Umhlanga, also known as the Reed Dance, is an event filled with color, dancing, and community spirit. Thousands of young women in Eswatini dress in traditional attire and celebrate not only their culture, but also their womanhood. However, there are unique health impacts to the event, as well, because it has served as a health promotion event in recent years. In doing so, it has uplifted safe sex habits, public health resources, and more. The dual impact of this event makes it unique, as it serves to maintain culture and promote health. It serves as a model for how cultural events can be leveraged to promote health and uplift human rights, empowering individuals with access to information, autonomy, and critical care, while connecting women to their own culture.
Credits: Wajiha Mekki
Umhlanga and Its Cultural Significance
The Kingdom of Eswatini has hosted Umhlanga since the 1940s. The purpose of the event is to celebrate chastity among young women. There is a similar event for young men called Incwala with the same purpose. However, in Umhlanga, the young maidens focus on honoring the Queen Mother through their participation in the ceremony.
This 8-day event draws thousands of young girls from across the kingdom, ranging in age from six to 25. In the 8 days, the young maidens are expected to participate in collecting reeds for the Mother Queen. With a guardian from their township, they travel far and wide to participate in all aspects of the event.
This event is key in health promotion, as it is a quick way to reach a vast audience. With the event hosting visitors from the Southern African region and from around the world, tens of thousands are in attendance. Most importantly, it is the country’s largest meeting of adolescent girls and young women, who constitute a group disproportionately affected by HIV in Eswatini. With support being mobilized by the government, it fosters trust among the constituency, which helps promote long-term health.
Where Public Health and Culture Intersect
Historically, the event has been known to provide key resources to young women; in 2002 alone, over 15,000 packets of books were distributed to young women, and additional resources, supported by local NGOs, were shared with the girls through presentations. The reintroduction of the event was praised as a way to connect the community, and, surprisingly, as a way to slow HIV/AIDs in the country. In 2019, the Kingdom of Eswatini and the Ministry of Health partnered with Population Services International (PSI) for the first time. This collaboration provided free HIV self-test kits and promoted voluntary male circumcision. Since then, collaboration has been robust in supporting the young women and their health needs through resources and information provided by Khulisa Umntfwana, NATICC, Edutainment, the Imbali Foundation, and many others.
These are key, as getting testing for HIV in Eswatini can be linked with a lot of stigma. Despite the prevalence of the disease in the country, testing levels for adolescent girls and young women are relatively low; this is tied to many factors, such as testing interventions not wanting to test young girls, them not being in a healthy environment to accept the results, and the judgment that exists around testing. With self-testing kits, these barriers are overcome, making it easier for women to know their health status and take the necessary precautionary measures to protect their health.
As a result of the partnership, from 2019 to 2020, over ten thousand kits were distributed to anyone who needed them, and there was a spike in clinic visits to discuss testing and male circumcision. Voluntary medical male circumcision is associated with an approximately 60% reduction in the risk for female-to-male transmission of HIV, which further reduces the HIV burden in the country. This change in health behavior is a real-world example of implementing to the right to health. Access to HIV testing is part of the right to health, as developed by the UN’s International Covenant on Economic, Social and Cultural Rights, and giving people the tools to know their HIV status respects their autonomy and motivates them to make informed decisions. Especially by targeting adolescent girls and young women, the gap that exists for vulnerable populations is slowly closed, which proves the sustainable impact of the intervention.
Credits: Wajiha Mekki
Cultural Acceptance and Health Behavior Change
There are very few events across the world that discuss health behavior in tandem with culture. However, Umhlanga is an example of the success of such intentional programs. By sharing health information that is culturally relevant, rather than siloed by the reality of clinical sciences, it becomes a tangible topic and reduces its level of intimidation. The demystification of the subject also helps improve health-related conversations long-term across the nation. By discussing such a seemingly sensitive topic amongst peers and families, it normalizes it significantly, which can promote additional discussions later on. By working to frame it through empowerment rather than shame, motivating youth to take ownership of their health further reduces the shame some students may have.
This then motivates young women to have key conversations with their partners; from discussing circumcision to using protection, these discussions can occur more quickly and inspire positive change in the long term. This also impacts the national conversation about sexual health, as well, making it easier for older generations to understand the nuances of the issue as it affects younger generations.
Credit: Wajiha Mekki
Challenges
Although the impact of such an intervention is vast, some challenges exist. One is the role of consent and autonomy. Especially for the male circumcision, it must not be coerced. All procedures and testing should be done with the utmost privacy and confidentiality.
There is also concern about how Umhlanga truly mobilizes women’s empowerment and addresses gender roles. Historically, it has served to promote chastity among girls, and navigating culture and gender roles has sparked a debate on the role of dance and its intersection with health. To fully promote human rights, key health interventions must be communicated in ways that avoid exploitation or disrespect of cultural contexts.
Human Rights
An observable truth from Eswatini and the role Umghlanga has in the community is seen through its role in promoting female empowerment. Not only are young girls able to feel empowered in their own self, but they also get the chance to gain access to tools critical to gaining control over their health decisions. Especially by supporting rural and underserved communities, this opportunity facilitates increased accessibility to health resources, mobilizes key interventions closer to the community, and ensures equity in the mobilization process.
Overall, Umhlanga is a key cultural event for young Swati girls across the country and has a unique role in supporting public health in the kingdom. It is key for additional integrations to be explored through the country, because when culture and health align, communities are not just healthier, they are freer and more empowered.
