Mmapaseka “Steve” Letsike is the chairperson of the Civil Society Forum of the South African National AIDS Council (‘SANAC’) and is also the Advocacy and Training Manager for the NGO—Anova Health Institute. The Civil Society Forum was established in 2012 to strengthen the civil society sector’s participation within SANAC through the leadership and constituencies of 17 Civil Society Sectors.
Anova Health through its Health4Men project offers health related services to MSM (men who have sex with men) in 5 provinces (Gauteng, Mpumalanga, North West, Limpopo and Western Cape) and has clinics in Woodstock, Khayelitsha, Bellville, Soweto and Yeoville. Letsike’s activism is not limited to involvement with these organisations however, as Letsike is committed to ensuring that the rights of all gender non-conforming people in South Africa are respected, promoted and protected.
Nomonde: Your work at Anova Health is aimed at ensuring that men access healthcare services. What, in you opinion, are some of the barriers to men’s access to healthcare?
Steve: In order to understand the barriers to men’s access to healthcare one first has to understand how men are perceived in health systems. The feminisation of healthcare services as well as the feminisation of the seekers of healthcare services and the perception of men’s power and strength bar all of us from taking into consideration the fact that men have health needs too. Men themselves have extremely low health seeking behaviours, which needs to change. This is especially true for men who have sex with men (‘MSM’), and this fact is worsened by the discrimination and stigmatisation MSM experience in healthcare facilities.
Nomonde: Do gender non-conforming people experience any challenges to their access to healthcare services? If so, what challenges do they experience?
Steve: Yes, gender non-conforming people do experience challenges to their access to healthcare services. Studies indicate that homoprejudice has an impact on MSM’s desire to access healthcare services. Providers of healthcare services have rejected MSM and LGBTI or offered substandard care to the population. This has consequently led to the population being reluctant to seek healthcare services or delaying their access of these services. Thus, this experience increases the health risks of the population. People tend to put their own beliefs system ahead of what they are required to do as service providers to community members. The providers of healthcare services have to be mindful of the principles for their profession and also be mindful that community members have the right of access to those services. It is not for them to articulate who should get what and when.
Nomonde: How do these barriers impact on the prevention and treatment of HIV?
Steve: Once you discriminate against people that level of discrimination impacts on the health status of that individual. This is especially the case for HIV for which the prevalence is especially high within the MSM community. And, if you do not target the group, you do not address the health needs specific to them.
Nomonde: What impact does the rise in hate crimes have on LGBTI people’s quality of life?
Steve: We live in a country where we have a constitution, policies and legislation in place. These laws and policies don’t translate into the lived experiences of people—the reality is something else. There is a lack of understanding and ignorance in our society, LGBTI people are told that their gender identities or sexual orientations are unAfrican but there is no understanding of the effect such statements have on their lives, which often leads to victimisation. This question, at its core, is about a person’s life, which is supposed to be free of association and expression, personal is political and anyone should confirm their preference and identity. How can one expect people to live their lives freely when they fear for their lives because of hate crimes? Lesbian women, gay men and the transgender community are not only raped, they are also brutally murdered. This act denies them the noble title of survivors and furthermore, the cases don’t get redress, which really speaks to justice not served.
Nomonde: What are some of the challenges faced by organisations that seek to help trans or gay people?
Steve: Resources now are a huge gap, a number of organisations are closing mainly because of funding. The second thing is sustainability, where programmes need to be integrated within the broader human rights programmes. Lastly is the struggle of solidarity from other organisation, everyone is focusing on their own business, somewhere somehow we as NGO’s need to have a collective voice and work together to fight the social illnesses.
Nomonde: How would you answer a person who says homosexuality or gender non-conformity are unAfrican?
Steve: I would first seek to unpack what exactly it means to be African. That is the starting point. When one speaks of African culture, it must be noted first and foremost that culture is fluid and changes over time. If you took an honest look at the structure of African society before the settlement of Westerners it is clear that the latter criminalised same sex sexual activity. This is an indication that they came, saw that it was happening then criminalised it and thus disproves the perception that homosexuality or gender non-conformity are unAfrican. I am African and homosexual, and thus I am not going to justify my identity to gatekeepers of what African is, we have to acknowledge the diversity of “African” and live with it.
Nomonde: What could be done to end hate crimes against LGBTI people by the government?
Steve: The government needs to fulfil its responsibility to protect, promote and respect the rights of all citizens in this country. Its mandate is to ensure that everyone in this country is treated well and have access to appropriate and affirmative services. In order to do so the government would need to: (a) put hate crime legislation in place; (b) implement that legislation successfully; and (c) educate and raise awareness in all corners of society.
Nomonde: What could be done to bring an end to hate crimes against LGBTI people by civil society organisations and the average man or woman on the street?
Steve: Firstly, people on the streets need to be open-minded. If you do not agree with homosexuality or gender non-conformity then be tolerant, educate and empower yourself. In the long run accept and respect people regardless of their sexual orientation or gender identity. Organisations need to have their own independence and autonomy (from government and the private sector). Organisations also need to present a collective view and find ways to come together and work together in our own autonomy. Ubuntu goes a long way for everyone.