by Roma Ramphal – HST
Pharmacist/Differentiated Care Manager
Pharmacy Month serves as a powerful reminder of the indispensable role that pharmacists play in supporting essential healthcare initiatives. Pharmacists stand as integral members of multidisciplinary teams working tirelessly towards the achievement of the UNAIDS 95-95-95 targets for HIV epidemic control, by enhancing medicine supply management, promoting rational medicine use, ensuring compliance at medicine pick-up points, and providing comprehensive training.
The Central Chronic Medicine Dispensing and Distribution (CCMDD) programme has emerged as a cornerstone in providing accessible, uninterrupted medicine supply to people living with chronic illnesses. Pharmacists are central to its success. They are the professionals who ensure that chronic medication reaches patients efficiently and consistently, transcending geographical barriers.
Efficient medicine supply management is vital to safeguarding public health. Pharmacists are the key players in ensuring that healthcare facilities are well-stocked with essential medications. Their expertise in inventory control, procurement, and quality assurance guarantees that patients receive high-quality pharmaceutical care.
In addition to their pivotal roles in healthcare initiatives, pharmacists are breaking new ground with their involvement in the Pharmacist-initiated Management of Antiretroviral Therapy (PIMART) programme. This programme empowers pharmacists to administer antiretroviral therapy (ART), further showcasing their versatility and commitment to patient care.
Through PIMART, pharmacists support improved access to life-saving HIV treatment to enhance patients' health outcomes, thereby entrenching pharmacists' status as valuable members of the healthcare team. This expansion of pharmacists' responsibilities aligns seamlessly with the spirit of Pharmacy Month, emphasising their unwavering dedication to promoting health care for all.
During Pharmacy Month, we honour the dedication and expertise of all pharmacists to patient care and public health, offering a beacon of hope for the realisation of healthier communities.
By Nompumelelo Ntshangase (HST CCPAC Project Manager)
October is known as Breast Cancer Awareness Month. Equally important, September is Cervical Cancer Awareness Month.
In support of the World Health Organization (WHO) 90-70-90 strategic goals for elimination of cervical cancer by 2030, Health Systems Trust (HST) is conducting the Cervical Cancer Prevention, Access and Control (CCPAC) Project, which is the first of its kind for HST.
Funded by Bristol Myers Squibb Foundation, the CCPAC project is implemented through a consortium of implementers and operational researchers comprising HST, the Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU) of the University of KwaZulu-Natal (UKZN), Genius Quality (GQ), and the Zululand Department of Health (ZDoH).
The project aims to address the challenge of high cervical cancer incidence and mortality, and focuses on education and awareness, improving access to early screening, diagnosis, treatment and palliative services for cervical cancer in the Zululand district in KwaZulu-Natal. Through community-informed, evidence-based interventions; building on and harnessing existing resources; community and stakeholder involvement; strengthening health system structures; healthcare worker capacity-building; and integration with existing Primary Health Care (PHC) services, the project aims to support the sustainability of these multi-pronged interventions beyond the programme's lifespan of three years, i.e. from 2022 to 2024.
Zululand District is largely a rural community, with over 100 patients diagnosed with cervical cancer every year. However, there are no facilities for cancer treatment in this district. Patients who are diagnosed with cervical cancer have to travel long distances, as far as Empangeni or Durban, to access treatment and care. Prevention therefore becomes very important for this community.
The human papillomavirus (HPV) causes the majority of cervical cancer cases. Most women who have a strong immune system are able to recover from this sexually transmitted infection. Those with a compromised immune system, especially people living with HIV (PLHIV), may not be able to recover from HPV so easily, resulting in persistence of this virus causing cancerous changes in the cervix.
Cervical cancer is unique in that it has a clearly defined pre-cancerous phase, hence the importance of doing a Pap smear to identify these abnormal cells early and treat them before they become cancerous and spread. Despite the education and availability of free Pap smear services at PHC level, women are still presenting at late stages of this preventable cancer.
During this month, most awareness campaigns are focused on educating the public on strategies to prevent cervical cancer. As part of this campaign, women are encouraged to be screened with a Pap smear at their local health facilities. The CCPAC Mobile Clinic Team also conducts Pap smear screening in hard-to-reach locations in Zululand, and this service has enabled more than 2 000 women to be screened for cervical cancer within their communities. This mobile clinic brings hope to these rural communities, as is evidenced by the overall positive response and reception of this service in the community.
The CCPAC project has partnered with two community-based organisations to run awareness campaigns and to educate the communities on cervical cancer prevention. Education on safe sex practices, including delayed sexual debut, which delays exposure to HPV and HIV, is important. Early sexually debut and multiple sexual partners have been identified as a risk factor for cervical cancer.
The DoH, through its School Health Programme, is running a campaign to promote HPV vaccination among young girls to reduce their risk of contracting cervical cancer. In support of this initiative and in collaboration with the DoH, HST is also educating and encouraging mothers to have their young daughters vaccinated.
By Mandisa Dlamini, HST Communications Intern
Childhood cancer is a leading cause of death of children and adolescents. Cancer is a group of diseases characterised by the uncontrolled growth and division of abnormal cells within the body. Unlike cancer in adults, childhood cancer presents unique challenges due to the developmental and physiological differences between children and adults. There are various types of childhood cancers that affect children, but the most the most common types of cancer diagnosed in children ages 0 to 14 years are leukemias, brain and other central nervous system (CNS) tumours, and lymphomas. The likely course for childhood cancer varies widely depending on factors such as the type of cancer, its stage at diagnosis, the effectiveness of treatment and the child's overall health. Some childhood cancers have high cure rates while others are more challenging to treat.
Causes and Risk Factors
The exact causes of childhood cancer are still largely unknown. Most cancers in children, like those in adults, are thought to develop as a result of mutations in genes that lead to uncontrolled cell growth and eventually cancer. In adults, these gene mutations reflect the cumulative effects of aging and long-term exposure to cancer-causing substances. Genetic changes that are passed from parents to their children known as germline variants can be associated with an increased risk of cancer. Other risk factors contributing to childhood cancer are chronic infections such as HIV, Epstein-Barr virus and malaria.
Children and adolescents who have cancer are often treated at a children's cancer center. This is a hospital that specialises in diagnosing and treating patients up to 20 years of age. Children's cancer centers also participate in clinical trials. Treatment for childhood cancer depends on the type and stage of cancer. Common treatment approaches include generic medicines and other forms of treatment, including surgery and radiotherapy. Childhood cancer treatments can have side-effects due to the impact on rapidly dividing normal cells in addition to cancer cells. These side-effects might include nausea, hair loss, fatigue, a weakened immune system and long-term complications affecting growth and development.
Challenges Faced by Young Patients
Childhood cancer is a complex and devastating condition that affects thousands of children worldwide. It has emotional and psychological effects on young patients and their families. Depending on their age, young patients might struggle to fully understand their diagnosis and treatment, leading to confusion and anxiety. Healthcare providers need to use age-appropriate language and methods to explain the situation to children. It also raises concerns to parents wondering what could possible happened to their young one. Families often experience financial strain due to medical expenses and the need to take time off from work. The emotional toll of watching a child battle cancer can lead to stress, anxiety, and depression.
For more info: Children's Oncology Group : NCIinfo@nih.gov
by Siyabonga Gema, HST Communications Officer
Mondli Shelembe, SA SURE PRO Driver Mobiliser and Peer Educator, says that his eight-year service at Health Systems Trust (HST) has been highlighted by seeing the fruits of his labour through men engaging with healthcare services freely, without fearing stigma.
Mondli is based in Zululand District, where he brings critical health services to the mostly rural communities surrounding Abaqulusi Sub-district. Mondli's passion for community work is driven by the desire to see underprivileged communities being developed and fully capacitated to be able to improve their living conditions. With a community development career spanning over 10 years, Mondli embodies 'active citizenry'.
What, in your view, is the biggest challenge in providing health services in some communities?
"One of the biggest challenges to men's access to healthcare is stigma and there is still a mammoth task ahead of us in addressing this issue. Men's mental health needs greater attention and in my observation, men are usually impatient when they come to health facilities and often look for 'quick fixes'. In my role, I always seek to infiltrate the hard-to-reach areas and conduct health talks where we address their concerns and try to deal with the reasons preventing them from engaging with health services."
Mondli facilitating a community Imbizo at Mondlo in Zululand
Other than your current role at HST, what other skills do you have?
"I have vast experience in youth and community development, and have always endeavoured to integrate my skills with my role at HST. I am an experienced facilitator and have handled functions for HST and the Department of Health in my district. I also have training skills that I acquired during my time before joining HST and some of the programmes I have been involved in include youth coaching programmes. Another skill that I possess is team building, which also dates back to my time before joining HST. All my skills are interlinked, and have contributed immensely in allowing me to effectively carry out my duties at HST."
What does your typical day at work look like?
"My morning routine starts off with a full vehicle safety inspection. This is vitally important to do, as my and my passengers' safety depends on it. To ensure that I have a productive day, I don't choose tasks according to my job description only, and I try to chip in if my assistance is needed. As the day progresses and challenges arise, I try my best to come up with innovative ideas on how we can ensure that our community work is carried out and that we leave a positive mark on the communities we serve. As a health promoter, one of my key functions is engaging communities and educating them on positive health choices while empowering them to be able to share the knowledge further."
Before joining HST, what roles did you hold?
"I was previously an Medical Male Circumcision (MMC) Co-ordinator where I conducted community training sessions, educating men on the benefits of taking up voluntary MMC. Part of my role also entailed co-ordinating clinics where communities accessed these services. I have also been privileged to work with the corporate sector where I organised leadership camps and team-building sessions."
What future aspirations do you have?
"I am passionate about uplifting and empowering others, so I see myself as being in the training sector where I will be involved with upskilling employees and assisting them to better themselves in their crafts. I also have the desire to be more involved in the development of community health programmes."
When not busy at HST, what do you do in your spare time?
"If I am not at work, I am busy in my community working with the youth. I facilitate youth training programmes at my church and this keeps me very busy, even during my spare time. I love what I do, so it does not feel like work to me. I always look forward to my time off from work because I get the opportunity to interact with the youth, which is something I truly enjoy."
What give you fulfilment about working at HST?
"This is a wonderful organisation to work for because we have programmes that directly contribute to improved health for the communities in which we work. A good example is the back-to-care programme, through which we have managed to attract men back to the health system and ensure that they have access to health services. The high volumes of men that we reach through this programme is truly inspiring, and it makes me very proud to have played my part in making a difference."
Children are vulnerable to social ills such as violence, poverty and disease. The onus to shield children from these and other forms of harm rests on the collective efforts of all sectors of society. For developing countries like South Africa, the challenge of protecting children's wellbeing is exacerbated by the economic landscape, which is negatively affected by alarmingly high employment rates and inequality. Access to health services for children is one of the key focus areas where improvements are needed to ensure that children are not robbed of their futures.
From as early as a few days old, children may already be placed in grave danger of losing their lives. In sub-Saharan Africa (SSA), it is estimated that 4.7 million mothers, newborns and children under five die annually. Causes of maternal and child mortality in South Africa include HIV and AIDS, pregnancy and childbirth complications, neonatal illness, childhood illness, and malnutrition, which are all related to poverty and great inequity. During the period between 1 January 2000 and 31 December 2002, infant and under-five mortality rates were, respectively, 67.5 and 21.1 deaths per 1 000 person-years. HIV/AIDS was the cause of 41% of deaths in the under-five age group, with a mortality rate of 8.6 per 1 000 person-years.
The use of antiretroviral therapy (ART) by pregnant mothers throughout their pregnancy and childbirth was identified as the most effective method to prevent perinatal transmission of HIV. In an effort to further curb the high mother-to-child transmission rate, the National Department of Health (NDoH) began the roll-out of oral pre-exposure prophylaxis (PrEP) to pregnant and lactating women in 2019.
The United Nations (UN) has committed to reducing neonatal mortality to at least as low as 12 deaths per 1 000 live births and under-five mortality to at least as low as 25 deaths per 1 000 live births by 2030, in line with the Sustainable Development Goals (SDGs).
While this points to a move in the right direction, countries like South Africa still have much more work to do in pursuit of these targets. One such task is to strengthen health systems with effective interventions to prevent conditions that may lead to child deaths. Public–private partnerships and support from the non-governmental sector have proven to be key in addressing issues associated with child health, such as the provision of medication and nutrition to underprivileged communities.
As part of health systems strengthening, Health Systems Trust (HST) is supporting the Department of Health in implementing programmes that contribute directly to the reduction of adverse health conditions among infants. On 1 October 2021, HST launched the UBOMI BUHLE project.' UBOMI BUHLE' is an acronym for the project and its intention of 'Understanding Birth Outcomes for Mothers and Infants, Building Healthcare by Linking Exposures'. The project monitors adverse effects on maternal health and birth outcomes from obstetric, therapeutic, clinical, infectious, and/or environmental exposures during pregnancy. The project is funded by WITS–RHI through funding received from the Centers for Disease Control and Prevention (CDC) through the U.S. President's Emergency Fund for AIDS Relief (PEPFAR), and the Bill and Melinda Gates Foundation. This multi-stakeholder project, with study sites across three provinces, i.e. Gauteng, Western Cape and KwaZulu-Natal, aims to improve understanding of exposures to medicines, substances and diseases during pregnancy that can result in adverse maternal and child health outcomes such as birth defects, low birth weight, stillbirth, premature birth, and neonatal deaths.
HST personnel and attendees from various other entities who participated in the eThekwini Children's Sector Capacity-building Workshop.
Capacitating health workers with the necessary tools and skills to address child health issues is key to ensuring that children's health is protected. Earlier this year, as part of Child Health Month, HST and other organisations converged at the Edward Hotel in Durban for the eThekwini Children's Sector Capacity-building Workshop. The session was aimed at building the capacity of the district's elected leaders from across the municipality with a better understanding of children's health issues and how to promote improved outcomes for children at community level, including identification and linkage to care of children living with HIV and TB. The workshop's overall objective was to refine strategic partnerships and consolidate collective ownership between government departments, support partners, civil society and communities.
By Mondli Shelembe – SA SURE PRO Driver Mobiliser and Peer Educator, Joslyn Walker – SA SURE PRO Programme Manager and Judith King – HSS Copy and Content Editor
SA SURE Driver Mobiliser and Peer Educator Mondli Shelembe urges men and women with disabilities to visit health facilities for assessment and support.
Few of us give sufficient thought to what it means to exist in a world where physical and social barriers are everyday, all-day challenges – in spaces designed to accommodate free movement for able-bodied people, and in so many areas of life that do not integrate the needs and potential of people with disabilities. The responsibility to progress despite these obstacles is often placed on the person living with disability.
In recognition and involvement of the disability sector for health and wellbeing, the Abaqulusi Disability Forum, in partnership with the Abaqulusi Local Municipality, hosted its annual Disability Sport and Games Day at the Cecil Emmett Sports Precinct on 2 August 2023.
This event forms part of the sub-district's yearly disability awareness programme to advocate for the rights of people with disabilities – such as equity in access to healthcare services, along with encouragement of their participation and inclusion in all spheres of life.
The opening address for the event was delivered by the Abaqulusi Local Municipality Mayor, Councillor Mkhwanazi.
Through the South Africa Sustainable Response to HIV and AIDS (SA SURE PRO) Project, Health Systems Trust (HST) supported the event by providing screening for sexual and reproductive health (including HIV testing services) and non-communicable diseases such as diabetes, hypertension, heart disease. SA SURE PRO Driver Mobiliser and Peer Educator, Mondli Shelembe, conducted a health education and health promotion session, encouraging men and women with disabilities to visit health facilities.
For all people, sport and recreational activities promote development of personal discipline, leadership, team-work skills and self-empowerment. For people with physical and mental disabilities, these activities promote their visibility [vis-ability] by showcasing their resilience, self-sufficiency and talent, and the benefits of an active and healthy lifestyle – whether indoors or outdoors ‒ enjoying positive social interaction, and moving their bodies and their spirits.
The wheelchair basketball team in action.
Various disability sport codes include athletics (100m, 200m, relay, wheelchair races), wheelchair basketball, netball, soccer, table tennis, chess, and mlabalaba (a local alignment board-game).
Physical activities help to sustain bone mass, strengthen muscles, and improve flexibility, balance, co-ordination and blood circulation. Recreational activities in general relieve stress and depression, heighten creativity and strategic skills, and broaden cultural awareness, with an individual and collective impact.
The Abaqulusi Sub-district event provided a platform for healthy competition to boost the participants' self-confidence and sense of achievement, and demonstrated that in the immediate and long term, community and multi-sectoral support can eliminate the stigma associated with disability, and remove emotional and physical barriers to an optimal quality of life.
Through the SA SURE PRO project, HST not only supports improved access at facilities, but also strengthens and increases the footprint of community-based services. This is designed to improve equitable access to health care for all people, regardless of their barriers to treatment.
Community health services provided by our Outreach Teams are critical for improving access for people with disabilities. Mondli Shelembe is one of a team of Driver Mobilisers and community-based HST staff who care deeply about universal health care, and are at the forefront of our efforts to bring services to people where they are.
By Mandisa Dlamini, HST Communications Intern
Women's Month is about recognising and acknowledging women in all areas of life. This is an opportunity to celebrate women's achievements and the important role that women of all races and religions play in South Africa. It is a designated time to promote gender equality, raise awareness about women's rights and issues, and highlight the importance of women empowerment. On this day we take pride in educating society about the contributions and achievements of women in history. On 9 August 1956, over 20 000 women from all walks of life marched to the Union Buildings in Pretoria, protesting against the discriminatory pass laws imposed by the apartheid regime, which had restricted the movement of Black women in the country. This historic event demonstrated the unity and power of women's voices and paved the way for subsequent struggles towards equality and justice.
Challenges and Ongoing Struggles
Sociocultural factors play a key role in gender inequality. Women are more likely to be unemployed than men as a result of fewer economic opportunities. Gender roles and expectations prescribe certain roles and responsibilities for women, such as caregiving, household chores and nurturing. These expectations can limit women's access to education, work and leadership positions.
Multiple and intersecting forms of discrimination against women and girls are rooted in gender inequality. Women may face barriers in accessing reproductive healthcare, maternal care, and treatments for certain conditions that may harm their health and well-being. Women and girls in many parts of the world face the risks of unintended pregnancies, sexually transmitted infections including HIV and cervical cancer, malnutrition, depression, and respiratory infections, amongst others.
Women continue to face significant challenges, particularly in relation to gender-based violence and inequality. Gender-based violence remains a pressing issue, demanding urgent attention and comprehensive action from society. Domestic violence, sexual harassment, and human trafficking also remain common in many societies. Women and girls are affected by these forms of violence due to deep-rooted gender norms and stereotypes.
Although South Africa has made strides in championing women's empowerment, a lot more can be done. In 2002, the South African government adopted the National Policy Framework for Women's Empowerment and Gender Equality, which set out goals and objectives for achieving gender equity in the country. Such legislation, supported by various policies adopted by the private sector are ongoing efforts to ensure that women have fair representation in all aspects of the economy. Another achievement has been the formation of the Department of Women, Youth and Persons with Disabilities (DWYPD), which is mandated to, amongst other things, lead on socio-economic transformation and implementation of the empowerment and participation of women, youth and persons with disabilities through mainstreaming, advocacy, monitoring and evaluation.
There is still work to be done to ensure equal representation and opportunities for women across all sectors and to ensure that all women regardless of their backgrounds have equal opportunities and access to resources in the economy.
Women's Month is a time to appreciate women's contributions, celebrate their accomplishments, and collectively work towards a more gender-balanced society. Women should be empowered to be leaders, change-makers, and active participants in all aspects of society.
The Health Systems Trust has a number of programmes that engage with improving health outcomes for women. To learn more please go to our list of programmes under About us
By Siyabonga Gema, HST Communications Officer
Sinethemba Mpepo, Health Systems Trust's (HST's) Acting Synchronised National Communication in Health (SyNCH) Helpdesk Manager says attention to detail, being solution-oriented and problem-solving skills are some of the personal attributes that someone occupying this position ought to possess. Sinethemba joined HST in July 2019 and boasts a B.A degree in Psychology, with education as a major; however, she says her experience in a call centre environment has been critical in enabling her to do the work required at the SyNCH Helpdesk. HST Communications had a brief chat with Sinethemba to gain insight into her role and take a peek into her personal life.
Unpacking what her role entails, Sinethemba says "As the SyNCH Helpdesk, we provide first-line support for all users of the SyNCH system. This means that we are at the forefront of monitoring the system, its use and developments that are necessary to ensure that the end goal of supporting the Central Chronic Medicines Dispensing and Distribution (CCMDD) programme is achieved. The role not only requires system knowledge, but it also entails stellar customer service, attention to detail, innovation and the ability to think outside the box to come up with solutions to any problems that may arise."
It's no surprise then that when she listed the personal attributes expected from someone in the role of SyNCH Helpdesk Manager, she went on to mention: the ability to work alone; willingness to mentor others; a high tolerance level; the ability to separate feelings from facts; being organised and focused; and the willingness to learn and grow.
What form of training did you receive in order to become competent with SyNCH?
"I received system training on the SyNCH system and CCMDD product knowledge, and in order to be able to assist the change that is happening on the ground, HST also provided Change Management training to ensure that I am able to be competent in my position."
How have the systems on SyNCH improved over the last period of time, and how have these improvements impacted service delivery?
Sinethemba explains, "The system has built in pop-up messages for drug interactions and doctor-initiated medicines that has been added since the pilot as it assists clinicians to better manage the patient. The system also has the ID Checksum mismatch functionality that allows us to verify the ID number of the patient upon registration on the spot. This ensures that public sector patients are getting benefits that were previously afforded only by those who could afford private healthcare services."
How does SyNCH help you with generating the required reports?
"Having an electronic record of all prescriptions on the SyNCH reporting system and each classified according to all disaggregation available being mindful of working within the Protection of Personal Information Act (POPIA), ensures that you can filter the information you need for the report required at your fingertips, and it can be retrieved within five minutes for your evaluation in graph or spreadsheet format."
What does a typical day at work look like?
Taking us through her day, Sinethemba says, "Having seven provinces implementing the SyNCH system and SyNCH Helpdesk consultants at each of these provinces means that each day cannot be carefully panned out as each day brings opportunity to grow our capability with the system. There are tools that Helpdesk uses to ensure system utilisation is optimal, checking if the provinces have any alerts or developments that we need to alert them to. A typical day would mean liaising with provincial DoH representatives, various District Support Partners (DSPs) within the provinces, SyNCH system developers and users that need telephonic retraining or attending meetings with the various stakeholders to ensure that any system issues are resolved within our 48-hour turnaround timeframe."
What do you like to do when you're not busy with HST?
"I am a typical homebody who values time with family, a good book and good food. So if I am not working, I would be found in the kitchen or in a corner reading a book."
What's next for Sinethemba?
"I would love to continue studying towards my Masters in Psychology with a focus on workplace education as I believe we all possess that ability to grow in any sphere at all ages within our professional lives. I am passionate about imparting my knowledge, being fully cognisant that this then allows me to learn from those I interact with."
Tremendous strides have been made in the global treatment of HIV, both clinically and academically. Governments continue to rally support for programmes aimed at educating the public about HIV, and efforts towards curbing it. Strong global partnerships and alliances have culminated in the development of solid plans and targets for ending HIV, most notably The Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets for epidemic control by 2030 – 95% of people living with HIV being aware of their status, 95% of those aware of their status being on antiretroviral treatment (ART), and 95% of those on ART maintaining viral load suppression by 2025.
The Centre for Strategic and International Studies reported that in 2019, nearly 4 500 South Africans were newly infected with HIV every week, one-third being adolescent girls and young women (AGYW) ages 15–24. What these figures suggest is that there is more at play than unsafe sexual behaviour or lack of access to treatment for those who are living with HIV. The stigma associated with HIV plays a massive role in perpetuating the epidemic by preventing HIV-positive people from living freely, knowing their status.
HIV stigma is a threat to HIV treatment interventions and is one of the leading causes of mental health issues among people living with HIV. This is especially rife in poor and uneducated communities where people lack basic knowledge of HIV and AIDS. The negative perception of people living with HIV as carriers of a 'cursed' or life-threatening illness has caused many communities to alienate and even punish those who disclose their HIV status. Stigma can be attributed to an array of causes, including cultural and religious beliefs, which calls on all sectors of society to raise awareness and end stigma.
On Friday, 21 July 2023, the world celebrated the inaugural Zero Stigma Day under the theme 'Human First'. The purpose of this campaign is to unite people, communities, and entire countries to raise awareness of HIV and take action to end HIV stigma in all its forms. The theme 'Human First' is a powerful reminder that places emphasis on the fact that in our common humanity, a person living with HIV is a person first and should be recognised, acknowledged and deserving of every human right, just like everyone else. The 'Human First' theme also recognises this year's 75th anniversary of the Universal Declaration of Human Rights, because discrimination against people living with HIV should be seen as a human rights violation.
The US Centres for Disease and Control and Prevention (CDC) describes HIV stigma as "… negative attitudes and beliefs about people with HIV. It is the prejudice that comes with labelling an individual as part of a group that is believed to be socially unacceptable", and lists examples as:
Since the mid-1990s, South Africa has witnessed a number of tragic incidents where people living with HIV have been attacked, raped and even murdered. In 1998, news broke that an HIV volunteer and activist, Gugu Dlamini, was beaten to death after being accused of bringing shame to the community by revealing her HIV status. This sent shockwaves throughout the country and saw government and social justice organisations taking a stand to condemn such acts.
Unfortunately, similar instances have continued to rear their ugly heads in other communities, and there is only one way to prevent it from happening: by taking action to shift people's mindsets about HIV. The CDC further advises that "… talking openly about HIV can help normalise the subject. It also provides opportunities to correct misconceptions and help others learn more about HIV".
Factual information about HIV and AIDS can be obtained on the following platforms:
For more information about Zero Stigma Day, visit https://zerohivstigmaday.org/
By Siyabonga Gema, HST Communications Officer
Socio-economic issues such as unemployment and inequality continue to ravage the country, giving rise to the already alarming rate of violent crime and the deadly monster of Gender Based Violence (GBV). Issues of abuse are most prevalent in poverty-stricken communities where the perpetrators are men who often have a financial hold over their victims.
The flip side of this, though, is that there are many other triggers. For some men, stress brought on by the added pressures of providing for their families during tough financial times, coupled with the dangerous notion that men should not speak out about their problems, lest they be seen as weak, sometimes also contribute to these and other issues. There is no definite clear cause for mental health issues among men, just like there aren't any for women. However, signs differ. According to the Mental Health Foundation (UK), while there isn't a different sort of 'male depression', some symptoms are more common in men than women. These include irritability, sudden anger, increased loss of control, risk-taking and aggression.
For millions of South African men, the only available stress relief may be the recreational use of dangerous substances like drugs and alcohol rather than talking about their problems. Drugs and alcohol abuse are synonymous with violence in South Africa. The men who don't succumb to drugs and alcohol, turn to suicide as an answer to their mental illnesses. The suicide rate in South Africa has increased drastically, with men leading the numbers. The South African Society of Psychiatrists says that South Africa is ranked number 10 on the list of countries with the most suicides with 23.5 suicides per 100 000 people. Of the 13 774 suicides reported in South Africa, 10 861 were amongst men.
Men's mental health issues have previously been swept under the carpet or dismissed as signs of weakness, however, there is a growing need for men, and society as a whole, to take a different approach. Authorities are increasingly committing to initiatives aimed at empowering men to access mental health support. On the traditional front, cultural practices such as initiations and coming-of-age ceremonies need to be utilised as platforms to raise awareness of mental health issues in boys and young men. Traditional gender roles that place men under the expectation of being providers and breadwinners often lead them to neglect their own feelings and causes them to bottle up their emotions, risking an explosion.
In South Africa, there has been an increase in men-centred organisations and other structures that seek to bridge the gap between factors that isolates men vis-a-vis their mental health problems and help-seeking behaviour. Public-private partnerships, and increased funding to Non-Government Organisations (NGOs) are proving to be effective in addressing issues associated with men's mental health issues. Men who need mental health support are able to access a myriad of platforms. The following platforms are available for men, or those close to men who need mental health support:
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