At the end of January 2021, the World Health Organization declared an international health emergency. In mid-March, the government in Tanzania imposed a total lockdown, which had been extended indefinitely at the time of going to press in early May. Costantine Nyambajo, who coordinates the projects of terre des hommes schweiz in Tanzania, provides information on the Covid-19 lockdown in his country at the beginning of May and explains why it is essential that we maintain our health work with young people.
What is your main task vis-à-vis our Tanzanian project partners these days?
Costantine Nyambayo: We are in constant contact with each other. I give them regular updates on the latest government regulations and instructions to combat the spread of Covid-19 and provide them with materials for their local hygiene campaigns. In the office, we are more flexible than usual. Our employees can take time away from work to spend with their families in this difficult situation.
What does the lockdown mean for the work of our local partners?
They can no longer carry out their work as before, as workshops in youth clubs and schools or direct personal counseling of young people, for example, are prohibited. The government’s curfew is binding for everyone. This gives us little room for maneuver.
Wait until the “spook” is over?
Not at all, because then we would be allowing young people – including those in acute need regardless of Covid-19 – to be left completely alone. Instead, we are adapting to the crisis situation. Our people – employees and volunteers, school and community leaders or parents and youth peer educators – use the available communication channels for education, information and help on sexual and reproductive health and rights (SRHR) on the one hand and related gender-based violence (GBV) on the other.
A proven focus of work at terre des hommes schweiz.
Exactly. SRHR and GBV are central to the physical health, mental wellbeing and longer-term life prospects of young people in Tanzania. We have a great deal of experience and expertise in this area and must continue this commitment now – anything else would be irresponsible. At the moment, we are simply adding preventive measures against the coronavirus. We have organized hand soaps, disinfectants and buckets of water, which we are distributing to young people and their social environment via our multipliers.
What channels do you use to communicate with young people when direct contact is prohibited?
Support for young people in a crisis is provided by telephone. Our partner organization KIVIDEA in Kigoma on Lake Victoria, for example, makes radio programmes, firstly to raise awareness in the communities and secondly specifically for adolescents and young adults. The youth program is made by the young people themselves, with the support of our employees and health experts. The radio program is interactive; you can call into the studio or send your questions using your smartphone.
Are social media applications also used?
Of course. Facebook, Instagram and WhatsApp are extremely important during lockdown, as are group chats among young people based on the peer-to-peer principle. We were already strong in this youth-oriented, agile help for self-help before the coronavirus crisis. However, we don’t reach all young people in this way because many don’t have a cell phone or internet at home. That’s a big problem.
A severe global recession is looming due to the coronavirus pandemic. What does this mean for the population in Tanzania?
For the vast majority of people and also for “our” young people in a precarious situation, there is much more at stake – it is a matter of bare survival. A healthy person can go to work and thus make a significant contribution to their family’s income. If they fall ill, they and their family are at risk of starvation. The coronavirus crisis is hitting the weakest members of society the hardest. Access to healthcare in Tanzania is poor, the quality is inadequate and only the privileged can afford it anyway. Our healthcare system is poor and not at all equipped to deal with crises. The capacity of the public sector to provide care will not be sufficient and there is already a shortage of qualified healthcare staff and medical equipment.
The corona pandemic will certainly have an impact on the sexual and reproductive health of young people in our project regions in the northwest and west of Tanzania. It will be very difficult to help them.
What are the other reasons besides the fact that many young people living in poverty in rural areas cannot be reached via digital channels?
For example, if the health centers and clinics are busy with Covid-19 treatments, patients with other needs have no chance of treatment. I am really worried. There is every indication that the health threat posed by the coronavirus pandemic will be enormous. It will reinforce existing inequalities in terms of age and gender. Sexual violence against minors and especially against girls and women will increase. We must expect more rapes and, as a result, more teenage pregnancies.
Many young people do not know the most basic rules of conduct when dealing with their own sexuality. They have unprotected sex or do not defend themselves against assault. Why does Tanzanian society allow this?
Sex and sexuality remain taboo topics, especially in rural regions and in marginalized social groups. The average level of knowledge about sexual health, safe sex, reproduction and sexual rights is low. There is a lack of sex education in schools and in most families. Cultural and religious values and norms, such as the circumcision of girls, make it impossible to discuss these topics openly. They ensure that children and young people are uninformed or misinformed about their sexual health and rights.
Studies show: Minors in Tanzania have sexual experiences long before they reach the age of 15. Girls in particular are at extreme risk of becoming pregnant and being infected with sexually transmitted diseases during unprotected sexual intercourse. This has negative consequences for the rest of their lives. Parents, caregivers, teachers and religious leaders. Even health professionals all have a part to play in this devastating practice.
Health professionals?
Many health workers have fundamental prejudices against teenagers seeking help and do not take them and their concerns seriously. Studies show that only a third of health services in Tanzania are youth-friendly. As a result, those seeking help do not receive contraceptives, cannot take an HIV test and are not treated for sexually transmitted diseases such as gonorrhea. There is even a well-founded fear among young people of sexual abuse by staff at the centers.
The realization is not new that the sexual health of young people in Tanzania is in a bad state. That is why the work of our partner organizations is so important and must be guaranteed even during the corona crisis! There are developments that give me hope – modern means of communication are certainly a great opportunity, as they allow more and more adolescents and young adults to access reliable information. However, archaic ideas about sexuality and gender persist. They prevent healthy development.
How do the terre des hommes schweiz projects on Lake Victoria and Lake Tanganyika contribute to the positive development of young people in Tanzania?
Teenagers are going through puberty. They are at a crossroads in their lives and the topics of sexuality are of great interest to them. Most of the young people I meet are oriented towards their peers. Many communicate via social media, read daily newspapers or watch TV. In the KIVIDEA project, we work with young people through various channels and with a variety of low-threshold activities.
No matter what we do, our focus is always on their needs and concerns. This is what sets us apart from other organizations. Education on sexual and reproductive health and rights, combined with training on how to deal with it wisely in everyday life, helps young people to make informed decisions for their own future lives. Empowered and informed young women and men lead the change towards a fairer world.
Interview: Anna Wegelin
