This week, UN Secretary-General Kofi Annan released two long-awaited reports on human rights issues affecting billions of people worldwide: the Study on Violence Against Women and the Study on Violence Against Children. AllAfrica's Margaret McElligott spoke to Mokgethi Tshabalala, EngenderHealth's country director in South Africa, who works with men to combat behaviors that he says destroy families and hasten HIV transmission. Excerpts:
What is the Men As Partners Network and how did it get started?
We started doing work in 1998 and the objective was to find ways to involve men constructively in the prevention of HIV infection and also the reduction of what we call gender-based violence or violence against women and children. Those were the two main issues that drove us to start this particular program. We started out as a reproductive health program. How do you get men to take an active interest in their own reproductive health, their partners, and their families? We also realized that violence against women and children makes men themselves vulnerable to HIV infection but also makes their partners vulnerable to HIV infections.
How does that work?
We have found that women that are in an abusive relationship are more vulnerable to HIV infection. It does not make sense to give a woman a condom if she is not able to use it. In an abusive relationship, where there is a domineering husband, a husband who is just controlling everything at home, it is just counterproductive. We need to start engaging the men, asking them—do you negotiate? Do you talk about sex at home with your partner? How do you respond when she says no? How do you respond when she says, "Can we use a condom?" This is a conversation we need to have with men and the community at large. Sex does not happen within a vacuum. In some situations, women have no say. That is what we are engaging men in. Let's talk about that—let's unpack that.
Basically it takes two ... you can't just talk to women about empowerment?
Absolutely. If you empower the women, they go back and face the same old men that come from a socialization of patriarchy that says that men are in charge and they cannot be told what to do. We have to deal with that. It is not an African phenomenon; it is a global phenomenon. Men were raised to believe that they are in charge. There is a lot to be done with men—hence the name, Men As Partners, as partners in good health, as partners in good sexual health, as partners in preventing violence against women and children, as partners against the spread of HIV infection. That is where the partnership comes in—these are our wives, mothers, sisters, and children that are being exposed to all this. The only ways we are taught to deal with emotion is to either get violent or to buckle it up until it gets to a level where I explode.
We started off with workshops and trained a number of organizations to carry out these workshops. We realize that men are given the skills, but they go back into the community which is still not sensitized to all this. Together with running workshops we need to move to community education.
Otherwise these guys will go home and do what they did in the workshop and get teased...
Exactly. That is exactly what happened. I was visiting home. I was sitting with my mother and aunt outside and my wife came out, gave me the baby, gave me the bottle, and asked me to feed the baby while she went inside to go watch TV. My aunt was completely amazed by that. It is not like she is going to cook; she is just going to go watch TV. It amazed her because that is not what a man is supposed to do. He is not supposed to be in a caring role; he can be a provider. This has implications for home-based care for people who are sick because the burden for home-based care goes back to women. We want men to be actively involved in prevention, care, and support.
You probably enjoy spending time with your son.
Sure. Last night I gave him a bath. I was teaching him how to take a bath. In the process, I was helping him. I enjoy that but sometimes we are not allowed that opportunity to bond. We then started engaging the service providers by giving them the skills to make the service-provision male-friendly. For example, we speak about how men should be partners. If his wife is pregnant and he goes to the doctor, he is blocked at the door. The message is that natal care and post-natal care is none of our business, it is a women's job. How do we expect men to provide support and care to their partner in the raising of this child, so you find out that the first four or five years of a child's life it is just the mother who is engaged, and from then on it is just the mother? The father provides, disciplines, and that is it. These are some of the issues we discussed with the service providers. How do you make your service center male friendly?
Then we moved beyond that to organizational development. Every organization we work with needs to integrate gender equality into their organizations because the last thing we want is to be working with an organization where the management does not follow these basic principles. We moved to issues of advocacy and lobbying. We have built relationships with government structures and organizations. We work with organizations that help form policy and that monitor policy implementation within communities and government structures. That was very important for us to use advocacy and lobbying to make sure that the policies are informed by what is happening at the ground-level. This is how we moved from just doing workshops to moving to all these different levels.
What has the reaction been on those different levels?
I think overall good. I would be lying to you if I said that we have not had any problems. There were men that were a bit skeptical. A group of men together start talking about soft issues—are you turning those guys into gays? Men cried, real men don't cry. Men started to break down during workshops. They started reflecting on their relationships with their own fathers; some of them grew up not even knowing their fathers. They did not even have a role models. Those role models that they had within the society—they were not guys who spent all their time with their wives. Guys who spend all their time at home—there is something wrong with them. They don't go drinking with the rest of the guys? He is sitting in front of the home drinking tea with his wife—these is something wrong with him.
Women's organizations [started] asking, "Are you drawing resources away from women's organizations?" Typically, women think we are going to want to walk in and take over. We work very hard to work with women's organizations. For example, the office for the state affairs with women is one of our key partners. The National Gender Initiative, which is led by women, we are actually working with them; we are part of the working community for them. We want to be accountable for our actions. This is a partnership. It is not always that we have been welcomed; there is suspicion. We just soldier on. We believe that the UN noticed, the Beijing Meeting, the Cairo meeting, that we are important. They are partners that can be brought in. That was important.
When you work with service providers, what are the hardest and easiest issues?
It is a problem that all developing countries face. South Africa is so advanced and yet we are still "developing." I wonder how "developed" we will be by the time we are "developed." Having said that, the use of resources is a challenge. The service providers are challenged. They have 101 things to do, and now you come in with a 102nd thing to do. How do they prioritize? They would like to work with you but they have got 101 things to do before they get to you.
It is important to build relationships with the service providers. When I say service providers, I speak of not only the provincial level, but also at a local level, getting to know the manager and getting to explain what has happened and considering the impact your work is going to have. Your workload is going to increase but this is what I can do to help it out; willing to mobilize other resources to make this job easier. Sometimes you think, well, they are just getting paid, so you must do that. They would like to do that but they do not have the resources.
At the Men as Partners workshops, how do you get men to come?
We recruit from existing organizations, workplaces, streets, literally the streets, inviting men, putting up a poster.
What are your strategies to get men to come?
I think networking is important. Whoever comes to the workshop goes back and tells three or four others about the next workshop. As we are recruiting, some of our partners, as they are recruiting, they are educating people about HIV/Aids. Then they start talking about the relationship between HIV/Aids and violence against women and children. Violence against women and children is always in the news in South Africa. Hardly a day goes by when you don't hear about a child that has been victimized.
We talk about power, we talk about socialization, we speak about violence. We have about 67 topics we can choose from.
How do you decide what you are going to talk about? Do you try to target it?
Yes. You need to know your audience. But if you are recruiting from the streets, you need to have a standard approach. People need to understand from the beginning why I work with men. Why are we calling men to come and work with them? Then we move onto to positive male role models because that is where it all starts. The book, Running To Stand Still , is about an Irish guy who had to come to terms with domestic violence, violence against his wife. He tracked them all the way back to the way he was raised—the longing for a relationship with his father, who was always there but they did not connect. His father would talk about him to his mother with him in the room. That just made him [feel] inadequate.
My friend was telling me the other day that he does not know how to comfort somebody because he does not know how to be comforted. He can never allow himself to be comforted. He used to cry himself to sleep because there was no one to comfort him. So if somebody breaking down, come on, get with the program, what's the story, you just get up and move. We can say that guy is so cold. Help men do a personal reflection. We do say we understand why you do what you do, so keep on doing it. By understanding who you are, you can start to deal with some unresolved feelings that are inclining toward this particular thing.
We've talked about resistance a little bit ...
Some men will say forget about it. This is how I was raised. This is my culture. I want to be seen as a man. When we engage the cultural leaders, they say that violence against women is not part of our culture. There is nothing traditional about a man beating up his wife.
Some break down and some put up this barrier saying get out of my face. But at least a person knows that the argument about my culture, my tradition does not hold water.
South Africa has changed tremendously in past years. How have things changed since you started the program in 1998?
I think there is more reporting on violence against women and children and you hear men talk about how they are starting to feel like they have less power, emasculated, but that is a lousy excuse. I cannot order my wife because she has her rights. You do not dare lift up your arm. Men are feeling a little bit angry. Everything that has been done has been for women. Once they start to unpack it, they realize that this is good because everybody is equal, everybody has equal rights which are being curtailed or flaunted. Everybody has a voice, everybody should be respected, everybody's dignity needs to be protected.
Has the availability of VCT and ARVs impacted your work?
I will speak as a man and as a man whose is working with other men. Part of our objective is to increase men's utilization of VCT. It has been a challenge because they way we are socialized as men is that we are not supposed to admit that we are sick, not admit that you are weak. To access VCT, as men, that can viewed: I am not as virile as a I thought was, I am not as macho as I thought I was, I am not as invincible as I thought I was. It is us as men understanding that knowing that you are sick is not a sign of weakness. It is a sign of strength. Be honest with yourself, you can do something. It is not only about HIV/Aids. We as men at times access help very late. It has been a challenge. Part of our objective is to get a lot of men to access VCT earlier on when we can still do a lot about it and actually prevent men from actually getting sick.
This is not actually about VCT. It could also be you have a stomach ache and you don't go to the doctor for weeks and weeks, then you have a horrible problem. A cold translates into a flu. You are just not taking care of yourself. It is such a trip to go to the doctor. I will make it; I will tough it out. I think those kind of socializations like I said when I started it is a common phenomenon.
How much does the ability of ARVs play into it?
I think the availability of ARVs plays a role. We are working [on] access to ARVs and also people getting to know the pros and cons of ARVs. It is something that is critical for men to know about ARVs and also access them. It is part of the work we do here. However, I do think that ultimately us being able [to get] VCT, we have to deal with the facing up to "I need help" and I need to admit as a man, based on the outcome of my test, if I need help, I will go and access help. That is part of our socialization as men. We need to be able to say 'I need help.'
How does that play into conversations with a spouse ... once I find I am HIV positive, do I tell my wife?
In fact, just this past week a guy went to test and when he wanted to speak to his wife he actually asked the counselor to go along with him. When they got home, he actually wanted the counselor to tell the wife what's up. The counselor said, no, you tell your wife what's up. This is the way to do it. The couple went to test together and they pledged that they will always protect one another. That is the direction that we want to see the country move in; that people within relationships would want to protect one another. We don't want men testing through proxy. My partner went to test, so I pretty much know my status off my partner. We as men need to step up to the plate and go test, discussing it with my partner and then going with my partner. Let us go test. Irrespective of the results, we will work on this together.
Saying this is based on partnership and love ...
Exactly. When I got married, my wife recommended that we go test. She probably wondered why I was working in the HIV field! So we went to test and our results came out and we were both negative. It was very important for me that we got tested together because that is a commitment to a relationship. Irrespective of the outcome of the result we were going to deal with that together. It is important that is the kind of message we send out there—partners should protect one another, trust one another, and be open and honest with one another.
The Men As Partners program is being used elsewhere. What have you learned from your experience in South Africa?
It is being used in Kenya and SE Asia. I think men can change, men are willing to change. Communities can change. I think there is a perception that men are stubborn and that all men really like the status quo. I have found that we really do not like the status quo; in fact the status quo puts us under a lot of pressure. If we are sleeping at night and there is movement outside, society expects a man to wake up and go check out what is going on. Who gets shot? Not that I have a problem with that. I will protect my family. Another issue: If you and I want to get married, if you are not working and I am, that is fine, but if I am not working and you are, society has a problem with that. How is that guy going to provide?
[If] I am not able to freely discuss reproductive health with my partner, it puts me at a loss because if she is sick and not able to tell me that she is sick, it could be something that she picked up from a toilet seat or whatever, she is not able to discuss it with me, I am going to get sick myself. If my sister, who I love dearly, if somebody beats her up, how does that benefit me? If somebody rapes her, how does that benefit me? How does men's ownership of women actually benefit us? It doesn't. There is a perception that men actually like things to stay the way that they are when in reality looking at these issues: the status quo does not really benefit anyone.
How do ideas of manhood – having a lot of girlfriends or drinking a lot – play into risk for HIV transmission?
I think it plays a major role and I am glad that you raisedthe issue. We were talking about it in a staff meeting. Men are defined by their conquests. That also exposes you to a lot of risky situations as a man. As a man, you are not supposed to protect yourself—that is wimpy. It is like a mother telling a young boy to wear warm clothes because it is cold outside. The boy will say to his mother, "you are fussing about too many things here." You feel like as a man I am supposed to take risks. That is why we go mountain climbing, we jump off cliffs, we ride motorcycles without a helmet. We want to see how far we can actually push this. That is how we see HIV/Aids—let me see how far we can actually go with this. We are risking not only our health, but also the health of our partners and the health of our unborn children. That definitely plays into it. Drinking, obviously, impacts your thinking, and you are not able to effectively protect yourself when you are drunk.
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Is it harder to talk about those issues because they're fun?
We need to be real about the fact that now it is not a free-for-all anymore. You have to think about what you do. It would be very unreal not to expect men to feel like they have lost a little bit of freedom that I had to do these things. We also need to show men; it not as [though] you have lost that freedom without gaining anything. You have gained the freedom to know where every action that you take is going to lead you. It is very important that we frame that not so much as a loss but we recognize that it limits the things that men used to do, but do those things really benefit you in the long-run? No, they do not. It just depends on how one frames it.
I know in addition to workshops, working with government, etc, you do street theater. What is street theater and why do you do it?
Street theater is what you call Ambush Theater taken from the South American groups. It is where we stage a disagreement in public. It is very loud; it is a very loud disagreement. It can be between a man and his wife. They are trying to shock people. Everybody stops. Just as soon as they get their attention, they start talking to people. You use that to shock people, then actually get them to pay attention. It works at times, sometimes it does not work. It can be risky. People can get hurt because some people can take it very literally. In this culture of guns these days, anything can happen. Fortunately, we have not had any unfortunate incidents, but it can be quite captivating.
So you mean a guy and a girl start arguing, and then a passerby thinks this women is in danger and intervenes ...
Exactly. We always have to be very careful about that. Other forms of street theater: Sometimes we will just start singing. When people start singing, we will always wonder what people are singing about. People will stop and afterwards the facilitators can mingle in the crowd and start talking about these issues. The songs will be dealing with violence against women and children or HIV/Aids.
What have you seen in terms of Men as Partners alumni? Do you feel you are making a difference?
Yes, there is no doubt in my mind. I am still a work in progress myself. I always tell people about my wife and I discussing family planning earlier this year and we were talking about all the different things she can do. We were lying in bed there looking at the ceiling and she said, "Why don't you go for the snip?" I said, "Why me!?!" She has just gone through four or five things that she can do, and I react to just one. That is just my socialization. Family planning is for women; that is not my responsibility. It is funny because I have been working in this field for the last eight or nine years. We are all still a work in progress. We have are own ghosts coming up now and then.
I think that is the great thing about the Men As Partners Network. We as the men that are working for Men As Partners do not think that we have arrived. When someone thinks that they have arrived, that is a very dangerous position to be in because that is when you really stop reflecting on yourself and that is when the danger slips in. All of a sudden if anyone raises anything at you, you are probably going to bark back at them: "Hey listen, I have dealt with my issues." Not to say that justifies any action that we take, it just cautions us that we should reflect. At every staff meeting on Monday, we do what we call check games because we always want to be in touch with our feelings and what we are going through—our irritabilities, our anger, all of those things. We never forget how to deal with ourselves as men.
