A last mile to fight HIV control in Mazowe

By Nhau Mangirazi

MAZOWE– Reason Magora (24) is one of gold miners around Mazowe district making strides in the last lap for HIV control when he was circumcised late last year.

His age group is among the worst affected in Zimbabwe through sexual transmission infections (STIs) as well as early pregnancies among girls around the country.  

“It was a personal decision after I understood that I saw that HIV pandemic is affecting mostly youths. Generally, illegal gold miners are not spared due to economic crisis affecting former commercial mines where several sex commercial workers visit around Mazowe district looking for clients,|” he said recently.

Magora’s testimony is part of Population Services International (PSI) Zimbabwe’s motto of “Going the Last Mile for HIV Control” currently funded by President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID programs here.

PSI Zimbabwe brand manager Kudakwashe Murombedzi said they operate within Mazowe and Mt Darwin in Mashonaland Central province.

This was part of PEPFAR funded (PSI) programs working with the Ministry of Health and Child Care (MoHCC) to implement Voluntary Medical Male Circumcision (VMMC) program since 2009.

The Mr Fun Day was held at Chipere primary school within Mazowe district.

‘PSI currently works in 22 PEPFAR funded districts with a target to circumcise 80% of men aged between 15-29. From program inception to date, VMMC program registered more than 1,2 million circumcisions as implementing districts near the 80% circumcision target,’ explained Murombedzi.

PSI works with USAID, health ministry, stakeholders, beneficiaries and communities to develop district specific approaches for sustaining population-level coverage of VMMC beyond the funded program duration.

Murombedzi added,

“In Mashonaland Central province, PSI operates in five districts, two of these are PEPFAR funded in Mt Darwin and Mazowe.”

Magora was among several hundreds who took part during PSI’s “Mr Smart Fun Day”.

Murombedzi explained that it is a community mobilisation activity designed to create a sense of ownership by local community for their own health toward the prevention of HIV through the uptake

of VMMC.

“This is a demand creation approach that allows community introspection and reformation using community leader speeches, group discussions, fun and games. involvement in planning and execution,” he added.

He also explained that the approach is primarily targeted at rural and peri-urban societies including former commercial farms where sprouting mining activities within Mazowe district.

“Of late, Mr. Smart Fun Day allowed clients and community to a positive experience provided by the VMMC, positive attitudes and helps break barriers and mistrust on the program,” said Murombedzi.   

The recent Mr Fun Day was punctured with traditional and nyau dances and poetry that made service delivery during community mobilization events helps to

reduce, anxiety and uncertainty towards VMMC procedure.

‘‘Circumcising men immediately after mobilization helps create positive peer pressure and works towards reduction of infections among youths,’ explained Murombedzi.

Mazowe district had 1200 annual target with site target pegged at 300.

However, through community mobilisation, the project has made strides surpassing monthly targets at Hota Mapere, Mvurwi Hospital, located 40km away.

The hospital under Mazowe district was engaged in 2011 for PSI programs where there are fixed tents offering clients besides mobile and daily outreaches.

Some outreach sites are at Donje, Forrester A, Suwoguru, Horta, Ceasar Mine clinics.

Non-clinic sites are at Holland, Forrester D and Impinge, according to Murombedzi.

With one Landcruiser vehicle, provincial field manager, district field officer, assistant field officer, service delivery staff includes three circumcisers, six assistants, four receptionists, they have made the life easier for some communal and resettled farmers here.

As part of community-based mobilisation there is a district health promotion officer, three community nurses, village health workers, three gold mobilisers.

Murombedzi said Mazowe achieved targets for the past six months that saw June and July getting 300 males circumcised apiece while in August there were 511 also clinically circumcised.

In September 300 males were also assisted while in October there were 357 males being circumcised while November and December had an average of 300 males.

According to World Health Organisation website, there is ‘compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%.

It adds that three randomized controlled trials have shown that male circumcision provided by well-trained health professionals in properly equipped settings is safe.

However, WHO and United Nations AIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence.

It warns that male circumcision provides only partial protection, and therefore should be only one element of a comprehensive HIV prevention package which includes: the provision of HIV testing and counselling services; treatment for sexually transmitted infections.

WHO calls for promotion of safer sex practices; provision of male and female condoms and promotion of their correct and consistent use to regulate the spread of HIV and AIDS.

For Magora, hope is restored that after being circumcised it will make a difference.

“I look forward to see majority of youths going through this as a health developmental approach on safe sexual encounters. This is not ‘free sexual ammunition’ for extra marital affairs but to abstain or use protection including both female and male condoms,”said Magora.

According to Magora and many of those who have taken up circumcision, this aides to PSI call on ‘Last mile in fighting HIV control around Zimbabwe’

There are 1.3 million on Anti-Retroviral Therapy (ART) who are taking life serving drugs.