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South African women bear biggest part of HIV burden

By Moyiga Nduru   

JOHANNESBURG, South Africa (IPS/GIN) — "We cannot have women carrying hospital beds on their heads," says Quinton Mageza of the global charity ActionAid International, referring to the growing army of women and girls playing the role of nurse at home for relatives living with HIV/AIDS. Women and girls in southern African are overwhelmed by the burden of looking after family members, Mageza recently told IPS (Inter Press Service) in South Africa's capital and commercial hub, Johannesburg. These women and girls have had no medical training.

ActionAid, which relocated its headquarters from London to Johannesburg earlier this year, is launching a campaign called “The Mutapola” Dec. 1, World AIDS Day. Mutapola is the name of the woman the charity is featuring in its campaign to highlight the plight of female caregivers.

"HIV/AIDS infects and affects women more than men. It is women who care for the sick and shoulder the burden," ActionAid's Carol Equamo told IPS. "It is rare that you find a grandfather looking after the sick. If people get sick in the city, they end up with grandmothers in the village.”

Southern Africa has only 2 percent of the world's population, but 70 percent of the world's population living with HIV/AIDS, according to the 2004 Report on the Global AIDS Epidemic, published by the Joint United Nations Program on HIV/AIDS (UNAIDS).

The situation is further compounded by the fact that in southern Africa, women and girls are disproportionately affected by the pandemic. The World Health Organization/UNAIDS World Epidemic Update shows that 56 percent of those infected in the region are women, and that young women and girls ages  15-24 are 2.5 times more likely to be infected than their male peers.

Among southern Africans ages 15 to 49, HIV and AIDS infection ranges from negligible in Seychelles and Mauritius to 4.9 percent in the Democratic Republic of Congo (DRC) and 40 percent in Botswana and Swaziland. Prevalence rates may be as high as 70 percent in areas linked to trading routes, according to UNAIDS.

As the epidemic continues to claim more lives, more children will be orphaned. In seven countries in the region — Zimbabwe, Botswana, Lesotho, Swaziland, Mozambique, Malawi, and Zambia — an estimated 15 to 19 percent of children are orphaned, while in five nations —South Africa, Tanzania, Namibia, DRC, and Angola — 10 to 15 percent of the children are orphaned, according to the UNAIDS. Women are at greater risk of infection, and the epidemic imposes other burdens on them as well. Community-based responses rely heavily on women, who must invest more time in the care and support of those infected by HIV/AIDS.

"We are saying that care should be the responsibility of the government," Mageza said.

Stephen Lewis, the UN Secretary General's Special Envoy on HIV/AIDS, has poignantly described home-based care as "conscripted labor.”

"While this may sound exaggerated, the reality of home-based care in southern Africa continues to be characterised by reduction in state expenditure on health care and a lack of the fact that for these women, remuneration is important because care activities take them away from other productive activities," ActionAid said in its campaign paper, “Promoting and Protecting the Rights of Women and Girls in the Context of HIV and AIDS in Southern Africa.”

"It is all too easy to investigate ways in which ‘community responses can be strengthened to deal with the pandemic.’ All too often, what this translates to is increasing burdens on women," it added.

The paper quotes a woman in Zimbabwe saying: "In addition to all other responsibilities that women have had to bear historically, women now have to carry hospitals on their heads!"

To highlight women's plight, ActionAid, in partnership with the Open Society Institute of Southern Africa (OSISA), will launch the “Mutapola” campaign and a video titled ‘No to Home-based Care’ in Johannesburg Dec. 1.

The video shows a day in the life of a woman who provides home-based care, and questions the state's role in delivering health services.

"We also want women and girls to have voices," said Mageza. “Right now, women and girls do not have voices around the issue of HIV/AIDS. We mainly hear the voices of men. Yet statistics say [that] over 60 percent of people infected with the virus are women.”

"We are not saying that men should not have their voices heard. They should. But this should not be at the expense of women. And it's not to undermine the voices of men who are doing good job. It's imperative that women be given a voice," he added.