The struggle of women and HIV and AIDS

Secondly, I discovered that Norman, after knowing his status, did not tell his wife (about 10 years his junior) and proceeded to have unprotected sex with her and thus infected her. I felt betrayed. How could he do this to his wife, someone else’s sister? How would he feel if some guy did this to me his sister? I thought he would always look out for me but by this he indicated otherwise. What would stop some guy from doing to me this that my brother did. How cruel I thought (Hutsinye chaizo!). This cruel man was my brother! Anyway, Norman’s young wife found living with Norman (whom she had to take care of during his bouts of sickness attacks) too painful, so she mustered courage and left him, illegally crossed over to South Africa to start a new life as an economic migrant worker where she can access drugs. During Norman’s funeral, our family discovered that Norman had secretly married another young woman in her early 20s whom he left pregnant. One more person he knowingly passed on the HIV virus to.

What kind of man does this? Norman was a great everyday guy, hard working, a loving brother and son. Clearly, it is the everyday guy who is part of the cycle that makes stopping the spread of HIV and limiting the devastation of AIDS difficult. The patriarchal nature of our societies, politics and economies continuously victimizes women and makes them vulnerable and susceptible to poverty, insecurity and infection with the HIV virus.

The magnitude and the consequences of HIV and AIDS in Africa have taught us that it is not only a health problem, it is also a governance and development problem. It is about States that are badly managed and whose interests do not address the needs and priorities of their populations. It is about patriarchal societies that refuse to transform themselves to their present realities and truths and rather draw on the past in the guise of culture and tradition to direct present and future contexts. Young men like Norman go about marrying and lording it over naïve and desperate women to all their peril. The two young girls became victims of society’s conspiracy against women which projects marriage as a woman’s ultimate moment of glory and so many get into it at any cost even if their lives are highly at risk as a consequence. We are killing our own young people across this continent!

The worst hit by the HIV virus are the peoples of Africa and because of poverty, conflict and geo political inequalities our continent is the most vulnerable. According to the World Health Organisation (WHO), off the 33 million people living with the HIV virus world wide at the end of 2007, 22 million (two thirds) were Africa’s children. Of the 2 million who died in 2007, three quarters were in Africa and of the 2.7 million new infections in 2007, 70% were in Africa. These are facts African peoples and leaders have to wake up to. We cannot hold on to the beliefs and practices that landed us on this mess anymore. Things have to drastically change.

The 15 to 49 years age group which is our most productive age group is the most desecrated by this virus. When they get sick and/or die we loose their skills, experience and dent our economies. The 2005 Human Development Report identified AIDS as the factor inflicting the single greatest reversal in human development history. Between 1990 and 2003, many of the countries severely affected by AIDS dropped sharply in the global ranking of countries on the Human Development Index. For example South Africa fell by 35 places, Botswana by 21 places and Zambia by 16 places. Adult deaths place an especially high economic burden on societies. The loss of working-age adults represents a loss of human capital and has a profound effect on household economic well being. A cross-sectional study of the effects of adult mortality on small farmers engaged in cotton and maize production in Zambia found that an adult death resulted in a decline in crop output of roughly 15 percent. Experiences in most highly affected countries in SSA show that key skilled personnel particularly teachers, health workers, civil servants and artisans are most affected leaving skills gaps for the country negatively impacting economic growth and reversing development (SADC Secretariat 2008).

The gender discrimination in our societies has had dismal consequences for women and girls. Women have become the victims of our societal values not just as the infected but as having to bear the burden of the consequences HIV and AIDS. 59% of the adults with HIV and AIDS are women. For every 1 young man age range 15 – 24 years old there are 3 young women with HIV within the same age group. A UNDP report of 2003 showed how young girls in Zimbabwe were dropping out of school to take care of infected parents. So really, the AIDS virus is corroding women’s bodies, demands women’s time, energy, sanity, steals young girls’ childhood, future and innocence. These are results women and girls struggle with because our world still perpetuates social, economic, cultural and political systems that are grounded in patriarchy and thus dis-empower women, legitimate inequality and exclusion. This is why the regional protocols, the national laws, the policies that exists across the continent to address HIV and AIDS have not haltered its spread or cushioned the most vulnerable from its invasive and destructive impact. Norman was able to get away with infecting his two wives in a Zimbabwe that has a law which persecutes and punishes anyone who knowingly infects another with the HIV virus (the Sexual Offences Act 2002).

A comprehensive study was carried out by the Physicians for Human Rights called ‘Epidemic of inequality: women’s rights and HIV and AIDS (2007). The study focuses on Botswana and Swaziland the countries who have the highest prevalence rates in the world 23.9% and 26.1% respectively. Botswana was highest all along until 2004 when Swaziland overtook it. The study shows how entrenched societal gender discrimination perpetuates HIV and AIDS prevalence. Both countries until recently had legalized gender inequalities where women had a lesser status than men in the eyes of society and the law; restricted property rights, minimal inheritance and hardly any autonomy. I recall my shock during my first stay in Botswana in 2005, when I filled out the form to open a water account. The form clearly indicated that if a married woman is wanting to open a water account she must produce evidence of consent from her husband. Clearly gendered values, norms and practices make women extremely vulnerable and as a study carried out in Zambia expressly shows subjects them to risky sexual behavior (Human Rights Watch 2007). Where women are disempowered and viewed as less in society, they are most likely to suffer the most from stigma if their status is discovered and are likely unable to make decisions in regards to their sexuality. This increases risk to themselves and spreads the infection.

Gender based violence (GBV) or fear of is another societal evil women struggle with which exacerbates the risk to HIV infection and/or affects women’s access and adherence to treatment. 1 in 3 women in SSA has experienced some form of violence. 1 in 5 women has been coerced or forced into a sexual act. The Human Rights Study, ‘Hidden in the Mealie Meal: Gender Based Abuses and Women’s HIV Treatment in Zambia’ (2007) shows that 1 in every 2 women who have ever been married has experienced GBV and abuses in the hands of her husband. Violence against women is a social crime that has been perpetuated over generations and coupled with the HIV virus deals a double blow to many women and girls. Turning deaf ears and blind eyes to wife battering, abuse of the girl child and pretending there is no rape of a wife by her husband or of young girls by their fathers or brothers/uncles had put many women and girls at risk. Treated as ‘domestic issues’, governments have been reckless and are responsible for the pain, the broken limbs and destroyed lives of women and girls who have been victims of GBV. Further to this is the escalated use of rape as a weapon of war. Rape be it in the marital bed or under a shrub in a conflict zone is a crime of hate, is violent and seeks to rob the victim of her or his humanity. Women and girls in the DRC, Northern Uganda, Darfur, Zimbabwe just to name a few of the currently on-going conflicts have been subjected to the violence of rape as their bodies became battle grounds in a war between a few men. As an ACORD seminar report of March 2007 ‘Exposing Hidden War Crimes: Challenging Impunity for Sexual Violence in times of Conflict’ remarks that it is the silence on GBV in times of peace that legitimate SGBV in times of war.

The ABC campaign has failed to halt and reverse the spread of HIV especially where gender dimensions are not considered. A rape victim has no multiple choice luxury. A wife in most African society does not have the luxury of choosing A or B or C. She cannot Abstain, it is her duty to give her husband sex and it is his right to take it from her if she wont give it. She can only Be as faithful as he is. Most African societies tolerate and look aside when married men have sexual relations with other women other than their wife. Should a married woman dare do the same, she is humiliated, insulted and becomes a social outcast. She can not chose a Condom, she would have to explain to her ‘lord’, her husband why she needs it. The call for ‘behavioural change’ means absolutely nothing when the playing ground is skewed against one side of the sexes, women. My late brother Norman and his two wives are a good example of how information provision and calls for testing are just not enough. They lived in a country with a massive education campaign on television, radio, billboards on HIV and AIDS.

The political will of African governments must now be made willing to deliver women’s rights. Our economic growth and rate of development heavily depend on it. The legal, social, cultural and economic environments of our countries have to change and guarantee gender equality! We unfortunately can’t afford the cost of no or slow change. Our beliefs, attitudes and norms that have relegated women to a lower position in society have to go, in every aspect of our lives and must not be tolerated. We must empower women legally, socially and economically. We acted against slavery, we acted against racism, we acted against colonialism and apartheid, we certainly have the capacity to act against gender discrimination.

The approach of prevention, control and treatment adopted by most countries in its general sense is correct. However governments have to rethink what they mean by each of these approaches and engender them through gender mainstreaming. Women’s unequal status in society gravely undermines their ability to participate effectively in the dimensions of this approach. As long as governments are paying little attention to the gender dimensions of prevention, control and treatment especially the impact of entrenched discrimination, GBV and abuse the destruction caused by the HIV virus shall continue. Adopting legal instruments and policies to deal with the HIV and AIDS pandemic is a good thing as SADC did by adopting the Maseru Declaration in 2003. However if the broader legal and social environment relegates a woman to a lesser being than a male there is no prevention and control that will happen. If the woman has no real autonomy, no capacity to be economically secure, if she can not be safe in her bed, her home or in her community then there is no controlling or preventing HIV and AIDS’ impact on our continent. If unemployed males can be free to harass a woman because they think her skirt is too short, they will feel free to access her body at will and terrorise any other female they encounter. Most African States have adopted international instruments that secure women’s rights and guarantee their enjoyment of all rights due to them as citizens. Almost all countries in SSA have signed CEDAW, the AU Protocol on women’s rights (2003) is now in force, in the Southern African region in August 2008, they adopted a SADC region Protocol on Gender and Development and most countries have national laws that give rights to women. This means that the legal and policy frameworks have been put in place, what remains it to make them work and deliver for women.

If our governments are recklessly spending resources on military hardware and not on health care then surely we wont be able to treat the millions living with HIV and AIDS. Over 70% of PLWH in Africa are not accessing treatment. If a government will be as irresponsible as recently reported of the Zimbabwe government to divert resources intended from the Global Fund to assist those with HIV and AIDS then all must condemn such recklessness that prioritises political interests over the lives of people. African governments must be serious about the people of Africa and the agenda for development. No more rhetoric, only real people centered action. The Human Rights Watch (2007) study further illustrates how gender discrimination, GBV and abuse of women (or the fear of) prevents women from accessing or adhering to treatments thus governments must ensure there is gender mainstreaming in all aspects of governance.

Regional Bodies must provide leadership and practical solutions to their Member States showing how gender mainstreaming and HIV mainstreaming are not just ‘cross cutting issues’ rather are intrinsic issues which are at the core of our developmental challenges. These issues are intertwined. It is not clever to approach them individual as if they have nothing to do with each other. We can’t talk regional integration, trade liberatisation, free trade area, food security if we don’t address gender discrimination and the dynamics presented in the fight against HIV and AIDS.

We need a vibrant women’s movement that is able to make demands and pressure for accountability from those with power to effect the needed change. While there is much that needs to be done to strengthen the women’s movement including taking proactive actions to engage with political, economic and social issues and processes beyond the traditional women’s issues, refine strategies and tactics, re-articulating messages to adapt to a changing context and environment. However for this to happen, women’s NGOs and the movement require resources, they need money. The least funded organizations in most SSA are women’s organizations. AWID in 2005 carried out an action research initiative entitled “Where’s the Money for Women’s Rights?” and found that funding for women’s rights work was the least funded and women’s oganisations are the least funded with most on survival mode. For the citizens to grow to a state of consciousness so as to demand accountability resources need to be applied into local groups’ organizing. Local NGOs, CBOs dealing with HIV and AIDS issues and/or women’s empowerment issues must be resourced. Policies to divert resources by donors to the fashionable political/ policy issues must recognize that without this ‘mass’ base the demands for policy implementation are not taken seriously by governments who respect and respond to numbers as numbers mean votes.

Therefore there is need for a huge change particularly by governments, political leaders, the donor community, inter governmental organizations such as the United Nations, The Africa Union, sub regional RECs. These institutions are extremely influential in supporting change processes and have been instrumental in encouraging the building of democratic institutions in most African states. They can exert the same influence on women’s rights and the gender equality agenda. However, current practice is when it comes to gender equality and women’s issues, they, like most political leaders, say all the right things and do not act according to their speak. A shift from rhetoric to implementation of the principles of gender equality and pushing for women’s rights is needed. If we are serious about wanting to halt the spread of HIV and AIDS and reverse its spread then we have to be serious about gender equality and women’s rights.

REFERENCES
ACORD (2007) Exposing Hidden War Crimes: Challenging Impunity for Sexual Gender Based Violence in Times of Conflict
Human Rights Watch (2007) Hidden in the Mealie Meal: Gender Based abuses and Women’s HIV Treatment
Physicians for Human Rights (2007) Epidemic and inequality: women’s Rights and HIV and AIDS
SADC Secretariat (2008) The Economic Cost od the three communicable diseases TB, Malaria and HIV and AIDS
UNDP (2005) Human Development Report
World Heath Organisation www.who.org

* Janah Ncube is a Zimbabwean activist and works in southern Africa.

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