"Posted home": migration, tuberculosis and structural violence in Maphisa, Zimbabwe (original) (raw)
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The paper aims to estimate the extent to which migrants are contributing to AIDS or tuberculosis (TB) mortality among rural sub-district populations. The Agincourt (South Africa) health and socio-demographic surveillance system provided comprehensive data on vital and migration events between 1994 and 2006. AIDS and TB cause-deleted life expectancy, and crude death rates by gender, migration status and period were computed. The annualised crude death rate almost tripled from 5•39 [95% CI 5•13-5•65] to 15•10 [95% CI 14•62-15•59] per 1000 over the years 1994-2006. The contribution of AIDS and TB in returned migrants to the increase in crude death rate was 78•7% [95% CI 77•4-80•1] for males and 44•4% [95% CI 43•2-46•1] for females. So, in a typical South African setting dependent on labour migration for rural livelihoods, the contribution of returned migrants, many infected with AIDS and TB, to the burden of disease is high. Résumé L'objectif de cet article est d'estimer dans quelle mesure les migrants contribuent à la mortalité due au Sida et la tuberculose (TB) dans les localités rurales. Les données sur les événements vitaux et migratoires proviennent de l'observatoire sociodémographique et de santé d'Agincourt (Afrique du Sud) pour la période 1994-2006. L'espérance de vie en l'absence de Sida/TB, ainsi que les taux bruts de mortalité ont été calculés par sexe, statut migratoire et période. Le taux brut de mortalité a presque triplé de 5•39 [IC 95% 5•13-5•65] à 15•10 [IC 95% 14•62-15•59] pour 1000 sur la période 1994-2006. La contribution des migrants de retour atteints du Sida/TB à l'augmentation de ce taux brut de mortalité est de 78•7% [IC 95% 77•4-80•1] pour les hommes et de 44•4% [IC 95% 43•2-46•1] pour les femmes. Ainsi, dans un milieu rural sud-africain typique dépendant de la migration de main-d'oeuvre pour sa survie, les migrants de retour, dont bon nombre sont atteints du Sida/ TB, contribuent grandement au fardeau des maladies.
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The Aids pandemic and structural adjustment policies (SAP) have had effects on lower income households in Zimbabwe which have been devastating and people have been required to adapt their livelihood strategies. Small towns meanwhile are growing rapidly in Zimbabwe and mobility towards these towns may be connected with the changes being forged by SAP on the economic landscape. This study seeks to establish how the individual migrant uses mobility to negotiate this landscape. This involves mobility directed towards small towns to access advantageous provisioning possibilities, and also the engagement in a multitude of family linkages from the small town to other places within the settlement system. Substantiated through a case study of Rusape, this study suggests that lower living costs, higher food security and a more accessible labour market may be attracting migrants from higher level urban centres. The role of the network of kin relations in mobility is important and migrants' networks over space cover both rural homes and urban areas. The access to networks, however, is being stratified under SAP and the ability to maintain linkages with relatives is declining, suggesting a rising vulnerability connected with the inability of leaving places and entering others.
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Mobile populations are at very high risk of HIV infection. At the same time, they can be catalysts in its spread. Migration from Matabeleland region in Zimbabwe to South Africa has several features that increase this dual disposition of those involved. These features include the largely irregular nature of migration, its circulatory nature, increasing feminisation as well as the working and living conditions of the migrants in the host country. Irregular migration exposes migrants to various forms of abuse by thugs, those who purport to assist them on the way and law enforcement agents. At the country of destination, undocumented migrants are often employed in precarious forms of jobs which expose them to abuse by employers and other workers. Female irregular migrants are particularly at risk both on transit and at destination. Although they often spend extended periods of time away from home, migrants occasionally return to their spouses or partners at home. This increases the risk of infection for spouses and partners who are often unable to negotiate for safe sex. Using observations from studies conducted in Ward Seven of Matabeleland Province in Zimbabwe, this article discusses some of the factors that expose migrants, particularly irregular migrants, to HIV infection as well making them catalysts in its spread.
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This dissertation explores documented and undocumented Zimbabwean migrant women‘s experiences in accessing public health services in South Africa. It unpacks migrant women‘s vulnerability and subsequent coping strategies they improvise against the shocks and stresses they face. Data in this study was collected over two and a half months using qualitative anthropological techniques. I used key informant interviews, unstructured interviews, life-histories and focus group discussions. The data was analysed using Chabal‘s (2009) model of ̳suffering and surviving‘. Findings in this study reveal that Zimbabwean migrant women in South Africa are excluded from accessing public health services, despite them being accommodated in policy frameworks and the South African Constitution. The excluded women improvise various strategies in accessing health services. In coping with exclusion, they use strategies such as marriage, social capital, local institutions and indigenous knowledge. These stra...
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