August 2014

Youth in Swaziland Speak Out for Health

Created by:

Eric Bond and Muzi Yende



Knowledge is power. And a young woman with knowledge about HIV is a powerful force indeed.

Recently, Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) staff empowered high school students in Swaziland through debates, with the youth in the spotlight as peer educators. This is especially important for the girls in this southern African kingdom where the HIV prevalance rate is the highest in the world — at 26%.

Students at five high schools in Manzini, Swaziland came together for debates about HIV and sexual reproductive health.

The HIV gender gap begins early in Swaziland, with girls between the ages of 10 and 14 infected at almost twice the rate of boys at that age. Teen pregnancy is also high in Swaziland. This combination — high HIV rates and high pregnancy rates among teen girls — puts babies at particularly high risk for HIV infection through mother-to-child transmission. Sexual relationships between adolescent girls and adult men have contributed to this dire situation.

Swazi girls who are considered orphans and vulnerable children (OVC) are more likely to engage in sexual intercourse at a young age. According to the Swaziland Ministry of Health, 9% of OVC girls younger than age 15 have had sexual intercourse, compared to 6.4% of non-OVC girls. This is a significant issue in a country in which 1 in 4 children is an orphan and many more are classified as vulnerable because of family death, poverty, or abuse.

Competing for Health and School Pride

A total of 1,284 students and 76 teachers from Swaziland’s central hub participated in the debate. The Ministry of Health chose schools with high drop-out rates due to pregnancy. Each class selected a male and a female student to present on assigned topics, such as HIV testing, HIV prevention, HIV treatment, substance abuse, and teen pregnancy.

A panel of judges — comprising school nurses, sexual and reproductive health officers, EGPAF officers, and clinic supervisors — evaluated the quality and comprehensiveness of each presentation. The judges provided feedback and gave awards, including computers, to inspire further research.

To keep the young people engaged throughout the program, a DJ played popular songs during portions, to the delight of the teens, who took to their feet and danced.

Busting Myths and Sharing Information

According Muzi Yende, EGPAF’s communication, advocacy, and outreach officer in Swaziland, “the debates were valuable because they cleared up common misconceptions about such issues as male circumcision and faith healing.”

Swaziland’s Ministry of Health has been aggressively promoting voluntary male circumcision as a means of reducing HIV. Circumcision does lower risk of HIV-infection in men, and is recommended by most public health advocates — including EGPAF — but male circumcision is not as effective as using a condom and it does not protect women. Student presenters reiterated that boys who choose to have sex should use condoms, whether they are circumcised or not.

Many students said that they had wondered if a person living with HIV could be healed through prayer. Student presenters counseled their peers to follow the antiretroviral treatment regimens prescribed by health workers if they have tested positive for HIV.

“The debates were enriching in the sense that the students brought into light factual information which was very helpful to peers, teachers, and other stakeholders,” said Cebile Fakudze, a career guidance teacher at St. Paul’s Methodist High School.

“The presentations were a good platform for peer education in a relaxed and enjoyable environment where the adults were there only to support and not to intimidate the students during the presentations,” she added.

“Having these platforms helps us young people understand more about the virus and how we can do things different to avoid unwanted pregnancies and contracting the virus, said Themba Mdlalose, a young debater from St. Paul’s. “I have personally learned a lot as I researched on the subject in preparation for the debates.”

Nothando Sithole, a young woman from St. Anne’s High School said that the debate filled gaps in her knowledge. “I didn’t know that the work done by EGPAF was this huge,” she said. “I hope for the best outcome out of these debates. I expect change of behavior from us as teenagers.”

“Teenagers should understand that being HIV positive does not mean the end in one’s career path, and these debates have helped us unearth that,” added Tebesuthu Nkambule, also from St. Anne’s. “We are grateful to EGPAF and USAID for this opportunity and are very sure that all of us will return to our schools different and empowered with more information. I hope this opportunity is availed even in future to help others.”

With the clear message that the debate was a success, EGPAF, with government partners, is planning another high school debate in the Lubombo region along the Mozambique border.

Learn more about EGPAF’s work to create an AIDS-free generation in Swaziland.