In the industrial landscape around the Johannesburg inner city, about 24 000 migrant men, mostly from KwaZulu-Natal, live in single-sex hostels. A further 15 000 men and women live in informal settlements. With 68% of the men and 80% of the women unemployed, life is a daily struggle for most.
The Reproductive Health and HIV Research Unit (RHRU), a research centre based at Baragwanath hospital, has recently conducted a behavioural and prevalence study of 2 500 residents in these communities.
Among the most disturbing results from the survey are HIV prevalence rates of 55,5% among women and 24% among men. This was determined using an anonymous antibody saliva test obtained with informed consent.
Living conditions in the hostels are terrible — 22% of the men sleep under beds, 44% share single beds and 41% don’t have access to working toilets.
Reported rates of sexual violence were also high, with 6% of the men reporting having used physical force to have sex with women and 12% of women reporting being victims of this abuse.
The results have been used by the unit in partnership with the Institute for a Democratic South Africa (Idasa) and the Greenhouse Project to pilot a programme called Mpilonhle-Mpilonde — meaning quality life, long life in Zulu — at three hostels and five informal settlements.
The European Commission-funded project is based on a sustainable livelihood approach revolving around “quality life” clubs. Specialist facilitators lead two-hour learning sessions with the clubs each week around community priorities such as food and nutrition, family health, water and sanitation and community relations. The clubs then meet in smaller “reflect groups” to discuss their problems.
The groups aim to create a communal environment in which residents can make informed choices about their lives. In the latter stages of the six-month process, once trust has been built, the sensitive issues of HIV and sexual violence dealt with.
The men and women of the Mangolongolo Informal Settlement, near Jeppe in Johannesburg, quality life club meet beneath a sparsely leaved tree beside a barbed wire fence. The members argue boisterously and often burst into resonant laughter.
The group has been discussing plans to mobilise the community to clean up the area and to stop the dumping of waste by surrounding businesses on their doorstep.
“We want to remove this mountain of rubbish, move the toilets and increase the taps,” says Mxolisi Mthembu, a club member.
The members of Mangolongolo have also started their own gardens in tractor tyres, growing beans, spinach and peas, though they struggle from lack of water, having only one tap in the community.
These initiatives by the club represent the seeds of social change that the project is hoping to achieve with the clubs.
After six months, members of the club graduate and chosen members will be trained by Idasa to become club facilitators themselves. In this way, the project partners hope the reflect groups will become sustainable and continue to grow and disseminate information. Eighty new facilitators from the communities will be trained by the year’s end.
“Sometimes I feel like I’m out of my mind,” says Thandi Nkosi, a member of the Mangolongolo club, “because there’s a lot of problems. But know-ledge has helped me persevere.”
Establishing groups at the hostels, particularly among older men, has proved difficult. Many of the men are only interested in involving themselves in programmes where there is a direct possibility of employment. The hostel groups largely comprise women from surrounding informal settlements.
Sandile Mkhasibe, a 28-year-old man, is a member of the Jeppe Hostel club. He is unemployed and hopes to be a facilitator himself, believing in the positive impact of the groups.
“If you don’t have somebody who you can trust, who you can share your problems with … you’re holding everything inside, it is killing you and it can affect everyone who’s living with you,” he says.
Mkhasibe believes tradition and social hierarchies are blocking open discussion in the hostels. He is bleak about the prospects of those with HIV in the hostels.
“People inside there are aware of HIV but they don’t want to talk about it … If you are HIV positive around here, you are a joke, everybody’s talking about you … they don’t give help or assist you with something … you can’t survive here with the virus,” he says
Myths and misconceptions around HIV continue to flourish. There is widespread mistrust of condoms. The survey showed that while almost all of those surveyed had been sexually active, only 52% of men and 48% of women had ever used a condom. Twenty-two percent of men and 21% of women had used a condom the last time they had sex. Sixty percent of men and 53% of women did not know where HIV-testing sites were in their community.
Mpilonhle-Mpilonde is a sustained attempt to try and facilitate education and discussion around sexual health.
About 80 members of the clubs now prepare for graduation at Metro Centre on July 4 with enthusiasm and hope. In an environment where short-term interventions around social issues and HIV have been largely unsuccessful or non-existent, Mpilonhle-Mpilonde may show a holistic way towards meaningful change. Yet, the test of this project will be whether this hope is transformed into concrete change and whether the groups continue to prosper under difficult circumstances.