIV has presented a new and potent challenge as migrant workers have fuelled the spread of the virus, which causes AIDS.
HIV-positive people all too often succumb to tuberculosis.
Generally, women that remain home in Zimbabwe, Mozambique, Malawi and Zambia, among others, have not only suffered infection but also socio-economic problems occasioned by the HIV/Aids pandemic.
In Mozambique, the One UN Project on HIV-TB has been helping women cope with the challenges relating to migration and HIV.
Based in 3 de Fevereiro Village in Xai Xai, Gaza Province, the support group is funded by the Employment Bureau of Africa in conjunction with the International Organisation for Migration (IOM) and UN.
Since last year when the group was formed, members meet three times a week to discuss issues ranging from challenges they face, gender-based violence to positive living.
They also access loans to start market gardening projects.
Vegetables for their family consumption and for sell to locals are in plenty whenever they harvest.
Fatima Bila, whose husband Manuel Nhone died of HIV-related illness seven months ago, is one of the unfortunate women of Xai Xai.
“Nhone would return home once or twice a year but would send money regularly. We had a decent life and home compared to other women whose husbands never left,” explains Fatima.
The pain of losing her husband, the breadwinner, still pierces her heart like a sharp arrow, yet she has remained strong.
The problem is not peculiar to Mozambique.
Most Zimbabwean men, as well, are going to work in South Africa and Botswana, only returning home to die, that is if they don’t die there.
For example, most teen women from Bulilima district who are married to malayitshas and injivas (Ndebele terms for SA-based Zimbabwean men who are hired to deliver goods from SA to Zimbabwe) test HIV-positive when they visit prenatal clinics.
There is a 15 percent HIV prevalence rate in that district and migration is behind the increase.
“The prevalence is alarming because of the migration patterns. Injivas come home and sweet-talk these young girls who cannot negotiate for safe sex,” says Bulilima District Medical Officer Dr Norbert Singine.
An estimated 3 million Zimbabweans work in South Africa with the bulk coming from Matabeleland provinces and parts of Masvingo because of their proximity to SA.
Zimbabwe’s 2012 census report says Bulawayo city has the lowest number of men at 303 346, Mat South (326 967) and Mat North (360 776).
Other provinces like Harare have 1 025 596 men, Mash West 747 475, Midlands 776 012, Masvingo 690 749, Manicaland 830 697, Mash East 651 781 and Mash Central 567 140.
In Mozambique most men from the Xai Xai area work in South Africa’s mines.
Just like Zimbabweans in SA, Mozambican men usually leave their families back home and send money, furniture, and sometimes groceries at the end of the month. Their wives care for their minor children.
And also just like their Zimbabwean counterparts, they usually come home once or twice a year during the Easter and Christmas holidays.
Then some are “swallowed” by the earth they work under and go up to 10 years without returning home, only making contact when critically ill.
Mozambique’s Gaza Province is feeling the effects of mass migration.
It has the highest HIV prevalence rate and the former South African mine workers contribute the biggest chunk.
Their wives, too, have not been spared.
Most who are uneducated and marry as young as 15 cannot negotiate for safe sex or initiate testing when their husbands briefly return home.
Upon return, the husbands usually confess to risky behaviour that includes unprotected sex with multiple partners yet their wives still have no power to negotiate for condom use.
This is worrying in a developing nation where more than half of its women live below the poverty datum line.
Mozambique is also ranked 125 out of 146 countries on the gender inequality index.
Seventy percent of that country’s population lives in rural areas.
Mozambique, too, has the seventh highest rate of child marriages in the world with almost one out of every two girls married before she reaches her 18th birthday, and one out of 10 girls is married before 15.
According to UNAIDS Mozambique director Jose Zelaya Bonilla, that country’s HIV prevalence rate (15-49 years) is 11.5 percent. An estimated 726 589 adults were eligible for treatment by 2013 while there was a 63 percent coverage of ART among eligible adults.
A total of 114013 children were eligible for ART in 2013 with ART coverage at 36 percent. There are 317 new HIV infections per day in Mozambique and 226 Aids related deaths in a country that offers free HIV treatment and maternal health services.
Government figures say 454 000 people are on ART.
Mozambique’s national director for public health Dr Francisco Mbofana said they had a bigger problem of HIV in the south of the country.
“The second Aids indicator survey will tell where we stand and allow comparisons with 2009 survey results,” he said.
He added that Mozambique was one of the 21 countries with high TB burden.
Dr Mbofana said they were doing well in terms of treatment but there were many other challenges.
The miners easily fit in these statistics and the living ones like Pedro Mavunga freely tell their stories.
He started working at Goldfield Mine in Carltonville in 1992, retiring in 2012 because of poor health.
“I earned R8000 per month and our life was good. My wife Aventina Tivane (58) would sometimes visit me in SA and I would also make regular trips to Mozambique. All was well until I became ill and was diagnosed with TB. I was treated and we got treatment in both SA and here,” he revealed.
In late 2012, he was tested for HIV and his results came back positive.
“I do not know how I got it since I used condoms. But I think I got it through blood contact under the mine. We would help other injured miners if they were accidentally cut underground. I believe I was in contact with someone with HIV.
“My wife and I were also told to use condoms when we found out we were both HIV positive and are part of this support group. None of our children were born HIV positive,” he added.
He says migration to South Africa is a big issue in their area as many men who go there come back HIV positive.
“My idea when I went to SA was to just work for my family and not bring back AIDS,” he said.
In their group, not everyone travels to collect their medication from the nearest health centre, a 30-minute drive from their village.
Instead, members contribute transport money, about $1 for a return journey and one person collects medication for everyone.
Health officials at the clinic are happy with the arrangement as this has helped with adherence.
Then there are women like Ana Antonio Bata (43) whose ailing husband was delivered from South Africa to her doorstep in November last year.
He had been providing for them since he started working at the mine and the furniture in their home tells of his hard work.
She, too, like Fatima, is still in black and her mourning period will end after a year.
Their economic situation after her husband’s death compelled her to send her elder son to work in South Africa so that he fends for the family. They need the money.
If anything, her other 12-year-old son is not in school because of non-payment of school fees. Only the eight-year old daughter is in school.
“In our culture, if a son is given certain responsibilities when his father dies, it is taboo to have sex if not married. I pray that he sticks to that and not come home ill like his father,” she said.
IOM Mozambique, TB focal person Gael Claquin, said migration to South Africa was a major complex challenge in Mozambique.
“It has social and economic roots beside the health aspects, which are also numerous. We try to address it globally on both sides of the border and take different elements into account. That is why we are pushing strongly for the social aspect.
“If people are not aware of their rights, if a woman cannot stay with her husband when he migrates then there are serious consequences and information flow has to be improved.”
He adds: “Mozambique, being generally far from mining sites, most men come home twice a year, at Easter and Christmas time.
“We used to have up to 50 000 migrant mine workers coming back during this period. Now about 30 000 come back. The high numbers were a result of most who worked without proper regularization. Now most mines want registered workers. We do not have official figures but an estimated 100 000 Mozambicans in SA mines mostly come from the south.
“Women also migrate and face sexual violence which leads to HIV transmission,” he said.
He said negotiating for condom use was hard for many women in the area.
“When husbands return from SA, it is still difficult for women to negotiate safe sex because of cultural values, norms and mentality. There are husbands who will say a woman should not discuss safe sex in his absence,” he explained.
He said it was not clear how many people stop taking their TB medication because of migration but suspected a huge number defaults since they lack family support when in foreign land.
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