Below are a number of expert commentaries about the vulnerabilities of women:
- Edith Ng’oma works with the Forum for African Women Educationalists of Zambia, an NGO advocating for change in the Zambian education system and more broadly on the needs of girls and women.
- Dr. Carolyn Bolton works with CIDRZ – a not for profit organisation affiliated with the University of Alabama, whcih started in 2001 to assist the Ministry of Health to roll out a national PMTCT programme. In 2004 CIDRZ began to provide ART to patients in Lusaka, Southern, Western and Eastern province and has been working closely with the Ministry of Health to expand ART and PMTCT programmes.
- Felly Nkweto Simmonds is a sociologist and has worked with the Corridors of Hope HIV and AIDS Prevention Project, and is currently an advisor with the Population Council in Zambia.
- Joyce MacMillan is a legal practitioner and analyst with the Zambian Law Development Commission.
- Professor Nkandu Luo is a former Zambian Minister of Health, and President of the Society for Women and AIDS in Zambia. She is well known for her project – TASINTHA which was designed to support and protect sex workers in a variety of ways.
In terms of access to education, the situation has greatly improved but the problem now is with retention and completion; girls are able to go to school, but they are not able to stay in school. In terms of the quality of education, improvement is badly needed. We now need to try and ensure everyone gets as far as grade 8 and 9. Not all schools have grade 8 and 9, so some children have to walk long distances. Then they arrive in school tired and cannot concentrate. Sometimes they start renting closer to the school and go home at the weekends to get food and so on but if they run out of food during the week, they must return home and so miss school time. In certain cases, we have schools without proper toilet facilities for girls, so most of the time when they have their periods they would prefer to stay at home. Many, they don’t have sanitary towels as these are considered a luxury. So you find that while education may be improving because the Ministry of Education is active, the quality of education is not what it should be. Girls have to sit the same exams and often they are not prepared and so don’t turn up for exams. We have examples of classes of more than 40 students where only 5 might come for the exam.
FAWEZA has sensitised communities and formed committees to try to monitor the schools. Students keep a record and mark how many times a teacher comes to class. Some teachers just tell the children to read specific pages and stay in the staff room, so the children are on their own in class. There are still all sorts of problems and issues with schools.
FAWEZA has two major programmes, advocacy and lobbying and interventions designed to increase female participation in education. We have worked on a ‘re-entry policy’ which has brought a number of girls back into school after pregnancy; now when a girl gets pregnant, she is allowed to go on leave and come back about 6 months after delivery – this is major breakthrough. We are also working on the issue of preventing, managing and eliminating violence against children in schools. We also have scholarship schemes where we support girls and boys in basic schools, high schools and as well as tertiary level. We do not support students up to grade 7 because this is supposed to be free although uniforms etc. still need to be bought. We are supporting 70% girls and 30% boys in the scholarships programme.
The other programme is focused on SMT interventions – Science, Maths and Technology. In the past it was believed that tough subjects such as these were for boys only, and girls were not allowed to take them. We have introduced a competition where the best 4 students of each province are brought to Lusaka for a quiz. This encourages the girls to participate in these subjects. In this current year the overall national winner was a girl and in the teacher’s competition (which looks at methodologies for teaching these subjects), a female teacher was also the national winner.
In the past it was believed that tough subjects such as these were for boys only, girls were not allowed to take them.
There are many other interventions such as reading circles (with books supplied by UNICEF) and what we call SAFE clubs – Student Alliance for Equity; they are designed to help students help each other to study and where they also learn life skills. Traditionally, girls cannot have boys as friends, they cannot mingle but in these groups this can happen. We have overseers and peer educators trained to lead these groups. So they talk about different life skills, how to be assertive, HIV and AIDS issues, how to prevent infection etc. We also have what we call Back-to-Back where women in the community who have a skill (knitting, sewing etc.), come together and help each other learn. Then we try to give them a seed fund so that they can start projects and raise funds. 70% of the profits usually go to the women, and the rest goes to the children who are out of school. This runs hand in hand with ‘transit schools’ in most communities where children who drop out of school are encouraged back. We also have a security and safety project as some girls have to walk a long way to and from school and run the risk of abuse or even rape. We now have ‘safe houses’ with matrons who care for the girls; we now have about 6 of these houses; we also have mobile libraries as most schools do not have adequate amounts of books. Ultimately, the challenge is about building real access to education.
Lack of education has a big impact on the kind of decisions women make e.g. how they defend themselves because they may not understand their rights. We have a lot of women who find themselves in positions where they say ‘If I stand up to my husband and say this, what happens if he kicks me out, where will I go, how will I care for my children?’. This affects the country as a whole. When a child goes to school, they come home with homework and may not understand it or how to do it. If the mother is educated then they will be able to help but if the mother is not educated, the children may fall behind, and may even eventually drop out.
Most schools have HIV and AIDS clubs, but not everyone belongs to them, and that’s one disadvantage. The only time a whole school would benefit is if the HIV and AIDS club decides to do a presentation at assembly or something like that. Then everyone will hear. So to a certain extent, it is filtering into schools but not really fully; it needs to be included more in the curriculum for all ages. Some people are ok with their children learning about condoms and sex. But others feel that by teaching them about these things we are giving permission to have sex and culturally, some people are not comfortable talking about sex and reproductive health at all.
There is so much excitement when you go to a community and the women have learned to write their name – it brings a lot of pride. Traditionally, when a girl comes of age she is sent to her grandmother to be taught about womanhood and marriage. But if the grandmother is unable to read or write, she will only teach the girl about the more traditional aspects of marriage, and nothing about the danger of HIV and AIDS. If those women are taught how to read and write, and have information about HIV and AIDS that is the time they can teach girls about protecting themselves. Sometimes the children just have to depend on what they learn from television, radio and their friends.
HIV and AIDS education needs to be better represented within the school curriculum, and it also needs to be more integrated into teacher training colleges because teachers need to have this information. In this context, we are trying to use a gender responsive pedagogy where teachers are being responsive to gender. The way we are approaching this pedagogy is the way we need to approach HIV and AIDS, through a gender focus. Through the colleges, we can reach the teachers. Through the teachers, the students. Through the students, the homes.
Through the colleges, we can reach the teachers. Through the teachers, the students. Through the students, the homes.
Right now, women have little say in terms of bedroom issues. They go by what the man says. But if they are given information about how they can share this information with their husbands, what their rights are, perhaps a lot of issues could be resolved.
We need to have mobile schools in rural areas where even just once a week in the really remote areas, we have teachers coming to see the women, teaching them something, leaving them homework for the following lesson. If we were to bring the school to the communities where they could spend a few hours, women would be very willing and maybe then, women in really rural areas can have access to education.
Some cultures believe that the earlier the girl gets married, especially if she is a virgin, then the better it is in terms of the dowry; this is a major issue. There are cultural traditions where if a woman dies, her sister takes her place without finding out why someone has died. Such cultural practices are hindering women.
The situation for women is now improving even in rural areas where there are groups of women who take part in these clubs and where they teach each other skills and reading and writing. They are making an effort on their own. In the past people chose to send the boy to school but for a girl, she would be married off. Now many have realised that it is not always the case that a girl should get married. The value placed on education is also changing. People are becoming sensitised and we now hear more about abuse etc. In the past we would have been told not to embarrass the family by talking about this. Sometimes we would only hear about it after a woman has died; now it is different, women can talk about it more. They also have the courage to report cases of abuse, although they still fear not being protected. Education is positive because people now know they have rights and women know where they can go to be kept safe. Women also now realise how important being educated is along with having work, so that they become self-reliant instead of just depending on their husband. This is what is happening, tradition is changing.
Edith Ng’oma is Programmes Manager at FAWEZA – the Forum for African Women Educationalists of Zambia, an NGO advocating for change in the Zambian education system and more broadly on the needs of girls and women.
Dr. Carolyn Bolton
At the moment people don’t think about the future, they just try to get through today.
The biomedical vulnerability people talk about arises because women are the recepticles. The virus is in contact with women’s mucosa for a much longer time, thats the most obvious part of it plus semenal fluid has a much higher viral load, plus micro-abrasions and STIs facilitate the entry of the virus into the body. The physical breaking down of the mucous-based barrier leads to inflamation and when there is inflamation, you have CD4 cells and where you have CD4 cells you have more receptors for HIV to bind to – so inflamation itself causes risk. If a man has a sore on his penis it is easy to see and they often get treatment, and will a lot of the time refrain from sexual activity until it is gone. For women, it is inside and you cannot see it. They may not even be listened to if they say it is sore inside, nobody will listen so the sex continues.
There are also issues with early sexual debut to do with the junctions and epithemial lining at the cervial entrance – it puts girls at a higher risk. And early sexual debut can mean more sexual partners, more high risk sex, and more exposures.
ARVs are now available at most district clinics within the provinces but the care women should be getting is both pre-ARV (those who are enroled into care, but are not yet on ARVs but who need regular care and counselling) and post ARVs. The goal of Anti Retroviral Therapy (ART) is to supress the virus, so that many of the complications we see in HIV patients are minimised. The virus attacks CD4 cells and the body’s immunity drops causing ongoing acute infammatory reaction, which can lead to other problems. The objective of ART is to lower the virus, which leads to an increase in CD4 count. To achieve this, we use a combination of three drugs for the basic ‘first line’ therapy – D4T (Stavudine), 3CT(lamivudine) and NVP (Nevirapine). It works quite well but there can be severe toxic side effects, however, it is cheap and can be taken in one tablet twice daily.
We do have some fairly low level ART clinics so the therapy can be brought to the people, but ART is not a simple thing. We have tried to simplify it for equity reasons and for accessibility but there are limits; you need people with some medical training to hand out ARVs. Some countries are using basic lay counsellors, which is fine for giving out ARVs. But to monitor patients and to decide if ‘second line intervention’ is needed, you do need some medical training; we need more nurses and more nurses with specialised care experience.
In the past four to five years, we have had much better drugs and have switched to ones with fewer side effects. We switched all our patients to a new first line drug. In ideal circumstances where patients respond well, where treatment is consistent and available, the first line ARVs should be good for ten to twenty years. But that is often not how it is, for instance, we have people becoming infected with primary drug resistant strains, which means the drugs don’t always work, we also have malnutrition, chronic diarrhoea infections etc. so we are now seeing the drugs being effective for maybe six or seven years. Then we have to switch to second-line drugs which, in Zambia, should give patients another five to ten years of resistance. We now also have patients on third-line treatment. Cost is an issue – third line drugs are up to ten to fifteen times more expensive than first-line. In this context there also needs to be greater patient accountability.
Part of the problem is the whole ‘Africa Shrug’. I was born in Africa, I am an African, but you see the shrug. Life happens, people die, people get born. It’s a very accepting attitude and it has had drastic implications, particularly with HIV.
Part of the problem is the whole ‘Africa Shrug’. I was born in Africa, I am an African, but you see the shrug. Life happens, people die, people get born. It’s a very accepting attitude and it has had drastic implications, particularly with HIV. Women need to be empowered and take the power and stand up, particularly with education. We cannot win with HIV unless women are empowered. It doesn’t matter how many drugs we have.
Bio-vulnerability does have a role but it is not the most important thing. Ultimately, it is about women not being able to say who they have sex with and when they have sex, it’s about women not enjoying sex. On average women in Africa have sex when the men want, there is no wooing or foreplay or natural lubrication and I think that’s really important, all too often it is a traumatic experience. The micro-abrasions and all the other things that come with traumatic sex make it high risk, plus the number of partners you have and the number of times and the fact that your husband isn’t faithful, all of these aren’t going to change unless women become empowered.
It’s not all about ‘poor women in Africa’ – women in Africa need to stand up.
Yes they may get kicked out of their homes, but they need to fall back on some system that will allow them to be single. Because here, you are no one until you get married. Not just here, all over Africa you are defined by your marriage. Society is not ok with single women in Zambia and I think that is the fault of both men and women. We need to be changing paradigms, if people don’t see that it is ok to be a woman who is not married and without children, we actually won’t be able to change any of this.
Women want to get married and women see their lives as being complete when they get married and have children. And yes it is acceptable for your husband to have multiple partners. The women reason by saying, “he will kick me out if I complain,” but maybe we need a generation of women who get kicked out. We cannot win otherwise, it’s not all the man’s fault; women need to take responsibility for themselves. I have been working in HIV for 10 years, people are being infected every single day, babies are dying every single day. Ten years down the line and where are we? Women are strong, women can change the world, and they need to. We need to start putting the responsibility back on the patients. It can’t come from outside, it has to come from the bottom up.
In terms of what needs to be done, education must be emphasised. Women have to believe they can change the environment, they must want to change the environment and they must believe that HIV is a virus, that it can be stopped by changing current practices. Until women believe they can change, that their children can get better, it’s not going to change. People need to dream of a better and realisable future. At the moment people don’t think about the future, they just try to get through today.
It’s not all about ‘poor women in Africa’ – women in Africa need to stand up, yes they may get kicked out of their homes, but they need to fall back on some system that will allow them to be single.
The government needs to ensure policy is kept updated and they need to ensure the education of the girl child. We need stronger laws against violence and rape but if we wait for the government change, we will lose generations of people. We need to recognise there is only so much the government can do but I am also sure that there are some in government who believe that women should still be barefoot and pregnant in the kitchen.
There are so many things that need to change – the health and education systems, the subordinate position of women, individual attitudes and behaviours, cultural beliefs and practices, and our inaccurate statistics etc. There are ways of moving on.
I’m not a sociologist, I’m not an anthropologist, I’m a doctor and I don’t know how to change these things. Its so complex because it’s so taboo, sex is so taboo.
However, things are improving in that we are treating a lot of people and a lot of people who were very sick are doing well, much better. They are productive and so they are able to go to work and look after their families and children. Particularly for children HIV is a terrible illness and ARVs improve the quality of life dramatically. I have had kids who had contratures, sores, bedridden, crying, who are now running around playing, painfree, which to me is a huge step forward. And our system is definitely improving.
Yes we have come on in leaps and bounds but we are still spreading the disease, engaging in high risk sexual practices, people not taking drugs properly. It must be that they don’t believe in the drugs or that they don’t believe the future is worth living for, otherwise they wouldn’t stop their drugs.
Dr Carolyn Bolton works with CIDRZ – a not for profit organisation affiliated with the University of Alabama, whcih started in 2001 to assist the Ministry of Health to roll out a national PMTCT programme. In 2004 CIDRZ began to provide ART to patients in Lusaka, Southern, Western and Eastern province and has been working closely with the Ministry of Health to expand ART and PMTCT programmes.
Felly Nkweto Simmonds
Some of the worst cases of violence against women in Zambia have been with professional women who begin to challenge the economic power of men, in particular their power in decision making – the power to say how many children they have or the power to say when or whether they leave the house. Economic empowerment comes with its own problems and that’s where we need to start. For me what makes young women vulnerable is the basic issue of power dynamics where both gender and economics work at the same time.
Traditionally, the power of decision making lies with the men whether as fathers, heads of household, husbands etc. From the moment a female baby is born, they are disempowered; decisions are made whether they can go to school, whether they can go out and play instead of doing chores etc. So even before we consider economic vulnerability, females are already less empowered in the way they are brought up as girls.
As a result of how they are socialised and reared, women often do not believe they deserve economic empowerment. What we need to appreciate is that girls and women become adults already disempowered at a very fundamental level, where you think of yourself as being less because you don’t have the same privileges, the same education and even if you do you are encouraged to think of it ‘as less’. You go to college the choice of courses for men and women are already different. This is not only in Zambia, it is everywhere, but here it is exaggerated.
So women go and do those courses but they still want to get married and the degree they do enables them to get married – that is what it is there for. And of course their parents are quite happy to get a big dowry for them because they have that education, which is really why they made you stay at the University of Zambia (UNZA). So although they get that extra education, it is not necessarily for them, it is for the benefit of those around them. If they have a degree from UNZA they are a commodity.
People actually believe that there is no point applying for a job if it is in the paper because they think ‘if I am not beautiful, I won’t get the job’. Women need to value themselves; to value yourself is really difficult unless someone values you. And sometimes people value you for reasons that are not about you – ‘I value my daughter because she will bring me a nice dowry, she can maintain me’ and all of this. So by the time a woman gets a job and a salary, is she going to get to keep it? The tension starts there. The women will have to ask for the money because the man thinks ‘I am the one with the money, I should have the money’. There is an ‘asking’ relationship going on. When we talk about girls and empowerment, we need to empower them in terms of a better education, and better money but the empowerment also needs to be internal. Women need to be given self confidence, they need to be people and have the right to make decisions and have the right to marry someone who is not going to belittle what they have done.
So although you get that extra education, it is not necessarily for you, it is for the benefit of those around you. If you have a degree from UNZA you are a commodity.
Economic empowerment has to go in tandem with other types of empowerment. If we do other income generating activities, they cause problems because they just throw money at people. For example, if a woman gets a loan in her women’s group and she goes home with the money, most of the time the money will be taken by the husband. When we do economic empowerment activities, we have to be very careful what it is that we do, so that we don’t disempower women even more. This is what has happened – I have seen it.
Economic empowerment for individual girls is first of all internal. Get the girl to think about themselves, to value themselves – that is internal self confidence, self esteem and then the money can work because you are your own self. You can make your own decisions about your life, your children’s lives, where they go to school etc. What makes women feel less empowered, even if they have money in their hand, is that they have no control, no power. All of these things undercut women. All women need to be empowered, but there is more work to be done to get there. I know women who are economically empowered, but it is at a cost – most of them are not married and, for example, when a woman dies, where do you think her property goes? To the husband! So once people are empowered, they need to know how to keep what they have.
I want girls to go to school, to be taught how to be people, to think that they are worthy; they are real whole people with integrity, so that if they do economic empowerment, they have that as a baseline for themselves so they will have the power to negotiate. The more economically empowered you are, your house will fill up with orphans. Women always have to care for their parents, their siblings, their siblings’ children. I don’t think there is a woman I know who works who doesn’t have orphans and other children in the house. They put their siblings through school and care for them.
Rural women are better off in some ways because they don’t depend so much on money. For rural women, it is land that is important. If women can have access to and legally own land which they can farm, they can grow. If you can grow maize to eat and sell the surplus you can buy the other things you need. People are better off, not in terms of cars and things like this, but in the way they live. I am not saying they are not poor in the rural areas, they are poor. They are poor and getting poorer. But when people get sick and die in towns, where do they send the orphans – back to the village!. So the woman who has a small piece of land and grows some vegetables now has a burden of children. So those children then have to go to school, as well as her own children if she has them. HIV and AIDS is making rural people poorer because the burden is getting bigger. When women have access to land, they are so resourceful, they grow things! Even in the towns, the most resourceful people are women. They grow vegetables, they keep chickens – they have several jobs at the same time. They are looking after lots of people. So the more money women have, the more responsibilities they are expected to shoulder, especially in the time of HIV and AIDS.
What makes women vulnerable to HIV? It is utterly the lives that women live, the lives girls are born into, the lives they are forced to live in, the only lives they can live.
There are lots of women who have power out there who are being mentors to the younger women, so it is not all bleak. But Zambia is still not ready for these women.
If women don’t have economic power, they are totally at risk of HIV and AIDS infection. To survive, women will put themselves at even more risk, so a married woman who knows her husband has two girlfriends is never going to say ‘you are not coming back into this bed’. The cultural expectations are that he is a man; he can do whatever he likes. Most HIV infections are in stable relationships, in marriage. Women will look for money – if they have children to feed, they will sell their bodies, even for a drink, they will sell their bodies. Women are more at risk the less money they have and the less control they have over their lives. And of course there is the whole thing about older men and younger women – so girls expect to have an older boyfriend to supply things e.g. finance, transport, communications etc.; a young guy is the one they go partying with.
What makes women vulnerable to HIV? It is utterly the lives that women live, the lives girls are born into, the lives they are forced to live in, the only lives they can live.
It sounds very bleak for those women and it is bleak for them, but we should be giving them education, giving them skills – risk assessment skills – know when you are at risk. Women walk blindly into things not realising they are in a terrible place. They think ‘you don’t want us to have fun’. Have fun, but just have fun safely, otherwise you will never get old! You need to have control. A woman’s life is a risky life in Zambia. It is not that women are always victims but sometimes women think they are in control and act on it, assuming they are actually in control.
Men are more at risk because they are the ones with more control and in theory, they can control the risk factors, but they choose not to, whereas it is the opposite for women. To choose to not be at risk is to stand up to a lot of things. It’s not as simple as saying ‘I’m going to protect myself’. This is why you can have as many abstinence programmes as you want – people don’t abstain. In the moment, girls think they choose to have sex, but all sorts of other things are happening actually. They don’t have much choice. The abstinence messages need to be targeted at older men – men need to abstain from having sex with children, men need to abstain from having sex with every woman that they see.
In the day of HIV and AIDS, they are saying it is ok for your husband to go and get HIV over there etc. until you are completely infected – that is marriage, and that is acceptable because you are a wife. If he does anything to you, keep it in the house! If he slaps you, beats you, bashes your head against the wall, keep it in the house!
A lot of people don’t realise what marriage is. It is like a big game but you only have a marriage certificate when you get married, not a marriage. Marriage in Zambia is very different. Traditional teachings tell women that when you are married you need to please your husband this way, if he travels, don’t worry, he will come back to you. In the day of HIV and AIDS, they are saying it is ok for your husband to go and get HIV over there etc. until you are completely infected – that is marriage, and that is acceptable because you are a wife. If he does anything to you, keep it in the house! If he slaps you, beats you, bashes your head against the wall, keep it in the house!
People who have power don’t exercise it directly; they get you to do it yourself. They teach you how to oppress yourself. A man doesn’t have to come to the kitchen parties and bridal showers to tell the woman how to behave, her mother will do it. Because if her husband sends her back to the family, people will point to the mother and say, what kind of mother are you? Did you not teach your daughter? Men go drinking under a tree, and women are killing each other over here. Oppressed people are very good at oppressing other people.
Women in positions of leadership are also on the side of the oppressor because they are powerful people. They play the same game. There is no women’s movement in Zambia; there was a fledgling movement in the 80’s. Zambian women were sent to international conferences to speak about Zambia and then come home and do nothing. So that was seen as one way to gain power – to become a spokesperson. For me it is the same as people who say they are activists, but don’t do anything. Unless you actually do something, it is just noise.
The main thing is how do we bring up the next generation of women in Zambia? We have to start at an individual level in terms of behavioural change, so we have to start at an individual level of beliefs and values, and this is a problem. You can’t just say change your behaviour by using a condom – that is nonsense. You have to start with what is sex to people, how do they use it, for each other, against each other? You need to challenge belief systems but also enable young people to see that there are different things that will, and can, happen. And they can happen. If things are going to change for young people, then adults need to change. It should be up to adults to say – “we will not marry our daughters off until they are 18.” A girl cannot say this. If parents say our daughter is not going to get married until she finishes school, can you imagine the difference that would make in the way that we value our girls, in the way they value themselves? We can all do something, no matter where you are.
Oppressed people are afraid of freedom because if you are free you have to make decisions and take responsibility. Victimhood is sometimes a very comfortable position.
Oppressed people are afraid of freedom because if you are free you have to make decisions and take responsibility. Victim-hood is sometimes a very comfortable position. People need to stop thinking like – “look at your daughter, she is 27, she has a degree, she has a job, no one will marry her” – that is totally the wrong way around. They should be falling over themselves for her. But people are afraid of freedom. Girls need to know they have a choice.
Felly Nkweto Simmonds is a sociologist and has worked with the Corridors of Hope HIV and AIDS Prevention Project, and is currently an advisor with the Population Council in Zambia.
I began practicing as a legal practitioner in a private law firm, then moved to corporate law as legal counsel and company secretary. Later I moved into the field of women’s rights where I worked for 8 years before coming to the Zambia Law Development Commission. The Commission is a Statutory Body empowered to research and make recommendations on the socio-political values of the Zambian people that should be incorporated into legislation, the anomalies that should be eliminated on the statute book and the removal of archaic pieces of legislation from the statute book, among other things.
The legal vulnerability of women in Zambia stems from the fact that discrimination against women has been legalised and that, as a result, women are restrained in exercising their right to self-determination, to autonomy and to physical integrity. Zambia has a non-discrimination clause in the Constitution, but that clause does not apply to customary law and yet everybody lives their daily lives governed by customary law because we are born into it and we are socialised by it. By failing, reusing or neglecting to exclude non-discrimination under customary law, we have effectively left the door wide open to discrimination against women.
There are certain things that a woman can and cannot do. As a married woman there are do’s and don’ts, there are norms. Women are forced or coerced, threatened and made to comply with those norms in daily life. This approach has permeated our laws beause the people who enact the legislation are socialised in the same manner they have the same values as do our judges. There are also silent, unspoken and intangible methods of control that force women to comply, and if you are not complying, then you risk becoming an outcast and because you have to comply, you are vulnerable to HIV and AIDS.
With customary law, from the time of puberty, you go through initiation and are taught how to be a woman and what is expected of you. Some customary practices during the initiation into womanhood also expose women to HIV infection. For example, in the Eastern Province of Zambia there is a practice where a sexually experienced older man has sexual intercourse with the girl before the coming out ceremony (the practice is called ‘kungenesa fisi’ and is practiced among the Chewa). The initiation makes young girls often below 18 years think they are now women and the coming out ceremony (called ‘chinamwali’ among the Chewa, the ‘Nkolola’ among the Tonga and the ‘ichisungu’ among the Bemba) is a public announcement that the girl irrespective of her age is ready for marriage and sexual activity.
From there, you go into marriage and it is from there that the danger of infection really takes hold because at least outside marriage women have some power to say no or ‘use a condom’. But for married women, we are socialised to, once you say “I do” – you say yes to sex, at his convenience, even though you know he may be interacting with other people sexually. There is further a lot of pressure to stay married and as many women remain economically disempowered, they cannot get out of marriage and then there is also the pressure to have children.
then there is also the pressure to have children. The courts do not use the Convention for the Elimination of All Forms of Discrimination Against Women (CEDAW) or other international conventions because they are not very self-effective. Zambia ratifies them but we then have to domesticate them and instead of doing so, we copy and paste, pick out what we like and paste it into law.
There is a multitude of reasons why women stay in a bad relationship – the social stigma, the economic implications – “what will I do, how will I eat?” and then divorce courts usually side with the man when dividing the property. We are now trying to change this legally.
The courts do not use the Convention for the Elimination of All Forms of Discrimination Against Women (CEDAW) or other international conventions because they are not very self-effective. Zambia ratifies them but we then have to domesticate them and instead of doing so, we copy and paste, pick out what we like and paste it into law.
We have a programme for women who are pregnant to access prophylaxis to prevent Mother to Child Transmission – we call it mother to child transmission, women are blamed and this has consequences. When a woman goes into an antenatal clinic and is tested positive, she has to sit down and think, should I tell him, or keep it to myself. Sometimes women who have told have suffered consequences and this discourages others from telling their partners.
Sexual harassment in the workplace is not a criminal offence; it is in schools when it involves children, but not in the workplace. A lot of women become infected because of sexual harassment in the workplace. A man just comes onto you and they are literally raping you or coercing you into having the sexual interaction because they have the power over you to fire you, discipline you or make life in the workplace extremely difficult for you. It is difficult to prove because it happens in private and it is your word against his, and he is often a more powerful, highly respected person than you.
Inheritance law excludes customary land, so if you and your husband are married, you build your home or your house on land held under customary tenure, you cannot inherit that land or the house. Because of this it allows the man’s family to come and take away that land or you can be inherited by his family. If you refuse, you have to go back to your pre-marital home.
But what strikes me the most is that the younger women should be allowed to stay to keep their children there. However the head man sometimes says ‘I do not want an infected woman who is young, who will infect other men in my village, so she must go!’ So he will influence the family to tell these women to leave.
So you will find a lot of women moving to the urban areas. In Monze, there is a compound, Zambia compound – if you go there, you will see a lot of widows and their children there. Out of every 5 houses, 4 are widows. We found that they are mostly all young women who have been dispossessed of land, and had no where to go back to, so they move to town, either build a place or rent one or two rooms in the compound. They become commercial sex workers during the night, and during they day maybe they sell some tomatoes or cabbages to provide for their family. Sometimes those women become very sick also, and it is the children who have to care for them.
Under customary law, women do not marry men, men marry women. Customarily the woman cannot divorce the man, it is the man that must divorce.
A lot of children are then being trafficked because they are trying to fend for their family. Some young girls are worked to the bone, sometimes paid with only one meal. You see young girls being taken from Monze to Chirundu or Livingstone to be used in the sex trade, and often getting infected. It is a vicious circle, it is so difficult.
There are a lot of Zambian women who do not opt for divorce but for judicial separation thinking that this order will separate them from the man and, as a result, they are protected from this man. But that separation order does not end conjugal rights, so at night, the man can come for sex, drunk or sober and the woman can do nothing. Women who apply for judicial separation now need to make an accompanying application for an injunction for restraining these conjugal rights.
Under customary law, women do not marry men, men marry women. Customarily the woman cannot divorce the man, it is the man that must divorce. So the woman will go to the court and explain and the court will say, you must make an application for something else (such as reconciliation) rather than divorce especially in rural areas and only if the court is satisfied that the couple cannot reconcile will an order for divorce be made. We need to move away from a lot of customary laws, but there is a lot of resistance, even from the women themselves. Some traditional leaders see the need for change but many others do not.
Joyce MacMillan is a legal practitioner and analyst with the Zambian Law Development Commission.
Prof. Nkandu Luo
What is particularly sad about the impact of HIV and AIDS on women in Zambia is that when you stratify by age, it is younger women that are more infected. In fact if you look at the statistics for women, they are 1.4 more times more likely to be infected than men, and young women could be as much as four times more likely to be infected than men. A UNICEF study found that, up to the age of 15, you see an equal infection rate for young women but somewhere between 15 and 19 something happens in the lives of these young women and the infection rates sky-rocket, especially around 17, 18 and 19. The infection rates again are quite high for married couples and it is true to argue that to be married is to be at risk.
I think a lot of us have been trying to understand why this is the case. Now we know that one of the main reasons for high infection rates among women is the whole gender inequality issue. We need to unpack what gender inequality means, and that’s where the issue of the socio-cultural aspects come in with, for example, the whole issue of gender based violence. We have evidence on the way women are socialised (as against men), women are socialised to be subordinate. They are socialised to be tools, not human beings. They are socialised not to enjoy their rights. Therefore as a woman grows, their primary goal is to be married. If you look at the opportunities available – if you go into a home with few resources, the choice of who attends school is very obvious; the boy will attend school and the girl will get married. You will find situations where older and younger women stay in abusive marriages, simply because that is what they are expected to do by society; do what you are told, do not question your husband even if he has multiple concurrent partners. But what about the rights of the woman, what about the rights of children in the home?
Traditional practices happen in urban areas as well as rural areas although because it is not so pronounced people don’t discuss it. Sexual cleansing, for example, happens in both urban and rural settings. What is interesting is that sexual cleansing traditionally is not just about sex; some people jump over a goat, wear some white beads or have mealie meal thrown over them to say ‘you are cleansed, you have moved from that husband, you are free to remarry.’ That is its primary meaning but now the sexual cleansing has become predominant. While it is decreasing in prevalence, it is still an issue upon which we must continue to campaign.
Another practice involves the use of herbs to dry the women’s vagina as it is believed that men enjoy sex more if the woman’s vagina is dry, so women put herbs in their porridge, in tea or even insert it into their vagina. However, as a result of awareness campaigns and increased knowledge, the practice is also decreasing.
…for many years, traditional healers have filled the gap in health services, they are the closest health providers at household level. Because people do get well so they believe in traditional medicine because there is no other alternative.
The other practice that is hidden and that people don’t talk about a lot is the situation where a man fails to make a woman pregnant – the ‘blame’ is passed to her. Often, the family gets together and talks about it quietly and arranges to find a brother or a cousin to father the child, there is a secret arrangement where the ‘arranged’ man makes the woman pregnant and the husband knows that this is not the child. That’s why, in our tradition it is never a child from the male side who becomes chief; it is always from the female side. This is because the woman then knows for sure that this is her child.
People in the rural areas have not been adequately reached in terms of information messages, awareness etc., especially as regards how they translate that knowledge to risk reduction.
In a lot of African countries there is very poor access to health services and people have to walk up to 50kms to get to a rural health centre and even further for access to a hospital. What is even worse is that having walked that far to a centre, there may be nothing, not even drugs. You might find unqualified people delivering health services and so, for many years, traditional healers have filled the gap in health services since they are the closest health providers at household level. Because people do eventually get well, so they believe in traditional medicine because there is no other alternative. Personally, I think we have not used traditional healers adequately in the fight against HIV. On a daily basis in a village, the homes of healers are full of people seeking help and this is a good opportunity to increase awareness and knowledge. For example, campaigns on the use of condoms and so on could have worked through these traditional healers.
A witch doctor is very different from a traditional healer. A witch doctor is someone who is believed to have magic, and can do things through magic whereas a traditional healer is someone who delivers traditional medicines to the people and this usually comes from the roots of trees, barks of trees and leaves – it is organic. If you look at how some medicines are made, they are made with the same ingredients; it is just that a traditional healer does not have a defined dosage, so they may ‘overdose’ the person or they may not know fully what medication for what disease.
People in the rural areas have not been adequately reached in terms of information messages, awareness etc., especially as regards how they translate that knowledge to risk reduction. They have to risk. They have often not had adequate access even to condoms (or to non-defective condoms). So we need to do a lot more. The whole crisis of orphan children has shown how the whole extended family system has broken down; given the poverty of rural areas it is increasingly difficult for people to look after these children.
We need to rethink our strategy for HIV. Despite the fact that we have known for a long time that women are more infected than men, we still undertake ‘general’ interventions; it is now time for interventions that target women directly. And not women generally, but women at different levels, because the epidemic does not affect an older woman in the same way it affects a younger woman.
Despite the fact that we have known for a long time that women are more infected than men, we still undertake ‘general’ interventions; it is now time for interventions that target women directly.
The other thing we need to appreciate better is that because women have been socialised to think they are subordinate or second class citizens, they lack assertiveness and self esteem – they look on themselves with pity. We need a lot of education and exposure for women at a very young age so that they begin to appreciate who and what they are in society. We continue to think that the people who develop our countries are men but, in my opinion, the male form of leadership in Africa has failed. In addition to that, we must mobilise women to become an increasing part of the decision making process. We can use HIV as an opportunity to deliver these messages. When you look at the National AIDS Councils all over the world, they are run by men and they don’t create enough programmes that address women’s issues per se.
The economic empowerment of women is vital; with respect to HIV, education is not enough. I work with one of the most vulnerable groups in the world – sex workers – and they are one of the most organised groups of women. They will tell you they know in detail about HIV because they have nursed their friends through it. Yet, they will go on the streets the next day because they have to. We need to empower them with skills so that they will start earning money and will not be on the street and exposed to HIV. At the centre of any HIV programme must be income generation and entrepreneurship. Educational campaigns alone are a waste of money because women know about HIV, but they will still expose themselves because they have no alternative.
The role of the government in relation to HIV and AIDS is crucially in the areas of policy and law, in addition to funding. What is sad about Africa is that too many of our governments have decided they have no money. But if there was an election tomorrow, they would find money for the election. So they need to rethink their priorities; we need to mobilise our governments to put money on the table. The government needs to wake up to the reality and know what the priorities are. One of these priorities is to reduce HIV infections in our nation and to reduce the burden of disease among the people, and also to reduce the impact HIV is having on people, households and families. It is time to move from rhetoric to action.
A former Zambian Minister of Health, Professor Luo is President of the Society for Women and AIDS in Zambia. She is well known for her project – TASINTHA which was designed to support and protect sex workers in a variety of ways.