Rural communities suffer for lack of HIV information

Lazarus Sauti

It was only when Alice Zvoushe lost her first born child at five months that she discovered she was HIV positive. The child, a boy, died from pneumonia soon after being admitted to hospital.

But Alice (not her real name) is from the subsistence farming communities around Shamva, and by the time she was able to travel the 25km into town, her son was already gravely ill, despite her efforts and those of her family to care for him.

“Of course, I have heard about AIDS and how it kills people, but I never thought my child would die from it, especially as I am still quite healthy,” Alice told this writer recently.

“It was only when I brought my child to hospital that I learnt he was suffering from pneumonia as a result of the HIV virus, which he contracted from me.

“If only I had known about the government’s mother-to-child AIDS prevention campaign, I could have been tested when I was pregnant and my son could have lived,” she says, sadly recalling how she had learned about the Ministry of Health’s efforts to treat pregnant HIV positive women to prevent the transmission of the deadly HIV virus to the unborn child.

For Alice, living in a relatively isolated rural community, it was a cruel lesson about not having sufficient information that could have saved her son.

And despite government and civic efforts to teach rural communities about the dangers of HIV and AIDS, and the drugs that are available today that can prevent the transmission of the disease from mother to child, Alice is just one of thousands of rural women in marginalised communities who have suffered as a result of a lack of information about this deadly plague.

Many thousands more are at risk as a result of the fact that government and civic groups are struggling to extend health education and counselling outreach services to these communities.

While significant strides have been made in reducing the transmission rate of HIV in recent years, mainly due to the widespread publicity campaigns about the disease, still more statistics suggest that marginalised communities are not achieving the same success rate as “more enlightened” urban communities.

One subsistence farmer from a new resettlement area at Rutherdale Farm in Shamva told this writer:  “We do not receive information about HIV and AIDS here. The only people who receive that information are those infected by the disease. But they have to travel to Shamva District Hospital, which is a considerable distance from this farm, and costs at least USD$2, which is not even easily accessible.”

Tariro Chikumbirike, head of Communication and Knowledge Management at the Southern Africa AIDS Dissemination Service, a regional non-profit organisation responsible for producing and disseminating HIV information, says there are marginalised rural communities where women still need to access up-to-date information about HIV.

“General information about HIV and AIDS is now there in most communities, but what is lacking is the current, quality and adequate information which will enable women to make informed decisions about their health. For instance, if a woman is HIV positive and pregnant, she needs timely information to know where she can access prevention of mother-to-child transmission services,” says Chikumbirike.

Ronald Chimunda, a Pioneer Zimbabwe student stationed at Dokson Farm in Shamva, says women at the farm crave for the latest HIV information, but behaviour-change facilitators in the area are to blame as they are not helping them.

“Women here long for HIV information but they are frustrated because for the past six months, we tried to get the facilitators to come here but to no avail. We asked them to give us reading materials but nothing materialised,” says Chimunda, adding that women have to travel long distances to reach the nearest clinic to access information about HIV.

However, David Nyamurera, Mashonaland Central National AIDS Council Provincial AIDS Coordinator, blames cultural value systems, such as patriarchal systems, that still dominate in some communities, which act as barriers to the effective flow of HIV information in these communities.

“Women in some remote areas still stand by their cultural and value systems. They are not free to discuss sex-related issues with strangers, especially in absence of their husbands. Therefore, these practices hinder effective dissemination of information on HIV, cancer, tuberculosis and the Human Papilloma virus (HPV), one of the main causes of cervical cancer,” says Nyamurera.

He also said emerging prophets and Pentecostal churches in the country discourage women from seeking quality HIV information.

“The country has made great strides in disseminating information about HIV and Aids but the rising popularity of prophets and Pentecostal churches is threatening the smooth flow of this all-important information,” he says, adding that “pastors and prophets are misleading people by telling their followers that they can cure Aids and do not need information about Western reproductive health information and services. This is contributing to the number of people who are shunning our services and exposing themselves to risk.”

Sharing similar sentiments, Violet Nkathazo, a gender and media analyst, says when it comes to rural areas, unlike urban communities, people are still very traditional, so issues related to sexual activity, such as HIV/AIDS, are therefore deemed taboo.

She also said despite a high level of awareness, HIV and AIDS remain highly stigmatised in Zimbabwe.

“People living with HIV are often perceived as having done something wrong, and discrimination is frequently directed at both them and their families. Therefore, in as much as rural women are enlightened on some issues to do with HIV and AIDS, they still frown upon discussing such issues,” says Nkathazo.

Despite Zimbabwe’s economic difficulties, stakeholders in the health sector continue to run outreach programmes in their efforts to ensure that information about reproductive health issues reaches all communities.

“Not every system is watertight, but we are making inroads in terms of information dissemination,” explains Nyamurera. “We explain that suffering from HIV is nobody’s ‘fault’, and we try to encourage all communities to welcome with love, open arms and support for all people living with HIV.”

He says they also try to explain how some cultural practices hinder the flow of information and prevent people, especially women, being in a position that allows them to make informed choices about their own health status.

Chikumbirike says SAFAIDS is now hosting community discussions as an advocacy tool to empower rural women and to ensure that HIV information reaches all communities.

“We are now taking information about PMCT services and HPV to people through hosting community dialogues as a communication tool. Such methods enable women to play key roles within their communities to ensure they promote access to important information about HIV/AIDS and other culturally sensitive health issues,” says Chikumbirike.

Accordingly, for Alice’s young son, such information has come too late. But at least for Alice, her HIV positive status is no longer a death sentence and she has now been able to subscribe to the government’s anti-retroviral therapy (ARV) treatment. And for her, that information has been a lifesaver.