1. ONGOING CRISES IN ZIMBABWE: Sexual Violence, Treatment Access & HIV 7 August 2008 Martha Tholanah ICW Member XVII IAC, Mexico City 2008

2. Zimbabwe Landlocked Southern African country Landlocked Southern African country Population – approximately 14million Population – approximately 14million 75% of the population live in the rural areas 75% of the population live in the rural areas 56% of population live on less than $1 a day, and 80% on less than $2 a day 56% of population live on less than $1 a day, and 80% on less than $2 a day 35% of all people living with HIV live in Southern Africa 35% of all people living with HIV live in Southern Africa Southern Africa accounts for 32% of all new HIV infections and AIDS deaths Southern Africa accounts for 32% of all new HIV infections and AIDS deaths

3. HIV & AIDS in Zimbabwe HIV prevalence among 15 – 49 year olds is 15.6% HIV prevalence among 15 – 49 year olds is 15.6% There are 2,214 AIDS-related deaths each week There are 2,214 AIDS-related deaths each week HIV is predominantly transmitted through heterosexual intercourse HIV is predominantly transmitted through heterosexual intercourse 50 – 80% of TB patients in Southern Africa are also HIV positive 50 – 80% of TB patients in Southern Africa are also HIV positive PMTCT targets have been achieved PMTCT targets have been achieved

4. Access issues in Zimbabwe The public health system shows a higher proportion of women than men receiving ART The public health system shows a higher proportion of women than men receiving ART The public health ART scheme uses a district zoning system The public health ART scheme uses a district zoning system One has to notify the district hospital to get a letter of transfer to another health facility if they are travelling outside their area for some time One has to notify the district hospital to get a letter of transfer to another health facility if they are travelling outside their area for some time Besides these barriers, transport costs and logistics have major impacts on access Besides these barriers, transport costs and logistics have major impacts on access

5. HIV, Violence, Access Zimbabwe, like other countries, has increasingly seen the evidence of the feminisation of HIV & AIDS Zimbabwe, like other countries, has increasingly seen the evidence of the feminisation of HIV & AIDS There are positive laws in place that address gender-based violence and sexual offences There are positive laws in place that address gender-based violence and sexual offences However, these come to nought in the context of political crises and conflict However, these come to nought in the context of political crises and conflict There are still negative attitudes about women and girls There are still negative attitudes about women and girls

6. Crises in Africa Transitions from colonial rule through liberation struggles Transitions from colonial rule through liberation struggles Ethnic and tribal wars Ethnic and tribal wars Political upheavals Political upheavals Economic challenges and poverty Economic challenges and poverty Internal displacements Internal displacements Seeking refugee status in other countries Seeking refugee status in other countries Zimbabwe has not escaped any of these Zimbabwe has not escaped any of these

7. Crises in Zimbabwe The last few years of the liberation struggle for Zimbabwe’s independence in the late 1970’s early 1980 found women and girls at the receiving end of sexual and physical violence The last few years of the liberation struggle for Zimbabwe’s independence in the late 1970’s early 1980 found women and girls at the receiving end of sexual and physical violence The operation - rounding up of women found walking alone on urban streets (early 1980s) The operation - rounding up of women found walking alone on urban streets (early 1980s) Gukurahundi – Matabeleland disturbances Gukurahundi – Matabeleland disturbances The land redistribution exercise The land redistribution exercise Operation Murambatsvina (clean out the trash) Operation Murambatsvina (clean out the trash)

8. Political Changes Political transitions as elections were held periodically in line with the Zimbabwean constitution Political transitions as elections were held periodically in line with the Zimbabwean constitution Each election period has presented a multitude of challenges for women and girls in particular Each election period has presented a multitude of challenges for women and girls in particular The challenges, that seem to escalate with each election phase, have included physical, sexual, and emotional abuse – and created barriers to access to basic services The challenges, that seem to escalate with each election phase, have included physical, sexual, and emotional abuse – and created barriers to access to basic services

9. Impact on Women Political crises and the resultant conflicts have left many women and girls vulnerable, as they have been subjected to sexual violence Political crises and the resultant conflicts have left many women and girls vulnerable, as they have been subjected to sexual violence Women have been punished with rape for supporting a political party other than the one favoured by the attacker Women have been punished with rape for supporting a political party other than the one favoured by the attacker Many times a woman or a girl has been gang- raped Many times a woman or a girl has been gang- raped

10. Impact on Women (ctd) Many women have taken refuge in neighbouring countries Many women have taken refuge in neighbouring countries Many who took refuge in South Africa also became victims of so-called xenophobic attacks Many who took refuge in South Africa also became victims of so-called xenophobic attacks Some have been uprooted from their homes and are in safe houses, or other makeshift temporary structures Some have been uprooted from their homes and are in safe houses, or other makeshift temporary structures Internally displaced people and refugees are still too scared to go back to their homes Internally displaced people and refugees are still too scared to go back to their homes

11. Sexual violence As political discourse falters, violence tends to erupt, and very often rape is perpetrated on women and girls As political discourse falters, violence tends to erupt, and very often rape is perpetrated on women and girls Women who are targeted are those who assert their right to political participation within their communities Women who are targeted are those who assert their right to political participation within their communities Women who also assert themselves in their sexuality – LBTI – are particularly vulnerable, as they become easy scapegoats Women who also assert themselves in their sexuality – LBTI – are particularly vulnerable, as they become easy scapegoats

12. Sexual violence (ctd) Targeting LBTI women for sexual attack manifests how women are denied the right to bodily integrity Targeting LBTI women for sexual attack manifests how women are denied the right to bodily integrity This homophobia puts us all at risk This homophobia puts us all at risk These issues have devastating effects on women’s sexual and reproductive health, including a very high risk of HIV infection These issues have devastating effects on women’s sexual and reproductive health, including a very high risk of HIV infection “Safe houses” have not provided protection “Safe houses” have not provided protection

13. Access to Treatment Internal displacements of women and girls due to political violence has resulted in disruption and failure to access treatment Internal displacements of women and girls due to political violence has resulted in disruption and failure to access treatment Women who need HIV-related treatment and are already on it and have been displaced have now defaulted treatment Women who need HIV-related treatment and are already on it and have been displaced have now defaulted treatment Health service providers have been telling people on the public scheme to go back to the districts they are registered in Health service providers have been telling people on the public scheme to go back to the districts they are registered in

14. Access to treatment (ctd) HIV-positive women who have been displaced have found themselves in conditions that put them at risk of TB infection HIV-positive women who have been displaced have found themselves in conditions that put them at risk of TB infection Those already on TB treatment have disruptions in treatment Those already on TB treatment have disruptions in treatment The environment is such that women are scared to report sexual violence The environment is such that women are scared to report sexual violence This has resulted in lack of access to PEP and other essential services This has resulted in lack of access to PEP and other essential services

15. Where are we… These conditions cause non-adherence, leading possible resistant strains of HIV and TB These conditions cause non-adherence, leading possible resistant strains of HIV and TB There is no safety net for the poor and most vulnerable There is no safety net for the poor and most vulnerable Civil society space for engagement and advocacy has continued to shrink as the political crisis continues Civil society space for engagement and advocacy has continued to shrink as the political crisis continues

16. What we ask for… An end to the violence An end to the violence Commitment to, and action on peace-building Commitment to, and action on peace-building Accountability and responsibility Accountability and responsibility Holistic support for victims and survivors of violence Holistic support for victims and survivors of violence Access to comprehensive healthcare services Access to comprehensive healthcare services Access to social and humanitarian services Access to social and humanitarian services Recognition that HIV is not just a medical issue Recognition that HIV is not just a medical issue

17. Women’s Plea Enough!!!! Enough!!!! Women bleed – as an inevitable biological phenomenon Women bleed – as an inevitable biological phenomenon Women have bled – as fighters in the liberation war as equals on the battlefield Women have bled – as fighters in the liberation war as equals on the battlefield Women are bleeding – as a consequence of the politically-motivated violence. Is this necessary? Women are bleeding – as a consequence of the politically-motivated violence. Is this necessary? Enough!!!! Enough!!!!

18. TatendaSiyabongaGracias