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Mitigating the impact of COVID-19 on KPs in Namibia

The COVID-19 pandemic is having a devastating impact on every aspect of life with most people facing loss of livelihoods and inadequate safety nets. However, at the closest receiving end of these effects are Key Populations and vulnerable people, specifically sex workers, men who have sex with men and transgender people.

To help mitigate the impact of COVID-19 on Key Populations (KPs) in Namibia, the Adolescents and Children HIV Incidence Reduction Empowerment and Virus Elimination (ACHIEVE) Food Assistance Program was extended to the Key Populations - Strengthening Technical Assistance and Response for Sustainable HIV Prevention and Treatment (KP-STAR) project for provision of short-term aid to address immediate nutritional needs of KP-STAR enrolled clients who are currently on antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP). The aid comes in form of a food voucher redeemable at specific retail shops for nutritious food parcels.

The KP-STAR project is funded by U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) from 2020 to 2025.

Mwaka*, a 38-year-old resident of Lwayaha location in Katima Mulilo, was one of the 4127 identified KP beneficiaries who received food vouchers through the KP-STAR project. She is a sex worker living with HIV and a beneficiary of the KP-STAR project. Mwaka, who lives with her two sons aged nine and sixteen, came to know about her HIV status in February 2021 after an encounter with KP-STAR Peer Educators in Zambezi region.

“One of Ophelia’s (KP-STAR Site Coordinator in Zambezi region) people found me and advised me to get tested for HIV as I was at risk of being infected. When my results came out positive, they put me on treatment,” she said, adding that the KP-STAR team has been helpful towards her by visiting her biweekly and constantly reminding her to take medication timely and do her refills as expected. “I usually don’t forget because I also have a reminder on my phone,” states Mwaka.

According to her, sex work has been her source of income since 2019 after the grocery shop she worked for closed down, leaving her unemployed. “It was the only way I could provide for my kids,” says Mwaka.

The mother of two further narrates that, she has come to learn that sex work is risky and especially worse during the COVID-19 pandemic. “This work is not safe for me and especially my children. Going to look for clients has also become hard because I fear that I might get COVID-19 from my clients and bring it to my family. Besides, the COVID-19 regulations and restrictions have made it very tough to get clients from our usual places,” Mwaka adds.

She however, expressed gratitude towards the food aid stating that it has helped her take medication on time. The parcels consisted of one canned fish, one can of baked beans, 1.5 litres of cooking oil, 12.5kg maize meal and one pack of dried beans. “It was a good thing and I appreciate it a lot because I did not have to do sex work to buy food during the COVID-19 lock down restriction. The food lasted for about two weeks” she recalls.

Furthermore, Mwaka says that ever since it was revealed to her that she is HIV positive she has always negotiated with her clients to use condoms. “I always make sure that my clients use condoms. I have never encountered anyone who refused to use a condom.”.

The food voucher initiative was implemented in nine towns across Namibia, namely Keetmanshoop, Gobabis, Otjiwarongo, Rundu, Katima Mulilo, Walvis Bay, Swakopmund, Oshakati and Oshikango.

IntraHealth Namibia Site Coordinator for Zambezi Region, Ms. Ophelia Samunzala says the food voucher initiative was a relief to KPs in Katima, who are mostly female sex workers. “COVID-19 has affected their work and as such they are unable to go to their usual spots because of curfew hours. Most of our clients who are on case management received food in two rounds. The food vouchers were a relief to them; however, I have encouraged them not to depend on free food,” says Ophelia.

Additionally, Ophelia says sex workers in Katima Mulilo have initiated community adherence groups to form support groups in which they contribute small amounts of money to start small businesses that will help them sustain their livelihoods.

“The problem is that when they wait to receive free food, they do not adhere to medication due to hunger on days when nothing is being given out and this raises their viral load. I want them to be self reliant and not to depend on handouts,” she says.

The KP-STAR project is being implemented by a consortium of partners namely, IntraHealth Namibia (Prime Recipient), Walvis Bay Corridor Group and KP-led Civil Society Organisations such as Rights not Rescue Trust (RnRT), Wings to Transcend Trust of Namibia (WTTN), Voice of Hope Trust (VHT), MPower, and Society for Women Empowerment (SWET). The KP-STAR project is being implemented in 10 Priority Geographic Areas (PGAs) namely Gobabis, Swakopmund, Walvis Bay, Oshakati, Rundu, Katima Mulilo, Oshikango, Keetmanshoop and Otjiwarongo and targets Female Sex Workers, MSM and Transgender.

*Not her real name.

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