Namibia pt. 1: Visit at the NAPPA-clinic in Keetmanshoop

 When I started planning this cycling project, I wanted to combine the tour with a fundraising to support the solidarity organization the Africa Groups of Sweden, that works in partnership with a number of local organizations in Southern Africa (Angola, Namibia, Zimbabwe, Mozambique and South Africa). One of their main causes is sexual and reproductive rights. Now, eventually arrived in Namibia, I’ve had the opportunity to visit a clinic operated by one of their partners, the Namibia Planned Parenthood Association (NAPPA).

 

Doctor Edson Muyambo in the assessment room. Photo: Sam Griffiths
 
NAPPA was established in 1996 as a part of the International Planned Parenthood Federation (IPPF). The association promotes sexual and reproductive health (SRH) by providing information, education, counselling and services particularly to the youth. On a national level much of NAPPA’s work has been focused on advocacy – lobbying the government and legislators to ensure that SRH and the human rights issues associated are being respected. Besides its main focus on young people (aged 10-24), NAPPA aims to reach out to disadvantaged and underserved groups, especially sexual minorities, women and sex workers. NAPPA operates six clinics in Namibia. I visited the most southern one, situated in Keetmanshoop in the Karas region. 

The clinic is located in the youth center, in the middle of the township.”Take the dirt road there and just continue straight down towards the bush”, we were told by a cyclist in the city center as we asked for the directions. ”And by the way, keep an eye on your stuff, guys!”, he added as we cycled off in the dazing heat. It’s Friday afternoon and the sky is still clear blue without a single little cloud, the sunlight is burning. 

 

Open since 2013, the clinic in Keetmanshoop is the most recent of the six health centres operated by NAPPA.
 
Edson Muyambo, the only doctor at the clinic, welcomes us with a wide smile. He’s Zimbabwean and has previously been working in Swaziland, where the rest of his family still lives. I apologize for our short notice, and say that it was fortunate that he was still in service. 

”No worries, I’m always around anyway”, Edson says. ”If I’m not here, the clinic is closed”. One of the things that separates the NAPPA-clinics from its government run alternatives, is it’s accessibility. Its long opening hours means that Edson, who’s the only doctor at the Keetmanshoop clinic, works about 13 hours five days a week. On Saturdays the clinic closes at lunchtime. 

Besides Edson, there are two nurses and two assistants working at the clinic. But he admits that it would be helpful if there was at least another doctor who could receive the clients while he’s not there. ”Many of our clients are stressed and if they have to wait for too long they run away”, Edson tells us and adds that his aim is not to let anyone wait more than half an hour before getting seen to. That would be a lot easier to achieve if there were two doctors. But since the work is low paid compared to its equivalent posts in the public sector, doctors are hard to recruit. 

According to Edson there is a higher grade of acceptance towards lesbians, gays, bisexual, transgender and intersexual people (LGBTI’s) in the south of Namibia than in the northern regions. Still, homosexuality in medical terms is classified as a disorder. Also, gender based violence remains frequent, in some cases towards sexual minorities. Edson tells us that the last case of gender based violence that he encountered was one week ago. His client had been victim of (so called correctional) rape because of her sexual identity

One of NAPPA’s main focuses is family planning. Keen on reaching out to the youth, NAPPA uses peer education projects to raise awareness about sexual rights, contraception and sexually transmitted illnesses (STI’s) such as HIV/AIDS. ”Sexual education is the key”, Edson says. He tells us that abortion is controversial and still illegal in Namibia, even assisting an abortion can lead to prison sentence. 

  
A good example of a peer education project in the Karas region is the so called Dream Team dancing and theater group. The group consists of a number of young adults, that NAPPA uses to reach out to schools and people in rural areas. ”When we bring the dancing team, we manage to get a lot more people tested.”, Edson says. The challenge at the moment is that the staff at the clinic does not yet have its own car, which would be very helpful. 

We actually had the chance to see their latest performance about family planning and STI-prevention. Besides the clear message it was a great show, with skilled and coordinated artists full of energy.  

According to UNAIDS, the adult HIV prevalence rate in Namibia is 16 percent, which is one of the highest in the Sub-Saharan region. Although Namibia is classified as a middle-income country, the income gap between rich and poor is among the highest in the world. Considering that the country is also the second most sparsely populated country in the world, the HIV epidemic has a significant impact on young Namibians. Therefore, it’s clear that there’s a need for organizations such as NAPPA. In 2013, NAPPA delivered 35,610 HIV and AIDS services, and in total 85,008 sexual and reproductive health services to the youth.

Support the fundraising for the Africa Groups of Sweden and NAPPA here!



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