Mines, Migration and HIV in Southern Africa

Karina is participating in the Gold Global Citizen Award. This is the first of her Global Blogs from South Africa. 

By Karina McGinley

There are a plethora of definitions for irregular migration, but as it is a ‘vague blanket term’ there is not one that is broadly accepted.  For the purpose of this article the International Organisation for Migration’s (IOM) explanation of an irregular migrant, as someone ‘who owing to unauthorised entry, breach of condition of entry or the expiry of his or her visa, lacks legal status in a transit or host country’, will be employed.  This article will explore the entrenched pattern of intra-regional irregular migration from Mozambique, on the eastern coast of southern Africa, to mining areas in South Africa. It endeavours to assess the vulnerability of Mozambican miners, recruited by private companies outside the framework of South African immigration law, and their dependents at home to HIV. This will be done by examining how their working conditions, living arrangements, access to healthcare and remittance channels contribute to the diffusion of HIV/AIDS. This article will use a study, conducted by The National Institute for Health in Mozambique, of 709 Mozambican men who worked in South African mines to draw a conclusion on whether irregular migration is a reason why the HIV and AIDS epidemic is so virulent in South Africa and Mozambique.

The ‘migratory process’ describes the factors that lead to migration and influence where people go. The long-standing pattern of irregular migration from Mozambique to South Africa is attributable to many push factors, such as war. However, this article will focus on economics, which have been recognised as a pull factor for migration since the nineteenth-century. Despite sharing a porous border, there are huge economic disparities between these countries. South Africa, endowed with abundant mineral resources, is the ‘economic powerhouse’ of southern Africa and deemed to possess lucrative employment opportunities.  In comparison, Mozambique is one of the Least Developed Countries in the world. Economics coupled with geographic proximity and the presence of existing networks, that decrease the economic, social and psychological costs associated with migration, make the mining areas of South Africa the preferred destination for irregular migrants.

South Africa is a labour-importing country. The migrant labour system began with the demand for cheap labour following the discovery of gold on the Witwatersrand in 1886.  Labour migration was driven by powerful private companies that were given a special dispensation to operate outside immigration laws. For example, contract labour migration did not fall within the realm of the Aliens Control Act, which was perceived to be a draconian piece of legislation that sought to regulate all facets of immigration.  Consequently many labourers were irregular migrants as they were recruited by companies who did not adhere to South African immigration policy. Mozambicans constituted the largest group of foreign-national workers in the mines, 110,000 Mozambicans worked in South African mines in the early 1970s. However, the Immigration Act, 2002 means that mining companies now have to ‘apply for corporate permits to import an agreed number of migrants’.  But, the migrant labour system remains a structural reason for the spread of HIV. As miners recruited for this system spend the majority of the year ‘away from home in an all-male environment of macho-masculinity with easy access to transactional sex’.

Sub-Saharan Africa, where both Mozambique and South Africa are geographically positioned, is the epicentre of the global HIV and AIDS epidemic. The virus, a medical condition restricted to only a few modes of transmission, is one of the most pressing issues afflicting the region. UNAIDS reported that southern Africa bears a disproportionate share of the global HIV and AIDS burden, with 69 per cent of the world’s HIV positive population living there in 2011.  The role of migration in transmitting infectious diseases is well-documented and there is consensus in extant literature that the diffusion of HIV and AIDS is ‘inexplicable without reference to human mobility’.

The lack of reliable data makes it difficult to determine the number of Mozambicans residing illegally in South Africa. As the political salience of irregular migrants has grown governments are using alarmist figures and discourse. For example, in 1998 the Minister for Home Affairs, Mongosuthu Buthelzi, commented that South Africa’s socio-economic resources were ‘‘being burdened by the presence of illegal aliens’’. However, from deportation figures published by the Department of Home Affairs it can be determined that their time in South Africa is characterised by impermanency. Mozambicans represent the largest foreign-national group dispelled from South Africa each year. For example, 69,533 irregular Mozambican migrants were removed between January and August 2001. The precariousness of their time in South Africa means that HIV is only one of a broad gamut of dangers they face. Therefore, as it is not fatal immediately they are not motivated to take precautions to prevent transmission.

Employment for irregular migrants in South Africa is spatially concentrated around mining metropolises, well-documented areas of vulnerability to HIV and AIDS. The ‘spaces of vulnerability’ concept outlines that ‘health vulnerability’, for example susceptibility to HIV and AIDS, is not simply a consequence of behaviour but also of environment where irregular migrants reside. For Mozambican migrant men who work in the mining sector death and injury are omnipresent. A job in the mines also entails separation from a regular sexual partner and being surrounded by an active sex industry. The IOM has reported that the dangers and ‘adverse working conditions’ encountered in the mines motivates ‘migrant workers to seek solace and intimacy through multiple sexual encounters’. Thus as border-crossing results in anonymity irregular migrants, released from the behavioural norms of their community of origin, are more likely to have concurrent partnerships. This amplifies their chances of contracting HIV and leads to a diffusion of the epidemic, initially in South Africa and in Mozambique upon their return.

Self-efficacy is an important determinant in health-related behaviour.  If one does not feel in control of their life this extends to their health. Irregular migrant miners are powerless against seismic movement and their fate against immigration authorities. In an interview a mine-worker from Lesotho, working in South Africa, commented that he would prefer not to know his HIV status, ‘it is better not to know and live your life’. The same is true for Mozambican mineworkers. The aforementioned study conducted in 2012 found that 74.6 per cent of those that tested positive for HIV did not know their status. This means that they engage in sexual-relations unaware that they have the virus and unconsciously transmit it to others.

There is no single explanation for the spread of HIV and AIDS among irregular migrant labourers and their dependents in Mozambique. However, single-sex hostels provided by mining companies are significant reservoirs of infection. They offer scant leisure amenities, limited privacy and are ‘the ideal environment for any sexually transmitted pathogen’ to find a niche. Alcohol and commercial sex, both conducive to the spread of HIV, are the only diversionary activities within close proximity. They render their inhabitants more susceptible to HIV as ‘peer-pressure’ to ‘adopt a ‘‘macho-masculinity’’ in which manhood is equated with prolific sexual prowess’ is pervasive in the all-male environment. Thus, men living in hostels are coerced into engaging in risky sexual behaviours which exacerbate their chances of contracting HIV.

As part of a more widespread trend there has been a ‘feminisation of migration’ from Mozambique to South Africa in recent years, but the IOM has reported that women are more likely to hold ‘irregular status’. Women migrate to the mines for altruistic reasons. They hope to earn enough to remit money home. However, as mining is a gendered occupation, dominated by men, they find it exceedingly difficult to secure employment. The gender disequilibrium surrounding mines has created a milieu where commercial sex work (CSW) can thrive. Thus in the face of limited employment prospects CSW, that brings short-term financial benefits but long-term health repercussions, becomes a survival mechanism for women. It is clear that the irregular migration of women, to the mining towns in South Africa, contributes to the diffusion of HIV and AIDS, as the employment that many of them engage in to survive strengthens their chances of contracting HIV.

Unprotected sex facilitates the spread of HIV and AIDS. Research has found that migrant miners are unwilling to use condoms when they spend some of their resources on sex. For example, only one in five Mozambican mineworkers used a condom the last time that they had sex, despite 94 per cent stating that they had access to free condoms at work.

Reasons they have articulated for their abhorrence of condoms include the belief that they inhibit virility and that their chances of contracting HIV are less than dying underground. In an interview a CSW stated that because their sexual-relationship decisions are determined by economic circumstances they have no choice but to have sex with men who insist on not using condoms. The South African Constitution (1996) guarantees the right to basic healthcare to all living in the country, regardless of their legal status. However, migrants that cross the border clandestinely are confronted with insurmountable barriers in accessing medical services. They cannot present themselves for treatment as they may be deported. As irregular migrant CSWs cannot readily access adequate healthcare they are unable to find out their HIV status. Therefore, they continue their livelihood strategy, which entails unprotected sex, without knowledge of their HIV status. Thus, they may transmit HIV to men that procure their services. This demonstrates that irregular migrantion has a significant impact on the incidence of HIV and AIDS.

Daan Brummer (IOM) highlights that irregular migrants do not simply act as vectors carrying and spreading HIV. He articulates that owing to their uncertain status they are more vulnerable to infection. The findings of the 2012 study that has been used throughout this paper corroborate his sentiments. As 14.5 per cent of the Mozambican mineworkers who tested positive for HIV during the research, reported that they tested negative a year before the survey. This increase is attributable to high-risk behaviour that they admitted to engaging in as a mobile person, faced with the danger of mutilating accidents in work each day and living in crowded hostels. This study also confirms the thesis that mobility, outside the framework of the law, leads to the diffusion of HIV and AIDS.

There is a cyclical relationship between poverty, irregular migration and HIV.Poverty drives irregular migration which acts as a catalyst for the spread of communicable diseases. HIV, one such transmittable disease, perpetuates poverty, which once again induces migration.

Remittances could also be included in this relationship as they play an instrumental role in poverty alleviation. However, owing to their legal standing irregular migrants cannot access formal remittance channels, such as banks. They rely on informal channels, such as cross-border taxis, which carry a greater risk. Therefore, despite being an integral source of income for many households in Mozambique, they are not reliable. This means that dependents in Mozambique have a similar precarious existence to irregular migrants and share the same vulnerability to HIV and AIDS.

Like Brummer’s aforementioned thesis that dispelled the unidirectional flow of transmission from migrant to receiving country, the ‘accepted wisdom’ that migrants go to the mines, contract the virus and infect their partners when they return home is simplistic and naïve.  As part of a study to examine the vulnerability of migrant miners partners to HIV eighty Mozambican women were interviewed. From the research, it was found that in year preceding the interview 14 per cent of the women ‘had sex in exchange for goods or money’. By having multiple sexual encounters with men for financial support and engaging in sex-work to satisfy their basic needs these women increase their chances of contracting HIV. Therefore, it is clear that the prevalence of HIV and AIDS in Mozambique is a manifestation of the deteriorating economic conditions that are a consequence of the unreliable remittance channels available to irregular migrants.

Mining has been a pillar of the South African economy for decades. However, the industry is in a parlous state and beginning to stagnate. This was seen through the recent strike, when miners paralysed the production of platinum from January 2014 until June 2014 by downing their tools ‘to demand a living wage’. This strike had impacts for mine-workers dependents in Mozambique, who did not receive remittances during this period. Mines in South Africa are old and deep. This increases the costs involved. Consequently many mining companies, including Anglo-American Platinum, have articulated their intentions to close down unprofitable operations. It has shortlisted potential buyers for its Union mine in Rustenberg and aims to sell it for $300 million in 2015. Declining employment in mines has led to a proliferation in illegal mining activities, in both operational and abandoned shafts.

The reported number of illegal miners called zama-zama, a Zulu word meaning he who seizes the opportunity’, has grown exponentially in recent years, as South Africa’s global positon as a gold producer has fallen. An article in The Guardian elucidated that zama-zamas are typically irregular migrants from poorer neighbouring countries, such as Mozambique.  They are lured by the possibility of earning a significant amount of money. However, as they do not have a regular, fixed income, the sum they remit fluctuates. For example, in an interview Joseph Sithole, an undocumented Mozambican migrant working as a zama-zama, highlighted that he earns less than $5 per day. However, he stated that it is worth the risk, as ‘hitting a rich seam’ will enable him to remit more money home to Mozambique.  Therefore, if amount repatriated is insufficient to satisfy subsistence needs or if the remitter dies or is maimed in the mine other family members may be forced to migrate or engage in sex-work, thus increasing the incidence of HIV/AIDS in Mozambique and South Africa.

Illegal mining is a result of economic necessity. This was highlighted by the Daily Sun, a sensationalist newspaper, which has the largest readership in South Africa. On 19^th June 2014 the front page contained the headline ‘Dying to live’, this feature story on zama-zamas, stated that ‘their families would starve if they didn’t battle the dangers underground’.

Sipho Mahabane, a zama-zama, commented that illegal mining is not ‘‘a choice but a must for survival’’. The reality of life in the subterranean tunnels and surrounding environment creates conditions that induce the spread of HIV. Inflated prices and CSW prevail. Legal workers ‘‘have made a killing’’ from zama-zamas. They charge exorbitant amounts for basic foodstuffs, such as 100 Rand for a loaf of bread which normally costs 8 Rand. Similar to around operational mines, CSW has prospered in the milieu surrounding abandoned mines where it is known that zama-zama work. Therefore, if illegal miners are spending money underground or on sex they do not have surplus money to remit home and increase their chances of contracting HIV. This perpetuates the cyclical relationship between poverty, irregular migration and HIV.

The geography of HIV and AIDS in Mozambique ascertains that the epidemiology of the virus is inextricably linked to the process of irregular migration. The epidemic has spread rapidly in recent years. In 2004 the HIV prevalence rate among Mozambique’s adult population (fifteen to forty-nine years) was 16.1 per cent, and fastest growing in provinces linked by transportation corridors to South Africa. HIV now accounts for 27 per cent of all deaths, the second largest after malaria. However, the Mozambique National Institute of Statistics found that HIV and AIDS was the leading cause of adult deaths (aged fifteen plus), accounting for 40 per cent. The figure varied across regions. It ranged from 32 per cent of deaths in Nampula, in the north, a considerable distance from transportation routes to fifty per cent of deaths in Gaza, along the South African border. This disparity correlates with irregular migration patterns and substantiates the thesis of this paper that mobility has a significant impact on the diffusion of HIV and AIDS in Mozambique. Researchers from the University of Witwatersrand concluded that the prevalence of HIV and AIDS in southern Mozambique is the ‘hallmark of social disruption’ caused by irregular and oscillating migration.

In conclusion, there is a clear link between the prevalence of HIV in Mozambique and irregular migration to South African mines. This was elucidated in this article by illustrating how the geography of HIV/AIDS in Mozambique correlates with patterns of irregular migration and how dangerous conditions in the mines, where irregular migrant Mozambican men work, increase the incidence of high-risk sexual behaviour that facilitates transmission. The connection between being dependent on an irregular migrant and increased susceptibility to HIV was explored by assessing the impact of the termination of remittances. Mobility has been an ubiquitous characteristic of our history. The complex mix of social, economic, political and environmental factors that compel people to migrate irregularly from Mozambique to South Africa will not be eradicated overnight or stemmed by stringent immigration policy. Therefore a long-term, cooperative and multi-faceted response that tackles the underlying causes of irregular migration, which is intimately connected to HIV and AIDS, must be found.