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Rural women struggle to get treatment
IRIN News
January 15, 2008
http://www.irinnews.org/report.aspx?ReportID=76250
HIV-infected women living
in rural areas are finding it increasingly difficult to access life-prolonging
antiretroviral drugs (ARVs) and tend to be more marginalised than
those living in urban areas, non-governmental organisations say.
"Rural
women who need ARVs find themselves in a quandary because levels
of income for a rural household tend to be low," said Tariro
Kutadza, provincial coordinator of the Zimbabwe
AIDS Network (ZAN) in the northern province of Mashonaland West.
According to
research conducted by the Zimbabwe
Women's Resource Centre Network (ZWRCN), three-quarters of all
women on ARV treatment are from urban areas, yet most of those who
need it live in rural areas and are often forced to rely on herbal
remedies.
With Zimbabwe in its
eighth year of an economic recession, marked by an inflation rate
officially cited at 8,000 percent but estimated by independent economists
to be running at about 25,000 percent, ARVs have become unaffordable
for rural women, who are often dependant on husbands working in
urban areas.
This week, the Herald,
an official daily Zimbabwean newspaper, reported that a one-month
prescription of Stalenev 30, a common first-line ARV drug, now cost
Z$85 million (about US$42.50 at the parallel exchange rate).
Kutadza, who works mainly
in rural areas, said the financial burden on rural women went beyond
the high cost of the drugs; they also had to travel long distances
to health centres to obtain them, so women who could not afford
the transport and drug costs tended to take ARVs infrequently or
not at all.
Zimbabwe is already experiencing
a huge gap between the number of people who need ARVs and those
accessing them. According to the World Health Organisation (WHO),
only about 91,000 out of the estimated 321,000 in need of treatment
are getting it.
An acute shortage of
foreign currency has made it difficult for the government and even
private pharmacies to import enough ARV drugs to meet demand. The
Herald reported that most essential drugs, including ARVs, were
now only found in one out of four pharmacies.
A recent report by the
International Treatment Preparedness Coalition (ITPC) estimated
that the number of people accessing treatment privately has declined
from 10,000 to 6,000 due to inflation and the unavailability of
drugs.
More
problems for women
Those rural women lucky
enough to get hold of ARVs sometimes have difficulty taking them.
"I have noticed that some men, particularly those that think
that they are not infected themselves, discourage their wives from
taking the ARVs," Kutadza told IRIN/PlusNews.
Betty Makoni,
director of the Girl
Child Network (GCN) and chairperson of Ray of Hope, an organisation
promoting the rehabilitation of mostly rural women who have experienced
domestic violence, said some women hid their ARVs from abusive husbands.
"As a result, women
resort to taking the ARVs when the men are not watching, for instance,
when they go to search for firewood or water, and in some cases
they leave the pills in the custody of other women," Makoni
said.
Many people in rural
communities still view AIDS as a dreaded disease with no cure. Men
and their relatives often viewed HIV-infected wives as a shameful
burden and chased them away from their homes.
Kutadza pointed out that
this created further problems for women registered to receive ARVs
at their local health centre, because they might not be able to
find the drugs they needed if they were forced to live somewhere
else.
Fear of stigma and discrimination
also discouraged HIV-infected people from coming forward for counselling
or treatment, said Kutadza, with some claiming that they had been
bewitched.
Makoni said although
men often contracted the virus while working in town and then passed
it on to their wives during occasional visits to their rural homes,
relatives and other villagers often accused the women of infecting
their partners.
She added that girls
were especially vulnerable to infection because they became sexually
active at a relatively early age and were not empowered to make
their own decisions "due to a rigidly patriarchal society".
"There is much need
for social structures to impart information to poor rural women
and girls, so that they know their rights as far as getting tested
and counselled, how to get treatment and the best way to deal with
husbands and partners who insist on unprotected sex," she said.
Rocketing prices and
shortages of even the most basic foods have also reduced the ability
of rural women to benefit from ARV treatment.
Sekai Chirevo, 36, of
Musana village in Shamva District of Mashonaland Central Province,
was diagnosed HIV-positive immediately after the death of her husband
from an AIDS-related illness three years ago. She was placed on
ARVs but constant bouts of tuberculosis have left her bedridden
and unable to generate an income.
"I cannot till the
fields to ensure food for my five children," she told IRIN/PlusNews.
"That makes my position even more tragic because, as a sick
person, I need good food to boost my immune system."
On the irregular occasions
when she gets food handouts from donor organisations, she gives
most of it to her hungry children.
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