Mining the Depths of an HIV Crisis in Zimbabwe’s Midlands Province: Beneath the Surface

Feature By Dumisani Ndlovu

Gokwe - Across the rugged Midlands Province, where the Great Dyke slices across the country like a geological scar, a crisis runs deep. The mining districts of Zvishavane, Mberengwa, Shurugwi and Kwekwe have long powered the nation’s economy, but today they are also epicenters of a silent health epidemic.

The tragedy is not only the depletion of natural resources, it is the alarming surge in HIV infections, a public health challenge as complex and unforgiving as the mines themselves.

The connection between mining communities and HIV isn’t new. Decades of research have shown that areas with extractive industries often see heightened rates of infectious diseases driven by transient workforces, limited healthcare access and social vulnerabilities.

But Gokwe South, a district recently chosen as the venue for World AIDS Day commemorations by the National AIDS Council (NAC), has also taken a fresh urgency.

“We didn’t pick this location by accident,” said Josiah Machakata, Acting Manager of NAC Midlands.

“This is an isolated mining pocket, and we want to ensure it doesn’t distort the broader picture or the progress we’re making in Gokwe South itself," he said.

Mining isn’t just an economic activity in the Midlands, it’s a way of life. Miners move between shafts, towns and homes, creating a web of interactions that stretches beyond the pithead.

Machakata said this interconnectedness of miners, who do not live in isolation, return home, visit neighbors and form intimate ties which is where the virus often spreads.

The transient nature of their work, coupled with erratic access to sexual health services, has created a combustible mix.

To address this, NAC has deployed a strategy with stakeholder collectiveness layered.

Peer educators and miners themselves act as bridges between medical services and the workforce. These grassroots champions distribute condoms, encourage voluntary testing and link infected individuals to treatment programs.

Meanwhile, the “sister-to-sister” model empowers adolescent girls and young women who are disproportionately affected.

Through this initiative, one mentor recruits 50 others, sparking a ripple effect of education and prevention that can shield communities for years.

The challenges, however, are formidable. In isolated mining pockets like Gwanika, health facilities are sparse and stigma looms large.

“Public clinics were once seen as places of last resort but now more people are making use of the available health facilities in what NAC says is progress.

The evolving mindset is the result of relentless outreach, including mobile clinics and integrated services that bundle HIV testing with cancer screenings and substance abuse awareness.

Even anti-retroviral therapy (ART) distribution has seen innovation. To combat the risk of treatment default among miners who travel abroad, the Ministry of Health has worked to decentralise drug access.

Gokwe South Ward 24 councillor Cosmas Maketo praised this efforts.

“ART has transformed lives. People are healthier, working, their families are thriving," he said, yet he also stressed that “those who leave the country for treatment and miss their doses remain vulnerable.”

Available data tells a sobering tale. While HIV prevalence in the Midlands has dropped from 18.1% in 2005 to 10.94% in 2022, disparities persist.

Zvishavane (16.37%) and Shurugwi (14.64%) remain hotspots, while Gokwe South, at 9.19%, is comparatively better off, a fact organizers kept a lookout for when selecting the city for World AIDS Day celebrations.

Yet, even these figures mask a stark reality, nearly 165,000 people in the Midlands Province live with HIV, including 7,119 children.

Hondo village head Windros Madungwe observed a cultural shift.

“People now speak openly about HIV. It’s no longer a hidden illness," he said.

“Improvements are happening, but they take time. In two to three years we’ll see the fruits of these efforts.”