Sexual and Reproductive Health Plays Second Fiddle to COVID-19 Pandemic

The advent of COVID-19 has sent many issues that used to be of paramount importance to governments and organisations sent to the back burner. There are growing concerns that after the battle against coronavirus is won, whenever that’s going to be, there will be new fires to put out. The United Nations has sent out an ominous warning that the next pandemic in line is in mental health. This is due to high anxiety levels precipitated by coronavirus, and other spin-offs such job losses, closure of schools and social distancing measures leading to seclusion.

In the Kingdom of Eswatini, it is feared another crisis of sorts is also growing in the wings of the raging pandemic. On Thursday, May 14^th, SafAids hosted a webinar where civic groups and adolescents discussed sexual reproductive health rights (SRHR) during lockdown. Panellists concurred that while it was essential to place the country on lockdown to curtail the spread of COVID-19, the move had the unwelcome impact of hampering access to sexual health services such as contraceptives, condoms and treatment, by young people. Travel restrictions would demand that these young people explain their movements to authorities whenever they need to access services. Faced with such a daunting task, it becomes easier to just forego the required services.

Before lockdown, there were platforms for relevant civic groups to engage with young people, but with social distancing measures banning public gatherings, these have been put on hold.  Safaids Social Accountability Mentee, Sikhulile Hlatjwako said there were groups still operational on social media. However, considering the high cost of data, coupled with a high unemployment rate among young people, not many would be able to participate in these groups, or benefit from them. The coronavirus pandemic has also dealt young adults who earned an income through informal employment a big blow, making it even harder for them to afford transport to places where they would have been comfortable obtaining sexual health services.

Hlatjwako also touched on an issue that has become a global concern -  sexual abuse during lockdown. Many women and children are currently locked up with their abusers. While governments have their eyes on flattening the coronavirus curve, the rape scourge is unfolding.  Research has shown that many cases of child sexual abuse are perpetrated, more often than not, but people closely related to the children or even staying under the same roof as them. Hlatjwako urged guardians to pay attention to their children if they expressed concerns around particular individuals, and be prepared to have discussions around sexual abuse with their children.

With a great degree of uncertainty surrounding the 2020 academic year, many school-going children could find themselves sitting at home with not much to do for months on end. Many schools around the world have adapted to online learning, but in a country like Eswatini, this remains a pie in the sky for many.  Ministry of Health SRHR Coordinator Zandile Masangane said too much idle time and a great sense of helplessness increase the chances of young people wanting to “steal sex”. The current state of affairs, therefore, makes it more urgent for provision of reproductive health services to  be considered an essential service, or else the country will have a huge fallout of unplanned pregnancies and a higher HIV infection rate. This issue would be an easy one to dismiss, especially for conservative parents, but it is actually a life or death situation.

According to UNAIDS, Eswatini had 210,000 people living with HIV, with an adult prevalence of 27,3%, as of 2018. There were 7 800 new infections recorded. The kingdom has been lauded for making impressive strides in HIV testing services and the provision of free antiretroviral treatment. It would be interesting to track how the shift of focus to the coronavirus pandemic and the subsequent lockdown will impact HIV statistics.

Safaids Country Representative, Mandisa Zwane-Machakata applauded government efforts to deal with the threat of COVID-19, but added that there should be no regression in SAHR service provision. She pointed out that information on delaying the onset of sex should still be given, albeit without allowing those children choosing to indulge to fall through the cracks.

Young people in Eswatini (unrelated to the story)

There was consensus among panellists that if ever there was a time for parents to roll their sleeves and get their hands dirty as far as discussions on sexual and reproductive health are concerned, it is now. There is not much such discourse happening, particularly in the African context, but parents need to open up to conversations on sex with their children, considering other channels of communication have stalled as a result of the coronavirus. Masangane said children could easily access information on reproductive health from other outlets, but it would be best if they got it first from their parents. She called for a further similar engagement to be organised, but this time with a focus on empowering parents on how to broach sensitive discussions with their children. A contributor, Ken Makhanya asked for assistance for parents who would like to engage their children but do not know where to start, “We’ve literally shifted responsibility to schools and [civic society organisations],” he said. Machakata said the current scenario provided an opportunity for society to go back to basics and forge relationships with their children. She implored parents to seek the right information from organisations such as WHO, so that they are better equipped to guide their children through growth phases.  An organisation called Khulisa Umntfwana has also availed itself to help parents with the necessary information during the pandemic.    

What stood out for me as I listened to contributions to this webinar was how the Eswatini narrative could fit anywhere else in Africa. Before coronavirus started wreaking havoc on the continent, most governments and organisations on the continent were focused on improving adherence to antiretroviral treatment among those living with HIV. The 90-90-90 target now appears to be a thing of the past as resources are channelled to the fight against COVID-19. Parents around the continent have also suddenly found themselves saddled with having to wear many hats at the same time, with no teachers and organisations to pass the buck too. One thing for sure is we all need to be tightening our belts and brace ourselves for the coronavirus aftermath.