Zimbabwe: MSF helps sex workers overcome adversity through peer education

For the young sex workers of Mbare and Epworth, Zimbabwe, the streets are more than a workplace—they are a battlefield. Violence, stigma, and a lack of access to healthcare have long defined their lives. However, a growing network of empowered young women, supported by Doctors Without Borders (MSF), is rewriting this narrative. These young women are not only accessing essential healthcare services but are also stepping up as peer educators, bridging the gap between their communities and life-saving care.

*Zira, a mother of two, and one of the peer educators in MSF Mbare project, recalls the night that changed her life. “I fell pregnant without knowing because I was drunk while working on the streets. I didn’t know about contraception,” she shares. Through the MSF programme, Zira learnt how to protect herself, gaining access to contraception, Sexually Transmitted Infection (STI) treatment, and HIV prevention services. But her journey didn’t stop there. She felt a calling to ensure other young women didn’t face the same struggles.

*Maida, another sex worker, describes the harsh realities young sex workers endure. “Sometimes a client refuses to pay after services. If you ask for your payment, they threaten or even beat you,” she says. Beyond the violence, accessing healthcare remains a challenge. Stigma in clinics often discourages young women from seeking help. “You walk into a clinic presenting with an STI, and before you even explain further, they start judging you,” Maida explains.

Despite these challenges, young women like Zira and Maida are pushing back. As peer educators, they distribute condoms, provide basic health services, share knowledge with their peers, and encourage others to seek medical care. “Many don’t know their rights or where to get help,” Zira says. “So, I go to them. In bars, in the streets. I ask—do you have condoms? Do you know where to get tested?”

The impact of MSF’s intervention in Mbare and Epworth has been transformative. Zira recalls an adolescent girl, who had been raped and was unknowingly living with HIV. “She didn’t know she was positive. Her parents didn’t know either. I brought her to the clinic, and she got the help she needed,” Zira says.

The peer educator model is fostering trust within the community, encouraging more young sex workers to seek medical care. Many young women call for expanded services, economic support, and better healthcare facilities. “I’m getting older,” Zira admits. “One day, I won’t qualify for these services anymore. What happens then?”

Samuel Sithole, MSF’s Health Promotion Manager, emphasizes the importance of the peer educator model. “Many young sex workers won’t trust traditional healthcare providers, but they trust someone who has lived their experience. When there is trust, there is acceptance. When there is acceptance, behavior change happens,” he explains.

Peer educators like *Jaya, who transitioned from being a patient to a peer educator, highlight the need for continued support. “Before, I only cared about money. I didn’t think about my health. But MSF empowered me—I no longer work in bars, and now I teach others about the importance of protection,” she says. Jaya also stresses the need for expanded services, such as condoms and better access to lubricants, to ensure safer practices.

The challenges are significant, but the resilience of these young women is undeniable. On this International Women’s Day, we honor their courage and determination. They are not just surviving—they are leading the charge, transforming their communities, and proving that even in the face of fear, strength can prevail.

Since 2016, MSF has been working in Zimbabwe, providing comprehensive sexual and reproductive health (SRH) services to adolescents and young people in collaboration with the Ministry of Health and Child Care. The integrated approach includes STI and HIV screening and treatment, family planning, mental health counseling, and psychosocial support. In 2024 alone, MSF provided over 8,400 consultations, many to vulnerable populations like young sex workers in Mbare alone.

 [The names marked with * have been changed to protect the privacy and integrity of the patients.]

Maida is a sex worker and she is describing to the peer educator the harsh realities young sex workers endure. “Sometimes a client refuses to pay after services. If you ask for your payment, they threaten or even beat you,” she says. Beyond the violence, accessing healthcare remains a challenge. Stigma in clinics often discourages young women from seeking help. “You walk into a clinic presenting with an STI, and before you even explain further, they start judging you,” Maida explains | Date taken: 27/02/2025 | Photographer: Lourino Pelembe | Location: ZimbabweSamuel Sithole, MSF’s Health Promotion Manager, is promoting a session of health education in a porch set up for the purpose in Epworth. Samuel emphasises the importance of the peer educator model. “Many young sex workers won’t trust traditional healthcare providers, but they trust someone who has lived their experience. When there is trust, there is acceptance. When there is acceptance, behavior change happens,” he explains. | Date taken: 27/02/2025 | Photographer: Lourino Pelembe | Location: Zimbabwe

Jaya, who transitioned from being a patient to a peer educator, is telling to MSF Community Mobilizer, Ruvimbo, the need for continued support. “Before, I only cared about money. I didn’t think about my health. But MSF empowered me—I no longer work in bars, and now I teach others about the importance of protection,” she says. Jaya also stresses the need for expanded services, such as condoms and better access to lubricants, to ensure safer practices | Date taken: 27/02/2025 | Photographer: Lourino Pelembe | Location: Zimbabwe

Nkosi Mahlangu

Communications Specialist, Doctors Without Borders (MSF Southern Africa)

• nkosi.mahlangu@joburg.msf.org
• +27(0) 11 403 4440
• +27(0) 82 924 8454

• www.msf.org.za
• MSFSouthernAfrica
• @MSF_southafrica

About Doctors Without Borders (MSF)

Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.

In South Africa, the organisation is recognised as one of the pioneers of providing Antiretroviral Treatment (ART) in the public sector and started the first HIV programmes in South Africa in 1999. Until today, the focus of MSF’s interventions in the country has primarily been on developing new testing and treatment strategies for HIV/AIDS and TB in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape).

In Tshwane, we run a migration project, and we offer medical and psychosocial care to migrants, refugees, and asylum seekers, who struggle to access public health services under South Africa’s increasingly restrictive.

Previously we offered free, high-quality, confidential medical care to survivors of SGBV in Rustenburg.

To learn more about our work in South Africa, please visit this page on our website (www.msf.org.za). To support MSF’s work: