MASHAVA — IN the enclave of Temeraire Mine, health issues has become a dominant subject, with sex workers spearheading the campaign against HIV and tuberculosis (TB) by distributing information to men before they have sex with them.
BY STEPHEN TSOROTI
“It is a tough call, but we believe it is the way to go, if we want to eliminate diseases like HIV-AIDS and (TB). As sex workers, we cannot just sit there and say nothing when things are not right on the ground,” says Tendai Sibanda, a Sex Worker Advocacy Group (SWAG) champion team leader.
“It is difficult for outsiders to imagine how we manage to persuade men to listen to this stuff before we have sex, but it is all about good public relations, using what is within our reach.”
Sibanda, who leads the Temeraire Mine SWAG cluster which has a membership of 50, says the group that was formed as a peer team to champion the passing on of important health information on sexual rights in the mining town.
The SWAG champions have mobilised other sex workers, making sure they reach out to all the mines in Mashava, as well as the neighbouring farming areas.
“SWs value the approach as another method that can be used in negotiating for safe sex, while allowing partners to gain confidence to raise other important health issues with their companions,” says Sibanda, a former employee at the asbestos mine.
“A sex worker in Mashava faces stigma and discrimination, as her work is considered unacceptable by the community. She is viewed as a disgrace to society and these attitudes are also shared by service providers. These views go beyond the accessing of sexual and reproductive health (SRH) services and rights. This acts as a barrier to their accessing of treatment as well.”
Buoyed by the on-going Targeted Screening For TB programme (TaS4TB) rolled out by Ministry of Health and Child Care (MoHCC) and partner, Union AgainstTuberculosis and Lung Disease (The Union), Sibanda and company say the TaS4TB programme has provided them with knowledge that has enabled them to easily tackle the thorny issues of sexuality, especially HIV/AIDS and TB.
Under the TaS4TB the MoHCC and partners have been providing services that include TB screening using X-rays, medical check-ups, HIV testing and diabetes screening to high risk groups, as well as informative workshops and meetings.
“We are better equipped now,” says Muchaneta Tinos, who leads another group from Gaths Mine.
She says contrary to what most people think, sex workers are open and frank, a thing that married women and society in general find difficult to do especially on sex matters.
Tinos believes dialogue in such matters helps to deal with issues that give birth to HIV-Aids and TB.
The Union Zimbabwe country director, Christopher Zishiri, said apart from service provision, the targeted screening campaign involves community discussion fora done to sensitise leaders about TB, educate them and also get their buy-in in terms of accepting the programme.
These have been conducted in 18 districts across the country, targeting traditional and community leaders including chiefs, headmen, councillors and religious leaders.
“This is aimed at mobilising the communities to seek treatment,” says Zishiri. “Leaders also commit to support the targeted screening campaigns, by encouraging members of their communities to take advantage of the services being provided. The involvement of high risk groups is important to the success of eliminating TB.”
The ministry of Health and Child Care’s National TB Control Programme with support from USAID’s Challenge TB and Global Fund have set its sights at reaching troubled hotspots across the country.
Sex workers are regarded as people who are underserving and have poor access to health-care because of stigma, discrimination and access barriers. They are also vulnerable to TB because of their social and living conditions and behaviours.
The TB risk in sex workers also impacts the surrounding communities, since sex workers with TB have a risk of transmission to the communities.
Deputy director of the National TB Programme in the MoHCC, Charles Sandy, said some groups of people who were more vulnerable to or affected by TB are at either increased risk due to their social and living conditions, behaviours or unsafe workplaces, or have poor access to healthcare because of stigma, discrimination and access barriers to health care, such as prisoners and SWs.
Zimbabwe is one of the countries in Sub-Saharan Africa worst affected by the HIV and Aids epidemic, although there is evidence that HIV prevalence has declined from 26,5% in 1997 to 14,5% in 2016.
According to the National Aids Council (Nac), the country has an estimated HIV incidence rate of 0,4% between 15 and 49 years, an estimated number of new infections of 58,472, and an estimated annual HIV deaths of 45,6211.
While the majority of HIV infections occur in the general population, specific sub-populations including female sex workers are at higher risk. It is estimated that 11% of new adult HIV infections occur among female sex workers and their clients.
The World Health Organisation submits that tuberculosis is a bigger killer than malaria and Aids combined and kills more women than all the combined causes of maternal mortality.
TB is an increasing burden to a number of countries worldwide as well as Zimbabwe.
TB is a major national health problem in Zimbabwe accounting for over 27 353 notified cases in 2016.
According to the executive director of Stop TB Partnership, Lucica Ditiu, recently published data on TB indicate a very small decrease in estimated TB burden and deaths and thus stagnation in coverage of services.
The estimated number of people in developing countries with TB remains the same high figure at 10,4 million, mortality reduced from 1,8 to 1,7 million, treatment success for drug sensitive TB remains the same at 83%.
She points out that the numbers are reflecting the work that happened in 2016, the first year under the new Global Plan to End TB 2016-2020.
“Compared with the 2015 baseline, there is no progress,” Ditiu said.
As for Sibanda and Tinos, there is no better thing than getting information that saves lives.