Leaving no one behind: Solutions to vulnerability, inaccessability and condom usage

Dr Shakira Choonara was the regional adolescent manager at the SRHR Africa Trust. This article is amended from a presentation given at a Higher Education and Training HIV/AIDS event in Durban in 2017.

Dr Shakira Choonara was the regional adolescent manager at the SRHR Africa Trust. This article is amended from a presentation given at a Higher Education and Training HIV/AIDS event in Durban in 2017.

The Higher Education and Training HIV/AIDS Programme (HEAIDS) has made significant strides in reaching young people at universities and colleges in South Africa. A recent gathering was an historic moment in South African history. More than 2 000 young people gathered to discuss the dire HIV/AIDS situation in our country, and what’s more, they took centre stage while senior officials and experts listened. I had the opportunity to raise a few key issues at the gathering as an invited speaker.

The address of the opening panelist, Professor’s Ahmed Bawa, who is the chief executive officer of Universities South Africa, was so fitting for the current state of affairs regarding HIV/AIDS and leadership. What I extracted as a central point from government’s recently launched fourth National Strategic Plan for HIV, Tuberculosis (TB) and sexually transmitted infections (STIs) 2017-2222 was this: when we look at the present leadership in South Africa, do we see HIV/AIDS making headlines? No! We see corruption, we see poor leadership, but we no longer see HIV/AIDS!

We have the opportunity to raise this issue with our deputy president, David Mabuza, as he attended the conference.

We have seen a generation of leaders such as Nelson Mandela pass on, we have held the 46664 concerts to raise awareness. Where do we see political leadership of that stature now, other than perhaps the Desmond Tutu Foundation? We need more of this quality of leadership in our political sphere, not corruption and not poor leadership!

Many in this audience have visited campus health facilities at university or college. When you look at me, you may think that I would have visited such facilities, especially being in the medical profession. But, to be honest, I have not.

Allow me to draw on personal experience. I am from a very poor background. When I got to Wits University, I found society has this stigma. If someone is standing at a National Student Financial Aid office (where you may get loans for disadvantaged students), people know that person is poor, that student cannot afford fees. That was one of my first embarrassments. It took me many years to realise it is not an embarrassment.

The second embarrassment I had was about my hands. They may look perfect, but that’s the thing about disability. Some disabilities are invisible.

Two years ago, I was diagnosed with what is known as arthralgia, more commonly known as arthritis. The stigma I experienced at university was immense. There were times when I would go to my office to cry after certain encounters with staff and students.

These sorts of experiences which had me thinking, would I ever, if I needed HIV information, go to the campus health facility, where nurses are rude and unhelpful? Would I go to be further stigmatised? And the answer is: I never went.

Now, though, I have reached a different stage in my life where I no longer care about stigma. I have learnt that you’re not disabled but differently abled.

I never expected to be differently abled myself, but I have always advocated for the right of persons with disabilities.

It is easy for us to pay lip service, to commit in our policies, “Let us include gays and lesbians; let us include persons with disabilities.” But do we actually implement anything for persons with disabilities?

When we speak about contraception, such as condoms, there are barriers to access at a university. Let’s not even go into the additional access barriers for person with disabilities. Do you see accessible bathrooms with condoms? No. But you see them in the standard bathrooms.

Consider this experiment in which a volunteer, Gugulethu, is blindfolded with a scarf. We as young people have been asked to provide solutions to the HIV/AIDS epidemic. Let us examine what we mean by solutions, accessibility and truly leaving no one behind – specifically for those who are visually impaired. Allow us to demonstrate the vulnerability and inaccessibility those with visual impairments may feel when accessing contraception. We will move on to solutions for differently abled condom usage.

Shakira: Gugulethu, I have two condoms, I am placing one in your right hand and one in your left hand. Can you tell the audience which is a male and which is a female condom?

Guglethu: The right hand is a female condom and the left is a male condom.

Shakira: Excellent! What a stroke of luck, the condom packaging has pictures and instructions for usage, can you see the instructions?

Gugulethu: No.

Shakira: There is a hotline number enlisted on the condom, can you see this?

Gugulethu: No.

Shakira: Finally, can you open one of the condoms for us?

Gugulethu: [Struggles and tears the condom in the process.]

This anecdote precisely demonstrates how our interventions are often not tailored to vulnerable populations. Consider the risk even when a visually impaired person is attempting to use contraception for prevention. Consider the possibility of a condom tearing.

While a differently abled individual will eventually figure out safe contraceptive usage, there is a period of vulnerability where one is susceptible and at risk of possibly contracting HIV. As a young person, the one solution I bring to the table at this conference is to ensure accessibility of these condoms and I challenge industry to innovate in this regard.