Without sufficient private and confidential space for counseling, women may not be comfortable disclosing and discussing gender-based violence. For example, the Lusaka-based Kalingalinga and Kamwala clinics, run by the government with support from CIDRZ, where a counselor sees between 70 and patients per day, have one adherence-counseling room each. Counselors must either wait for their colleagues to complete their adherence sessions before seeing their clients, or use the same room for more than one session simultaneously, thus compromising patient confidentiality, privacy, and the general quality of service.
As one supervisor in an HIV clinic in Lusaka put it,. The complaints that counselors come with [include the problem that] the clinics are congested. The space is so squeezed and used to be a ward. At least if we had three rooms in the clinic for adherence counseling, we would not have to wait outside until the room is free. Space is the biggest issue. Because of lack of infrastructure, you see in one side[of a counseling room], someone is getting blood, maybe CD4 count, and another counselor is giving adherence counseling in the same room.
The number and location of clinics determine how easy they are to reach.
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Chapter V discusses the drastic effects that property grabbing and insecure property rights upon divorce have on women's ability to afford transport to far-away clinics. This is particularly problematic in rural areas. Recognizing the transport challenge, clinics budget for emergencies that might prevent patients from renewing their prescriptions on time: two to three days' worth of extra pills are provided with each dispensation of ART and clinics also allow pre-registered family members or "buddies" to collect the medicine on behalf of patients if needed.
When asked about the steps taken to improve patients' access to care, the district commissioner of Chongwe, a district that has trained counselors, [] said that the government provided thirty bicycles and motorbikes for the district's 28 clinics, including clinics providing ART, so healthcare staff can reach patients who are unable to attend clinics due to distance or poor road networks.
The director of Lusaka's District Health Management Team also said that that the Zambian government has increased the number of clinics delivering ART-related services in Lusaka and a number of other provinces, and expanded some of the clinics to provide more space for ART services. Most healthcare facilities that provide ART lack of appointment systems, which allow patients to make appointments in advance.
This compounds the problems that women affected by gender-based abuses encounter in their daily lives and impacts their adherence to ART. The only clinic that has an appointment system that Human Rights watch identified in its research was the Kara Clinic. The director of the Lusaka DHMT said that introducing an appointment system in Zambia will be difficult given that patients might not be able to arrive on time.
As discussed earlier in this report, the violence and other abuses that women experience in Zambia sometimes compel women to hide their HIV status from their husbands, partners, and other family members. In such circumstances women have to make up explanations for their trips to attend clinic appointments, such as telling their husbands that they are visiting relatives or attending a funeral. In the absence of an appointment system, women end up waiting long hours at clinics. A number of women testified that they experienced violence at the hands of their husbands for arriving home late from clinics and for failing to prepare the food on time.
Then women must also wait at clinics without food. One woman who told Human Rights Watch that her husband beats her up for the slightest delay, even if she was buying vegetables in the market, said, "The problem is when I go to the clinic to get ARVs. I go there six in the morning and come back at hrs. They don't give you food, so when it is time I drink my medicine without food.
Community-based support is an important element of a successful AIDS response, including in terms of receiving and responding to referrals from healthcare facilities addressing gender-based abuses. In Zambia, particularly in urban settings in Lusaka and the Copperbelt provinces, there is a wide range of women's organizations and other nongovernmental organizations and community-based organizations that provide services to women affected by gender-based abuses, including domestic violence and lack of enjoyment of property rights.
Yet currently there are almost no formal referral paths between health facilities providing ART and these organizations. But Human Rights Watch knows of no specialized support groups dealing with gender-based violence that are associated with healthcare facilities providing ART. Some of these organizations are linked to ART providers. Addressing the gender-specific problems that arise from health system policy and infrastructural problems discussed above may materialize through better representation of women and women's organizations in health and HIV policy and coordination bodies.
The essential role of women in decision-making and as full partners in relation to the national and international fight against AIDS has become evident and increasingly recognized globally. While the NAC includes youth groups, faith-based groups, traditional healers, and other stakeholders in its thematic groups, there is no thematic group specific to women.
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Despite several positive reforms, the legal framework and justice system in Zambia fall short in providing the necessary respect for and protection of women's rights, as required by Zambia's human rights obligations. Zambia's constitution is currently undergoing a review process, which is likely to conclude in Although the existing constitution contains language that forbids discrimination on the basis of sex article 23 , this provision specifically excludes from its application key areas of personal and customary law. The draft constitution, published for discussion in , contains new language that would remedy this and other shortcomings in the current constitution.
Articles of the draft provide that every person is equal before the law and has the right not to be discriminated against on any ground, including on the ground of sex; that women and men have equal rights to property and inheritance; and that "any law, culture, custom or tradition that undermines the dignity, welfare, interest or status of women or men is prohibited.
Zambia has no specific legislation to address domestic violence, so women must resort to the general penal code provisions on assault occasioning bodily harm. Weak criminal provisions and the lack of other sufficient civil enforcement mechanisms mean that many women, particularly poor women, may be forced to choose between having their husbands arrested and incarcerated or keeping an abusive breadwinner in the family home.
It is also due to social pressure. Women have withdrawn charges against abusive partners even where they received free legal services, for example, through the Centre for Coordinated Response to Sexual and Gender-Based Violence known as the "one-stop center" where women survivors of domestic violence receive free legal support.
According to the director of the center, 50 percent of the cases that the center addresses, especially in the area of domestic violence, are withdrawn. The Penal Code does not specifically criminalize marital rape. Chapter XV, Section , of the penal code defines a rapist as: "[a]ny person who has unlawful carnal knowledge of a woman or girl, without her consent, or with her consent, if the consent is obtained by force or by means of threat or intimidation of any kind, or by fear of bodily harm, or by means of false representations as to the nature of the act, or, in the case of a married woman, by personating [sic] her husband.
It has been suggested that one problem is that the definition of rape and the law do not foresee the possibility of "unlawful" carnal knowledge of one's wife. A new proposed bill, the Sexual Offences and Gender Violence Bill , which WiLDAF drafted in consultation with other nongovernmental organizations, addresses sexual offenses and violence against women and girls in and outside the home. It also introduces new provisions relating to domestic violence.
The draft bill contains a definition of domestic violence which incorporates physical, sexual, and psychological violence. Women's rights to acquire, administer, enjoy and inherit property, including upon divorce, are inadequately protected under Zambian law. The protections that do exist are poorly enforced. In terms of property rights upon divorce, the Matrimonial Causes Act, which is awaiting presidential approval as of October [] and applies to marriages covered by article 3 of the Marriage Act, [] provides for property-related settlements in court upon divorce, instead of current practices where it is often assumed that the matrimonial property belongs to the husband.
The Act is silent in relation to equal division of property upon divorce. Since many people in Zambia prefer to marry according to customary law rather than according to the civil marriage statute, the protections of the Matrimonial Causes Act, once in force, will not apply to them. The Zambian government describes customary law as "unwritten, patriarchal," and administered by "non-professional justices who are predominantly male.
Inheritance is another area where customary laws discriminate against women.
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Under the customary laws that most Zambian ethnic groups practice, couples do not own property jointly, and traditions in most ethnic groups stipulate that the deceased husband's family retains all inheritance rights. The World Bank's report, Engendering Sustainable Growth in Zambia, states that compared to men, "women [in Zambia] have much lower prospects of inheriting marital assets, land, or money even when the deceased party is their spouse. In matrilineal communities only persons related to the deceased through the deceased's mother or more remote female ancestor are eligible to share in the estate.
In patrilineal communities eligibility is limited to those related to the deceased through a common male ancestor. The Intestate Succession Act of was intended to "make adequate financial and other provisions for the surviving spouse, children, dependents and other relatives" of people who die without leaving a will. Instead, they use the Local Courts Act to distribute inheritance without reference to the percentages specified by the Intestate Succession Act, and often mandate low fines for property grabbing. Thus, in many cases, widows receive little inheritance.
The Zambian government has responded to women's insecure property rights under customary law by initiating consultations with traditional chiefs on the need to change practices that discriminate against women in terms of access to land. The VSU has officers in police stations in Zambia's nine provinces.
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Although the existence of the VSU is an indication of political will to address gender-based abuses, there are serious problems that undermine its ability to carry out its functions effectively. Like other government institutions in Zambia, the unit lacks resources.
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A nurse counselor in Kafue told Human Rights Watch that she tried to help women patients who had visible signs of physical violence to report their husbands to the VSU, but that VSU officers said they had no transport or were short staffed, and unable to help the women. The head of Community Services Department also said that staffing levels were inadequate compared to the responsibilities of the VSU.
In Lusaka province, which has the highest number of VSU officers, there are VSU officers based in 21 stations who are also deployed as "foot officers" in unplanned settlements. Due to high staff turnover, [] and the lack of a system of ensuring that officers are trained regularly, [] fewer than half of the VSU officers are properly trained to handle victims of violence.
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The YWCA held several training workshops on gender-based violence, only to have the officers who received the training move to other departments. With the exception of the Center for Coordinated Response to Sexual and Gender-Based Violence, the rooms allocated for VSUs are often not adequate to ensure privacy for victims and survivors of sexual violence.
For example, in some cases, the police encouraged reconciliation rather than pursuing reports on domestic violence. For you to have an affair with your father you must like him. A number of women interviewed by Human Rights Watch reported cases of corruption among police officers. One woman said that she believes her former husband bribed VSU officers, and as a result, they stopped pursuing him to pay maintenance as per a court's decision.
One of the major problems that women who experience gender-based abuses - especially property grabbing and unequal distribution of their marital property upon divorce - is obtaining information on their legal rights and representation in court cases.
The Zambian government established a legal aid department that provides free legal aid for those who cannot afford to cover legal costs. However, a number of those interviewed said that this department failed to have a meaningful impact due to its limited capacity and resources. Lawyers at nongovernmental organizations said that there were only four legal aid lawyers who cover Lusaka, Ndola, Kitwe and Livingstone districts.
Denial of women's property rights is apparently not a priority, as the focus is often on crimes such as murder or aggravated robbery. WLSA reported that because of the lack of financial and human resources, the Legal Aid Department was "a myth in the lives of many Zambians, particularly women. Zambia's government has not provided shelters for women and girls who are survivors of violence and other forms of abuse.
The only two shelters in the country are run by the Young Women's Christian Association. YWCA staff told Human Rights Watch, "We only have one shelter in Lusaka and it is constantly full, as it can only accommodate up to 13 women and their children.