Zimbabwean stories of "Best Practice" - SAfAIDS

Indeed, SEVACA had noted a trend that showed that initiates often married soon after the ceremony,thereafter dropping out of school. This led to further entrenchment of the social and financial subordinationof the girl child in the community. It also heightened the young girls' risk of HIV infection as they were oftenmarried by older and sexually experienced males. As such, SEVACA has led efforts towards increasing theage at which young girls undergo the initiation ceremony.“Girls usually go for the initiation ceremony at the onset of menstruation but we are involvedin advocating for a delay to allow girls to mature first.”- SEVACA Implementation Staff MemberSEVACA's success in achieving meaningful cultural reform is also being observed in modifications aroundmale initiation rites. Male circumcision, which forms the hallmark of the young boys' initiation ceremony,is a practice that has historically put their health at risk. As a nurse aide with the Chikombedzi MissionHospital notes, young men were known to faint or even to die from continuous bleeding as a result of thesevering of the foreskin from the penis.Also, the process was often conducted with the use of one knife or cutting instrument, putting the boysat risk of infection with disease. At one point, the Chiredzi Rural District Council sought the hospital'sassistance with painkillers, and anti-septic solutions to deal with the infections occurring among the youngmen.SEVACA's advocacy has been important in ensuring interface between the community, cultural leaders andhealthcare providers on the risks involved in using unsterilized tools. Hospital staff are now actively involvedin the male initiation ceremonies andconduct the circumcisions with theuse of local anaesthetic, cleansurgical blades, gloves and antisepticsolutions (see Figure 27 right).“In the past, the boys werecircumcised in great pain buttoday, we can even be chattingto them while it all takes placeas there is no pain involved.”- Nurse Aide at Chikombedzi MissionHospitalBy putting the community's top Figure 27: A Chikombedzi Mission Hospital nursetraditional leaders at the forefront demonstrates the steps involved in male circumcision (withof the intervention, SEVACA put the aid of a model penis)much of the responsibility fortransformation on them. An initial objective of the SHC project was to ensure that traditional leaders andother custodians of culture had accurate knowledge on HIV, culture and gender. To achieve this, SEVACAembarked on a capacity development programme targeted at the leadership. The programmes were culturesensitive and initially built capacity around leadership and governance issues in general and later addressedleadership issues in HIV responses.Subsequent programmes addressed the relationship between HIV and community development. Theseinitial interventions with the leadership prepared the groundwork for the introduction of more culturallysensitive issues around HIV and AIDS, culture and gender. SEVACA used the HBC programme as an entrypoint for community engagement on such issues.63