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July 27
“This generation of broken people ends with us”

​by Zamacebisa Zakwe​

zama iac (2).jpg 

I am a DREAMS Ambassador working for HST, seconded to the uMgungundlovu Municipality. The goal of the DREAMS campaign is to help adolescent girls and young women develop into Determined, Resilient, Empowered, Aids-free, Mentored and Safe women.

I was invited  to the 2018 International AIDS Society Conference by The US President's Emergency Plan For AIDS Relief (PEPFAR), a United States governmental initiative to address the global HIV and AIDS epidemic and help save lives.

PEPFAR invited me to share my personal story and my journey with DREAMS so that people can understand the impact that DREAMS has on the lives of girls, using my story of how I grew up and how DREAMS has helped me find my voice and heal my pain and anger.

I was also invited to moderate the DREAMS satellite session and spoke at some other sessions like the SANAC (South African National Aids Council) 'She Conquers' session. She Conquers is a national campaign that aims to empower adolescent girls and young women in South Africa and improve their lives.

I hope that I can try to advocate for prevention of sexual and gender-based violence, to support adolescent girls and young women (AGYW). For example, at our Thuthuzela Care Centres we can get assistance after a sexual assault, but there is nothing in place to prevent these crimes against AGYW.

The biggest highlight for me was the pre-conference session called Women Now. It's all about African women coming together to support and empower each other.

What a space, knowing you can say whatever you want in there and feel safe. We need that support and mentoring from other African women who have been through the things we went through. It just took me to another place. I loved it.

I learned so much there. Our great-grandmothers were fighting these issues and we are still fighting them. It ends with us. This generation of broken people ends with us. We will make this a better place for our kids so that they don't have to go through what we went through.

I've been to the US before, but this is my first time in Europe. The Netherlands is so different – the crime here is so low; you can actually walk around the city and not get scared. It is so safe and so quiet and so free. People are just free. You can just be you here.

People who sell sex here are protected by the law and can access health services. It really touched my heart.

Zama iac18 (2).jpg


June 28
Employee wellness: HST partnering with the private sector to fight HIV

Employee health and wellness is a crucial part of the fight against HIV and TB, as well as numerous non-communicable diseases such as hypertension, diabetes and heart disease.

Yesterday HST participated in a Wellness Day at Reutech Communications in the New Germany industrial area of Durban.

The private sector has been a key player in implementing HIV and AIDS programmes since the early years of the AIDS epidemic.  eThekwini is part of the Fast-Track Cities initiative supported by UNAIDS to engage urban leaders in developing multilateral partnerships to meet the 90-90-90 targets.  This means that if 90% of people with HIV and TB know their status, get treated and stay on treatment, this will help prevent the spread of the disease and keep people healthy.

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Sindy Naidoo, human resources manager at Reutech says employee wellness is important, not just to reduce absenteeism but also to remove the stigma around certain diseases.

"We encourage people to know their numbers – whether that is blood pressure, cholesterol or HIV and TB status. We need to create knowledge and understanding so we can take away the fear and stigma about these conditions."
Naidoo adds that while Reutech has about 400 staff on site, it was also important to include contractors such as cleaning and security staff in this programme.

"We also know that it can be difficult for workers to get to the clinics for testing and treatment because the clinics are closed by the time they leave work. Having a day like this at least once a year is helpful as it allows staff to test for a range of conditions and get proper treatment."


Apart from employee welfare there is a clear business case for such an approach.
Having staff tested and stable on treatment reduces absenteeism and makes it easier for the employer to plan and deliver on production. ​

HST offers this service completely free of charge to employers in the manufacturing sector in eThekwini.

For more information please contact Roger Tevan

April 26
Voices from the Adolescent Girls and Young Women (AGYW) Summit 2018


Nozipho Mbembe (20)

I am from East London and I am a volunteer for the Siyakhanya community youth group.

My goal is to help young children who are depressed or get no love or attention at home. This can make them feel like there is a void inside, so they often try fill it with drugs or sex when they get older.

In my community there are very young girls getting pregnant, even before the age of 13! It is easy for men to exploit them by making them feel special and that someone cares.

I do this because I also went through abuse and depression until I started writing and sharing my story. Our group does activities with the kids such as traditional dancing, poetry and story writing.

My message to youth is that if you need help, please reach out to a teacher or social worker. Support is available and you are not alone.


Hlobisile Inamandla Masinga

I am from Inanda in KZN and I am a student at the University of Zululand. Our area is very traditional, so we try to create a welcoming environment for LGBT students. We also work with university employees such as campus security, so they understand how to deal with LGBT students sensitively when they make a complaint. Obviously, many of these are older people so it is important we educate them as well as our fellow students. Our goal is to integrate LGBT students within the university community, so we can work together as a cohesive whole. 

"Normal" is relative – we need to embrace our incredible diversity as South Africans in all ways.​

April 25
"I refuse to become a statistic"


My name is Zamacebisa Zakwe and I am 26 years old, from KZN.​

I am proud to be a DREAMS ambassador. DREAMS is a space for young people to come together and refuse to become just another statistic. 

It is hard to be a girl growing up in South Africa. You have to fight all the time: fight to stay in school, fight against sexual violence, fight to stay HIV negative. In South Africa, HIV is the leading cause of death for girls between 15-19 years.

The problem is that girls do not have the power to negotiate safe sex or make reproductive health choices so it is hard to protect themselves. I grew up in extreme poverty and experienced issues like gender based violence at first hand. I was deprived of role models and dreams for the future.

We go to the community and educate girls, not just about HIV but about their life options. For example, we have girls’ clubs that teach girls about saving and starting a business. Not everyone can go to university. We also need entrepreneurship, so DREAMS educates girls holistically on issues ranging from business development to reproductive health. 

DREAMS is not just about the here and now – we need to keep the legacy alive!​

I am Lindiwe Msimang and I am working for Health Systems Trust. Like Zama, I am dedicated to using the DREAMS programme to improve the lives of girls and women. 
I work in uMgungundlovu which is one of the districts hardest hit by HIV.

My job is to ensure there is a coordinated response among a diverse range of stakeholders, from the mayor to the amakhosi to traditional healers. Each one has a vital role to play in ensuring we can implement the programme successfully.

For example, some traditional healers have had training on HIV prevention. When clients consult them, the healers not only dispel myths about HIV but also ensure they give clients information about safe sex. When amakhosi see our teams arrive in their areas, they understand what we are doing and support us. ​

This response is already showing an impact: the department of education tells us that the rate of teen pregnancies in schools in the district has dropped. We have also had anecdotal feedback that post-violence care has improved significantly.​

As an older woman it is important for me to be there to support girls and young women, to help them realise their potential and reach their dreams.

December 11
December WEL News

​Dear colleagues

​I trust that you are all well.

This month, I thought I would start with a historical quote that still has relevance today:

It is more important to know what kind of patient has the disease, than to know what sort of disease the patient has.

Caleb Hillier Parry of Bath (1755‒1822)

This perspective aligns with our public health and WEL approach in addressing situations, and is a lens for viewing the world that can enrich our observance of International Human Rights Day on 10 December.

On your quest to spend time with loved ones during the holiday season, be mindful that a focal theme for this month is prevention of injuries.

Not all injuries are physical. I came across a fascinating TED Talk delivered by a man of African origin who shares how to handle anxiety in a society that is uncomfortable with emotions. By the time you get around to reading this, you may have engaged with World AIDS Day or the International Day of Persons with Disabilities ‒ so after viewing this clip, you might choose to engage differently: ​

And if you're thinking: 'I know enough about stress', new research indicates that stress can only be bad for you if you believe that to be the case. Doubtful? Then watch this TED Talk by psychologist Kelly McGonigal, who explains how stress can be used positively, and introduces an unsung mechanism for stress reduction: reaching out to others. l invite you to share your thoughts on these ideas:

Kelly McGonigal: How to make stress your friend | TED Talk |

So, your practice for this month is around you and gadgets ‒ technology.

  • Consider a 'digital vacation': Choose one day a week to stay away from a device completely. If that feels too overwhelming, start with a few hours, by placing the device in a bag or another room.
  • Set guidelines and discuss your expectations with others: For example, at meal-times, agree to put your phones away. For some, that might take place only after they have taken a picture of their plate to post to social media ‒ and that is ok.
  • Try to reduce screen-time before bed and keep screens out of the bedroom: This applies to both you and the younger generation and is slightly more difficult to enforce. It is easy to stay up later than intended when you are online, gaming, or responding to mail. There is also evidence that the blue light emitted by devices may affect healthy sleep, long after you have turned the device off.
  • More tips are available via this link:

And the last word comes from a WEL participant:​

During weekends the laptop is not in the bedroom, my husband he appreciates it. I have more time, more energy, am healthier and can support others.

WEL participant 2013

​Take care.​

 Sarah Davids


December 05
World AIDS Day 2017

​On Friday 1 December Health Systems trust was out in full force at the national World AIDS Day celebrations in Mthatha, Eastern Cape.

While our nurse-clinician​​s tended to patients in HST's mobile clinics, our lay counsellors educated community members on how to be tested and treated for HIV as well as how to adhere to medication.

We spoke to some people attending the World Aids Day celebration addressed by the Deputy President and Minister of Health:​


"Things are getting better in my area. This year I have not seen a single baby born with HIV because mothers are taking up treatment to prevent mother-to-child transmission." - Nqabisa Mafuna, community health worker from Port St Johns.


"I'm a coach who works with children to build their self esteem because this makes them less likely to get infected. For those living with HIV, we empower them to know their status and adhere to treatment." - Thobo Thabede


"I came all the way from Port St Johns today because as a girl I need to protect myself, my family and others to stay HIV free." - Nontyatyambo Demesha (20)


"We work to support children infected and affected by Aids. We build a healthy mentality and compassion for the vulnerable, including themselves." - Snoux Poswa (48) from CINDI in Umthatha



"Mobile clinics are a great help for those of us working in the community. In rural areas it's very hard for people to get to the clinics for testing and treatment." - Patience Dlakavu from Sibangweni.

July 19
Empowered and educated – our DREAMS for the youth of South Africa

My name is Njabulo Banda and I am from KwaNdengezi in Ethekwini.

I am here to tell you all about the DREAMS campaign which HST is running in KwaZulu Natal.


Did you know adolescent girls and young women make up 74% of people who are infected with HIV in sub-Saharan Africa? And did you know that girls and young women are eight times more likely to be infected with HIV than boys and men in the same age group?

There are a number of reasons why teenage girls and young women are at higher risk of HIV infection. Some of it has to do with biology, which means women become more easily infected. ​

Another reason is poverty, which leads young women to have "sugar daddy" and "blesser" relationships with older men. Some girls and women have to do this to put food on the table. Others are influenced by peer pressure and a desire for "nice things" from sanitary pads to lip gloss to phones.

Young people also tell us they are afraid to go to the clinic for advice because they are not youth-friendly and they feel judged by nurses at the clinic.  

Some do not know that they have the right to say "no" to sex and that their body belongs only to them.

Others are the victims of rape and abuse and cannot negotiate safe sex.

Of course, not all girls are affected equally. Girls from poor families or in the rural areas, or places with minimal basic resources, are most at risk because they are more vulnerable. In South Africa, race and class intersect and overlap because of the history of apartheid, so most of the girls and young women infected are black/Africans.

DREAMS is a programme that addresses the unique needs of adolescent girls and young women in South Africa. The goal of DREAMS is to reduce new HIV infections by improving the lives of girls and young women and help them develop into Determined, Resilient, Empowered, Aids-free, Mentored and Safe women.

For this to happen we need to ensure we have youth friendly services so teen girls and young women can access health services such as HIV counselling and testing, or start antiretroviral therapy if necessary.   It is important that these girls and women know their rights, can protect themselves from pregnancy and STIs and complete their schooling.

A girl with an education is more likely to remain HIV negative and achieve her career goals.  These girls are more able to support themselves and their families, less likely to face violence and abuse, and more likely to enter the workforce and contribute to the economy.

A huge part of the problem is that they don't have proper role models to look up to. Social media such as Facebook and Instagram create the illusion that celebrities and social media "influencers" who flaunt expensive brands of everything from shoes to champagne are normal. Ours is an aspirational society and the pressure on both boys and girls to keep up and flash cash is immense.

Did you know that in clubs, young people can actually "rent" bottles for their table for the night, so that their Instagram pics look like they can afford a table full of expensive alcohol (they have to give back most of those bottles at the end of the night). Basically it is all for show.

Designer labels and fancy parties cannot take the place of character and hard work. The value of a man should not depend on how many luxuries he can provide. The value of a woman should not depend on the clothes she wears or an expensive hairstyle.

My message is "love and take care of yourself.  It is ok to be different or unique or not do all the things that your friends do. Be your own person

I come from a very ordinary family but have been able to study psychology, get a Master's degree in early childhood intervention, and am now working on my PhD.

We need to change the youth's view of success- show them that there is another way – a way that will ensure a happier and healthier future.

Follow our DREAMS work on Facebook here.

May 31
HST is leveraging the power of digital media for social change
At Health Systems Trust, we have conceptualised an innovative social media campaign driving behaviour change among young people in South Africa to take up HIV testing and treatment services.
You're better off knowing, the campaign tag-line, is premised on the fact that in this digital era people have a wealth of knowledge at their fingertips, yet many do not know their HIV status. In language that resonates with youth and high risk groups our campaign messages seek to encourage people to take the first step and test for HIV, building on this to encourage them to seek and adhere to treatment.

The campaign uses several media channels to disseminate high impact messages designed to grab attention and create awareness among target audiences. In the first phase in 2016, we used radio, print, billboards, display adverts, digital and social media, supported by outreach activities to deepen the communication and educate communities. In the current phase, we are using social media to extend the conversation to a much wider online audience. 

The campaign has been very successful in its first nine months, achieving 42 678 engagements on Facebook and 106 750 on Twitter. The website has received over 1.7 million hits from 60 000 unique visitors.  

Better off Knowing was showcased by Health Systems Trust at the South Africa AIDS Conference  held in Durban from 13- 15 June 2017 under the track 'Best Practices: Programmes, Communications and Community Engagement'.  

Follow the Better off Knowing Campaign on Twitter and visit the Better off Knowing Website for more information.