Teresa Kambarami
*
She left her rural home in Chiwaka village, under Chief Mukota in Mudzi, within the Mashonaland East province, heading towards Kotwa growth point, hoping to secure employment to support her family.
It was an arduous period for finding a suitable job at the developmental stage, which led Kambarami, a single mother of two, to give up on her employment hunt and turn to prostitution instead.
In just a few months, Kambarami had become one of the most notable sex workers operating between Kotwa growth point and Nyamapanda border post.
Nevertheless, life did not prove easy for Kambarami, who faced numerous challenges and hardships that darkened her selected career path, forcing her to move elsewhere.
She needed to find lush grazing lands and became part of the "grand migration" to Makaha, a gold-abundant area in Mudzi South.
The Makaha Business Centre is alive with activity, featuring high-end vehicles navigating through the unpaved streets, emerging restaurants and bars, along with growing informal enterprises. A recent trip to the location showcased this vibrant scene.
For Kambarami and numerous other sex workers, the bustling activities at Makaha have proven to be advantageous.
“At present, I have nothing to complain about,” she stated.
Business conditions are more favorable here than in Kotwa and Nyamapanda.
Throughout the day, I run a restaurant with a buddy, and once night falls, I hit the bars and clubs with my siblings.
“Both jobs are paying.”
Nevertheless, similar to any profession, sex work comes with its set of challenges.
Kambarami is one of many sex workers in Mudzi district who face significant risks of gender-based violence (GBV) and sexually transmitted infections, such as HIV.
Based on the 2024 national HIV figures, Mudzi district reports an HIV prevalence rate of 10.8% along with an incidence rate of 0.11%.
Multiple elements increase sex workers' susceptibility to HIV/AIDS along with gender-based violence.
Numerous individuals working in the sex industry encounter various challenges related to culture, society, and law.
They similarly face violence within their communities, at work, or in their private lives, thereby heightening their susceptibility to both HIV and gender-based violence.
The "Zimbabwe Sex Worker Formative Research" report indicates that numerous sex workers experience violence, including beatings, threats with weapons, rape, and coercion into sexual acts.
"Some men lure you into going with them to their place or yours after meeting at a bar, but once there, they refuse to pay. Sometimes this leads to violence, and when you report it to the police, they claim they aren’t involved in matters concerning sex workers," Kambarami explained.
In Zimbabwe, particularly within the rural areas such as Mudzi, engaging in sex work is heavily stigmatized, and those who participate frequently face condemnation, labeling, and prejudiced behavior.
Currently, there are no regulations overseeing sex work, and law enforcement officials seldom take action against the violence endured by individuals in this profession.
Conversely, these women are deemed unethical and worthy of being punished.
A lot of sex workers view violence as "normal" or an expected part of their work and lack knowledge about their legal rights.
Against this backdrop, the National AIDS Council (NAC) has developed a range of HIV prevention measures aimed at decreasing infection rates within key population groups in Mudzi.
An initiative like this involves a peer-to-peer approach for sex workers throughout the region, focusing on areas with high rates of HIV infection such as Kotwa growth point, Nyamapanda Border Post, and Makaha within Ward 14.
This strategy aims to bolster social entrepreneurs within critical groups so they can expand current endeavors or create fresh commercial ventures that yield lasting positive outcomes for their respective communities.
As stated by NAC, the core idea behind the peer-led approach is to tackle the HIV/AIDS and sexual reproductive health requirements of marginalized communities by providing platforms where they can gain knowledge from their fellow community members.
"When sex workers earn a consistent salary, they become more resilient and can push for better safety measures during sexual activities, thereby lowering the chance of HIV transmission," stated Trader Muzamhindo, who is the NAC district AIDS coordinator for Mudzi.
This initiative was launched in reaction to worries from sex workers that their profession has become unsustainable economically.
We aim to provide economic empowerment to these sex workers so they can advocate for safer sexual practices and make well-informed decisions regarding their reproductive health.
Muzamhindo stated that they have reached out to the Ministry of Women's affairs for assistance in enhancing the capabilities of sex workers in saving techniques, commonly referred to as Mikando.
Apart from income-generating projects, peer educators have also been trained in HIV prevention methods, including pre-exposure prophylaxis, post-exposure prophylaxis, adherence to antiretroviral therapy, and general healthcare.
"We have received training on sexual reproductive health and we are sharing this knowledge with our peers," stated one of the peer educators, Georgina Chokuposhiwa.
These revenue-generating initiatives are assisting us in numerous aspects, and we are delighted as we become more empowered with each passing day.
Chokuposhiwa mentioned that she was chosen to mentor her peers since having married women instruct sex workers within their workplace might not be very effective.
In addition to managing a successful Mukando group, the peer-to-peer model has assisted the sex workers in launching various other economic initiatives.
"We have 100 chickens, comprising both roadrunners and broilers, as part of our poultry initiative," stated Chokuposhiwa.
We hope to broaden the scope of the project due to the high demand.
We are engaged in livestock farming as well, and similar to our poultry initiative, we aim to boost the quantity of animals under our care.
Muzamhindo states that there are 17 peer educators selected from sex workers spread throughout the district.
"A significant portion of these peer educators are present in Makaha due to our belief that substantial activity has been generated as a result of mining operations," she stated.
“These peer educators engage fellow sex workers and conduct education through outreaches and refer them to clinics if there is need.
They aren't specifically targeting sex workers, but they may still interact with their clientele.
I'm delighted that these women have thriving initiatives such as raising chickens, livestock, home decor, and they also have a traditional dance troupe.
Across the Mudzi district, there are roughly 820 sex workers, making up 75% of the key population.
Muzamhindo mentioned that they were collaborating with the Ministry of Health to implement outreach programs throughout the district. This initiative has made it possible for marginalized communities such as those in Badze and Rwamba to receive healthcare services.
She mentioned that the services encompass cervical cancer screenings, tests for sexually transmitted infections (STIs), HIV testing and counseling, along with hypertension checks, amongst other offerings.
Charles Mayonga, the councillor for Makaha (ward 14), expressed his support for the peer-to-peer program as well as numerous initiatives provided by NAC and its collaborators aimed at decreasing HIV infection rates.
"As evident, there is significant activity at the business center due to gold mining," he stated.
We have embraced this program as we observe these women developing various income-generating initiatives.
You'll notice that society often looks down on sex workers, but if these women had legitimate projects, nobody would mock them.
We are deeply grateful to NAC and the Ministry of Health for initiating this commendable program.
They offer numerous other interventions aimed at various age groups, such as young women and girls, artisanal miners, and those affected by tuberculosis.
Mayonga expressed hope that these programs would persist even with the reduction in donor funding, particularly concerning the distribution of antiretroviral treatments.
John Zengenene from Mabhande village in Ward 14 similarly expressed his approval for the program, stating that it would significantly contribute to increasing public understanding about HIV and sexually transmitted infections.
"There is considerable activity at the business center during nighttime," he stated.
These programs stand out because they engage the participants directly.
They are exchanging details amongst each other, and this information will reach their clients.
The peer-to-peer model is one of multiple HIV intervention strategies initiated by NAC with the aim of transforming and expanding prevention services within communities.
This responds to the elevated HIV rates within particular population segments including sex workers, prisoners, artisanal miners, and more.
The NAC implemented these models to deliver combined HIV prevention strategies to demographic subsets that face a higher risk of contracting HIV.
The adopted models encompass the Bortha2Brotha approach, designed to tackle the sexual and reproductive health requirements of teenage boys and young males.
The Sista2sista approach aims to support teenage girls and young females by providing them with sexual and reproductive healthcare services.
The updated version of Determined, Resilient, Empowered, AIDS-free, Mentored and Safe—commonly known as DREAMS—is aimed at decreasing new HIV cases among adolescent girls and young females between 10 and 24 years old who face vulnerability and have an increased risk of contracting HIV.
Albert Manenji, who serves as NAC’s finance and administration manager, stated that the nation needs more than $400 million each year for HIV intervention programs, according to the Zimbabwe National HIV and AIDS Strategic Plan (ZNASP).
Manenji told journalists attending a workshop in Chinhoyi last Thursday that a large chunk of HIV intervention support was coming from foreign funding.
ZNASP has been steering HIV programing, allocating resources, and implementing the HIV response since 2021, continuing through to the end of this year.
"The nation needs over $400 million annually as stated by ZNASP," Manenji mentioned.
The resource will aid initiatives across several themes including prevention, care, treatment, and support; program coordination and oversight along with program logistics and assistance.
Over the last decade, Zimbabwe has made significant progress against HIV, as reported by the World Health Organization. The nation has successfully met the 95-95-95 UNAIDS Fast-Track goals for adults, highlighting its persistent dedication to combating the HIV crisis.
These goals aim for 95% of individuals living with HIV to be aware of their condition, 95% of those identified as positive to receive medical treatment, and 95% of those undergoing therapy to achieve undetectable viral loads.
The latest HIV estimates suggest a positive trend, with the prevalence of HIV among adults aged 15 to 49 years declining from 12,69% in 2019 to 10.49% in 2023.
Manenji stated that the success of the HIV program can largely be attributed to significant international backing, which covers most of the costs, with the remaining portion being managed primarily through domestic funds sourced from the AIDS Levy.
Nevertheless, Minister of Health and Childcare Douglas Mombeshora has reassured individuals affected by HIV not to worry since the nation possesses an adequate supply of antiretroviral medications.
"You have likely all become acquainted with the sudden reduction in funding recently implemented by the U.S. government and the possible consequences this may have for addressing HIV and associated illnesses within our nation," he stated.
“As government we have already begun to put strategies in place to ensure that our people are not vulnerable.
The prudence of the government in setting up the National AIDS Trust Fund (widely referred to as the AIDS Levy) is now clearly evident through the necessity for reliable local financing solutions when donors decide to withdraw.
Along with the tax, the government is also developing several long-term programs, such as the National Health Insurance and additional measures.
We have allocated $12 million for purchasing new supplies of antiretroviral medications, and in June, we will receive another shipment that will last us until the end of the year.
There’s no reason to worry; we’ve made sure to prioritize the supply of HIV medication. Our aim is to continue treating those affected by HIV. We don’t want patients to miss their doses due to shortages, as this could lead to serious complications.
Mombeshora stated that the government is currently planning without considering the donors.
“This is not about the health sector, but it cuts across all sectors,” he said.
The Health minister stated that since Zimbabwe has achieved considerable progress in combating HIV and AIDS, the country must not become lax at this point.
"HIV and AIDS continue to pose major public health issues, with the dynamics of the epidemic continually changing," he stated.
New instances of HIV persist at elevated levels within particular susceptible groups including teenage girls and young women along with sex workers, whereas the provision of treatments continues to lag behind for younger individuals.
“Furthermore, new challenges like reaching critical groups and maintaining consistent treatment adherence call for creative solutions and collaborative action.”
*Not her real name
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