In the continued fight against HIVAIDS, Zimbabwe, through the Ministry of Health and Child Welfare and Population Services International (PSI) have set a goal of circumcising 1.2 million men by 2015. Since the launch of PSI’s, GetSmart or Pinda Musmart male circumcision campaign in 2010, about 40,000 men have gone under the knife. Other countries are following Zimbabwe’s example and getting behind the male circumcision, in fighting HIV. Rwanda is another country that has most recently jumped on the male-circumcision bandwagon, and they have done so in a most innovative manner.

Rwanda is introducing a painless, non-surgical circumcision that causes no bleeding!

Read more below:

Circumcision has been shown to lower the risk of HIV transmission and infection in Africa. Now, a new device known as the PrePex enables circumcision to be performed without surgery or any blood loss, by nurses, who don’t need extensive training to use the apparatus.

The Rwandan Government has completed its third trial of PrePex with nearly 600 volunteers and has concluded the device is a safe and efficient way of performing circumcisions. It now aims to reduce new HIV infections by fifty percent, in part through a campaign to circumcise two million adult men over the next two years.

The results were presented at the 16th International Conference on AIDS and Sexually Transmitted Infections (STIs) in Africa (ICASA).

Michel Sidibé, Executive Director of UNAIDS said:

“Innovation is key to achieving our target of 20 million voluntary adult male circumcisions by 2015 and saving millions of lives. Devices such as PrePex have the potential to facilitate safe and rapid scale up of male circumcision for HIV prevention, an urgent need in Sub Saharan Africa.

We commend the government of Rwanda for progressing the science of HIV prevention for the benefit of the region.”

An evaluation from the World Health Organization said the study of the PrePex device provides further clinical evidence that circumcision performed by nurses when using the PrePex device is fast, safe and effective, enabling a bloodless procedure that requires no injected anesthesia, no sutures and no sterile settings.

Agnes Binagwaho, MD, M(Ped) PhD hc, The Minister of Health of Rwanda said:

“We are unwilling to allow our health system resource challenges to dissuade us from our mission: to create a healthier, HIV-free Rwanda. We are committed to finding innovative, safe and effective solutions to make this happen …

This study shows that with the non-surgical PrePex device we can safely task-shift circumcision from surgeons and family physicians to nurses, which if nationally scaled up, would make a significant contribution to our public health system.”

Controversy regarding circumcision and HIV risk
There has been some controversy regarding the effectiveness of circumcision to prevent the spead of the HIV virus. Circumcision rates are far higher in the United States than in Western Europe, yet HIV cases remain stubbornly higher in the US and W. Europe, contrary to what might be expected if circumcision is so effective.

While many doctors are in agreement as to its effectiveness in Africa, the topic has its detractors that range from those demanding more research and scientific proof, some who point to contradictory findings from several studies, to wild conspiracy theories.

How does the device work?
The device basically works by stopping the flow of blood to the foreskin. It remains in situ for a week, after which time it is removed along with the foreskin that has died due to lack of circulation.

The average time for installation of the device is less than three minutes, with the advantage that it doesn’t involve surgery or cause blood loss, and thus can be performed by nurses.

The device and procedure, which can be performed in a regular doctor’s consulting room has an AE rate of 0.34% (2 out of 590), and the total study adverse event (AE) rate when performed by nurses was 0.83%. All resolved with minimal intervention, and the AE rate was lower than previously reported AE rates for surgical male circumcision when performed by surgeons (4.8%).

In Rwanda there are only 300 trained physicians for around 10 million people, and nearly 90 percent of the population live in rural areas that lack sterile facilities.

Analysis shows that scaling up circumcision via surgical procedures would drain resources from surgeons who work in vital life saving areas, not to mention the likely resistance from the local population.

The study was approved by the Rwanda National Ethics Committee and was conducted in Kanombe Hospital, Kigali Rwanda, between July 2011 and October 2011.

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The World AIDS Day umbrella theme until 2015 is “Getting to Zero – Zero New HIV Infections. Zero Discrimination and Zero AIDS Related Deaths”. UNAIDS has developed 10 strategy goals by 2015 in relation to the Getting to Zero campaign, and these are listed below:

1.Sexual transmission of HIV reduced by half, including among young people, men who have sex with men and transmission in the context of sex work
2.Vertical transmission of HIV eliminated, and AIDS-related maternal mortality reduced by half
3.All new HIV infections prevented among people who use drugs
4.Universal access to antiretroviral therapy for people living with HIV who are eligible for treatment
5.TB deaths among people living with HIV reduced by half
6.People living with HIV and households affected by HIV are addressed in all national social protection strategies and have access to essential care and support
7.Countries with punitive laws and practices around HIV transmission, sex work, drug use or homosexuality that block effective responses reduced by half
8.HIV-related restrictions on entry, stay and residence eliminated in half of the countries that have such restrictions
9.HIV-specific needs of women and girls are addressed in at least half of all national HIV responses
10.Zero tolerance for gender-based violence

(http://www.unaids.org/en/aboutunaids/unaidsstrategygoalsby2015/ )

This year’s World AIDS Day was barely over when I read an article about a South African journalist detained in, and deported from Qatar due to his HIV-positive status.

Naturally this news report brought up numerous questions. Even though I knew that some countries have visa restrictions for HIV/AIDS, I did not realise the extent of these restrictions, and the lengths to which and procedures some countries followed in order to enforce these rules.

Including Qatar, 47 countries worldwide have the HIV restrictions mentioned in UNAIDS strategy goals. Restricting the travel of people who are HIV positive is a measure these countries have taken to curb the spread of AIDS. Up until recently, the USA and China were among the countries that listed having HIV as a medical basis for inadmissibility and denial of visas.

I have tried to think of the reasons behind these prohibitions. It seems a logical move, I guess. Almost like the reverse of quarantine. The separation of infected people as an emergency response to prevent the spread of disease (especially those about which little is known) has been practiced throughout history, the world over, and in theory, should be quite effective in preventing the spread of HIV. But … I don’t think so!

We now know a whole lot more than we did in the 80s and 90s about the nature of HIV/AIDS and there is therefore no need for such draconian restrictions, which I feel do little more than fuel the fires of stigma and further marginalize people living with HIV in an age when openness about the disease is being encouraged and treatment is mostly readily available.

The world has become a global village and it is now not unheard of that nationals from one side of the globe, travel and even work on the other side of it. What has happened to this South African journalist is a harsh reminder of how bad the situation currently is and how much work still needs to be done on the issue. As UNAIDS continues in its call for the “global freedom of movement for people living with HIV”, I’m wondering how they might help this victim of discrimination and ill treatment due to HIV-positive status, and maybe use this issue as a platform to effect change and shed light on HIV discrimination and stigma?

I used to think that women who were beaten by their partners had no backbone. I saw them as weak and stupid. I didn’t really understand how difficult a step it was to bring the culprits to justice in Zimbabwe, until my own sister was entangled in such a relationship.

The first time she told me that he was beating her, I immediately thought “We’re so, gonna get him arrested!” And so, the very next morning, with her injuries still fresh(ish), we drove to Mabelreign police station, ignoring others’ suggestions to take matters into our own hands and get him thoroughly beaten up. I had really high hopes that he would be properly punished, according to the law, for what he had done. In retrospect, we should have beaten him ourselves!

It did not take long for me to see that the matter was of little or no importance to them. They asked her to make a statement, which they convoluted, writing it in their own words and later asked her to sign. They then casually mentioned that they had arrested him before for assault and knew him reasonably well. They laughed as they recapped previous encounters with him. The whole issue seemed to have lightened to mood of the station and offered the officers some comic relief. I told them this was not a laughing matter.

They assured me that they were sending a car out to get him, he arrived nearly 2 hours later, (driving his own car), nonchalantly eating an apple. The “Public Relations” officer explained that he would like to talk to them both, in order to ascertain what really happened, and give them both counseling. I insisted on going in with my sister, (I was not going to let her be in the same room as that monster!). The counseling, if one can call it that, was done in a small room where we all sat on the same small bench. Was I dreaming? How can they expect a victim of domestic violence to sit next to her abuser and give all the details of the experience?

I complained to them about the whole procedure and their lackadaisical attitude and several of the police officers said to me, “Siyanai nazvo. Inyaya Dzerudo!” (Stay out of it. This issue is about love). They would say this to me again and again as I made repeated attempts to report the beatings my sister received in 2009. The attitude the police have is that domestic violence is not a real criminal issue but a minor problem within personal relationships, and is therefore too trivial for them to bother with.

When faced with this reality, how can another women, a new victim of domestic violence of a long-sufferer who has had enough go to the police and expect help? Where can women go for real help, when those whose jobs it is to protect all citizens from this country from a myriad of harms, think her husband or boyfriend beating her is a laughing matter?

I am not discounting the existence of compassionate members of the police force out there, who would treat matters of domestic violence with some level of professionalism and treat these matters with the importance they deserve, but I, and the majority of Zimbabwe’s women are yet to meet or hear of such a police officer.

Kubatana’s World AIDS Day winning text message sent in from a subscriber:

To prevent HIV transmission try various sex positions with one partner. NOT one position with various partners.
- Lloyd Nyarota

The many women who are violated in our country have duties in society. They have things they have to do and ways in which they contribute to the Zimbabwe being what is on a daily basis. Whether she is a teacher, street vendor, nurse, secretary or indeed a housewife, she is making a consistent contribution to society, regardless of whether she is paid or not.

When workers get injured either at work, or while off duty, he/she is either compensated and/or given time off to recuperate. Either way, the individual’s productivity is affected by these injuries. Why then do we not see that injuries sustained by a woman who is affected by gender based violence (GBV) affect both her physical well being as well as her ability to perform her designated duties, therefore impacting negatively on the economy?

Who does the work … while she nurses her wounds, while the police give her the run-around, while she pursues her case against a perpetrator in the courts, or when the monster has finally killed her? Who will do the work while women continue to be violated?

Society’s apathy towards the apparent increase of GBV frightens me. Maybe if we look at this issue from a purely selfish point of view, that of wanting to ensure that the economy flourishes and that business continues as usual, we might finally grasp the seriousness of the impact of GBV. Read the following article from the Herald for a more in-depth look at how GBV impacts Zimbabwe economically:

They are the mothers, teachers, cleaners, caregivers, cooks, nurses, entrepreneurs, vendors and cross-border traders. The list of women’s contribution to society and the country’s economy is endless yet in most cases unrecognised or even ignored. Worse still, their loved ones barter them.

While gender-based violence is perpetrated by both men and women, UNFPA reports that 95 percent of victims are women while 99 percent perpetrators are male. Indeed, Zimbabwe’s financial economy is dependent on women’s reproductive and care-giving work for the fitness, well-being and the very existence of the paid workforce. The economy also relies a great deal on women to pick up the pieces ignored by the paid economy. These include nursing elderly people, tutoring and childcare. The value of unpaid work is as much a part of the monetary economy as paid work. Yet precisely because it is unpaid, the work has long been overlooked and undermined in the economic equations. Sometimes women themselves ignore the fact that unpaid work is actually work.

Some of the women who are not formally employed and stay at home will say they are not employed and overlook the cleaning jobs at home. These are unpaid duties expected of them by society, nothing more.

This is due to the many years of socialisation women underwent from childhood when they would be given dolls and pots to play with while boys where given cars, toy guns and bicycles to ride.

Interestingly, when the same woman gets an office job and they hire a domestic worker, they are expected to pay the domestic worker.

Some women have dedicated their time and energy towards volunteer care work yet it is also another vital unpaid contribution women make to their communities as well as to the economy.

Volunteer work is varied and extensive and takes a lot of energy out of women who also have to go to their homes and take care of their families.

But despite all these contributions to the country’s economy, most women are subjected to all forms of gender-based violence. The Multiple Indicator Monitoring Survey of 2009 indicated that in Mashonaland Central Province some women are beaten up for simple things like burning a pot of sadza, failing to look after children, refusing to have sex, going out without telling their husbands and arguing with husbands.

Many women have lost their lives leaving behind children some as young as two months old. Some cases have gone unreported with the victims suffering in silence. Placard-holding women have marched on the streets denouncing this monster that has “feasted” on the flesh of many women.

Some members of our society have simply watched the increasing cases of GBV with apathy.

Unscrupulous people would rather report the matter in their neighbourhood to “H-Metro” as part of their entertainment, while some law enforcement agents are reportedly dismissing GBV reports by women as trivia.

Most dangerously, some people have accepted GBV, especially between married couples as a “normal” phenomenon.

This year’s commemoration of the16 Days of Activism Against Gender Violence stretching from November 25 to December 10 should be a time of introspection for perpetrators of GBV, families, society, government and everyone who cares.

Perpetrators of GBV should carefully study their balance sheets and income flows and establish the economic impacts of their heinous deeds.

They should publish full statements showing how much they fork out to pay for the medical bills incurred by their maimed wives, litigation, transport on trips to hospital, airtime to seek counselling from relatives and friends.

And there is absence from the woman’s care work while she nurses wounds if not funeral costs.

The Government and the police should consider the amount of taxpayers’ money that is lost through the court processes, calculate how much money is spent to convene a full court session, paperwork, and prosecutor and judge to preside over GBV matters. What about the pressure of work added to the already overwhelmed hospital staff and equipment?

The police should realise GBV is a burden to the national fiscus and that has a direct impact on their salaries too.

Police attended to 1 940 cases in 2008, increasing to 3 193 in 2009, then skyrocketing to 7 628 in 2010. Between January and March this year, 2 536 cases have already been reported to police, a high number compared to that of last year during the same period.

The majority of the reported cases are those of physical violence but sadly most of the cases are withdrawn before going to court or in court. Any right thinking police force should be concerned about these records. So should everyone else.

Its is apparent that 16 Days of Activism Against Gender Violence is not long enough to address GBV. However, the annual campaign serves to mobilise support for zero tolerance to GBV for the many generations to come.

The 16 Days of Activism Against Gender Violence is an international campaign originating from the first Women’s Global Leadership Institute sponsored by the Centre for Women’s Global Leadership in 1991.

Participants chose the dates, November 25, International Day Against Violence Against Women and December 10, International Human Rights Day, in order to symbolically link violence against women and human rights and to emphasise that such violence is a violation of human rights.

This 16-day period also highlights other significant dates including November 29, International Women Human Rights Defenders Day, December 1, World Aids Day, and December 6, which marks the anniversary of the Montreal Massacre.

The 16 Days Campaign has been used as an organising strategy by individuals and groups around the world to call for the elimination of all forms of violence against women.

If zero tolerance against GBV means zero tolerance against economic distress, then Zimbabwe should use its budget, its police force, its politics and all means necessary to stop violence against women.

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Women’s issues have a long way to go in Zimbabwe, especially Gender Based Violence, but how much progress can be made when we continue to receive such meagre budget allocations? The article below explores the poor allocation to the Women’s revolving fund, and resultant impact of GBV on the 2012 budget as a whole. Have a read:

Finance Minister Tendai Biti announced the $4 Billion 2012 National Budget on Thursday, but made a serious omission when he mentioned foreign travel as unnecessarily gobbling public resources at the expense of other pressing national needs. Gender based violence is as much a ‘cancer in the management of public resources’ as multiple foreign trips are.

Whilst the 2012 budget makes mention of women-specific issues which treasury intends to address, the cost of GBV weighs heavily on the health and home affairs expenditures. Despite women’s contributions to their families, communities and country’s economy, they reap very little in terms of revenue. Worst still, they are subjected to all forms of GBV.

The Multiple Indicator Monitoring Survey of 2009 indicated that in Mashonaland Central Province some women were beaten up for simple mistakes like burning a pot of sadza, failing to look after children, refusing to have sex, going out without telling their husbands and arguing with husbands.
Police attended to 1940 cases in 2008, increasing to 3193 in 2009, then skyrocketing to 7628 in 2010. Between January and March this year, 2 536 cases have already been reported to police – a high number compared to last year during the same period. The majority of cases brought to the attention of police are those of physical violence, but sadly most of the cases are withdrawn before going to court or in court.

The courts have also been laden with GBV cases. Some women have lost their lives, leaving behind children as young as two months old. Some cases have gone unreported, while others have been swept under the carpet, with the victims suffering in silence.

Finance Minister Biti’s statement overlooked the need to put in place measures to stop the loss of revenue caused by GBV. If domestic violence is not curbed, then treasury will have to fork out more and more resources towards the implementation of the Domestic Violence Act. This will mean ensuring that police posts are adequately staffed and resourced in order to attend to the numerous GBV reports.

Perpetrators of GBV should consider the amount of tax payer’s money that is lost through the court processes, and how much money is spent to convene a full court session, paperwork, prosecutor and judge to preside over the case.

The 2012 budget allocation towards health care and maternal health care will have to cover the many cases of forced pregnancies, rape victims and physical and mental abuse. Meanwhile, families are losing money in medical bills, litigation and counselling. Other economic losses to the nation include the loss of productive time as victims nurse injuries.

Reducing the costs of GBV on the national fiscus could unlock resources for other gender equality and equity issue. For example, the 2012 budget has only allocated a paltry $3 Million to the Women’s Revolving Fund under the Ministry of Women Affairs Gender and Community Development- a fund that purports to empower women economically. Yet women constitute 52 % of the population estimated to be at 13 Million. If that fund was to be shared equally among Zimbabwe’s women, then each woman would get less than $50.

If the treasury wishes to plug all the leaks in the nation’s economy, it has to audit the cost of GBV and seek corrective measures. – ZWRCN

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