Coming home to die

FATIMA Bila from 3 de Fevereiro Village in Xai Xai, Gaza province in Mozambique, is a distraught woman.
Her husband, Manuel Nhone, who worked at a mine in South Africa, died of an AIDS-related illness six months ago. She does not remember the name of the mine Nhone worked for; neither does she remember her age.  But she recalls she married in 1977 a year after Nhone got the mining job in South Africa. She is HIV positive, and believes her husband transmitted it to her since they rarely spent time together and she was faithful. But she is not angry.

Instead, she mourns and honours him by wearing all black as per custom. Her mourning period will end in the next six months. She contracted TB soon after Nhone’s death and believes she got it because a certain cultural practice was not properly followed when he died. Fatima explains her predicament to The Sunday Mail Extra, her head resting on her shoulder.

Through it all, she rarely smiles — understandably. She is one of 20 women and two men aged between 54 and 75 seated under a coconut tree at a village meeting point. Most of the women’s husbands were mine workers in South Africa and “returned home to die” of Aids-related illnesses.

The two men —Constatino Masago (55) and Pedro Mavunga (73) — also worked in South African mines. They say they are HIV positive. As are their wives. They form part of a support group supported by the Employment Bureau of Africa in conjunction with the International Organisation for Migration. Since last year when the group was formed, members meet three times a week to discuss issues affecting them.

They also access loans for market gardening.
In this part of Mozambique, many women see their husbands leave for South Africa, some of them never to return. “None would return home once or twice a year but would send money regularly. We had a decent life and home compared to other women whose husbands never left,” explains Fatima.

The problem is not peculiar to Mozambique. Many Zimbabwean men are working in South Africa and Botswana. And returning home to die.
Many teens in Bulilima district are married to malaichas and injiva (men hired to deliver goods from South Africa to Zimbabwe), and the incidence of HIV here is high.

The prevalence rate is 15 percent, well above the national average of about 12 percent. “The prevalence is alarming because of the migration patterns. Injiva come home and sweet-talk these young girls who cannot negotiate for safe sex,” says Bulilima district medical officer Dr Norbert Singine.

Zimbabwe’s 2012 National Census Report says Bulawayo province has the lowest number of men at 303 346, and the trend is the same in Matabeleland South (326 967) and Matabeleland North (360 776). Harare has 1 025 596 men, Mashonalnd West 747 475, Midlands 776 012, Masvingo 690 749, Manicaland 830 697, Mashonaland East 651 781 and Mashonaland Central 567 140.

Many migrant workers only return home for Easter and Christmas. Some die without ever returning. They will have been “swallowed by the earth”. Mozambique’s Gaza province is feeling the effects of mass migration. It has the country’s highest HIV prevalence rate. A lot of women here are uneducated and marry as young as 15. They cannot negotiate safe sex and initiate testing when their husbands briefly return home.

Mozambique is also ranked 125 out of 146 countries on the Gender Inequality Index. Mozambique, too, has the seventh-highest rate of child marriage in the world with almost one out of every two girls married before she reaches her 18th birthday, and 10 percent of 10 girls are married before 15.

According to UNAIDS Mozambique director Jose Zelaya Bonilla, that country’s HIV prevalence rate for those aged 15-49 is 11,5 percent. An estimated 726 589 adults were eligible for treatment by 2013 and there was 63 percent coverage of ART. Some 114 013 children were eligible for ART in 2013 with ART coverage at 36 percent.

There are 317 new HIV infections per day in Mozambique and 226 AIDS-related deaths in a country that offers free HIV treatment and maternal health services. Mozambique’s national director for public health, Dr Francisco Mbofana, said HIV was a major headache in the south of the country. The second AIDS Indicator Survey will tell where we stand and allow comparisons with 2009 survey results,” he said.

He added that Mozambique is one of the 21 countries with high TB burden, but the country was doing well in terms of treatment despite the challenges. Not everyone in their support group does the 30-minute drive to collect medication at the nearest health centre. Instead, members contribute money for a return journey and one person does the trip on everyone’s behalf – an arrangement officials at the clinic have no problem with.

Then there are women like Ana Antonio Bata (43) whose ailing husband was delivered from South Africa to her doorstep in November last year. He is now dead. He had been providing for them since he started working at the mine and comfort in their house tells of his hard work.

Leather sofas, a refrigerator, television set, a DVD player, a home theatre system are evidence of the good side of working in the South Africa’s mines. Her late husband built a decent home with asbestos roofing.

But like the parcels that were delivered to her doorstep from South Africa, her ill husband was brought home. Like Fatima, she is still in black and her mourning period will end after a year. “He had TB and HIV and I would send him ARVs since treatment is free here. My husband just stopped communicating with me for two months and I knew something was wrong. He was supposed to come here in July but never showed up. Then one day as I was sweeping I saw a car slowly drive towards my home. In the car, he slept helplessly. He said he had sharp pains in his chest.

She has four children – and her 15-year-old daughter is married. Ana says it was not a forced marriage. Their economic situation after her husband’s death compelled her to send her older son to work in South Africa. They need the money. Ana’s 12-year-old son is not in school because of non-payment of fees, though the eight-year-old daughter is in school. IOM Mozambique TB focal person Gael Claquin says migration is a complex problem.

“If people are not aware of their rights, if a woman cannot stay with her husband when he migrates then there are serious consequences and information flow has to be improved. Mozambique being generally far from mining cites, most men come home twice a year, at Easter and Christmas time. We used to have up to 50 000 migrant mine workers coming back during this period. Now about 30 000 come back. “The high numbers were a result of most who worked without proper regularisation. Now most mines want registered workers. We do not have official figures but an estimated 100 000 Mozambicans in SA mines mostly come from the south (of the country). Women also migrate and face sexual violence which links to HIV transmission.”

He says negotiating condom use is hard for many women.
“When husbands return from SA, it is still difficult for women to negotiate safe sex because of cultural values, norms and mentality. There are husbands who would say a woman should not discuss safe sex . . .”

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