Migrants, IDs & healthcare woes

doctors

Thandeka Moyo
A faint cry can be heard from outside Gogo Siphiwe Mathwasa’s Njube home in Bulawayo. It is from her seven-year-old physically-challenged granddaughter, Kimberly.

Not only is she struggling to move her limbs due to disability and HIV-related ailments, but the numerous tablets she takes daily reduce her to a state of helplessness too.

The excruciating pain from her broken and twisted left leg (a result of a botched operation to fix her swollen knee) keeps her awake and in tears most of the time and no amount of pain killers can ease the pain.

Her mother left her with Gogo Mathwasa at the age of three – with no birth certificate. This makes it impossible for donors to help the girl who was abandoned by her mother when she left for greener pastures in South Africa.

Kimberly is one of the 2,4 million people  in the country who according to the Unicef 2014 Multiple Indicator Cluster Survey  do not have birth certificates and who also struggle to access services. At her age Kimberly is supposed to be in Grade Two, but because she has no birth certificate she is unable to attend school.

The sight of Kimberly’s bony frame wrapped in tattered clothes, is plain evidence that she is malnourished. Her permanently bent left knee, the source of her pain, can easily be noticed, popping from an improvised napkins made from old T-shirts.

With eyes wide open, she cries out in indescribable pain prompting Gogo to sing her a soothing and enchanting lullaby in a futile attempt to lessen her pain.

With no pension or source of income, every day is a struggle for Gogo who has taken care of Kimberly for the past four years.

“She spends three quarters of her life sleeping since she cannot sit up, talk or interact with other children.

“I struggle to change her clothes and feeding her is a mammoth task,” says Gogo Mathwasa.

Kimberly’s mother’s parents are both late and she grew up with her grandmother.

Gogo Mathwasa is constrained under Zimbabwean law from getting a birth certificate for her since she is Kimberly’s paternal grandmother.

Kimberly’s 18 year old brother, who lives in Cowdray Park dropped out of school after Grade Seven as he too does not have a birth certificate.

According to Gogo Mathwasa, Kimberly’s mother, who has a new family in neighbouring South Africa wants nothing to do with her daughter.

“She left in 2012 and is not bothered to at least help me get this child a birth certificate. I have accepted that Kimberly is now my sole responsibility.

“She has access to antiretroviral therapy (ART) but my major worry is that as she grows she will fail to access other services without the birth certificate. At times we go for days without a proper meal but donors cannot help her without the birth certificate. The truth is, I sometimes don’t even have money to buy essential medications and this worsens her health,” Gogo Mathwasa adds.

She says she could not even access the free maize that was being distributed by Government to the elderly over the past year.

“I have failed to access free food for her and donations from well-wishers. What hurts me most is that even her mother, my daughter-in-law does not have a birth certificate.”

Kimberly’s mother is one of the many Zimbabweans who emigrate with no identification particulars. They too also face a number of challenges in the neighbouring South Africa and Botswana where many Zimbabweans have flocked to in search of greener pastures.

Ms Ntobeko Mthunzi from Tsholotsho who has been working in South Africa for ten years says most of her relatives and friends do not have birth certificates.

“To me this issue is more of a generational curse than anything else. My late maternal grandmother had no birth certificate. My mother who is also late did not have one which has also made it difficult for me and my children to have birth certificates,” says Ms Mthunzi.

“Since we do not have passports we face a lot of challenges in South Africa especially in accessing health services and getting employment. I am on ART and had to strike a deal with my family to send me medication from home as I cannot access it here,” she says.

Her three children stay with her younger sister in Tsholotsho and they are all attending school.

“The issue of birth certificates affects our children back home as well because they can only go as far as Grade Seven. Things are tough in South Africa as we can only do menial jobs with less pay hence I cannot raise enough to fix the problem.”

Mr Tinashe Chauke from Inyathi, rural Matabeleland North struggles to access ART and other health services in South Africa due to lack of identification documents.

“I know a lot of people in my circles who have to travel back home when they fall sick because they cannot easily access health care in South Africa. I am not sure how this situation will be fixed. We want to be registered in our country but we cannot change the systems overnight,” he says.

A local health activist, Mr Luke Sibanda, who assists migrants in South Africa access ART and other services says migrants, especially those in South Africa, have been subjected to abuse because they do not have identification particulars.

“We are advocating that they should at least they access free ART and maternal health services. The challenge is that there are some who fake identities and it is difficult to assist such individuals,” he said.

A woman from Berea in Johannesburg whom we shall call Soffie says she has two identities.

“I come from Nkayi and due to poverty and lack of birth certificates I only went up to Grade Seven. The last time I checked with my parents and grandparents they did not have birth certificates. That was a perfectly normal situation,” she says.

“When I moved into South Africa in 2007, I fell pregnant and organised with someone to forge an identity document so I could access maternal health services.

“I gave birth to two children and sent them to my mother in the rural areas.

“I could not risk keeping them here as I am always at work. I bribed someone so that omalayitsha (transporters) could take them to Zimbabwe without papers,” she says.

Soffie’s two children are now in primary school. She says she cannot imagine what life will be for them after Grade Seven as their South African health cards (their source of identity) do not bear her real name.

She says many of her friends who are on ART rely on those back home for ARVs.

“I dread falling sick as it exposes the reality about my identification particulars. The situation is exploited by unscrupulous South African employers who may under pay us. Some women are raped or abused but they remain silent as seeking justice may jeopardise their stay in this country,” says Soffie.

In one of its reports, Zimbabwe’s National Aids Council (Nac) bemoaned the high numbers of HIV patients who default medication due to migration.

“Some of our patients who travel to South Africa fail to access medication due to lack of identification documents. They end up defaulting.

“Those who default may be lucky to be sent back to Zimbabwe. These are the same people who burden the economy as second line ARVs are expensive to purchase,” says Mrs Sinatra Nyathi, Nac’s provincial aids coordinator for Bulawayo.

Director of Trinity Trust, a local non-government organisation Mr Phumulani Mpofu says his organisation is failing to cope with the number of children in need of birth certificates in Matabeleland region.

“Children and adults without birth certificates have no identity or rights.

Yes, they may go up to Grade Seven but eventually their choices in life become limited,” says Mpofu.

“This year alone, we have dealt with over 600 cases of people without proper identification being deported from South Africa together with their children.
According to the Ministry of Finance and Economic Development 2016-2018 Interim Poverty Reduction Strategy rural areas had a higher proportion (45.7 percent) of children aged 0-17 years with no birth certificates, compared to urban areas with 21.7 percent.

“The 2014 Multiple Indicator Cluster Survey shows that only 30 percent of children in Matabeleland North and South provinces have birth certificates which jeopardises their chances of accessing education,” said Mr Mpofu.

“In Bulawayo, 56 percent have birth certificates. We have also realised that there are economic, social and cultural hindrances which have slowed down the whole process.”

He said people were worried at the rate at which health institutions were withholding birth records for non-payment of maternal fees.

“Hospitals are not willing release birth records before payments are made. We are dealing with a lot of children in Bulawayo who were born in South Africa without documentation and were sent back to Zimbabwe with their parents.

Many of them are failing to enrol for ECD or access healthcare,” said Mr Mpofu.

He adds that though his organisation had sought help for Kimberly, the issue of her birth certificate slowed down everything as some donors needed her identity particulars.

Bulawayo provincial registrar, Mrs Jane Peters said families facing challenges with birth registration should visit Registry offices so they can be helped.

“Our role is to register births for everyone hence we do all we can to help members of the public. Kimberly’s family should come and explain their story and I am sure we will help her register,” said Mrs Peters.

“I would like to urge members of the public to ensure they register every birth with us to avoid complications,” she said.

@thamamoe

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