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MOZAMBIQUE: Bridging the prevention gap

27 Feb 2009 16:38:39 GMT
Source: IRIN

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CAIA, 27 February 2009 (IRIN) - A new bridge is being built across the Zambezi River at Caia, a town in the central Mozambican province of Sofala; near the end of the workday three young men try to get the bridge construction workers to pay attention to their HIV and AIDS prevention messages.

"The workers' routine could be risky and contribute towards the high HIV prevalence in Caia, which is why they need frequent lectures on AIDS," said activist Alfredo Ranguisse. He and his colleagues belong to the Cupona ("to live" in the Ndau language) Association.

The association has been sub-contracted by the National Highway Administration to inform workers on the Zambezi River Bridge Construction Project about HIV prevention.

The bridge is 2.5km long and 16m wide and links Caia in Sofala Province with the town of Chimuara in Zambezia Province, on Mozambique's main north-south highway. Government figures put HIV prevalence in both provinces at about 20 percent.

Prevention campaigns also target nearby communities, informing workers and the local population about the dangers of commercial sex, the importance of condom use, sexual health and voluntary testing.

Condom distribution is an integral part of the campaign: the construction workers are often far from their families and have cash at their disposal to spend on alcohol, while poverty in the surrounding communities often leads to sex work in response to ready cash.

The campaign has also focused on integrating the workers into the community, so that they learn local rules of conduct from neighbourhood leaders and do not live in camps, thus avoiding a situation where women and children are left behind when the project finishes and the men return to their home provinces or countries.

"We've carried out awareness-raising work about proper behaviour with the bridge workers, but because they're away from home for so long they end up getting involved with local women," said Xavier Muxenga, a community leader in Caia's Chandimba neighbourhood.

Manuel João was one such man. "A girl was given over to my care because I took her virginity. It's my obligation to live with her as husband and wife, because her parents think that I might abandon her when my job is over," he told IRIN/PlusNews.

A necessary warning

Prevention initiatives only began in 2006 after Save the Children, a UK-based NGO, warned in its report, Bridge across the Zambezi – What Needs to be done for Children? that if measures were not taken, a great number of children would end up dropping out of school to work on construction projects or in the surrounding areas, and become involved in high-risk activities such as sex work.

The study found that many workers were accused of sexually abusing minors; there were also cases of teenagers diagnosed with sexually transmitted diseases.

However, the report noted that it was possible to reduce the negative impacts of such projects on the community through prevention, protection, care and support initiatives, mainly aimed at children.

"The study helped us make sure we had tight control to avoid an increase in cases of sexually transmissible diseases, including HIV, during the construction of the bridge," said Elias Paulo, director of the Zambezi River Bridge Construction Project.

Health services

Local health facilities were also reinforced with more professionals while construction was in progress, and two more ambulances were allocated to the Caia Rural Hospital.

A clinic specifically for workers was set up next to the construction site, offering counselling, voluntary testing and, if necessary, antiretroviral (ARV) drugs. The cost of these health services was carried by the construction company.

"Up to a point, the campaigns have led to healthy behaviour among the workers. So far, the impact of HIV has not been as devastating as would have been expected among bridge workers and the community," said the Cupona Association's Ranguisse.

An average of 150 to 180 workers visit the clinic every day. "A lot of them seek out the clinic's services to become better informed about HIV, and do routine tests voluntarily," said Nina Bondarenko, a Ukrainian physician who works at the clinic.

Twenty-five bridge workers are living with HIV, and five are on ARV treatment; all of them receive basic food baskets every month to help ensure a balanced diet.

The Zambezi River Bridge project employs 500 people directly and 2,000 indirectly. Construction of the bridge started in the 1970s but was interrupted by Mozambique's 16-year civil war. Work on the bridge began again in March 2006 and is scheduled to be completed in June of 2009.

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