Livelihood and Income-related Difficulties

161 following statements from a married, male participant and a widow respectively, highlight income as their greatest difficulties.

The most difficult is on how to get money that I find most problematic, because I find that if I can have some reasonable amount of money, then I could carry out my things the way I desire (R20:married man, aged 26-35 years, 94).

When I go and line up there [PSC], I will have to pay the charges levied there. But sometimes my income does not make it possible for me to be able to pay these charges. This is a big challenge for those PLHIV. Yes. It is a bit challenging for those PLHIV because sometimes someone may not even be able to get this money, but truly they are unwell (R37: 41-year-old widow, 75).

Participants in FGDs and KIIs also cited lack of proper and sustainable sources of income as one of the key difficulties PLHIV contended with. According to one FGD participant,

I would say that the challenges the PLHIV face are maybe in terms of income, their income…

You find that they do not have any source of income. So this one is also a stress in them that

“how can I get somewhere that I can get a living.” You stress yourself with this at the same time, maybe if you get that work, or you don’t get that work, it forces you to do a work that now you use a lot of energy in doing (FGDMY-003, 280).

A KII participant, a PSC coordinator had the following to say:

Another challenge I was talking about is this still level of poverty. Our level of poverty. We still cannot manage so much as clients because HIV is quite demanding. And even people who have those, today it is so good that somebody is taking care of the drugs, and laboratory tests.

But if it was left for the clients, then we would have no clients here (KII-001, 59).

Lack of a stable source of income, or incomes that were considered insufficient resulted in inability to meet financial obligations. Hence, one of the difficulties most mentioned by both male and female participants had to do with lack of or inadequate income. In both cases as exemplified above, access to sufficient income was viewed as being critical for one to meet their obligations.

According to some of the participants, income for secure livelihoods could be earned in a variety of ways. These ways included paid employment, self-employment, and business. For the majority, earning an income was mostly in context of employment and if they could secure a stable employment opportunity, they would have secure livelihoods. One man commenting on the challenge of getting employment and thus means of livelihood said:

162 One major challenge that I face is that now I have not... since I was into the ...I mean I was...I took up the responsibility of having a family, I have not got, I have not got a sustainable job.

So this is one thing that worries me so much. And that is why I have made a decision that self-employment is the way to go and am right now saving towards the same (R21: married man, aged 26-35 years, 74).

In some cases, the PLHIV realized that lack of proper qualifications were barriers to getting better job opportunities. They did not access proper career training due to lack of finances and were themselves now caught up in a trap of poverty. The experience of one female participant is illustrative:

The greatest difficulties I am confronted with, first, the income is low. Our income is very low. Number one, I am not employed. I also went to school but school fees could let me reach only form three. So I have no certificate with which I can look for a job. So you find that our income is low and we have brought forth children into the world and we would like these children to go to school. So we find that we have a lot of burden. So many other issues about the family require a financial resolution (R47: married woman, aged 36-45 years, 81).

In the above case, the participant clearly locates the interconnections that exist between low income, lack of employment and proper academic qualifications. She traces her lack of employment to low qualifications and subsequently, her low incomes to lack of employment.

This kind of situation makes it difficult for her to fulfil the social obligations including paying school fees for her children.

For a number of participants, the ability to have a secure livelihood and thus to provide for themselves and their families was linked to their capacity to effectively perform their daily tasks. Consequently, incapacity to fulfil these expectations was largely attributable to diminishing physical strength. In their own terms, their diminished physical health therefore compromised their ability to have secure means of livelihood. Most of their daily activities included working in the farms or in casual labour. The following statement, by a female participant represents this view.

The challenges I face -because you know me now I am not in full strength- so food, I do not get in an easy way only if we work hard. And also paying school fees for the children (R13:

51-year-old widow, 81).

The above statement was corroborated by a male in-depth interview participant in the following terms:

163 The need to earn an income. It becomes difficult for them [PLHIV] because first of all, there is some weakness that sets in because sometimes you are weak. Because people who are in the early stage of their lives, you find that they are having some weakness in their bodies. Because for you to now do something difficult/hard as a means of earning an income, you find that you are stressed. This is the greatest. That is they become weak (R36: 48-year-old married man, 90-92).

For those who rely on self-employment as a means of livelihood and especially working in their farms, one other reason that jeopardized their livelihoods was bad weather conditions.

Even though this was not a permanent condition and even though it affected those not infected with HIV as well, its impact on PLHIV was much greater because of the circumstances under which they found themselves. Often, poor harvests occasioned by adverse weather conditions worsened the food scarcity in households having someone living with HIV and made them more vulnerable.

I am just okay, only that managing the daily life is what is difficult because of the means of getting an income. Like now, after we planted, it shone [a dry spell] that there is nothing we are going to harvest. So we still do not know how it is going to turn out. But where we are, we grow sweet potatoes, cassava. But now that is not possible. We do not know how things are going to be here ahead of us. What lies ahead we just believe that God is the one who knows.

Because piny otho [the harvest has failed] and that is where our hopes are grounded; is where my hopes are normally laid; that is the source of my help. That if I work well in the farm, then I may find a way of feeding my children and myself (R25: 37-year-old widow, 129).

Living alone without support from a spouse or a partner was also a difficulty. However, this invariably effected female than it affected male participants. The three female participants who mentioned living alone as a presenting a difficulty in providing for their households were either widowed (2) or were separated (1) from their spouses.

Okay, there are difficulties since now as a single parent, you find that sometimes, the harvest is not good. You are the one to look for food. You are the one to do everything. A child is also going to school. Sometimes one is unwell—like one is now unwell [she had a sick child admitted at the time of interview]. So these must be there (R24:36-year-old widow, 113).

Lack of the means for a sustainable livelihood and for meeting other obligations was perceived as one of the greatest difficulties. A number of participants either lacked the relevant qualifications for securing formal employment, did not have sufficient strength to work in their farms or in the case of widows and separated women, lacked the support of a life partner with whom they could work together to support themselves and their families. A

164 good number who wished to be self-employed lacked the financial resources to do so. As such, life for these participants was a struggle since they could not comfortable afford food, school fees and levies charged in the health facility.