26 October 2011
Women lead the way in the struggle against Swaziland's HIV crisis
A support campaign for Swazi women living with HIV is transforming lives, but needs international backing
Siphiwe Hlophe's shrewd, enterprising spirit is apparent within moments of meeting her. "You work for Comic Relief?" she says. "Brilliant! I might walk away from this meeting with some money." Hlophe, a Swazi woman living with HIV, wants the money for the charity she directs, Swaziland for Positive Living (Swapol), which supports rural communities affected by HIV.
Her resourcefulness is striking in a country where women are denied the right to register property, prohibited from opening a bank account or starting a business without the permission of their husbands, and paid 71% less than men. Yet it is not unique. Similarly enterprising women across Swaziland – where 31% of the female population is HIV positive, compared with 20% of men (a figure that rises to 49% for women aged 24-29) – are leading the HIV fight-back.
These women fight a tireless tripartite battle against HIV, the stigma it places on them, and their inferior status in Africa's last absolute monarchy. Hlophe, whose husband ended their marriage on grounds of "dishonour" after she contracted the virus from him, has conquered all three.
Kathryn Llewellyn, the founder of Positive Women, which co-funds Swapol, said: "Extraordinary women provide safe havens for women rejected by their families. Despite the fact that women are disproportionately infected and affected, or maybe because of this fact, they're not being overwhelmed. They're uniting and fighting back."
Some cross the border to South Africa. Thandi Maluka, of South Africa's Treatment Action Campaign, points out they're escaping a country where, in 2009, "one MP suggested branding people with 'HIV', so they cannot infect others … they believe women carry the virus".
Hlophe stayed put. She founded Swapol in 2001, along with four other rural women; all had been recently diagnosed, and were determined to resist destitution and ostracism.
Two have since died, but Hlophe continues, empowering Swazi women living with HIV through programmes that transform them into businesswomen. On a visit to a rural neighbourhood care point, I met six women making and selling peanut butter to fund their village orphanage. In another rural community, I encountered a crop-seller; Swapol gives her seeds to grow vegetables, helping her to sell surplus stock to locals.
Women operate at grassroots level in tackling HIV because they're rarely trusted with real responsibility. But they are increasingly making their voices heard. In 2008, when the king chartered a plane for nine of his 13 wives to go shopping, hundreds of Swazi women protested. In response to their cries of: "We need to keep that money for ARVs [antiretrovirals]", senior princes denounced them as "un-Swazi". Care of Swaziland's 80,000 Aids orphans increasingly falls to grandmothers, 1,000 of whom gathered last year to discuss action priorities, such as campaigning for fair inheritance rights. And in July, 100 people protested at the government's inefficiency in financing the response to the HIV and Aids pandemic. Leading the march, Vusi Nxumalo said: "There's a problem with procurement, supply and service delivery [of ARVs]."
Yet the crisis is too far-reaching for women to tackle alone, and men are now being actively encouraged to take responsibility. When I travelled across the border from South Africa to Swaziland as part of an Action for Southern Africa delegation, I was handed a health department leaflet advocating circumcision. The initiative to circumcise 175,000 men by December 2011 is based on studies suggesting this could reduce annual HIV incidence by 75% by 2025. But in Swaziland, where polygamy is commonplace, men often demand sexual favours from women in return for employing them, and less than 20% of people know their HIV status, these targets feel overambitious without a wider push for social change.
The economic downturn and the government's financial irresponsibility have exacerbated the HIV crisis. ARV supplies were recently reduced from three months to one month a person for each clinic visit. Travelling to collect ARVs is expensive and exhausting for people in poor, isolated rural areas.
You might expect the Global Fund, established to combat HIV by "directing resources to areas of greatest need", to prioritise Swaziland. But Hlophe says: "We keep crying out for answers, but we haven't received a response about where our Global Fund money is. We've now been waiting for nine months."
In reply, the Global Fund, whose last HIV grant disbursement was in April 2011, said they "will be engaging with Swapol to determine the way forward on their involvement" with phase two of the disbursement.
Allegations of corruption in January this year led to the Global Fund stalling grants – clearly problematic when it disburses funding through a body of Swaziland's undemocratic government – rather than giving directly to already overstretched NGOs such as Swapol.It is down to the international community to sharpen its focus on Swaziland, lest women like Hlophe run out of steam – and HIV infections spiral upwards.