For most people, health care in Botswana is a very debatable issue. While most are quick to point out the privilege of free, accessible health care most citizens have been afforded, many are quick to dismiss the service dispensed by the health workers.
The lesbian, gay, bisexual, transgender and intersex (LGBTI) community in Selebi Phikwe is divided when it comes to health issues concerning the LGBTI community in the once famous mining town. Issues ranging from breach of confidentiality to lack of health education are just some of the matters the LGBTI community have to grapple with in accessing health care.
While confidentiality of results seems a routine, it has become almost common practice for health workers to reveal patients private information to the public. Most LGBTI community have shown a reluctance to HIV/AIDS testing because of previous circumstances of health workers not honoring their part in the patient health confidentiality agreement. Tshepang Madiba’s world was turned upside down when a rumour began about him being on an ARV treatment program. Perhaps the most stunning angle of this rumour is it was completely not true, but rather the allegations were made by a health worker Madiba had trusted with his medial information. “I got texts and calls from friends asking me if indeed it was true that I was HIV positive. I questioned where they got such talk and they confirmed the story was being spread by a health worker who had previously tested me”. Madiba goes on to further relate how the rumour caused a lot of complications in his life. “Firstly the rumors were not true. I was not on any ARV treatment. Secondly it caused a rift in my relationship as my boyfriend had to content with constant rumours and speculation that I am on ARV treatment and HIV positive. I also had to deal with constant glares, judgment and staring from people because I was supposedly HIV positive”. Despite the horrible ordeal, Madiba now serves as a peer educator at Silence Kills support group. “After reporting the case to Silence Kills and the matter being resolved, I joined Silence Kills as a peer educator. Part of my work is encouraging people to test for HIV/AIDS and know their status but most importantly I reassure them of confidentiality.”
For many people, talking about their sex life with health workers can be an intimidating and embarrassing task. For the LGBT community, once they manage their fears, more red tape lies ahead in the form of discrimination and narrow mindness of health workers. Madiba has had a few encounters with health workers in the local clinics and he reckons the service he had to endure with bordered on discrimination. “I went to a local clinic and told them my symptoms. The first nurse left the room and another nurse came in. Then she referred me to another nurse. The nurses just kept referring me to another nurse”. Lebo Mashabane, a former peer educator at Pride and Ratanang, however argues that most LGBTI patients are not honest about their conditions hence not receiving proper help. “My experience with dealing with most health workers in Selebi Phikwe is that most are very helpful if you are honest about your condition. Most LGBT are not honest about their condition especially if it is sexually related because they fear being judged and ridiculed. However, most health workers I have met have been very helpful”. Mashabane further argues that most clinics are showing effort in embracing the LGBT community. “Most clinics in Phikwe have lubes easily accessible and free. A few years most clinics offer such but now have stands where anyone can get some easily.”
Despite his appreciation for the effort made, Mashabane’s parting shot hints at room for improvement. “LGBTI health education is little if not nonexistent in Selibe Phikwe. There is not enough education on LGBT health matters and we need more seminars or workshops to enlighten the LGBT community and health workers in Selibe Phikwe.”
In an attempt to address the grievances of the LGBTI community, the Lesbians, Gays and Bisexuals of Botswana (LEGABIBO) launched its Health and Recreational Drop In Center (DIC) in July 2017 in Gaborone and Francistown. The LEGABIBO DIC aims to increase demand for and uptake of targeted comprehensive HIV prevention, treatment, care and support for LGBTI, men who have sex with men (MSM) and women who have sex with women (WSW), raise awareness on Sexual and Reproductive Health Rights (SRHR) services, to establish safe spaces and to provide spaces that enable movement building.