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Women and girls carry the heaviest burden By Lewis Machipisa HARARE - When Mariah's husband died late last year of AIDS, she decided not to tell anyone for fear of isolation. "I first knew of my HIV status when my husband got ill. We both went for HIV testing and we were counseled and given our results. We were both found HIV positive,'' recalls the 35 year-old mother of three. "My husband got worse and finally died late last year. His relatives insisted that I should be inherited by one of his brothers. This is when I decided to tell them that I was HIV positive and that my husban2 had died of AIDS.'' Then all hell broke loose. "My in-laws started accusing me of having killed their son and they told me that I should leave their family and go back to my own relatives,'' she says. She was kicked out of her rural Mutoko home, about 200 kilometres from the capital city Harare, and separated from her children who are two, five and 12. Mariah's story is a common one in this Southern African nation. Family members do not usually have a positive attitude towards HIV positive individuals, especially when they are female. In fact, due to gender-specific roles, women and young girls are more likely than men to bear the negative consequences of the HIV/AIDS epidemic, according to a community-based study conducted by the United Nations Development Fund for Women (UNIFEM) in Zimbabwe. Women and young girls are becoming the primary caregivers of other relatives who have HIV, and are the ones who assume the responsibility of caring for the orphans left behind when both parents die of AIDS. Due to the increased number of AIDS patients in Zimbabwean hospital wards and the cost of caring for these patients, hospital authorities have resorted to discharging these patients and encouraging Home-Based Care (HBC). Women are once again found in a dilemma of taking care of these terminally ill patients. "The majority of care givers are women in child bearing ages who have no previous experience in caring for patients with AIDS and usually experience practical nursing problems with their patients due to inadequate information on HBC,'' the study points out. Zimbabwe is severely affected by the HIV/AIDS epidemic with one in four sexually active adults infected. The UNIFEM study, carried out in the five Zimbabwean provinces of Mashonaland East, Manicaland, Midlands, Matabeleland South and Mashonaland Central, found that even young children, 76 percent of whom are young girls, are being taken out of school to look after a sick relative or AIDS orphans. "There doesn't seem to be much support coming from the Social Welfare Department. Orphans are not being supported and this places another burden on women,'' says Martha Mahonde, programme officer, UNIFEM Southern African Regional Office (SARO). "But of the orphans, the hardest hit is the girl child. She takes over after the parents die. We also found out that the girl child drops out from school and takes over the responsibilities of the family, even if she is younger than the boy child,'' explains Mahonde. This scenario, she says, perpetuates the long-standing educational imbalance between boys and girls, which in turn jeopardises the girls' opportunities in life, thus exposing them to greater economic exploitation and higher risk of infection. For example, Mahonde says she was "shocked to find out that some old traditional practices which were thought to be dying are still being practised. I was shocked to find out in Plumtree( a town in southern Zimbabwe near the South African border) that truck drivers have sex with young girls in the belief that it minimises their chances of being involved in an accident,'' she adds. "The epidemic is a gender issue. It's time people start internalising the problem. Once we begin to do this, we will realise that the impact of this disease affects everybody, but women are more burdened,'' says Mahonde. "Before we had the HIV/AIDS problem, women were always poor. And now, they have to take care of the poor,'' says . In order to address the issues related to HIV/AIDS and gender, UNIFEM executed a two-year (1999-2001) global pilot project entitled "Gender Focused Interventions to Address the Challenges of the HIV/AIDS Epidemic". As part of the project, in addition to Zimbabwe, UNIFEM conducted the community-based studies in India, Mexico, Vietnam, Senegal and Barbados. In Zimbabwe, very little information was known about the gender dimensions of the socio-economic impact of the disease at the household level to facilitate the formulation of comprehensive mitigation strategies. "When I went out into the rural areas, what really touched me was that despite being the poorest of the poor, women are going out of their way to a make a difference,'' says Mahonde. "It's sad to note that there is quite a lot of money for HIV/AIDS, but it is not reaching the remote areas where it is needed most,'' says Mahonde. "Maybe we are spending too much time strategising on how to do the work, meetings and conferences. It's time to make that bold move to the rural areas where people are desperate for our help,'' she adds. "While a lot has been done, more resources should be channelled to these people.'' The aim of the pilot project is to build the capacity of women's organisations to zero in on the new emerging challenges of HIV/AIDS in a gender-responsive manner, and to expose the legal and social issues that hinder adoption of preventative measures in matrimonial settings. The project is core funded by UNAIDS and UNFPA. Women, because of their low economic status, are the most vulnerable to HIV infection through sexual abuse and their inability to negotiate safe sex, even in marriage. "Because of their economic and social dependence on men, it is difficult for women to refuse unsafe sex or negotiate safer sex. Double standards that encourage men to have many sexual partners are common, with the result that more women -even those who are monogamous- are placed at risk,'' notes the study. "Already bearing the burden of socio-economic and gender inequality, women who are HIV-positive have less access to health care and psycho-social services than men,'' the study says. They also have less expendable income to devote to their own comprehensive health care, Mahonde says. "Since women are already the poorest of the poor and not educated, you can imagine how the impact is. The unfortunate thing with HIV/AIDS is that you need money, and for women, they simply don't have that money,'' says Mahonde. "There is also need for more information. What we have is awareness and little detailed information for people to make informed choices such as a woman being able to decide whether to breastfeed or not,'' she adds. Communities in Zimbabwe still hold negative perceptions about people living with AIDS, according to the research. "Of more concern was the issue of integration and acceptance of PLWAs (People Living With AIDS) in the community,'' the study says. Caregivers interviewed, it adds, noted that some patients have been neglected so as to "speed up the death process''. The UNIFEM study recommends that the Zimbabwean government needs to develop gender-sensitive, multi-sectoral programmes and strategies to empower women and girls, and to enable men to assume their responsibilities to prevent HIV/AIDS. "Of paramount importance is the need to disseminate and translate into vernacular languages, the vast amount of information so far gathered in different researches on HIV/AIDS,'' the study says. But even if women had the knowledge about HIV/AIDS, strategies to lessen their economic dependence on men are key because without economic independence, the majority of women would still not be able to use this knowledge, the study stresses. "This highlights the helplessness expressed by most women, who admitted that due to their economic dependence on men, they are unable to negotiate safe sex,'' the study notes. "A gender-sensitive approach to addressing HIV/AIDS will allow the safeguarding of women's interests, enhance their rights, thus creating an enabling environment within which women will effectively contribute in the fight against HIV/AIDS,'' the study points out. |
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