ZAMBIA: Fear of violence blocks access to HIV/AIDS services

The high level of gender-based violence in Zambia is preventing many women from accessing HIV/AIDS services, according to a new report by global watchdog Human Rights Watch.

The researchers warned that the ability of Zambian women to get HIV/AIDS counselling, testing and information has been "seriously impaired by the perceived and real control of men [particularly intimate partners] over their lives".

In the report, Hidden In The Mealie Meal: Gender-Based Abuses and Women's HIV Treatment in Zambia, the New-York based lobby group found that many women were taking life-prolonging antiretroviral (ARV) medication without informing their husbands, and were forced to resort to extreme measures to hide their medication.

"Some of the women testified that they dug holes in the ground or in flowerpots to hide ARVs. These women then retrieved the medicine - which they must take for the rest of their lives - twice every day and then hid it again," said the report, which documented various abuses that obstruct Zambian women's ability to start, and adhere to, HIV treatment regimens.

According to UNAIDS, about 1.6 million of the 11.7 million population are HIV positive, 57 percent of them women, but only 100,000 people are receiving ARVs from the government's free treatment programme.

Zambia, which has one of the world's highest HIV infection rates, has set ambitious targets for rapidly scaling up HIV/AIDS treatment as part of its commitment to ensuring universal access to AIDS treatment by 2010, but researchers say women's unequal status will greatly undermine the success of the programmes.

Nada Ali, author of Hidden In The Mealie Meal, told IRIN/PlusNews: "Government is paying little attention to the gender dimension of treatment, especially the impact of entrenched discrimination and gender-based violence and abuse. This must change if HIV treatment is to be provided equitably."

Hiding the medicine

A woman identified only as Maria T is quoted as saying in the report: "I fear to tell my husband [about my HIV status] because I fear that he can shout [at me] and divorce me. He uses bad language with me.

"I hide the medicine, I put it on a plate, add mealie meal [maizemeal], so when he takes the lid off he does not find it [the medication]. When I take the medicine I have to make sure that he is outside. That is why I forgot to take medicine four times since I started treatment. Last year he hit me around the back with his fist."

Elizabeth Mataka, a UN special envoy on HIV/AIDS in Africa, called for concerted efforts in addressing domestic violence, and stressed that women needed socio-economic empowerment to overcome the problem.

"It is indisputable that domestic violence is one of the serious drivers of the spread of HIV/AIDS in this country, and at its bedrock is the issue of poor empowerment and economic status of women," Mataka told IRIN/PlusNews.

Women are often the victims of unequal property distribution in divorces, and suffer property-grabbing by in-laws on the death of a spouse, which analysts say impedes their ability to lead decent lives or adhere to AIDS treatment.

Under the customary law of most of Zambia's 72 ethnic groups, women have lesser property rights than men, and the fear of losing homes, land and other property usually keeps women in abusive marriages.
"Time has come for concrete actions that will directly impact the lives of the women on the ground. There are no two ways about it: we just have to give our women enough resources for them to become independent of all abusive men," Mataka said.

Nelson Mwape, of the Zambian Chapter of the Young Women's Christian Association [YWCA], pointed out that of the 874 cases of domestic violence recorded by the YWCA since 2006, 427 have tested HIV positive.

"About 75 percent of all cases of abuse involve husbands and relatives, which is why we are now saying, 'no home is safe anymore for both women and children'."

Not enough legal protection

Women's groups have charged that the Zambian government has not done enough to guarantee the rights of women: the country has no specific law criminalising gender-based violence, and the penal code does not cover marital rape or abuse.

Elizabeth Simwanda, national coordinator of women entrepreneurship at the International Labour Organisation offices in Zambia, called for legislation that would reduce cases of domestic violence.

"We are very much interested to see government enact a specific law on gender violence, so that all culprits can face the wrath of the law. The lack of specific legislation on gender-based violence has contributed to high numbers of cases of women being abused; it's easier to deal with these cases when you have the law in place," Simwanda said.

The permanent secretary in the ministry of gender, Matondo Yeta, admitted that "our socio-cultural set-up does not favour reporting of cases of domestic violence. Victims are usually made to fear that by reporting, the situation might become worse for them; that they might lose their marriages or that their children might suffer."

The government has begun a process of incorporating all international human rights instruments to which Zambia is party into domestic legislation. "Government is also working on formulating specific legislation on gender-based violence and we hope it would be completed by the end of next year [2008]," Yeta told IRIN/PlusNews. "This will protect women against violence from men."