The Hidden Tragedy of COVID-19 on Adolescent Girls in Malawi

By The Global Fund

November 25^th, 2020

In this story, 24-year-old Grace Ngulube (wearing a green t-shirt in the image below), takes us through the intimate lives of adolescent girls and young women during school closures in Malawi. Born with HIV, Grace’s passion for advocacy is driven in part by her lived experience. She is a board member of the National Association for young people living with HIV in Malawi and a member of the Global Fund’s Youth Council.

The Hidden Tragedy of COVID-19 on Adolescent Girls in Malawi

It all began as a mysterious disease, a myth, an uncontrollable plague pushing the world inside and keeping it confined. Restrictions on movement and school closures – while successful in halting the spread of COVID-19 in Malawi – contributed considerably to fueling a pandemic of violence against adolescent girls and young women behind closed doors, threatening to reverse decades of progress in the fights against HIV and gender inequality.

When schools were closed, my phone kept beeping incessantly with messages from adolescent girls and young women. For many, home had become a place of loneliness, fear and abuse. They felt isolated, they needed money, they didn’t know where to get access to HIV treatment and contraception services, they missed school, their friends and the freedom of going out and about. With teen and mentoring clubs closed, they had nowhere safe to go. I decided to travel around the country to meet some of these adolescent girls and young women, whose lives were abruptly disrupted.

“Covid-19 has disrupted my education. I feel like my future is doomed. I think we have lost a lot of time and the outcome will never be a true reflection of our potential.” - Josephine, 18, Thyolo, Malawi.

For many adolescent girls and young women, education was never a guarantee. With school closures, it became even more out of reach. There were reports of increased teenage pregnancies in several districts across the country. In many cases, the pregnancies were the result of sexual violence and limited access to sexual and reproductive health services. The loss of family income forced adolescent girls and young women into transactional sex and illegal prostitution to afford basic supplies such as food, soap and clothes. Desperate parents resorted to marrying off their under-age daughters to make ends meet. Sadly, even though schools have now reopened across the country, many girls may never return.

“Sometimes I find myself doing things that I would never think of. School kept us from these behaviors. Many girls are getting pregnant and married off, especially here in Phalombe.” - Caroline, 19, Phalombe, Malawi

The measures taken to control the spread of COVID-19 at health centers contributed to restrict access to the already limited services for adolescent girls and young women. With the increased poverty, most of them can’t afford to buy face masks.

“Care and treatment are no longer being offered the way they used to be. For a young girl like me living with HIV, it means I’m not getting my treatment. With the current financial hardship in my village, having access to free masks would be lifesaving.” - Beatrice, 16, Phalombe, Malawi.

Currently, people living with HIV receive multi-month-supplies of treatment to avoid large crowds in health facilities.

In many communities, there still is a belief that young people living with HIV automatically also have COVID-19. Because of this, some young people have been put out to the streets by their guardians. This situation brings back a dark time and old traumas of persecution when we need each other more than ever before. Creating new safe spaces for adolescent girls and young women was critical.

My organization, Youth Health Connect360 has teamed up with other youth organizations in Malawi to continue to provide care, support and reliable information related to HIV and COVID-19 to young people over messaging and social media platforms. These online platforms are supporting the work of peer educators and helping to direct adolescent girls and young women to safe spots for HIV and sexual and reproductive health services. They have also become a trusted channel to report cases of violence, unplanned pregnancies and stock-outs of HIV medicines. More than 200 young people have joined our chat groups so far.

This ‘new normal’ is a wake-up call. COVID-19 is infecting the lives of an entire generation and ripping off the dreams of millions of adolescent girls and young women. The knock-on impact of the pandemic could result in a vicious cycle that will fuel the HIV epidemic, stall progress toward gender equality and perpetuate inter-generational cycles of poverty. As we prepare to celebrate World AIDS Day and mark the 16 Days of Activism Against Gender-based Violence, I urge governments and community leaders to put young women and girls at the center of all preparedness, response and recovery efforts. Now is the time to create, together with adolescent girls and young women, a bold movement to revitalize their rights to health and education. This is fundamental to dismantle the entrenched gender inequalities, win the fight against HIV and combat the too often hidden, yet devastating, impact COVID-19 is having on adolescent girls and young women.

Grace.

In Malawi, the Global Fund has approved US$31.4 million to mitigate the impact of COVID-19 on lifesaving programs, reinforce national COVID-19 response and strengthen health systems. The funding has helped the country adapt HIV programs to ensure uninterrupted access to services for adolescent girls and young women. This includes multi-month supplies of antiretroviral therapy, personal protective equipment for peer educators to provide face-to-face care in hard-to-reach communities, a focus on parent-child communication, virtual support groups to provide HIV health services and referral for sexual and reproductive health through text messages and information on gender-based violence and unplanned pregnancy prevention on radio stations. Additional funds are urgently needed to meet the new challenges caused by COVID-19 and keep girls safe from HIV.