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Botswana

Articles by Botswana

Pride flag
20 June 2019

Pride 2019: What’s changed since last year?

The right to be who you want to be and love who you want to love is a human right – and no one should ever face prejudice or persecution for it. As such, since last year’s Pride Month, places around the world have taken huge strides towards LGBTI equality, and here we are celebrating just some of them: India  After generations of oppression under a colonial-era law, India scrapped part of the Indian Penal Code in September 2018, which had previously outlawed consensual same-sex sexual relations. A historic win for communities that have been pushed into the shadows, India’s Chief Justice Dipak Mishra made it clear that  “any discrimination on basis of sexual orientation amounts to a violation of fundamental rights.” Austria 2019 kicked off with Austria’s first same-sex marriage taking place following years of campaigning, with Nicole Kopaunik and Daniela Paier being the first to tie the knot in their country. In 2017, the Austrian constitutional court had ruled that same-sex couples should have the right to marry from 1 January of this year, replacing the restrictive previous system of registered partnership, which granted fewer rights than marriage. Taiwan In May of this year, thousands of activists and supporters flooded the streets outside the parliament of Taiwan as it became the first place in Asia to legalize same-sex marriage. Its constitutional court also ruled in 2017 that same-sex couples had the legal right to marry, and gave the Tawainese parliament a two year deadline to change the law.  Ecuador Just this month, the top court in Latin American nation of Ecuador approved same-sex marriage after two couples challenged the decision to deny their request to marry. Of the victory, Diane Rodriguez (president of the Ecuadorian Federation of LGBTI Organizations and the first trans woman elected to Ecuador’s National Assembly) had this to say: “After a fight of almost 20 years, gay marriage has been achieved. It gives us a guiding light for many other proposals on human rights.” Botswana Also this month, Botswana’s High Court overturned a ban on same-sex relationships, ruling the law used to criminalize such relationships as unconstitutional. It’s old law was more or less a copy of the law in many other former British colonies introduced during colonial rule.  “All our work has been proven worth it through this decision,” said Monica Tabengwa, one of the first leaders of LeGaBiBo (Lesbians, Gays and Bisexuals of Botswana). Bhutan The lower house of the parliament of Bhutan voted to repeal two sections of the Bhutan Penal Code, taking a historic step towards decriminalizing homosexuality. While the law had never been used, the country’s Finance Minister Namgay Tshering, said that sections 213 and 214 had become "a stain" on the country's reputation. The work continues As ever, IPPF is in awe of the people and organizations who work tirelessly and sometimes even risk their safety to make all this change happen. As we have recently seen in Kenya, which upheld a law criminalizing gay sex, and the United States, which banned certain transgender people from serving in the military, the urgent need for this work very much continues. We hope that the remarkable global progress elsewhere inspires and encourages other nations that still impose discriminatory practises on its citizens to reflect and finally do what’s right for everyone – regardless of their sexual orientation, gender identity and expression.   Image by torbakhopper

Some IPPF volunteers - Zero Discrimination Day
28 February 2019

1 March: Zero Discrimination Day

On Zero Discrimination Day, IPPF stands for respect, dignity, compassion and care for all. We are committed to providing quality healthcare to every person that visits one of our Member Association’s clinics, regardless of their age, sex, gender identity, race, ethnicity, sexual orientation, religion, economic status or anything else.  When you provide healthcare with dignity and respect, you can inspire others to do the same. Meet some of people who were so motivated by the discrimination-free healthcare they received from our Member Associations, or by the potential to support their communities in need, that they decided to become much-valued volunteers. Lakshmi from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “I made a plan that I would come back home [to Palpa], disclose my status and then do social work with other people living with HIV, so that they too may have hope to live. I said to myself: I will live and I will let others living with HIV live.” Read more about Lakshmi Leilani, a trans woman from Tonga – Volunteer at the Tonga Leiti Association, supported by Tonga Health Family Association “I think Tonga Family Health has done a lot up to now. They always come and do our annual HIV testing and they supply us [with] some condoms.They really, really help us a lot. They [are the] only one that can understand us.” Read more about Leilani Eric from the USA – Outreach volunteer for the Planned Parenthood Federation of America  “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification, I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Read more about Eric Hasina from India – Sex worker and volunteer at the Family Planning Association of India “Selling my body doesn’t make me a bad person, but working as a peer educator has helped enabled me to help many like me.” Read more about Hasina Milan from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “There are 40 children in this area living with HIV,” he says. “I talk to them, collect information from them and help them get the support they need. And I tell them: ‘If I had given up at that time, I would not be like this now. So you also shouldn’t give up, and you have to live your life.” Read more about Milan Joseph from Botswana, a gay man living with HIV – Client at the Botswana Family Welfare Association “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA [Botswana Family Welfare Association].” Read more about Joseph

Joseph is HIV positive and receives treatment from BOFWA

“I feel comfortable here”

19-year-old Joseph Ikatlholeng attends the Botswana Family Welfare Association (BOFWA) clinic in Gaborone every three months to receive antiretroviral treatment for HIV. He’s currently at university, studying for a degree in transport and logistics. “I hope to start my own transport business, maybe in the future an airline,” he says, laughing at the grandeur of his dreams.   Joseph first came to BOFWA when he and his boyfriend decided to start practicing safe sex in March 2017. “I had put myself in risky situations so thought I should get tested for HIV,” he says.   After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment, but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.”     Feeling safe is important to Joseph, who regularly faces discrimination as a man who has sex with other men. “Last week I was walking along, and these guys came past in the car shouting “gay, gay, gay.” I experience that treatment a lot.”    Now, he and some LGBTI friends in Botswana are trying to work with their community to change the status quo about LGBTI people in the country. “We’re trying to tell the elders that we are here, we’re trying to change perceptions that LGBTI people are not just on drugs and having sex,” he says.  

Jackie, 34, sex worker and peer outreach worker

“We were dying in large numbers because we were afraid of those clinics”

“I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie Selelo, 34, sitting in one of the temporary office buildings at the Nkaikela Youth Group in Gaborone.   With the support of BOFWA nurses, the Nkaikela Youth Group provides a range of sexual health care to sex workers: “They need health services for STIs, smear tests, HIV tests, and to be enrolling onto antiretroviral treatment for HIV,” Jackie explains.   Female sex workers are in a particularly high-risk group for contracting HIV – the prevalence rate is 61.9% among the community – so having access to testing and treatment is vital. However, Jackie says many women don’t feel safe going to the government clinic. “They don’t accept us. It’s like we’re doing this because we want to, and just bringing disease. We’re not comfortable there and so sex workers are not [being tested and treated] in large numbers. Before BOFWA we were dying in large numbers because we were afraid of those clinics.”     The difference between being treated by the staff at BOFWA is huge, according to Jackie. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.”   She’s concerned that if funding continues to be cut, BOFWA nurses will stop coming to the Youth Group completely. “If they stop it will be difficult for us. We will die, we will be infected,” she says.  

BOFWAに通っていた患者の一人、ハバツワネさん。セレビ・ピクウェの自宅近くで
24 July 2018

Vital HIV care for local communities forced to stop

The Botswana Family Welfare Association (BOFWA) has been providing sexual and reproductive health care through its eight clinics across Botswana since 1988. Health care includes HIV and STI tests and treatment, cervical screening, contraception, family planning advice and counselling. BOFAW is one of the few organizations to offer youth-friendly services and safe, accessible tailored care to vulnerable populations. With a population of approximately 2.3 million, the prevalence rate of HIV amongst Botswana’s population is 18.5%.  Access & stigma  Although HIV treatment is freely available at government clinics across Botswana, individuals from vulnerable communities need tailored healthcare according to Una Ngwenya, head of the BOFWA. “While the government provides health services to all its citizens… good quality services does not necessarily translate into reaching everyone equitably. We have many sub-communities like female sex workers, men who have sex with men, and the LGBTI population more generally who often do not access health services due to stigma and discrimination. At BOFWA we are conscious, mindful, and sensitive to their specific needs,” she says.    Funded by USAID, the Linkages programme launched in 2016 enabling BOFWA to partner with organizations that support vulnerable and marginalized communities, like men who have sex with men and female sex workers. Individuals were linked to BOFWA clinics for HIV testing and treatment. HIV prevalence among these communities is particularly high (among female sex workers the prevalence rate is 61.9%, for example), yet treatment rates are low.    Through Linkages, hundreds of HIV positive individuals were able to access treatment. “Since working with BOFWA… people who tested positive got linked into care and we were able to retain them. From the 90 clients we targeted in September 2017, we managed to get 93% of them on treatment and virally suppressed. That’s how much BOFWA helped us,” says Kamogelo Maribe, 26, who works at the Nkaikela Youth Group in Gaborone, which supports female sex workers.    The Global Gag Rule   Since the Global Gag Rule was reintroduced in January 2017, the Linkages programme has been forced to end. This vital care and support for local communities can no longer continue.    The loss of USAID funding has forced the BOFWA clinic in Selebi Phikwe, a small mining town, to close. One of the many women affected is 44-year-old Gabatswane. When she lost her husband, and with few employment opportunities, Gabatswane was forced to turn to sex work to provide for her three children. When she contracted HIV she used to go to the BOFWA clinic for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers,” she says.   Gabatswane is concerned about visiting the government clinic for treatment where she fears she will face stigma and discrimination for being HIV positive. “I’m scared [to go there] because now the community might know my status. At the government clinic you get ARVs in a separate space from everything else, but at BOFWA I used to go, and no one could identify me,” she says.   Gabatswane now works at the local council. However, she worries about having to take hours or days out of work each month for treatment might mean she loses her job. “It’s a situation of hopelessness,” she says. The government clinic is also very busy, as after the mine closed HIV positive workers were transferred from the mine clinic to the government clinic, putting a strain on staff there. Gabatswane says it can take a long time to get treatment now: “Sometimes you get [to the government clinic] around 8am and you don’t leave until 2 in the afternoon. It means you have to wake up very early to access that service.”  Supporting sex workers  400 kilometres north, in the city of Francistown, BOFWA is the only NGO providing youth and marginalised-community-friendly health care. Here, BOFWA had been partnering with Legabibo, an LGBTI organization, and Matshelo Community Development Association (MCDA), which supports sex workers, to provide HIV testing and treatment. The HIV prevalence in this region is above the national average at 23.3%.   BOFWA has been an important place for local sex workers to seek healthcare, many say they can’t get the same type of treatment and care at other clinics. Fear of treatment not being confidential at government clinics is a major barrier to receiving healthcare for many sex workers. They wish that more services were available to them, including Pre Exposure Prophylaxis – a HIV treatment for those that are HIV negative but at risk of contracting the disease.   Naima Mutukwa, 31, is a peer outreach worker for Legabibo. Since the Linkages programme ended he has had to transfer his HIV positive peers from BOFWA to a new clinic and worries some of them will not continue treatment. “I told them in 3 months you must be treated again but that we can’t go to BOFWA, and they said they don’t like the new place. So now they’re just not getting treatment, they refuse to get tested or treated with the government,” he says.     

woman looks in mirror

In pictures: Vital HIV care for local communities in Botswana forced to stop

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"I suspect I contracted HIV from my sex work. There were times I had to engage in risky sex, depending on the money on the table." Gabatswane used to go to the BOFWA clinic in Selebi Phikwe for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers.” Due to the Global Gag Rule’s funding cuts, the BOFWA clinic has been forced to close. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Goabaone, sex worker & peer outreach worker "I've been a female sex worker for 5 years and a peer outreach worker for the last two. I was looking at the problems that us sex workers encounter, and thought that this peer outreach system might be able to help,” says Goabaone, explaining how she came to work with MCDA. Since the Global Gag Rule funding cuts the scheme has ended, and she now has to refer them to the government clinic. BOFWA was different: “At BOFWA we felt free, there is no stigma. They didn’t ask [how you got the infection], they just treated you every time,” Goabaone says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Jackie, sex worker & peer outreach worker “I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie, 34. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.” Read Jackie's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Joseph, university student Joseph, 19, first came to BOFWA in 2017 when he and his boyfriend decided to start practicing safe sex. “I had put myself in risky situations so thought I should get tested for HIV,” he says. After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.” Read Joseph's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Keanantswe, BOFWA client A few months after beginning her HIV treatment the BOFWA clinic was forced to close due to the Global Gag Rule funding cuts. “In April I received a call from my nurse telling me the clinic is being closed. She gave me tablets for two months up to June 2018. She told me I will get transferred to a government clinic," Keanantswe says. Although getting treatment is now much harder for her, she has to continue going every month or risks getting sick and even dying. “We have lost so much without BOFWA, not only me, but many women. I wish it would open again,” she says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Botswana Family Welfare Association

Botswana Family Welfare Association is a non-profit, non-governmental organisation founded in 1988 and registered with the Registrar of Societies. BOFWA promotes and provides Sexual Reproductive Health & Rights (SRHR) services to underserved communities including adolescents and young people, women and children in hard to reach areas and LGBTQI. 

BOFWA in partnership with government, the UN family and locally communities work toward improved SRHR outcomes. This it attains through advocating for improved SRHR environment, continually educating beneficiaries and providing targeted services. 

BOFWA strives for increased efficiency, effectiveness and accountability in delivering services.  

BOFWA has been a key implementer of the ESA Ministerial Commitment 2013 providing Comprehensive Sexuality Education for the out of school youth. 

BOFWA exists in six districts but has increased and reduced its reach as determined by needs on the ground and evidence.  

The organization reaches an average of 26 500 adolescents and young people providing close to 160 000 services annually. 

BOFWA provides an Integrated Package of Essential Services (IPES) including and not limited to; 

  • Contraception and Family Planning 
  • Pre and post abortion counselling services 
  • HIV Testing & counselling services 
  • ARV therapy and support services 
  • STI counselling, screening, testing and counselling 
  • Gynae & Obstetrics including cancer screening and ‘see and treat’ 
Pride flag
20 June 2019

Pride 2019: What’s changed since last year?

The right to be who you want to be and love who you want to love is a human right – and no one should ever face prejudice or persecution for it. As such, since last year’s Pride Month, places around the world have taken huge strides towards LGBTI equality, and here we are celebrating just some of them: India  After generations of oppression under a colonial-era law, India scrapped part of the Indian Penal Code in September 2018, which had previously outlawed consensual same-sex sexual relations. A historic win for communities that have been pushed into the shadows, India’s Chief Justice Dipak Mishra made it clear that  “any discrimination on basis of sexual orientation amounts to a violation of fundamental rights.” Austria 2019 kicked off with Austria’s first same-sex marriage taking place following years of campaigning, with Nicole Kopaunik and Daniela Paier being the first to tie the knot in their country. In 2017, the Austrian constitutional court had ruled that same-sex couples should have the right to marry from 1 January of this year, replacing the restrictive previous system of registered partnership, which granted fewer rights than marriage. Taiwan In May of this year, thousands of activists and supporters flooded the streets outside the parliament of Taiwan as it became the first place in Asia to legalize same-sex marriage. Its constitutional court also ruled in 2017 that same-sex couples had the legal right to marry, and gave the Tawainese parliament a two year deadline to change the law.  Ecuador Just this month, the top court in Latin American nation of Ecuador approved same-sex marriage after two couples challenged the decision to deny their request to marry. Of the victory, Diane Rodriguez (president of the Ecuadorian Federation of LGBTI Organizations and the first trans woman elected to Ecuador’s National Assembly) had this to say: “After a fight of almost 20 years, gay marriage has been achieved. It gives us a guiding light for many other proposals on human rights.” Botswana Also this month, Botswana’s High Court overturned a ban on same-sex relationships, ruling the law used to criminalize such relationships as unconstitutional. It’s old law was more or less a copy of the law in many other former British colonies introduced during colonial rule.  “All our work has been proven worth it through this decision,” said Monica Tabengwa, one of the first leaders of LeGaBiBo (Lesbians, Gays and Bisexuals of Botswana). Bhutan The lower house of the parliament of Bhutan voted to repeal two sections of the Bhutan Penal Code, taking a historic step towards decriminalizing homosexuality. While the law had never been used, the country’s Finance Minister Namgay Tshering, said that sections 213 and 214 had become "a stain" on the country's reputation. The work continues As ever, IPPF is in awe of the people and organizations who work tirelessly and sometimes even risk their safety to make all this change happen. As we have recently seen in Kenya, which upheld a law criminalizing gay sex, and the United States, which banned certain transgender people from serving in the military, the urgent need for this work very much continues. We hope that the remarkable global progress elsewhere inspires and encourages other nations that still impose discriminatory practises on its citizens to reflect and finally do what’s right for everyone – regardless of their sexual orientation, gender identity and expression.   Image by torbakhopper

Some IPPF volunteers - Zero Discrimination Day
28 February 2019

1 March: Zero Discrimination Day

On Zero Discrimination Day, IPPF stands for respect, dignity, compassion and care for all. We are committed to providing quality healthcare to every person that visits one of our Member Association’s clinics, regardless of their age, sex, gender identity, race, ethnicity, sexual orientation, religion, economic status or anything else.  When you provide healthcare with dignity and respect, you can inspire others to do the same. Meet some of people who were so motivated by the discrimination-free healthcare they received from our Member Associations, or by the potential to support their communities in need, that they decided to become much-valued volunteers. Lakshmi from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “I made a plan that I would come back home [to Palpa], disclose my status and then do social work with other people living with HIV, so that they too may have hope to live. I said to myself: I will live and I will let others living with HIV live.” Read more about Lakshmi Leilani, a trans woman from Tonga – Volunteer at the Tonga Leiti Association, supported by Tonga Health Family Association “I think Tonga Family Health has done a lot up to now. They always come and do our annual HIV testing and they supply us [with] some condoms.They really, really help us a lot. They [are the] only one that can understand us.” Read more about Leilani Eric from the USA – Outreach volunteer for the Planned Parenthood Federation of America  “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification, I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Read more about Eric Hasina from India – Sex worker and volunteer at the Family Planning Association of India “Selling my body doesn’t make me a bad person, but working as a peer educator has helped enabled me to help many like me.” Read more about Hasina Milan from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “There are 40 children in this area living with HIV,” he says. “I talk to them, collect information from them and help them get the support they need. And I tell them: ‘If I had given up at that time, I would not be like this now. So you also shouldn’t give up, and you have to live your life.” Read more about Milan Joseph from Botswana, a gay man living with HIV – Client at the Botswana Family Welfare Association “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA [Botswana Family Welfare Association].” Read more about Joseph

Joseph is HIV positive and receives treatment from BOFWA

“I feel comfortable here”

19-year-old Joseph Ikatlholeng attends the Botswana Family Welfare Association (BOFWA) clinic in Gaborone every three months to receive antiretroviral treatment for HIV. He’s currently at university, studying for a degree in transport and logistics. “I hope to start my own transport business, maybe in the future an airline,” he says, laughing at the grandeur of his dreams.   Joseph first came to BOFWA when he and his boyfriend decided to start practicing safe sex in March 2017. “I had put myself in risky situations so thought I should get tested for HIV,” he says.   After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment, but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.”     Feeling safe is important to Joseph, who regularly faces discrimination as a man who has sex with other men. “Last week I was walking along, and these guys came past in the car shouting “gay, gay, gay.” I experience that treatment a lot.”    Now, he and some LGBTI friends in Botswana are trying to work with their community to change the status quo about LGBTI people in the country. “We’re trying to tell the elders that we are here, we’re trying to change perceptions that LGBTI people are not just on drugs and having sex,” he says.  

Jackie, 34, sex worker and peer outreach worker

“We were dying in large numbers because we were afraid of those clinics”

“I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie Selelo, 34, sitting in one of the temporary office buildings at the Nkaikela Youth Group in Gaborone.   With the support of BOFWA nurses, the Nkaikela Youth Group provides a range of sexual health care to sex workers: “They need health services for STIs, smear tests, HIV tests, and to be enrolling onto antiretroviral treatment for HIV,” Jackie explains.   Female sex workers are in a particularly high-risk group for contracting HIV – the prevalence rate is 61.9% among the community – so having access to testing and treatment is vital. However, Jackie says many women don’t feel safe going to the government clinic. “They don’t accept us. It’s like we’re doing this because we want to, and just bringing disease. We’re not comfortable there and so sex workers are not [being tested and treated] in large numbers. Before BOFWA we were dying in large numbers because we were afraid of those clinics.”     The difference between being treated by the staff at BOFWA is huge, according to Jackie. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.”   She’s concerned that if funding continues to be cut, BOFWA nurses will stop coming to the Youth Group completely. “If they stop it will be difficult for us. We will die, we will be infected,” she says.  

BOFWAに通っていた患者の一人、ハバツワネさん。セレビ・ピクウェの自宅近くで
24 July 2018

Vital HIV care for local communities forced to stop

The Botswana Family Welfare Association (BOFWA) has been providing sexual and reproductive health care through its eight clinics across Botswana since 1988. Health care includes HIV and STI tests and treatment, cervical screening, contraception, family planning advice and counselling. BOFAW is one of the few organizations to offer youth-friendly services and safe, accessible tailored care to vulnerable populations. With a population of approximately 2.3 million, the prevalence rate of HIV amongst Botswana’s population is 18.5%.  Access & stigma  Although HIV treatment is freely available at government clinics across Botswana, individuals from vulnerable communities need tailored healthcare according to Una Ngwenya, head of the BOFWA. “While the government provides health services to all its citizens… good quality services does not necessarily translate into reaching everyone equitably. We have many sub-communities like female sex workers, men who have sex with men, and the LGBTI population more generally who often do not access health services due to stigma and discrimination. At BOFWA we are conscious, mindful, and sensitive to their specific needs,” she says.    Funded by USAID, the Linkages programme launched in 2016 enabling BOFWA to partner with organizations that support vulnerable and marginalized communities, like men who have sex with men and female sex workers. Individuals were linked to BOFWA clinics for HIV testing and treatment. HIV prevalence among these communities is particularly high (among female sex workers the prevalence rate is 61.9%, for example), yet treatment rates are low.    Through Linkages, hundreds of HIV positive individuals were able to access treatment. “Since working with BOFWA… people who tested positive got linked into care and we were able to retain them. From the 90 clients we targeted in September 2017, we managed to get 93% of them on treatment and virally suppressed. That’s how much BOFWA helped us,” says Kamogelo Maribe, 26, who works at the Nkaikela Youth Group in Gaborone, which supports female sex workers.    The Global Gag Rule   Since the Global Gag Rule was reintroduced in January 2017, the Linkages programme has been forced to end. This vital care and support for local communities can no longer continue.    The loss of USAID funding has forced the BOFWA clinic in Selebi Phikwe, a small mining town, to close. One of the many women affected is 44-year-old Gabatswane. When she lost her husband, and with few employment opportunities, Gabatswane was forced to turn to sex work to provide for her three children. When she contracted HIV she used to go to the BOFWA clinic for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers,” she says.   Gabatswane is concerned about visiting the government clinic for treatment where she fears she will face stigma and discrimination for being HIV positive. “I’m scared [to go there] because now the community might know my status. At the government clinic you get ARVs in a separate space from everything else, but at BOFWA I used to go, and no one could identify me,” she says.   Gabatswane now works at the local council. However, she worries about having to take hours or days out of work each month for treatment might mean she loses her job. “It’s a situation of hopelessness,” she says. The government clinic is also very busy, as after the mine closed HIV positive workers were transferred from the mine clinic to the government clinic, putting a strain on staff there. Gabatswane says it can take a long time to get treatment now: “Sometimes you get [to the government clinic] around 8am and you don’t leave until 2 in the afternoon. It means you have to wake up very early to access that service.”  Supporting sex workers  400 kilometres north, in the city of Francistown, BOFWA is the only NGO providing youth and marginalised-community-friendly health care. Here, BOFWA had been partnering with Legabibo, an LGBTI organization, and Matshelo Community Development Association (MCDA), which supports sex workers, to provide HIV testing and treatment. The HIV prevalence in this region is above the national average at 23.3%.   BOFWA has been an important place for local sex workers to seek healthcare, many say they can’t get the same type of treatment and care at other clinics. Fear of treatment not being confidential at government clinics is a major barrier to receiving healthcare for many sex workers. They wish that more services were available to them, including Pre Exposure Prophylaxis – a HIV treatment for those that are HIV negative but at risk of contracting the disease.   Naima Mutukwa, 31, is a peer outreach worker for Legabibo. Since the Linkages programme ended he has had to transfer his HIV positive peers from BOFWA to a new clinic and worries some of them will not continue treatment. “I told them in 3 months you must be treated again but that we can’t go to BOFWA, and they said they don’t like the new place. So now they’re just not getting treatment, they refuse to get tested or treated with the government,” he says.     

woman looks in mirror

In pictures: Vital HIV care for local communities in Botswana forced to stop

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"I suspect I contracted HIV from my sex work. There were times I had to engage in risky sex, depending on the money on the table." Gabatswane used to go to the BOFWA clinic in Selebi Phikwe for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers.” Due to the Global Gag Rule’s funding cuts, the BOFWA clinic has been forced to close. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Goabaone, sex worker & peer outreach worker "I've been a female sex worker for 5 years and a peer outreach worker for the last two. I was looking at the problems that us sex workers encounter, and thought that this peer outreach system might be able to help,” says Goabaone, explaining how she came to work with MCDA. Since the Global Gag Rule funding cuts the scheme has ended, and she now has to refer them to the government clinic. BOFWA was different: “At BOFWA we felt free, there is no stigma. They didn’t ask [how you got the infection], they just treated you every time,” Goabaone says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Jackie, sex worker & peer outreach worker “I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie, 34. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.” Read Jackie's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Joseph, university student Joseph, 19, first came to BOFWA in 2017 when he and his boyfriend decided to start practicing safe sex. “I had put myself in risky situations so thought I should get tested for HIV,” he says. After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.” Read Joseph's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Keanantswe, BOFWA client A few months after beginning her HIV treatment the BOFWA clinic was forced to close due to the Global Gag Rule funding cuts. “In April I received a call from my nurse telling me the clinic is being closed. She gave me tablets for two months up to June 2018. She told me I will get transferred to a government clinic," Keanantswe says. Although getting treatment is now much harder for her, she has to continue going every month or risks getting sick and even dying. “We have lost so much without BOFWA, not only me, but many women. I wish it would open again,” she says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Botswana Family Welfare Association

Botswana Family Welfare Association is a non-profit, non-governmental organisation founded in 1988 and registered with the Registrar of Societies. BOFWA promotes and provides Sexual Reproductive Health & Rights (SRHR) services to underserved communities including adolescents and young people, women and children in hard to reach areas and LGBTQI. 

BOFWA in partnership with government, the UN family and locally communities work toward improved SRHR outcomes. This it attains through advocating for improved SRHR environment, continually educating beneficiaries and providing targeted services. 

BOFWA strives for increased efficiency, effectiveness and accountability in delivering services.  

BOFWA has been a key implementer of the ESA Ministerial Commitment 2013 providing Comprehensive Sexuality Education for the out of school youth. 

BOFWA exists in six districts but has increased and reduced its reach as determined by needs on the ground and evidence.  

The organization reaches an average of 26 500 adolescents and young people providing close to 160 000 services annually. 

BOFWA provides an Integrated Package of Essential Services (IPES) including and not limited to; 

  • Contraception and Family Planning 
  • Pre and post abortion counselling services 
  • HIV Testing & counselling services 
  • ARV therapy and support services 
  • STI counselling, screening, testing and counselling 
  • Gynae & Obstetrics including cancer screening and ‘see and treat’