Africa, Development & Aid, Headlines, Health

HEALTH-BOTSWANA: Reaching Young People to Beat AIDS Pandemic

Mercedes Sayagues

GABORONE, Sep 9 2002 (IPS) - It is midnight on Saturday. Thick crowds pack the three bars in Kilimanjaro, a shabby shopping centre in the Gaborone township of Broadhurst. Beer and whisky bottles litter the grounds. It is brisk business for liquor, dagga and sex.

A few blocks away, business is also booming in the more upmarket George’s bar. The crowds at Kilimanjaro are solid black. At George’s the sex workers are black but a lot of clients are white.

Sex happens in cars, on the street or in the bush, in the dark, where women cannot check their clients for signs of sexually transmitted diseases, where it is harder to negotiate safe sex.

Prostitution is illegal and criminalised in Botswana. The women operate alone or in pairs, vulnerable to abuse from clients and police alike.

“We are tired of being thrown in the bush re sena go jewa ke batho (after sex). Even the police rape us or threaten us with prison if we refuse sex. They do this knowing we have no place to run to,” claims a sex worker.

On average, the women have three clients a night and up to six around payday. The price ranges between P50 to P200.

One U.S. dollar is equal to 6 Pula.

The demands range from oral sex and group sex to dry sex, where women put herbal powders in the vagina to make it dry and tight. Dry sex lacerates the delicate vaginal walls, facilitating HIV infection.

Clients pay less for sex with a condom. Most prefer sex without a condom. They believe that if the woman is fat, she is AIDS-free; that if the man is STD-free, a condom is not needed; and they “don’t want to eat a sweet with its wrapper”.

The data comes from a first-ever survey among sex workers in Broadhurst, Bontleng and Old Naledi townships in Gaborone, the capital of Botswana.

Botswana, with a population of 1.5 million, has the world’s highest rates of HIV infection, with 40 percent of adults infected, reaching 45 percent in Francistown and 56 percent in Selebi-Phikwe.

Sex workers are at great risk, yet misplaced notions of “morality” keep them invisible and marginalised. Their rates of HIV infection are unknown.

Countrywide, only two AIDS programmes target them. A successful project started in 1994 by the NGO Emang Basadi stopped for lack of funds.

Help is on the way. The United Nations Foundation (UNF) is sponsoring a 1.8-million-U.S.-dollar, three-year-long AIDS awareness project in poor townships of Gaborone.

It will reach young people at risk, such as sex workers, street children, orphans and unemployed youth.

“We are targeting those who are usually ignored, 15 to 20- year-olds in poor areas,” says Irene Maina, of UNAIDS.

The Urban Youth Project (UYP) is part of Telling the Story, a UNF-sponsored scheme to improve AIDS awareness among youth in seven Southern African countries.

Of the sex workers interviewed, half were aged 15-24 and a quarter was aged 12-14. Most were recruited into this work by friends or family, some as young as nine years old.

The idea is to train young people as peer educators among their own age group. Provision of youth-friendly services for reproductive and sexual health is also important.

“Young people don’t go to the local clinic because they fear finding the auntie or the neighbour there,” says Matsae Balosang, head of the Family Health Division at the Ministry of Health in Gaborone.

Informal sex work is another problem. Half of Botswana’s people are poor. Jobs are scarce. For many girls, sex is the only way to acquire goods.

“Rape and sex for gifts are a significant problem among teenage girls,” says Baatweng Motladiile, training coordinator at the Scripture Union, which runs sex education workshops for young people and their parents.

At Kilimanjaro and at George’s, the young sport the latest fads.

“We live in a material world, as seen in MTV,” says Ndanji Lesetedi, 19. “You need Reeboks and a cellphone to look hip, so guys and girls will do anything to get one.”

Brain Rich Morem, 22, a poet in Old Naledi township, estimates that one out of three girls he knows exchanges sex for gifts.

“Youth of Botswana, you are amazing, in heroic deeds and in reckless sex,” he boomed at an event in Old Naledi recently.

Botswana has one of the world’s highest rates of teenage pregnancy, although slightly decreasing. Half of all teenage girls get pregnant. The number of illegal and unsafe abortions is unknown.

“Most of my friends have babies,” says Banyabotlhe Methle, 19, a student in Old Naledi.

Why? To show parents they are grown-up, to prove their fertility, to catch a husband, to have a baby to love. Boys impregnate girls to show their manhood.

In Botswana, fertility confers social status. Young women come under parental and peer pressure to bear children even out of wedlock, says Botswana Human Development Report of the UN Development Programme (UNDP).

Studies report that some teenagers believe sex during adolescence will enhance their fertility. Others believe that standing up and shaking your hips after sex prevents pregnancy.

Half of the households in Botswana are female-headed. Rooted in history — migration of men to work in South African mines — this has become a pattern.

In 2001, nearly 80 percent of pregnant women were single, according to a national survey in antenatal clinics.

Rapid urbanisation — urban population rose from 18 percent in 1981 to 46 percent in 1991 and 50 percent today — also impacts on lifestyle.

“Marriage is devalued,” says Lydia Matebesi, a health officer with the UNDP. She adds that, on the one hand, women are free to leave unhappy marriages or not to enter one. On the other, female-headed households tend to be poorer and do not promote the family as role model.

“Teachers drink with their students in bars, parents have sex outside marriage, what do you expect from youth?” asks Clifford Segwagwe, 23.

An activist with UYP, he works to boost young people’s self-esteem and convince them to live healthier lives and say no to unsafe sex.

Reaching for the young is Botswana’s best hope to beat the pandemic.

 
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