swaziland times

BABANE — As the Kingdom prepares for a busy weekend of events, concerns are rising about health issues related to sex workers and the threat of monkeypox.

The country will host three high-profile events including a reed dance ceremony, the Swaziland International Trade Fair and a cycling event to be held at the Sidvokodvo Knights Ranch. Many visitors from different countries are expected to attend some of these events. A number of concerns were raised by sex workers at an indaba held yesterday at the SibaneSami Hotel in Ezulwini for the country’s sex workers. They complained about being excluded from important health discussions, claiming they were not educated on how to protect themselves from diseases such as HIV/AIDS and monkeypox (formerly known as monkeypox). Notably, the Ministry of Health, the Human Rights Commission and the Ministry of Justice and Constitutional Affairs were represented at the meeting.

Vulnerabilities

It was also learnt that police officers were invited to the meeting but allegedly did not attend, according to Lungile Khumalo, who oversees sex workers issues in the country.
Kumalo admitted to Swaziland News that sex workers are vulnerable to diseases because they have not received education or capacity training on how to protect themselves. She said due to their economic vulnerability, some sex workers were allegedly raped and abused by clients, leaving them infected with diseases such as HIV. “Sex workers are treated badly by society and that is why they are not included in educational health programmes. We have noticed a sharp rise in HIV/AIDS infection rates among them because they are not educated on health precautions,” she said. Kumalo said it was time for the government to change its mindset towards sex workers and accept them as part of society. She said during the rally, sex workers admitted they felt ignored, not only in terms of health education but also in terms of employment opportunities.

Death toll

South Africa’s National IHR Focal Point (NFP) has notified the World Health Organization (WHO) of 20 confirmed cases of Mpox, including 3 deaths (case fatality rate 15%), between 8 May and 2 July 2024. These cases were reported in 3 of the 9 provinces, namely Gauteng (10 cases, 1 death), Western Cape (1 case) and KwaZulu-Natal (9 cases, 2 deaths). These are the first cases of Mpox reported in South Africa since 2022, when the country reported 5 cases, none of which were severe, and no deaths.

There is research suggesting that if the virus continues to circulate widely among these and other vulnerable groups in South Africa and neighbouring countries, there is the potential for greater health impacts. Poxviruses are spread primarily through person-to-person contact, meaning physical contact with infected body fluids, rashes, sores, scabs, or blisters. It can also be spread through touching, kissing or sexual contact, or contact with contaminated items used by an infected person, such as bedding, towels or clothing. According to research, people who have close contact with infectious disease patients, such as medical staff, family members (including children), sexual partners and sex workers, are very likely to be infected.

Newborns, children, pregnant women, and people with underlying immune deficiencies (such as those with advanced AIDS) are at higher risk of contracting Mpox.
The sex workers’ industry is to make money by sleeping with different types of people every day. Some of them are said to sleep with 10 clients in a 24-hour period. Swaziland is one of the countries where such business is known to exist, although it is not legal under the country’s laws. The business is most prevalent in the regions of Mbabane, Ezulwini, Matsafa and Manzini. Even in remote towns such as Nhlangano, Pigg Peak and Sitki, such business is reported to exist.

Earlier, the Swaziland News Agency also reported that this business exists even in rural areas of the country, and local residents have learned that there are groups engaged in sex trade there. The U.S. National Library of Medicine reported in a recent article that in six months (May 6 to October 3, 2022), the global human poxvirus outbreak had spread to 99 non-endemic countries and had a particularly severe impact on marginalized communities.

Vaccination

“Despite the considerable risk posed to sex workers by the Mpox virus, the public health response has focused little or no attention on sex workers. To date, in most cases, sex workers have not been prioritised in vaccination campaigns, and there have been reports of uneven access and prioritisation for vaccination among men who have sex with men. The article reads in part: “The HIV and COVID-19 pandemics have highlighted the disproportionate burden of infection borne by sex workers in different settings, and the urgent need to address the unmet occupational needs of sex workers, which must be considered in the response to the Mpox virus.” Significantly, the country’s health authorities have not yet conducted any known campaign to raise awareness among local sex workers about the threat of Mpox, especially when dealing with tourists from other countries.

Nsindiso Tsabedze, the communications officer at the Ministry of Health, was asked in a questionnaire about concerns about the country’s sex workers being excluded from the Mpox discussion, but they make a living by having sex with different clients every day. He was also asked if the Ministry of Health had considered educating sex workers on how to protect themselves from the virus, especially since it is understood that some of their clients come from abroad.

His response: “The Ministry of Health, through the Health Promotion Unit, has been actively and robustly promoting Mpox throughout the country. Promotion efforts are being carried out through various media platforms such as radio, television and social media, as well as community events. These efforts are aimed at ensuring that everyone, including sex workers, have access to information about the disease so that they can make informed decisions.” Tsabaze also said that as a department they are advising all Swazis to look up information about the disease online so they are informed and able to protect themselves. When further questioned whether the sex workers had attended a workshop held a week ago to sensitize emaSwati on the dangers of Mpox, the communications officer responded in the negative.

“The recent workshop was only to enhance the capacity of the health workers. These health workers from different regions and departments are now qualified trainers who will pass on their knowledge to other staff in facilities across the country. The Ministry of Health, with the help of the World Health Organization, recognized the need to strengthen preparedness for a potential Mpox outbreak and ensure that the health workers are intellectually prepared to deal with Mpox,” he further said.

Danger

Sabez also assured that plans were in place to sensitize people at border crossings about the dangers of the virus. He said the Ministry of Health, through carefully selected staff at the ports of entry, has been sensitizing travellers about the Mpox disease. He said their Environmental Health Department further utilized the Port Health Desk to collect information from travelers through the health screening program, which he said the ministry has been advocating to the public through local media and social media due to its importance. Tsabedze then implored all travelers to allow time for health checks in order to assist the country in preventing the spread of infectious diseases.

“We will soon launch a campaign to raise awareness among travelers about Mpox and other infectious diseases,” he said. On the other hand, Police Information and Communications Officer Senior Superintendent Phindile Vilakati was asked why they did not accept the invitation to attend the indaba as sex workers had expressed concerns about how the police were treating them. These included allegations of physical assault, verbal abuse and even rape. Veerakati said she would have to verify whether such an invitation had indeed taken place. However, she advised the workers to lodge a complaint with the National Police Commissioner (NATCOM).

“It will not help to lump these issues together, but they must come to the state police chief and voice their concerns, not on a platform where we are not present. We don’t want to assume that they are police haters. If they have been raped or abused by police, they should come out with evidence,” said Veerakati.