One Stop Centres as Key Accelerators Towards Zimbabwe’s Progress To End AIDS By 2030

Women and girls who experience Gender Based Violence (GBV) are at high risk of contracting HIV. According to UN Women, GBV is a risk factor for HIV infection, and a consequence of stigma. Addressing violence and gender inequality is therefore essential to ending the AIDS epidemic and protecting the human rights of all people to safety, equality and the highest attainable standard of health.

By Michael Gwarisa

For Roselyn Magaso* 24, from Ngangu, Chimanimani, having been married at the age of 16, she experienced all forms of abuse at the hands of her husband. Marital or Spousal rape, physical violence, verbal, emotional and even economic abuse, she has seen it all.

She has two beautiful children, but she says they used to remind her of the abuse her husband inflicted on her. Because her husband does not work and whenever he made a dollar, he would squander it all on booze, Roselyn decided to take up responsibility and start providing for her family herself. She now does menial jobs such as brick laying work and working in people’s fields just to fend for her family. These are strenuous jobs usually done by men.

 Despite working these tiresome jobs, I would get home, do my daily chores and my husband would come home from the club and still want to be intimate with me. Whenever I refused, he would beat me up for refusing him sex. I had to endure the sexual abuse as he forced himself on me every other night. This went on for years,” said Roselyn.

Though enshrined in the Domestic Violence Act (DVA) and also listed as one of the forms of domestic violence in the 1993 United Nations Declaration for the Elimination of all Forms of Violence against Women which Zimbabwe has ratified, Marital rape remains highly prevalent in marriage settings in Zimbabwe. In Sub-Saharan Africa, women account for 59 percent of people living with HIV and according to research, the bulk of these women are married or are in long-term relationships.

Fortunately for Roselyn, information about her abuse reached the One Stop Center (OSC). The center deployed SASA Champions to talk to her and ensure she gets the required assistance. SASA stands for Start, Awareness, Support and Action. SASA champions are community volunteers working under the SASA Model being implemented by the Zimbabwe Association of Church related Hospitals (ZACH). The organisation has two components that they are implementing in Chimanimani district with one of them being the Stop Centre and also the SASA model.

“A SASA Champion came to my house and he talked to me and my husband about the abuse issue. He offered to help us through getting spousal counseling and other forms of support. I was taken to the One Stop Center where I got tested for HIV and my results came out negative. My husband was also tested and we are now both living together as a happy couple.”

Her husband has since stopped abusing her in any way. Even the sexual abuse has stopped. They are now working together as a couple to budget and plan for they life.

Anotehr survivor of rape, Sarafina Mwaera* 22, from Chimanimnai reveres the assistance she received from the One Stop Centre and how getting services on time gave her another shot at life.

“I was raped at 16, however I could not share with my family and relatives,” said Sarafina. “I did not know that after getting raped, one has to report within 72 hours. However, through the help of SASA Champions I was assisted at the One-Stop-Centre where I received all services from reporting my case, clinical services to prevent any infection including HIV as well as counselling and HIV testing and my results came out negative.”

Sarafina’s has since picked back her pieces and is now married and running a good farming project with her husband.

A umber of One Stop Centres were established by the United Nations Development Program 
(UNDP) in four target Districts to offer comprehensive treatment and legal support for 
victims of Gender Based Violence (GBV). The Four Districts are Chimanimani, Umguza, 
Kwekwe and Umzingwane.

ZACH is implementing the Global Fund Adolescent Girls and Young Women (AGYW) Grant and the One Stop Centre in Chimanimani is a brainchild of that grant. The AGYW Model 3 (2021-2023) grant’s overall goal is to reduce new HIV infections among AGYW between the ages of 10-24 years and end AIDS as a public health threat by 2030.

In Chimanimani, the One-Stop-Centre has not only reduced the prevalence of intimate partner violence and GBV but has resulted in the reduction in new HIV infections.

Media Matirongo, the District Program Officer for ZACH in Chimanimani said the increase in the number of GBV and Sexual Abuse cases being reported early, has resulted in very few new HIV cases being recorded in 2023.

“From January to June this year (2023), we had around 238 cases of GBV survivors reporting at the One-Stop-Centre. Due to early reporting of such cases, we had no new HIV infections. Even amongst the survivors that are the survivors that came here, we had no HIV positive clients under the same period because they managed to access services earlier. However, in the third quarter, we had one positive case,” said Matirongo.

The One Stop Centre in Chimanimani was established in 2018. Annually, the Centre serves between 145 to 250 clients including survivors of sexual gender based violence. Since 2018, they have served slightly below 1000 survivors.

She added that the One-Stop Centre model was fast tracking the progress towards achieving the project’s goal of preventing new HIV infections. Survivors of Sexual Abuse are given Post-Exposure Prophylaxes (PeP), screened to STI and also receive treatment for STIs. She added that before the establishment of the One Stop Centre, survivors of GBV would struggle to access referral pathways but the centre has removed all barriers and brought services to the doorstep of survivors.

“The community is embracing the view that GBV it is a public health issue. Even child marriages are now being reported either by chiefs or communities. Because of the presence of our officers here, women are no longer intimated and they have found confidence to report abuse. Legal services for example are not something that is available in the rural areas. But here at the One Stop Centre, we are offering those services. We even offer legal services when we do our mobile One Stop Centre visits in communities.”

ZACH is implementing SASA/OSC programs in six districts to bring positive change in the community in addressing Gender Based Violence (GBV) and HIV. SASA! OSC program offers series of activities that include GBV and HIV modules by SASA! Champions, OSC survivor assistance, Outreach demand generation, community dialogues, annual public events, and National Monitoring & Evaluation (M&E) support visits to One Stop Centres. ZACH is offering comprehensive services for GBV survivors in the district. This means someone who have faced GBV or Sexual Gender Based Violence can get all services that are required by GBV survivors under one roof.

Meanwhile, in Umguza, Ntombi Ndlovu* (17) who fell pregnant at 14 years to her 15 year old boyfriend said the One-Stop-Centre has given her a new perspective to life.  The One Stop Centre at Nyamandlovu Hospital assisted her to mend relations and one day, she hopes to gather the stragnth to resume her studies.

“I visited the One Stop Centre where I got assistance from the police officer, Counsellor, and lawyer.  I also received HIV testing as well as screening for Sexually Transmitted Infections (STIs). The HIV for HIV came out negative as well as the STI one,” said Ntombi.

The One Stop Centre houses an administrator, the Zimbabwe Republic Police (ZRP) Victim Friendly Unit (VFU) to facilitate investigating and reporting of cases, a nurse who offers emergency medical and health related services, a legal officer who offers legal related services to survivors and a Counsellor who offers Psycho-Social Support to survivors.

Pride Ndlovu, the ZACH District Programs Officer for Umguza said they are also doing community awareness programs for GBV and this has resulted in more survivors reporting at the centre.

“The program started in 2018 here. From 2019, we reached out to 122 clients who are survivors of GBV. Our numbers were still low because people were getting to know the programme. In 2020, we had 280 clients, that was during the COVID-19 era and our numbers went up. In 2021, we attended to 180 clients at the centre. In 2022, we had 365 clients because we were now doing community outreach programs and people were now aware of our programs.  Since beginning of 2023 to date, we have recorded 334 clients,” said Ndlovu.

The National AIDS Council (NAC) as the Sub Recipient for the Global Fund AGYW Grant, is also facilitating and training of community volunteers to identify GBV cases and refer them to the One Stop Centre for services.

Mongiwabesuthu Ngwenya, the National AIDS Council (NAC) District AIDS Coordinator said, “…for the One-Stop-Centres, NAC is responsible creating an enabling environment for the implementation of programs at the One-Stop-Centre. Gender Based Violence issues are very sensitive.

“NAC is creating an enabling environment thorough the engagement of gatekeepers like chiefs, traditional healers, traditional leaders and others to make sure that the program is accepted and executed very well within the communities where it is being implemented in. NAC also identifies and trains people who are working as community volunteers under the One Stop Centres for example SASA Champions.”

To ensure that clients gets all the help they need, the One-Stop-Center concept works with other stakeholders where they can refer cases or receive referrals from there. The stakeholders include the Ministry of Women Affairs, Social Development, the Court, and the Ministry of Health. The OSC also works with partners including but not limited to Plan International, Musasa, Simukai and Childline.

 

NB// Names* of the interviewees have been altered to protect the identity of the survivors 
of Sexual and Gender Based Violence.

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