It is 15.45 and two young women are already sitting outside the Night Clinic in Moatize, a small town in Mozambique's northern Tete Province, near one of the largest coal mines in the southern hemisphere, owned by Brazilian mining giant, Vale. The national 123 road cuts through the town, and the clinic lies just off it, intentionally located to bring its services as close as possible to its target patients: miners, truck drivers and sex workers.
"When the big mining companies were established here, people started moving in from neighbouring countries: Zimbabwe, Malawi and Zambia. Tete became a window of hope, but when people don’t find the jobs they hoped to find, many of them end up involved in prostitution or criminality," said Oswaldo Inacio Jossiteala, a programme officer at the International Centre for Reproductive Health (ICRH).
Every mining boom brings the fear of a rising HIV infection rate, particularly in a country like Mozambique, where the estimated prevalence is already 11.3 percent.
Although the incidence of infection in Tete has been stable at 7 percent, officials are concerned that this could be changing. In an interview with Radio Mozambique, Domingos Viola, the coordinator of the provincial working group for the fight against HIV/AIDS, noted that in 2012, 35,000 cases of sexually transmitted infections (STIs) were registered in the area, 10,000 of them in Moatize, at the centre of the coal boom, which has just 40,000 residents.
The recently opened Night Clinic is part of a project called the Improved Sexual and Reproductive Health and Rights Services for Most at Risk Populations (MARP) in Tete, set up with the goal of reducing STIs and HIV in Tete and Moatize.
Most of the patients are between 16 and 35 years old, and 30 to 35 receive medical attention every evening. According to Jossiteala, "The target group are often stigmatized when they go to ordinary clinics - we believe they find it easier to come here, and that the new clinic will attract more patients."
The project is a collaboration between Mozambican health authorities, the International Centre for Reproductive Health, USAID, and the Flemish International Cooperation Agency (FICA). Vale has contributed $200,000 for the infrastructure, while the local health authority is paying for staff and medicines.
The Night Clinic has activists working in local communities, at trucks stops and guesthouses, trying to convince target groups to visit and make use of the services. They also lobby for the rights of sex workers in the province.
"If a sex worker is beaten by a customer, or if a customer doesn’t pay, the women have the right to take the case to court. But since most of them are here illegally, that is very difficult. The women are afraid that the authorities will turn against them, but now we see small changes in the attitudes."
The Mozambican media last year reported cases of policemen abusing foreign sex workers in Tete and soliciting bribes from them, but Jossiteala noted that since clinic staff began educating sex workers about their rights, this is slowly changing.
As mining companies flourish in the province, residents are growing increasingly unhappy with the inadequate contribution of the firms to the wellbeing of surrounding communities. Most of the people working in the mines are men under 40 years old, many of them living alone. Américo Conceicão, acting Permanent Secretary of Tete Province, has urged the mining companies to do more.
"They have internal HIV-programmes, but how their employees act affects the whole community, not just the mining company. They need to work together with the health authorities concerning these issues," he said.
Carla Mosse, the provincial director of health in Tete, hopes that with the worrying rise in the incidence of STIs and HIV, mining companies will step up and play a bigger role.
"We are too disorganized. We need to elaborate a provincial plan for social responsibility where we, together with the companies, have decided what they will contribute each year. Now, if we need something we send a letter asking for help, and the answer is always, ‘No, no, no’."
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions