George Sanzila
Katima Mulilo-The Zambezi Region faces a raft of developmental challenges hampering efforts to remedy sexual reproductive health rights and HIV and AIDS.
Some health facilities in the region are not accessible to residents that find themselves in the vast sparsely populated region. To reach health facilities for some residents that are mostly destitute means having to walk over 10 kilometres, risking crossing paths with dangerous wild animals.
This came to light during a recent fact-finding mission by the Parliamentary Standing Committee on Gender Equality, Social Development and Family Affairs to Health facilities in the Zambezi region. The visit – part of the committee’s oversight function – specifically targeted health facilities to look at sexual reproductive health rights and HIV and AIDS.
The Southern African Development Community Parliamentary Forum (SADC-PF) that has been driving issues of reproductive health rights through its recently launched SRHR PROJECT has partnered with lawmakers to champion this cause. The project is funded by the Norwegian and Swedish embassies.
Head of the delegation Petrina Haingura MP restated it was important for parliamentarians to be advocates of sexual reproductive health rights, not only as a constitutional mandate but as members of society concerned about health issues.
“We need to be heard talking about these issues as parents and as we implement SDG’s as representatives of the people. Many issues such as family planning, antenatal care, prevention and treatment of STIs including HIV and AIDS, abortion, teenage pregnancy and GBV are issues we have to talk about,” said Haingura when she met health officials at Katima Mulilo State Hospital.
Health challenges in Zambezi Region
Zambezi Region has one district hospital, three health centres, 28 primary health clinics and over 51 health outreach points. According to the director of health in the region, Agnes Mwilima, even though most health services are offered at various health facilities, most of these centres are sparsely located, making it difficult for many residents, particularly in rural areas to have prompt access to these services.
The region further grapples with an acute shortage of health professionals and poor infrastructure.
“We only have one district hospital which has not yet been upgraded into an intermediate facility even though plans are at an advanced stage to transform it into one. Therefore some patients requiring specialists are referred to Rundu, which is over 500 kilometres away.
“We lack doctors and nurses and this puts a strain on our staff. Our clinics are sparsely located leaving out some of our communities. On the other hand, some of our capital projects are stalling due to poor workmanship,” Mwilima noted.
Despite these impediments, Mwilima noted family planning services were offered at all health facilities in the region. Ante natal care is estimated to have reached over 90 percent coverage with teenage pregnancies having been reduced to 15 percent from 19 percent last year.
The HIV prevalence rate has also been reduced from 7.7 percent in 2016 to about 6.3 percent in 2017 with over 17,000 patients on anti-retroviral treatment out of 41,698 people estimated to be living with the HIV virus.
When visiting the Muyako Clinic, over 70 kilometres east of Katima Mulilo, it became apparent that the community was growing tired of lack of health services due to the protracted construction of a clinic that has stalled without completion since 2012.
The clinic, which is strategically located and was supposed to also cater for surrounding areas, such as Zilitene, Iseke and Ngala, has been one of capital projects of the Health Ministry subjected to poor workmanship.
A mobile clinic stood next to the stalled infrastructure as a temporary emergency measure even though residents still complained of lack of medicine, a situation that forces them to travel over 30 kilometres to Bukalo to access health services.
“As you can see we only have a mobile truck here serving as a clinic, with only one nurse. The renovation of this clinic started as far back as 2012, but no progress. HIV patients are not getting their ARVs since February. Bukalo is far and most people don’t have transport money and the ambulance is not available and if it comes you have to pay for it,” moaned one resident.
Over 140 kilometres west of Katima Mulilo, the Sangwali Health Centre still operates as a clinic due to lack of staff and the necessary infrastructure. Only three nurses staff the facility that is supposed to be replete with a doctor and patients’ rooms.
According to Annette Sitina Chunga, a senior registered nurse at Sangwali Health Centre, accommodation for nursing staff is a major challenge that has affected the provision of health services in the area.
“We only have three nurses and often they are overloaded with work. Accommodation and water are also a big problem here. Most people in this area stay far and don’t have transport to come to the centre. This has affected us that we had 17 cases of teenage pregnancies since January, with the youngest girl being only 13 years old,” stated Chunga.
However, the introduction of a youth-friendly corner in the health centre, as well as schools outreach programmes, have made a positive impact on the reduction of teenage pregnancy in the area that had considerable numbers of adolescents falling pregnant.
Sangwali is an area surrounded by national parks, such as Nkasa Lupala and Mudumu, posing a danger to many residents who walk long distances to access health services.
Lilata Priscilla, the village development committee (VDC) secretary, noted in concerns read to members of parliament that the health centre should function as initially intended to meet the growing demand for health care in the area.
“Our people travel long distances to Katima Mulilo when referred to go and see a doctor, which is over 14 kilometres. As a health centre we want it to function as such with the availability of a doctor,” Lilata remarked.
Namibia committed to sexuality education
Namibia recognises the fact that sexuality education is part and parcel of human rights and human health development as enshrined in Namibia’s constitution. Sexuality education opens the doors for Namibian citizens to make choices regarding their sexuality and reproductive health rights.
Namibia has already committed itself to sexuality and reproductive health issues by signing various regional and international conventions aimed at ensuring the successful implementation of SRHR. It recently became the implementer of the SADC-PF project on SRHR following other SADC countries such as Zambia, Seychelles, Angola, Tanzania, Lesotho, Mauritius and Zimbabwe.
Through this project, which ends in 2018, Namibian members of parliament have committed themselves to be advocates of sexual reproductive health rights and to help combat the spread of HIV and AIDS.
Some of the challenges related to SRHR include gender-based violence, HIV and AIDS, abortion, lack of antenatal care, teenage pregnancy, child marriages, poverty, child trafficking and stigmatisation of homosexuality, among others.
* George Sanzila is the chief information officer in the Division Research, Information, Publications and Editorial Services at the National Assembly.