“You are loved”: A clinic for at-risk people in Eswatini

At the Sitsandziwe Clinic, MSF provides comprehensive and inclusive sexual health care for vulnerable people.

Staff at the Sitsandziwe Clinic in Zimbabwe, which translates to “you are loved."

Eswatini 2024 © MSF

The small but bustling town of Matsapha in Eswatini is known for its industrial businesses and textile firms. Women from across the country come here seeking employment opportunities, often in factories offering minimal pay. 

Known as a town "where the buyer meets the seller," Matsapha is also a hub for sex work. This year, Doctors Without Borders/Médecins Sans Frontières (MSF), in collaboration with stakeholders from Eswatini's Health Ministry and community leaders, officially opened a clinic, which the local community has named “Sitsandziwe,” translating to “you are loved.”

Serving at-risk people

The clinic's scope of health coverage was informed by a 2022 MSF study on sexually transmitted infections (STIs), which identified a significant prevalence of STIs, particularly impacting people between the ages of 18 to 29.

Matsapha is also a welcoming place for the LGBTQI+ community, and has hosted events to encourage marginalized groups to seek health care.

In response to the need for an inclusive and comprehensive sexual health clinic, Sitsandziwe aims to offer effective and convenient sexual health services. The team provides all services free of charge, while ensuring a safe and private environment.

Addressing the STI burden is a long-term endeavor that involves not just medical solutions but also tackling social challenges.

Luis Neira, MSF head of mission

“The ultimate goal of the clinic's activities is to gather data, identify challenges, and uncover opportunities for the national program, leading to policy changes. These could include the introduction of lab-based STI diagnosis and treatment, as well as hepatitis services at primary health clinics,” said Dr. Hayk Karakozian, MSF medical coordinator in the clinic.

“Addressing the STI burden is a long-term endeavor that involves not just medical solutions but also tackling social challenges. This underscores the importance of ongoing engagement with the communities we serve as we introduce new strategies, thereby enhancing the quality of care,” said Luis Neira, MSF head of mission. 

Since beginning clinic operations in September 2023, MSF has provided over 3,093 services to 1,400 patients, including digital HIV testing and treatment for all STI diagnoses. Throughout the year, we plan to introduce additional services, such as injectable PrEP, a pre-exposure prophylaxis for HIV.

People line up next to new clinic in Eswatini.
A 2022 MSF study revealed a pressing need for specialized health care, leading to the opening of a new sexual health clinic in Matsapha town, offering comprehensive sexual and reproductive health services, tackling STIs, providing family planning, and more.
Eswatini 2024 © MSF

Partnering with communities

Over the years, MSF has initiated several projects to engage with the community. These discussions have been vital in understanding how best to serve the community, including LGBTQI+ people, factory workers, survivors of sexual and gender-based violence, and young women.

“The medical objective is to address the STI burden, with a focus on involving communities and targeting specific key populations. A lab-based STI treatment approach will demonstrate to the Ministry of Health the necessity of this model of care,” added Luis Neira.

MSF has hosted representatives from various communities to gather feedback on our services and involve them in designing our community programs, holding us accountable as a medical organization. Additionally, we've  collaborated with established platforms like the annual international trade fair, facilitating community understanding and access to our aid. To guarantee our activities reach those in need, MSF teams in the community are reachable through social media, ensuring an answer just a click away.

About MSF in Eswatini

MSF has been working in Eswatini for over 16 years, initially focusing on HIV, drug-resistant tuberculosis (DR-TB), and COVID-19 during the pandemic in the Shiselweni region.

MSF’s Sitsandziwe Clinic in Matsapha offers STI testing, diagnosis, and treatment, along with consultations and provision of family planning methods; clinical management of sexual and gender-based violence cases; HIV testing; digital self-testing; initiation of antiretroviral therapy; human papillomavirus (HPV) testing; and diagnosis, treatment, and care for pre-cancerous lesions and hepatitis B and C, along with hepatitis prevention.