30 April 2010
Address the barriers of transport costs undermining rural women’s right to health in South Africa

The South African authorities must urgently address a key barrier to women’s enjoyment of their right to health – the lack of reliable, affordable and safe transport, particularly for women living in poor, rural communities. The authorities appear to be overlooking this critical issue in their increased efforts to combat the HIV epidemic and to address violence against women.
In South Africa, women are disproportionately affected by the country's HIV epidemic. Rates of infection among women 15 to 34 years of age are two to four times higher than among men of the same age. An average of 30 per cent of women attending antenatal clinics are HIV positive.

As noted by Deputy President Kgalema Motlanthe in late 2009, these stark gender differences in HIV prevalence rates are linked to the disempowerment of women, which is one of the “key drivers of the epidemic”.

South African-based studies show that women in abusive relationships have a long-term increased risk of HIV infection. They are less able to refuse unprotected sex with a male partner. Furthermore, men who are perpetrators of domestic violence are more likely to be involved in high risk behaviour, such as having multiple concurrent unprotected sexual relationships.

While several laws have been amended to increase the protection of women from sexual and other forms of gender-based violence and improve their access to justice, such abuse remains pervasive. Women from poor rural communities are often unable to reach places of safety and other emergency services. Long distances as well as relatively expensive and infrequent transport, especially late at night, act as major barriers for them.

These barriers must be overcome, to enable women who experience gender-based violence to have access to places of safety, and to have access without delay to emergency medical treatment, including to reduce their risk of HIV infection.

These same transport barriers also prevent women living with HIV in similar circumstances from regularly accessing treatment, care and support services. While the health authorities continue to expand access to comprehensive HIV services, including the provision of anti-retroviral therapy (ART) for AIDS, these services are still primarily provided through hospitals. The cost of transport to these distant facilities is often high, especially for women affected by poverty and unemployment.

In February 2010, the government announced an increased budget for combating HIV. In April, the government and the South African National AIDS Council launched an implementation plan to scale up the HIV and AIDS prevention and treatment programmes. The objectives of this plan are in line with a widely agreed strategy in place since 2007.

However, while all government departments have been urged to cooperate in these reinvigorated efforts, the role of the Department of Transport has not been recognized.

The Government has marshalled resources to improve urban-based transport systems for the World Cup starting in June 2010. It must also give meaningful consideration to the transport needs of economically and socially marginalized, rural women at risk of or living with HIV.

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Call on the government to ensure that rural women’s urgent transport needs are considered in their new efforts to combat HIV.  

Send your letter to:

Mr Collins Chabane
Minister of Performance, Monitoring & Evaluation as well as Administration
Office of the Presidency
Private Bag X1000,
South Africa

Fax: +2712 321 8870

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Address the barriers of transport costs undermining rural women’s right to health

Dear Minister,

I welcome the government’s reinvigorated plans to combat HIV and AIDS in South Africa. However, I am concerned that rural women at risk of or living with HIV will be excluded from benefiting from these new prevention and treatment efforts unless their particular needs are addressed. The Department of Transport has a vital role to play in this regard and transport officials should be encouraged to take action.

Treatment and care services for HIV are largely provided by hospitals. Long distances and high transport costs are a barrier to accessing services, meaning that people living with HIV in poor rural communities are frequently unable to reach these facilities. Women form the majority of people affected by the HIV epidemic and by poverty. Consequently women living in rural areas can be particularly disadvantaged by the barrier of transport costs.

Lack of adequate, reliable and safe transport also prevents women living in poor rural communities from accessing emergency and other services for gender-based violence, which can leave them at increased risk of HIV infection.

The national Department of Transport’s strategy documents for rural communities briefly refers to “gender differences in transport needs”. However they should give serious consideration to the urgent transport needs of women affected by gender-based violence and poverty trying to reach vital care for HIV and other services.

I urge you to ensure that transport plans developed to address these needs are incorporated as part of the coordinated government response to the HIV epidemic. Transport officials at national and provincial levels should be encouraged to improve the regularity and accessibility of safe rural transport services to enable rural women to access critical services.

Yours sincerely,

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September 15, 2011

This issue is so peculiar, so that this must not be ignored.
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