report summary PARLIAMENTARY STANDING COMMITTEE ON HUMAN RESOURCES, SOCIAL AND COMMUNITY DEVELOPMENT

ERONGO AND HARDAP REGIONS FIELD VISITS

11-24 MAY 2008

COMPILED BY MICHAEL CONTEH CONTENTS LIST OF ACRONYMS AND ABBREVIATIONS

AIDS Acquired Immunodeficiency Syndrome ARV Anti-Retroviral CAA Catholic AIDS Action CAFO Church Alliance for Orphans CCLO Chief Community Liaison Officer CEO Chief Executive Officer CDC Constituency Development Committee DAC District AIDS Community ECD Early Childhood Development ELCAP Evangelical Lutheran Church AIDS Programme GBV Gender Based Violence HBC Home Based Care HAART Highly Active anti-retroviral Treatment HIV Human Immunodeficiency Virus IGA Income Generating Activities LADC Local Authority Development Committe MDG Millennium Development Goals MoE Ministry of Education MGECW Ministry of Gender Equality and Child Welfare MoHA Ministry of Home Affairs MoHSS Ministry of Health and Social Services MoLSW Ministry of Labour and Social Welfare MoME Ministry of Mines and Energy MoSS Ministry of Safety and Security MTI Ministry of Trade and Industry MWTC Ministry of Works, Transport and Communication MP Members of Parliament MTPIII Medium Term Plan III NDT Namibia Development Trust NGO Non-Governmental Organisation NIED National Institute for Education Development OPM Office of the Deputy Prime Minister OVC Orphans and Vulnerable Children PIN People in Need PMO Principal Medical Officer PMTCT Prevention of Mother to Child Transmission RACOC Regional AIDS Coordinating Committee SME Small and Medium Enterprises STI Sexually Transmitted Infection TAC Technical AIDS Committee TB Tuberculosis UNAM University of Namibia UNDP United Nations Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAIDS United States Agency for International Development VTC Voluntary Testing and Counseling

2 ERONGO AND HARDAP REGIONS FIELD VISITS LIST OF ACRONYMS AND E x e c u t i v e ABBREVIATIONS S u m m a r y

This report presents the findings and recommendations regional OVC database should be established. Concern of the Parliamentary Standing Committee on Human was expressed that some schools were receiving grants Resources, Social and Community Development based for OVCs, but then discriminating against them. The on fact-finding visits to the Erongo Region (11th-17th May, division of responsibility for OVCs between two Ministries 2008) and Hardap Region (18th-24th May, 2008). The two (MGECW and MoHSS) created some operational difficulties regions are characterized by widespread poverty, linked especially for service delivery to the community. Concern to economic changes in the farming sector, and the was expressed about the need to provide quality-control challenge of dealing with widespread alcohol-abuse. for the many Early Childhood Development Centres that were being established in the regions. The visits took place as part of a project implemented by the Ministry of Gender Equality and Child Welfare in The report identifies a number of income-generating collaboration with Parliament and with the support of projects in the two regions, but recognizes the widespread the three UN agencies namely UNDP, UNICEF and UNFPA. poverty encountered and the implications this has on The project is entitled “Strengthening Commitment the health of the population, such as the fact that HIV and Leadership of Government to Expand HIV and AIDS positive people fail to take their ARV treatment when Response, Gender Issues and Women’s Empowerment”. they are unable to obtain food. It also raises concerns The primary aim of the project is to examine the about the rising number of teenage pregnancies and the provisions made in the regions to cope with a number of fact that HIV positive pregnant women are continuing to key issues, namely: Gender-based violence, Orphans and breastfeed their children as they are unable to obtain Vulnerable Children (OVCs), HIV and AIDS, reproductive formula milk. One of the greatest concerns raised by the health and income-generating activities. report is the low standard of maintenance and cleanliness experienced in many of the health facilities visited. The main aims of the regional visits are to monitor the The poor state of the health infrastructure in the two effectiveness with which Government policies on these regions extended to the lack of sufficient ambulances to issues are being implemented, to receive direct input provide an adequate service to the community and the from the relevant agencies in the regions about the lack of adequate accommodation for medical staff. The challenges and difficulties they face and to engage with prevailing conditions contribute to staff shortages which NGOs working in the sector. are compounded by the shortage of trained Namibian doctors and the difficulties faced in processing work On the issue of gender-based violence the report notes permits for expatriates. that there are no functional safe houses for victims exist in either Erongo or Hardap Region, cases involving The report makes a number of pertinent observations gender-based violence were frequently withdrawn as the about the administrative structures in place to cope with family relied financially on the perpetrator, there was the problems focused on by the Committee. It notes that widespread concern about the limited availability of the small local NGOs often played an important role, but that new rape kits at Women and Children Protection Units the co-ordination and communication between these (and of trained staff to use them), alcohol abuse was organizations and the state structures could be improved. perceived as a central cause of many cases and this is Regional AIDS Coordinating Committees (RACOC) were directly linked to inadequate control of the operation of functioning in both regions, but also required more shebeens and the relevant laws and guidelines were not support in the form of transport and materials in order widely available. to increase their impact. One key consequence of the shortage of transport is that it limits the ability of doctors The report gives detailed attention to the issue of and social workers to make sufficient visits to smaller OVCs. It recognizes that OVC Committees have been rural settlements. widely established, but need to receive further training and become more broad-based to increase their The report makes a number of specific recommendations effectiveness. The lack of transport and shortage of to address the concerns raised at meetings in the two social workers seriously hinders the adequate provision regions. Separate recommendations are made to the of services to OVC Committees, especially in the smaller Ministries of Education, Gender Equality and Child settlements. Delays in obtaining identity documents also Welfare, Health and Social Services, Home Affairs, Labour delayed the registration of OVCs and it was noted that a and Social Welfare, Safety and Security and Trade and

ERONGO AND HARDAP REGIONS FIELD VISITS 3 Industry. family values;  Enquiring into and monitoring international The report also notes a number of general concerns that protocols, conventions and agreements that may were widely raised in the Erongo and Hardap Region. One affect the country’s human resources, social and was that the observation that the residents of the two community development and, when necessary, regions faced particular difficulties due to a shortage of making recommendations to the Assembly. adequate housing and sanitation, and inadequate public transport facilities. In addition there were repeated claims Although significant progress has been made in Namibia that there were insufficient educational opportunities for towards achieving the Millennium Development Goals young people in the southern part of Namibia. It was also (MDG), and Vision 2030, these efforts are being undermined argued that staffs were being employed in key sectors by what is known as the “Triple Threat” – which comes where good communication is crucial, such as social work from the HIV and AIDS pandemic, intensifying food and policing, without the necessary linguistic skills to insecurity and the lack of human capacity. adequately express themselves to the local population. The awareness of these more general concerns should In an effort to address the above-mentioned challenges, inform decision-makers when addressing the range of the Ministry of Gender Equality and Child Welfare in specific challenges covered by the report. collaboration with Parliament and with the support of UN Agencies: UNICEF, UNDP and UNFPA, entered into a co- 1. INTRODUCTION operation to implement a project called “Strengthening Commitment and leadership of government to expand the HIV and AIDS response, gender issues and awareness The overall mandate of the Committee on Human and protection of women’s rights”. The project targets Resources, Social and Community Development is to the Members of Parliament (MPs) from the Parliamentary consider any matter it deems relevant with regard to Standing Committee on Human Resources, Social and the Offices, Ministries, Agencies and all State owned Community Development as implementing partners. Enterprises and Parastatals responsible for the following category of affairs which shall, inter alia, include: The overall goal of the field visit is to address gender inequality that contributes to the spread of HIV and AIDS.  Education & Training, Sport and Culture The specific objectives of the project are;  Employment Creation  To promote interaction between parliamentarians  Health and Social Services and communities on various issues pertaining to  Housing gender, gender based violence, HIV and AIDS and  Women’s Affairs and Child Welfare Sexual and Reproductive Health;  To increase parliamentarians’ awareness on In this respect, the Committee has the duty to gender related issues at national, regional and investigate, examine, monitor, consider, advise, make community levels leading to more debates on recommendations and report to the National Assembly on gender issues and; important issues such as:  To advocate for increased allocation of resources for services that benefit women and children such  Addressing gender issues across party lines and as protection, SRH, HIV and AIDS and education promoting gender equality to improve the status of women in Namibia; In an effort to realise the stated objectives and in  Ensuring that there is gender balance in all fulfillment of the mandate of the Parliamentary Standing legislation being considered; Committee on Human Resources, Social and Community  Scrutinising and reviewing the implications of Development, members of the Committee undertook a Bills and Acts that discriminate and negatively visit to Erongo and Hardap Regions from, 11-17 May and impact on the lives of women and children; 18-24 May 2008, respectively. The Erongo region team  Liaising with NGOs, agencies, and institutions to comprised of Hon. George Kaiyamo (Chairperson of the be informed about and monitor programmes that Standing Committee and leader of the delegation), Hon. are aimed at uplifting the social and economic Hansina Christian (Deputy Chairperson of the Standing conditions of communities; Committee), Hon. Dr. Moses Amweelo, Hon. Eunice  Facilitating the implementation of Iipinge, Hon. Ida Hoffman, Hon. Reggie Diergaardt, Hon. recommendations reached at international level Royal /Ui/o/oo, Hon. Michael Goreseb and Hon. Alexia on HIV and AIDS prevention and care programmes Manombe Ncube The MPs visited the following places in such as gender equality, children’s rights and Erongo region: Swakopmund, Walvis Bay, Henties Bay,

4 ERONGO AND HARDAP REGIONS FIELD VISITS Usakos, Karibib and Omaruru. more detailed process report is made available to both the Hardap and Erongo Regional Councils for follow-up The team that visited the Hardap region comprised on the more detailed specific concerns that affect the of Hon. Hansina Christian (Deputy Chairperson of the respective constituencies. Standing Committee and leader of the delegation), Hon. Dr. Moses Amweelo, Hon. Eunice Iipinge, Hon. Dr. Chief Ankama, Hon. Ida Hoffman, Hon. Reggie Diergaardt, Hon. A) GENDER-BASED VIOLENCE Royal /Ui/o/oo and Hon. Asser Mbai. The MP’s visited the following places in the Hardap region: Mariental, Aranos, Hoachanas, Maltahöhe, Rehoboth, and Klein-Aub. The MPs A1. AWARENESS ON GBV LAWS AND were also accompanied by technical staff of the United RELEVANT GOVERNMENT POLICES Nations agencies namely the United Nations Children’s Fund (UNICEF), United Nations Development Programme It was observed that there is a general lack of awareness (UNDP), United Nations Population Fund (UNFPA), and on GBV laws and the stipulations therein as well as service personnel of line ministries namely the Ministry government policies including policies on HIV and AIDS of Gender Equality and Child Welfare (MGECW), Ministry and OVC as well as the MTPIII. It was reported that of Safety and Security (Women and Child Protection Unit) there were not even copies of some of these guiding (WCPU) National Coordinator and Parliamentary technical documents in some of the towns visited and offices of staff. service providers.

The aim of the visit was to introduce Parliament to A.2 WOMEN AND CHILDREN PROTECTION the achievements and challenges service providers and UNITS (WCPU) communities are faced with regard to issues of OVC, HIV and AIDS, Gender-based Violence Reproductive Health As the responsibility of this function is shared by Ministries and Income-generating Activities. The ultimate goal is to of Gender Equality and Child Welfare, Ministry of Safety have the parliamentary committee responsible for social and Security and the Ministry Health and Social Services and community development, conversant on these issues the concern raised was that there was an evident lack and to become advocates for women and children’s rights of effective co-ordination and cooperation and that in parliament. the three Ministries are working in isolation to address issues of gender-based violence. The town of Rehoboth 2. PURPOSE OF THE REPORT in the Hardap region was singled out as the single highest contributor to cases of Gender-based Violence (GBV) as the town is aggregating even higher number of cases than The aim of the report is to inform Members of Parliament of the capital Windhoek, while the town of Walvis Bay is the situation on the ground on the above-mentioned issues said to have the highest crime rate in the Erongo region, in the Erongo and Hardap regions. This report consists of a cause alleged to the high influx of migrant workers in three parts. The first part provides background information search of jobs at the harbour. and an introduction to the field visit and the process that led to it. The second part focuses on the findings which It was further noted that all the staff members of WCPUs are listed according to the main themes of concern to the visited by the Committee expressed concerns about Committee. The third part provides recommendations shortages of trained staff to deal with issues of gender- based on the findings. The recommendations are listed based violence and the lack of equipment. Concerns under each of the line Ministries which, it is suggested, were raised over the fact the WACPUs have no budgetary should play the lead role in considering and taking forward allocation within the structures of the Namibian Police each recommendation. and thus lack basic office equipments to function effectively. All the WCPU’s and/or the Police stations 3. FINDINGS (with the exception of Mariental in Hardap region and Swakopmund and WalvisBay in Erongo region) were not supplied with the new rape-kits and critical staff equally Although these findings are by no means exhaustive, remained untrained on the new rape kit. Some health they do however present a general and a holistic professionals of the towns visited in both regions have overview of the most important issues that were raised reported that these new rape-kits were very complex to in terms of OVC, HIV and AIDS, Gender-based Violence, administer without training and as such they continue to Reproductive Health, Income-generating activities and utilize the old ones. Staff of WCPU has voiced concern general developmental issues while the Committee was about the slow process of training medical doctors on the on the field visit to the regions. It is suggested that the ERONGO AND HARDAP REGIONS FIELD VISITS 5 new rape kit. The training of medical doctors will serve has learned that the uncontrolled late operating hours as a means of sensitization to deal more sensitively with of these shebeens and the resultant alcohol abuse not rape survivors and also facilitate the collection of primary only fuels GBV but also adversely impacts on household evidence needed for successful prosecution of these food security as people spend the bulk of their income cases. . The Committee has learned that only Mariental on alcohol -instead of on food and the maintenance of and Rehoboth in the Hardap region had established their children. It reportedly also contributes to the high WCPU and that only core staff members of the satellite failure and school drop-out rates as these vulnerable police stations of Aranos, Gochas, Gibeon, Maltahöhe, youths neglect their studies and roam between these Hoachanas and Stampriet received specialized training shebeens until late exposing themselves to sexual and on how to work with traumatised victims and to interview physical abuse. This situation is exacerbated by the abused children. erosion of families and the lack of parental control which also contributes to the vulnerability of the youth. The A.3 PLACES OF SAFETY OR SHELTER FOR Hoachanas police have noted that alcohol abuse is the ABUSED WOMEN single most important driver of GBV and stock theft in the settlement. The Hardap Regional Police Commander has One important mechanism for dealing with cases of voiced his concern about alcohol abuse amongst juveniles domestic violence is the provision of a `place of safety’. and feels that greater parental involvement is needed Generally there is a huge shortage of shelters to provide as this abuse has recently resulted in the tragic lost of 5 safety in emergencies or life threatening cases. The only young lives in the town of Mariental. available shelter in Erongo Region is not functional and had no personnel to manage and coordinate its operation. B) ORPHANS AND VULNERABLE Hardap Region has no shelter and the police and social CHILDREN (OVC’S) workers make use of the hospital to keep women and children overnight. B.1 FUNCTIONING OF OVC COMMITTEES A.4 WITHDRAWAL OF CASES It was noted that, in both regions, the establishment It was widely reported in both regions that cases of common of the relevant regional OVC committees has taken off assault and assault with “grievous bodily harm” (Assault as each village could report either MoE-based or NGO- GBH), rape and other forms of gender-based violence based committees or activities in the respective regions. were often withdrawn as families agreed to ‘out-of-court’ However, the functioning of these committees and their settlements. It is commonly known that the withdrawals activities was at times exclusive and not broad based of these cases are based on the unequal social positions in their operations, and it was evident that all the new of the victims and at times absolute dependency on the OVC Committees were still in need of training to help economic support of the perpetrators. An example was them do their job effectively. Such training could focus given in Henties Bay where a husband stabbed his wife on the clarification of the policy environment that deals but the case was later withdrawn citing the reason that with the OVC’s, as well as the resource environment `family mediation’ had resolved the conflict. The police in terms of available service and support organisations have reported that the victims requested them in many and their contact details, service qualification criteria instance to only warn the perpetrators formally. This stark etc. The Ministries of Education (MOE) and Ministry of reality came to the fore in almost all the towns visited Gender Equality and Child Welfare (MGECW), supported by the MPs in both regions as several police units have by Catholic Aids Action (CAA), the Evangelical Lutheran reported that this practice exerts enormous pressure Church AIDS Programme (ELCAP) and some NGOs continue on the morale of the staff that are investigating these to support OVC activities which need to be intensified to cases as well as consumes and increases their transaction meet the increasing demands. time stretching their already meager resources. This also means that perpetrators remain at large in the B.2 SERVICE DELIVERY FOR OVC communities with the probability of re-offending. The communities of Aranos, Hoachanas and Maltahöhe A5. ALCOHOL ABUSE expressed their concerns on the lack of access to services due to the unavailability of services in the towns. It was emphatically reported in all the places the They urged the MGECW social worker to improve the Committee visited in both regions that alcohol abuse and communication and outreach programs to ensure her the mushrooming of, mostly illegal, shebeens contributed availability to rural communities. The towns of Karibib, enormously to gender-based violence. The Committee Usakos and Omaruru expressed dissatisfaction over the

6 ERONGO AND HARDAP REGIONS FIELD VISITS fact that the social worker in Erongo region is faced with It was reported that although there is a national policy in serious challenges; such as lack of transport to visit the place regarding the exemption of OVC from the payment towns, overloaded with work as she has to cover many of school development fund fees it was not adhered to other small settlements and a proper office space, placing by some school principals. For example, the schools in a barrier to effective service delivery. This situation, Aranos were reported to have seized the financial and coupled with the lack of transport has created a situation useful contributions of NGOs (like CAA and ELCAP) for where the social worker can only visit the towns once OVC’s livelihoods (for example toiletries for the school every three months. The Aranos community members development fund) whilst refusing these and other and officials responsible for registering OVC have noted children and families in arrears the end of term report that registration in rural areas in the south has stopped cards. The latter practice was addressed and rectified but that the context and reasons for this action remained after a community meeting with the Hardap Education unexplained fueling speculation of administrative neglect. Regional Director who explained the policy and ordered The Maltahöhe community members felt also that MoE the handing back of these reports cards. Notwithstanding, was discriminating against OVC outside the official school the NGO members have reported that the seizure of framework as they are not catered for. The need for the OVC’s grants for the school development funds has social grants for OVC in the region also underscores the continued in Aranos. The Mariental meeting reported reality that increasingly overburdened families are less that some formerly advantaged schools are discriminating likely to take on OVC of their direct relatives due to against OVC’s by ‘out pricing’ them and that the present economic hardship, unemployment and the rising cost of policies of the MoE remain inadequate to protect OVC living. B5. DIVISION OF RESPONSIBILITIES B.3 PROVISION OF IDENTITY DOCUMENTS BETWEEN MINISTRIES TO FACILITATE REGISTRATION A significant problem is that the public are not informed A common complaint at many of the meetings was that on who is responsible for OVC issues between the MoHSS it was difficult to obtain identity documents as it was and MGECW. The MoHSS was responsible for welfare work difficult to travel to an office of the Ministry of Home for the children, but the function was transferred to the Affairs. For example, residents at Hoachanas complained MGECW. The result is that whilst important functions (such that they could not afford to travel to Mariental (N$120 as the administration of maintenance grants and foster return trip) to obtain their documents, while residents of care allowance) had been transferred to the MGECW, the Maltahöhe (N$100 return trip to Mariental) also reported staff with the skills and training to carry out these tasks that the increase in the transportation costs to obtain had largely remained with the MoHSS. The slow pace of national documents is places a heavy burden on their the handing over of child welfare files by the MoHSS to meager resources. A birth certificate is a requirement the MGECW was also voiced by the regional social workers before a child can be registered as an OVC and benefit as a factor hampering their work. Some officials within from the social grants. the latter ministry have suggested that the division of responsibility should afford the MoHSS the ability and It was noted by the NGO representatives in the Aranos and resources to focus on pressing issues such as sex workers Mariental meetings that the MGECW should spearhead and developing social safety nets or programmes for other the development of a single authentic regional OVC vulnerable group. register or database. Such a database is envisioned to be compiled by obtaining information about OVC’s from B6. SHORTAGE OF SOCIAL WORKERS AND schools and NGO’s working in the communities which EQUIPMENTS would help to identify those children who were in need of care and protection. An attempt is being made at Henties A persistent complaint of the shortage of qualified social Bay to re- register all the OVC in the town to ascertain workers in both regions was raised as the visiting team has the exact number and to ensure that all OVC benefit from established that the Hardap region with a total population the services provided. The regional register initiative was of 68,249 people is presently being served by only two started by the Otjozondjupa Region last year and it would social workers, a principal social worker in Rehoboth and be wise to benchmark the Otjozondjupa process properly by one additional social worker in Mariental, assisted in an attempt to replicate the process in both the Hardap by two administrative personnel. In Erongo region there and Erongo regions. are three social workers. The critical staff shortage is compounded by the lack of adequate office space and B.4 EXEMPTION FROM SCHOOL FEES S&T provisions to enable social workers to travel within the regions and insufficient or obsolete computer and

ERONGO AND HARDAP REGIONS FIELD VISITS 7 printer equipment. It was reported that the social worker Henties Bay, when taking a tour of the jail, MPs saw a in Swakopmund does not have an office space and at juvenile that police reported is very notorious in the town times she is accommodated at WCPU. The shortage of for crimes and who was in custody facing six different social workers meant that many health centers relied charges. There was a serious appeal to the government on foreign staff that lacked local language skills which that the traditional authority be authorized to withdraw hindered the provision of an optimum service to clients. all the shebeen licenses that do not comply with the act The shortage hindered the effective provision of services to establish community harmony and social coherence. to vulnerable social groups and this also impacted on the The MPs were also informed that the fact that the closing ability of the system to deal adequately with OVC and times for shebeens were not adhered to is a major cases of gender-based violence. contributing factor for the abuse. Since the majority of these shebeens are in residential areas, the impact on C) INCOME-GENERATING young people are clearly visible as they experiment with ACTIVITIES alcohol from an early age making them vulnerable to losing their education, teenage pregnancies HIV infection, and the dreaded reality of unemployment. In Walvis Bay C1. POVERTY it was reported that parents are also contributing to the problem as they sometimes send their children to buy It was noted that poverty is endemic amongst the their alcohol in the shebeens. rural population, especially in the Hardap region, and mostly in some of the locations in Erongo region. For The nurse in Hoachanas reported that both the elderly the vast majority of the population their only source and the youth are drinking excessively on the social of income is the government pension, social grants and pension payment days and that some shebeen owners are remittances from migrant workers in Windhoek or from giving credit to old people leading to them spending all farm labourers. It was widely reported that pensioners their pension money on alcohol. It was reported in Klein could no longer cope on their pension as they also had to Aub that a large number of young people do not return cater for the needs of family members and OVC who are to work after pay days, and only return in most cases not registered due to the absence of national documents after spending all their income on alcohol. The Klein and inaccessibility of registration services. The MPs Aub community leaders also reported that young people asked what the root causes of poverty in the area were, and especially Grade 10 dropouts are also resorting to upon which some members informed the meeting that drinking homebrew at these illegal shebeens. poverty in the Maltahöhe area was reportedly fuelled by a structural economic change by farmers in the area from Social workers in Mariental and Walvis Bay have established mainly livestock rearing farming activities to tourism, as an inter-ministerial Alcohol Reference Group and Alcohol the latter industry needs a skilled and lean workforce. Resource Centre with the objective of supporting This change has rendered many former farm workers households that are going through this problem in a jobs redundant. The Klein Aub Settlement Committee professional, informed and supportive manner. members reported that unemployment and the abrupt closure of the mine coupled with the failure of their settlement to attract any new investors or economic C.3. SUPPORT FOR INCOME- activity are the main causes of poverty in this area. GENERATING ACTIVITIES

C2. ALCOHOL ABUSE AND SHEBEENS The MPs noted that there were quite a number of Government supported IGAs in Henties Bay, Walvis It was noted that alcohol abuse and the profusion of Bay and Swakopmund. MGECW is supporting a panel- unlicensed shebeens are a major problem in both regions. beating project in Walvis Bay. Development partners The community councilors and social workers in Rehoboth are also supporting IGAs in both regions. NGOs like the voiced their concerns about this out of control and dire Namibia Development Trust is supporting IGAs in three situation as they noted that the number of shebeens are settlements visited by the MPs in the Hardap regions. The presently over 80 in the informal settlements of Rehoboth NGO is presently supporting HIV and AIDS and community alone. A high number of people are selling alcohol in these and women’s service groups in Aranos, Hoachanas and communities from their homes without the authorities’ Mariental. The German Gesselschaft group operating consent. The two main towns of Mariental and Rehoboth from the neighbouring commercial farm which is world are experiencing alcohol related juvenile disorderly renowned for wind gliding light aircraft sports are also behavior, delinquency and crime such as harassment supporting two IGA’s in Hoachanas namely a community and assault on community members by these youths. In bricklaying project and one community member who was

8 ERONGO AND HARDAP REGIONS FIELD VISITS supported to start a car repair and welding shop. FACILITIES

D) REPRODUCTIVE HEALTH E.1 TB & HIV TREATMENT

D1. FORMULA MILK A widespread comment was that many patients were defaulting on their treatment because of poverty resulting It was noted that there was no national policy regarding in the lack of food. It was noted that in Aranos the two the provision of formula milk for mothers with new local NGO’s (the CAA and ELCAP) have pleaded with babies, especially HIV and AIDS infected mothers. The MoHSS to support their efforts to supply feeding rations Hoachanas Community Health Administrator has reported to patients receiving ARV treatment. It was reported in that HIV positive mothers are breastfeeding and clearly both regions that patients that are on ARV’s treatment disregarding the advice health authorities are giving due will not be able to pay for these meals under the present to poverty and the inability to provide formula milk for economic conditions. their babies. The same sentiments were expressed by the social workers in Erongo region who reported that they It was reported that the RACOC in both regions was sometimes have to assist their clients with their own active however the structure needed transport, S&T and promotional material to spread its activities to D2. TEENAGE PREGNANCIES AND INCEST all constituencies. The group has not picked up any complaints in the settlements visited by the MPs regarding It was reported in Hoachanas that a teenage girl as the operations of the structure, instead it is reported young as 13 became pregnant and in an effort to that this regional HIV and AIDS governance structure has conceal the pregnancy and to protect the father from been instrumental in the establishment of Settlement possible prosecution gave birth at home with near fatal Health Committees in all major settlements visited in the consequences. Two other cases of deliveries by girls under Hardap region. 15 years of age were reported but the latter deliveries took place under the supervision of the health officials in E.2 CLEANLINESS OF HEALTH FACILITIES Mariental. It was reported that these statutory rape cases remained unreported as these families are financially The state of hygiene and the general state of the laundry dependent on the perpetrators of these crimes and s systems in several of the health centers, hospitals and also that the social workers were unable to bring these clinics visited in both regions was a major cause for cases to courts as the parents and the victims were not concern especially, the dilapidating infrastructure and the willing to report these cases to the courts. This leaves visible lack of simple maintenance of public facilities. The the burden of laying the charges and appearing in courts newly renovated Omaruru hospital was already showing on the social workers. Not many cases were reported cracks which are ascribed to very poor workmanship and in the Erongo region, but it is believed that this is not materials. The maintenance of equipment at the Walvis indicative of the issue being non existent, but probably Bay State Hospital also leaves a lot to be desired. The illustrates the lack of awareness on teenage pregnancies. Maltahöhe and Aranos Health Centres are the ones in The town of Rehoboth reported the problem of teenage the most despicable state in Hardap, as these public pregnancies to be widespread. Incest is reported to be assets are clearly going to waste and clearly rebuilding common in Rehoboth resulting in early pregnancies. similar new facilities could cost the nation nearly four times the original cost. The Maltahöhe Health Centre D3. FEMALE CONDOMS (FEMIDOM) was the dirtiest site and the workers were even bringing their own cleaning materials from home to use at work. MPs were informed in both regions about the myths Such unhygienic conditions were likely to increase the and challenges surrounding the use of femidoms. risk of infection to patients and therefore the cost of Its availability and usage is very low especially in health care to the Government. However, it was observed Erongo region. Myths around femidom exist such that the hospitals and clinics in the Hardap region were as its lubrication being used to treat pimples, scars generally kept very clean despite the apparent lack of in the face and cleaning of scratched CDs. The official maintenance support and commitment. need for sensitization was expressed by the relevant stakeholders as a matter of priority. E.3 SHORTAGES OF AMBULANCES AND OPERATIONAL VEHICLES

E) HIV/AID AND HEALTH A particular concern was raised at a number of places ERONGO AND HARDAP REGIONS FIELD VISITS 9 about the lack of ambulances to take emergency cases the existing vacancies as the present staffing situation to the nearest hospital. The issue was raised in all the is impacting the quality of service provision adversely in towns visited where people expressed the need for the the Hardap region. respective hospitals, clinics and health centres to be provided with their own ambulances to be able to fulfill The stone processing plant in Omaruru whose operation emergency response services. Although the MoHSS has depends on foreign nationals from Italy also lamented earmarked some centres to be provided with ambulances, the cumbersome process at the Ministry of Home Affairs it was reported Erongo Region would only receive one in granting work permits. ambulance for Omaruru. E.6 ACCOMMODATION FOR NURSES Similarly, it was reported that the hinterland of AND FOREIGN DOCTORS Maltahöhe which covers the Namibrand is a high tourism area attracting foreign tourists and when these tourists It was noted that accommodation to house nursing staff are involved in accidents the health center at Maltahöhe and medical doctors remains a major problem and it is is called upon due to its proximity however the health discouraging nurses to take up positions in rural areas center lacks a world class emergency response vehicle where the condition of the houses, if provided at all, and are at times helping these people with pick-up is often poor. The Hardap Region’s Health Department trucks without canopies. Both regions reported that they reported that qualified registered nurses and medical always have to resort to using donor sponsored vehicles doctors are reluctant to take up positions in the region to transport patients – a practice which is actually not due to an acute lack of accommodation in these areas. allowed as per the conditions attached to such vehicles. They have shown statistics to corroborate that statement as only 65% of positions for registered nurses are filled It was widely reported in both regions that transportation compared to 100% of posts for enrolled nurses. is a major impediment for effective services in every ministry as, due to the lack of public transport, community members are unable to reach government services which E.7 COMMUNITY HEALTH OUTREACH are offered to them. For instance, apart from the lack PROGRAMMES AND ACCESS TO SERVICES of ambulances in these settlements to cater for the sick, the communities of Gochas, Aranos, Hoachanas, Klein It was noted in both regions that doctors are only visiting Aub and Maltahöhe are severely constrained by the lack clinics and communities once a month and, in the case of public transportation serving these settlements. of Klein Aub, only once in three months due to a lack of transport. Consequently, patients are forced to travel E.4 SHORTAGES OF DOCTORS very long distances (if they can afford to), to access essential services and this not only drains their meager It was noticeable that not only was there a shortage of resources, but perpetuates their downward spiral into doctors in state hospitals and clinics, but that those who the cycle of poverty. were employed in the National Health Service were often foreign nationals. It was suggested that one reason for F) OTHER RELEVANT ISSUES the shortage of Namibian doctors was that Namibians received loans for their studies and were, therefore, encouraged to go into private practice upon their return F.1 PARTNERSHIP BETWEEN GOVERNMENT to Namibia in order to pay off their debts as quickly as AND NGOS possible. It also emerged that the conditions of service are not encouraging and doctors have to work under the It was noted that in many communities NGOs, church- most unfavourable conditions as a result of inadequate run and privately-run institutions play an important role staff. in addressing social problems – such as OVC, income- generating activities and HIV/AIDS. For example, E.5 WORK PERMITS FOR FOREIGN Catholic AIDS Action (CAA), Evangelical Lutheran Church NATIONALS AIDS Programme (ELCAP), “Genade Gawe Project” of the Dutch Reform Church in Aranos, Church Alliance It was noted that several hospitals complained that delays for Orphans (CAFO) in Mariental, the Ark OVC Home in in processing work permits for professional expatriates Rehoboth and “The Bridge” juvenile justice and child contributed to the shortage of skilled staff. The Mariental rights organization in Mariental, NASOMA, SMA, Love the MoHSS urged the central government to do more to recruit Child and many more. Whilst these organizations were qualified professionals from neighbouring countries to fill performing an important service to their communities

10 ERONGO AND HARDAP REGIONS FIELD VISITS and reducing the pressure on state institutions they often community members are living in unhygienic corrugated faced financial problems and a lack of support from state iron shacks and during the very cold winter climate the institutions. people are exposed to bronchitis and pneumonia and as such these houses remains a persistent health hazard. The F.2 EDUC ATION Aranos resident doctor complained that even the Health Centre’s sewerage system is severely blocked due to the It was also reported that the high failure rate of learners lack of maintenance further compromising the health of in Grade 10 is directly linked to the automatic promotion in-patients. system. Thus learners who fail to perform at lower grades but are promoted find it increasingly difficult to perform F.5 HUMAN TRAFFICKING at higher grades. There was a concern raised that the education system had faced considerable challenges MPs were informed that human trafficking is not common since it focuses on quantity, rather than quality, and at in the region although one case was reported by the the end of the day the learners drop out of the system police in Erongo region years back. It was noted that this when they fail Grade 10. is not an indication that the problem do not exist but can be attributed to the lack of research, awareness and poor The view was expressed that the rights of school learners reporting on the matter. and children need to be revisited because most of the children were abusing their rights and had lost respect 4. RECOMMENDATIONS for their parents and teachers. This made disciplinary measures difficult for teachers, especially when the children misbehaved. On the basis of the above findings, the recommendations of the MPs are listed with reference to the relevant line The Mariental councilors meeting expressed the feeling Ministry. that bursaries and study loans were not equitably distributed between all the regions. It was widely 4.1 MINISTRY OF EDUCATION (MOE) perceived that the South is being treated unfairly when it comes to the granting of bursaries, even though they 4.1.1 OVC should be exempted from the payment of have the highest pass rate at Grade Twelve. The same school development fund fees. A circular should be sentiments were expressed with regard to vocational sent to schools containing a form to be completed training and colleges on the basis that such institutions by parents wishing to apply for exemption from are not found in the South to provide learners with the fees and guidelines on the criteria to be satisfied opportunity to further develop their skills. The only before an exemption is approved and the channels vocational training in the South is in the Hardap Region through which parents may appeal a case should and this training facility is allegedly dominated by an application for exemption from the payment trainees from other regions according to the allegations of fees be turned down by a school. made in these meetings and is thereby denying local student’s places. 4.1.2 The Ministry should communicate policy directives and also follow through these directives to the school level so that exemptions for school fees F.3 COMMUNICATION BARRIER are handled the same in all schools.

It was indicated over and over again in both regions that 4.1.3 The Ministry should collaborate with the Ministry communities are not able to communicate with service of Gender Equality and Child Welfare to establish providers because of the language barrier. This was ECD centers in all thirteen regions and the with particular reference to social workers and police MGECW should equally spearhead and fund the officers, thus hindering effective service delivery to the development of a standard curriculum for ECD’s community. Efforts should be made to ensure that service in all thirteen regions. providers are able to communicate with local communities and if that principle cannot be achieved the communities 4.1.4 It is recommended that every school in Namibia should have access to standard translation. should have a classroom dedicated for learners living with a disability [or, at least, that a F.4 HOUSING AND SANITATION specialized school with hostels (or a specialized unit within a school) should be established in It was observed in Aranos and Hoachanas that some every region].

ERONGO AND HARDAP REGIONS FIELD VISITS 11 human rights, ethics and especially women’s 4.1.5 It is recommended that the government revise rights should be conducted through local language the current quota system approach to granting radio services and intensified in all the regions. bursaries to give greater weight to the academic performance of learners. 4.2.7 The Ministry to commission a study on human trafficking for a comprehensive understanding 4.1.6 The ministry should plan and hold yearly special of its magnitude in Namibia and for necessary policy interpretation and or regional common intervention. agenda setting workshops with all regional stakeholders to strengthen collaboration and 4.2.8 The Ministry need to develop a strategy to address foster the mutual understanding and support for the issues of statutory rape and intensify its all programme areas under its ambit. education campaigns on gender based violence at levels. 4.2 MINISTRY OF GENDER EQUALITY AND CHILD WELFARE (MGECW) 4.2.9 The Ministry to train community leaders on GBV, legislation and child protection 4.2.1 The officials responsible for Orphans and Vulnerable Children in the Ministry should meet 4.2.10 The Ministry to seriously look into issues of office with their colleagues at the MoHSS to develop a space, equipment for officials and to review the transitional plan to ensure that the transfer of salaries of social workers. responsibility does not have a negative impact on service provision. Measures might include the 4.2.11 the Ministry should register places of safety and temporary secondment of staff from one Ministry conduct regular inspection and investigation to another, the provision of in-service training where necessary and the provision of bursaries for specialised training at institutes of higher education. 4.3 MINISTRY OF HEALTH AND SOCIAL SERVICES (MOHSS) 4.2.2 It is necessary that in regions where MGECW has no social workers, an arrangement should 4.3.1 Each region should be asked to submit a short be entered into with MoHSS and vice versa to report indicating the number of social workers provide social services until such time a social that are required to deal with the work load in worker(s) is appointed the region, the number and distribution of social worker posts in the region and the number and 4.2.3 The Ministry should make budgetary provision for distribution of social workers actually in post. a `Place of Safety’ in each region that can be The report should also indicate the availability used as a temporary shelter for the survivors of and type of transport available for use by social gender based violence including children. Since workers and list the computer and printing the main aim of such buildings is to remove the services available and the date that any equipment survivor from direct threat provision should be available was purchased (in order to indicate made for survivor to travel to other regions when whether the equipment has become obsolete). necessary. A report should be compiled quantifying the national shortage of social workers, identifying 4.2.4 The Ministry should collaborate with the the causes of the shortage (i.e. Is the root cause Ministry of Safety and Security to ensure that a lack of trained social workers or the reluctance budgetary provision are in place for establishing of trained social workers to take up posts in rural or renovating police holding cells to be juvenile areas) and proposing solutions. friendly for juvenile delinquents. 4.3.2 A report should be produced on staffing levels 4.2.5 The Ministry should expand its support for income- relative to the number and types of cases dealt generating activities, especially for the youth, as with at clinics and hospitals across the country. this contributes to employment creation. MGECW An equation should be made to calculate the ideal must work closely with the Ministry of Trade and staffing levels for each health institution given Industry and other stakeholders to support SME. their case load. Recommendations should be made on the basis of these statistics to identify 4.2.6 Sensitization and awareness programmes on institutes where staffing levels and the number

12 ERONGO AND HARDAP REGIONS FIELD VISITS of beds and services available to patients are the light of the MoHSS handing over of the social overstretched so that a plan can be drawn up to services of children to the MGECW. address these problems. 4.3.10 There is a need for health facilities to have petty 4.3.3 A budget should be drawn up to cover the cost cash for day-to-day administration. For example, of providing formula milk to mothers as well as to enable staff to buy batteries, bulbs, etc. Even feeding scheme for patients on TB and HIV and though these are minor issues, they can have a AIDS treatment. Provision for this should be made great impact on the delivery of health services to within regional budgets. different communities.

4.3.4 School learners should be encouraged to take 1.1.11 The Ministry of Health should reinstate laundry up medical studies in order to ensure that there services at the Maltahöhe Health Centre as general are sufficient national doctors in the country. workers are hand washing the linen at the Health Furthermore, Namibian students training to be Centre due to the broken washing machines that doctors should receive full scholarships. However, were removed and never replaced. these should be provided on condition that the student signs a binding contract to work for the 4.3.12 The Ministry of Health need to intensify its work on State for five years (at least) with no possibility alcohol prevention as this is a major contributing of private practice during the said period. factor to gender based violence, HIV infection and malnutrition. 4.3.5 A needs assessment should be carried out to form the basis for the development of a budget 4.4 MINISTRY OF HOME AFFAIRS (MOHA) for the purchase and maintenance of a national ambulance service. The Ministry should then 4.4.1 A plan should be drawn up to increase the number budget for the maintenance and replacement of offices of the Ministry of Home Affairs in the of the ambulances and seek donor funding for regions in order to make it easier for people to the initial purchase of a fleet of ambulances for obtain identity documents as this will make it distribution to the regions. The distribution of easier for people to register OVC and pensioners. ambulances should be decided according to a In the short term mobile teams should be sent calculation which takes account of the volume of to the regions to gather applications for national cases in each area and the size of the area to be documents and provide identity documents to covered by each ambulance. the community.

4.3.6 Regular inspections should take place in 4.4.3 The Ministry should request the relevant line all hospitals and clinics. Health and Safety Ministries to provide information regarding current Inspection reports should be submitted regularly skill shortages in the fields of health and social to the Ministry. The reports should not only be welfare. The list of shortages in specialized areas concerned with the cleanliness of each facility, should also include the required qualifications of but also the state of fire-fighting equipment and those applying for such posts. The list should form evacuation procedures. the basis for the `fast-tracking’ of applications in key areas of need to expedite the process of 4.3.7 It was recommended that the MoHSS should recruiting such expatriates. strengthen the capacity of the RACOC in Hardap Region through training and providing the 4.4.4 The Ministry should send out mobile service necessary transport and resources for it to be teams periodically to the regions to enable the able to function effectively. poorest segments of the communities to access its services in the settlements in both region. 4.3.8 MoHSS should advocate to the Ministry of Works for more assigned houses to accommodate nursing staff and foreign doctors. 4.5 MINISTRY OF LABOUR AND SOCIAL WELFARE (MOLSW) 4.3.9 It was recommended that the MoHSS benchmark, develop and implement special focus programmes 4.5.1 The Ministry should enter into partnerships with or interventions targeting sex workers as a special organizations that provide a social service and vulnerable group. This was advanced especially in meet agreed performance standards. Government

ERONGO AND HARDAP REGIONS FIELD VISITS 13 grants should be provided to these organizations implementation of the restorative justice system on condition that they achieve specified annual for children in conflict with the law. goals and submit an annual narrative and financial report. 4.7 MINISTRY OF TRADE AND INDUSTRY (MTI) 4.5.2 Labour inspectors should visits commercial farms to do an assessment of the plight of farm workers, There should be close cooperation between the child labor activities and to ensure that they are MTI, and all stakeholders to ensure that shebeen registered to be eligible for pension. owners are informed about the Liquor Act and the parameters under which they are allowed to operate. 4.5.3 The labour inspector should also deal with employers who are reluctant to release their 1.7 Ministry of Works, Transport and Communication employees to collect their monthly ARV (MWTC) treatment. 1.7.1 There needs to be effective inspection of capital 4.6 MINISTRY OF SAFETY AND SECURITY projects. It was reported that those who get (MOSS) tenders to build schools, clinics, etc., do not use good quality materials and supplies, as a 4.6.1 A meeting should be held with the Ministry result buildings start to fall apart shortly after of Safety and Security to discuss the possible completion. It was also reported that those who transfer of the Women and Child Protection Units receive tenders do not deliver on time. throughout the country to the Ministry of Justice under the leadership of the prosecutors. WCPUs 1.7.2 There is a need to undertake structural changes should be having more senior ranks officers to to all HIV testing centres to have two doors: one raise its profile and to ensure effective service entrance and one exit to enhance confidentiality delivery and hopefully encourage people to go for testing. 4.6.2 It is recommended that each WCPU is requested to submit a brief report identifying its staffing, MINISTRY OF MINES AND ENERGY transport, training and equipment needs (MOME) and highlighting priorities. The information should then be collated into a national `Needs 4.9.1 The Ministry needs to look into the provision Assessment’ which can provide the basis for the of electricity to different communities in the development and upgrading of the units. region. The informal settlement at DRC in Erongo and Maltahöhe in Hardap are requesting to be 1.1.3 A meeting should be held with the Ministry of added to the national electricity grid as they also Safety and Security to discuss the prosecution can afford electricity especially through the rural of rape cases. It is suggested that when a victim electrification scheme. withdraws a case after receiving compensation from the perpetrator (and/or their family), but 4.9.2 The community in Maltahöhe also recommends to there is sufficient evidence to proceed with the the ministry to guide oil exploration companies case it should continue as a state prosecution. working under their license to consider the local The Ministry should consult internationally to people for unskilled work and employ people identify and obtain advice from countries where from other areas from the onset. this policy is already in place, as in Germany

1.1.4 The Police must strictly enforce the regulations and offenders should face the full wrath of the law, even if it means closing down their shebeen with immediate effect.

1.1.5 The Ministry should make budgetary provision for establishing and strengthening the child justice forums in every region to allow for the

14 ERONGO AND HARDAP REGIONS FIELD VISITS