THE day of the graduation ceremony I told you about last week, I was earlier at the University of Zambia speaking to about 60 women staff as part of their commemoration of International Women's Day. The theme of my talk was "Why the Zambian HIV and AIDS epidemic has a woman's face". I told them how Zambia's HIV prevalence is at 14.3 per cent average - but 16.1 per cent in women and 12.3 per cent among men. More women are infected with HIV and affected by AIDS.
Women carry most of the burdens of our lives and of HIV and AIDS for several reasons. They are sociologically, economically and biologically more vulnerable to HIV infection. Furthermore, when men, other women and children get sick with AIDS-related conditions, women give up everything else to take care of the sick, often to be bed-side 24 hours a day. It is also women who are victims of abuse, disempowerment and violence, and who have little or no control over protecting themselves from HIV infections in their own lives.
I told the UNZA ladies about "Nazingwa" - the Zambian woman who is the face of HIV and AIDS in Zambia. Nazingwa was coined by my wife Chilufya, when she was preparing a presentation she was going to make to an international audience in the US about the female condom and Zambian women. She was looking for a way to build a profile and put a name or face to the typical Zambian woman vis-a-vis HIV/AIDS, and the female condom. We built a profile and struggled for a few days to find a name that was appropriate to Zambian women's HIV plight. That's how Nazingwa was born!
I told the ladies that they too knew Nazingwa well, because she is many women. She was sitting right next to each one of them on both sides. She was also their neighbour at home or from the next compound, and so on. She is young or younger and she is old or older than them.
We all know Nazingwa too because she is present every day in all our busy lives. We see her if we bother to look. She has many health and HIV related challenges - no control of prevention methods, gender-based power gradient which makes her be of lower status than men and probably a victim of gender-based violence as a result. She is HIV positive and she is negative, or she does not know because her husband does not allow her to test.
In the rural area where I live, I see Nazingwa as soon as I step out. She is always carrying the burdens of life on her head - bundles of firewood, or 20 litre containers of water, or sacks of charcoal, or hoes to go and till the land. She often has a load on her head, a baby on her back and a lot of other heavy baggage in her heart. Nazingwa is also in the cities and towns - in the townships and compounds, in the minibuses, selling or buying in the market stalls, teaching or learning in the schools, working in offices and other work places. At night she stands in the streets in Rhodes Park, and on Kafue Road in Lusaka and places in other towns looking for sex work because that is all she can do to earn a living and look after herself and her child. Nazingwa sometimes has to work without protection - knowing full well the dangers involved.
On average, Nazingwa spent fewer years in school than a man born in Zambia the same day as she was. She discontinues school because of pregnancy, lack of resources or her parent's lack of belief in the need to educate girls beyond very basic primary school level. As a teenager, she is much more likely to have experienced sex perhaps several times - by coercion, or by persuasion - most likely with a much older man - thus becoming exposed to HIV infection.
There are so many things I could chronicle that place Nazingwa at a disadvantage with regard to HIV and AIDS. But as I spoke to the ladies at UNZA, a thought suddenly occurred to me and I shared it with them. I will also share it with you now.
I told the ladies that if Nazingwa's life and HIV plight can be our major focus in the fight against HIV in Zambia, we could turn this epidemic around. If we can galvanise Nazingwas' collective resolve and sense of determination to survive, we can win this.
Here's one of the reasons why. When around the year 2000 or so we told Nazingwa to have an HIV test in pregnancy so we could reduce the number of her babies born with HIV, infected at birth or and through the breast milk, Nazingwa did not cry foul about infringement of her "human rights". The men protested that Nazingwa's rights were being violated. Nazingwa herself complied. I remember visiting a pilot PMTCT programme in rural Monze in 2000. The women were accepting to be tested but not all their men. In Lusaka, men were refusing to come and test when called to do so, and some were beating their wives if they took the test without their consent.
Nazingwa was not daunted. She was told if she didn't want the test she could 'opt-out'. Did she? PMTCT coverage rose from 14 per cent of HIV positive women in 2005, through 60 per cent in 2008, to an enviable 93 per cent in 2011. The number of our babies being born with HIV has dropped because of Nazingwa's efforts and acceptance of the PMTCT programme.
Can you imagine if we empowered Nazingwa with the deciding controlling power - about the problem of low and inconsistent use of condoms, reducing the number of concurrent sexual partners that men have, and increasing the uptake of HIV testing?
If we empower Nazingwa, we can stop this epidemic!!