For two months this year, the Mpumalanga province faced a free condom shortage due to supplier stockouts. While the full consequences of the situation remain to be seen, the observations of clinic staff at one truck stop in Mphumlananga’s Ehlanzeni District suggest that truck drivers and sex workers are among those suffering the fallout.

The Komatipoort truck stop near the border between Mpumalanga and Mozambique is home to a roadside wellness clinic run by Trucking Wellness, a primary healthcare delivery system dedicated to the health and wellness of those employed in the road freight and logistics industry. 

There — amid the choking diesel fumes, smoke and dust — clinic staff provide condom-use education and screening for sexually transmitted diseases (STI), HIV, TB and malaria, among other services. The clinic also distributes condoms.

The N3 highway was reopened on 27 October 2021 after truck drivers protested against foreign nationals being employed. (Photo: Felix Dlangamandla)

Blessing Mahlalela, a clinic coordinator at the Komatipoort site, told Daily Maverick that the Ehlanzeni District was first impacted by the condom shortage in June.

“We still don’t have enough condoms at the moment. We used to get maybe 15, 20 boxes of cartons. But now, maybe sometimes you get the one [box], because sometimes they supply just the hospitals, not the clinics,” he said.

“I heard that at warehouses there are condoms but on our side, we didn’t receive it — at the moment we are running short of condoms.” 

One of the nurses at the Komatipoort clinic, who asked to remain anonymous, confirmed that there was a shortage of condoms. She said that the people she runs health tests on are often dependent on the availability of free condoms and will forgo using condoms if free ones are not available. 

In response to Daily Maverick’s enquiry, the Mpumalanga Health Department stated that lack of free condoms in the province resulted from contracted condom suppliers not receiving enough stock from the manufacturers outside the country.

“The manufacturing was negatively impacted by Covid-19 as they also have a huge backlog,” according to the department. 

“Condoms were available in our health facilities. However, it must be pointed out that the available stock could not allow the department to meet its monthly and quarterly targets because that available stock was already counted as having been distributed to secondary sites and there was no supply in the primary distribution sites (warehouses).”

Campaigns to address the shortage using a “sharing strategy” were implemented between July and August. The department assessed the availability and supply of condoms from one facility to another, and shared stock among different facilities to address the lack of supply to end users.

“Processes which the department applies to ensure sustainable supply of condoms is that condoms are procured sufficiently on time and stored at the warehouses as buffer stock. The department has three warehouses across the province,” it stated.

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A rise in STIs

The nurse at the Komatipoort roadside wellness clinic told Daily Maverick that the combination of increased trucking traffic and a condom shortage had — on the face of it — led to an increase in cases of STIs and HIV at the clinic.

“There’s an increase of STIs, especially at our work on the truck stop — we see a lot of STIs rising because people are not wearing condoms at the moment. We can’t be sure if it’s because of the condom [shortage] or [because] people are starting to be negligent… but on our side, we assume that it’s especially the condoms [shortage],” said Mahlalela.

The Komatipoort stop has seen an increase in trucking traffic since 2020 — a phenomenon that Mahlalela believes is due to truck strikes at Richards Bay in KZN, a key export point.

“The truck numbers, it’s going higher and higher. So, due to the number of truck drivers increasing, even the number of sex workers at night… increases too,” he explained.

“That’s influenced the increase of STIs… at our clinic, because we’re seeing a big number of people with STIs who are coming to the clinic due to the number of truck drivers that are here and the shortage or lack of condoms in our province since June.”

Trucking Wellness has not been able to show a definitive increase in sexually transmitted infections and HIV cases among truck drivers in Mpumalanga due to the condom shortage, according to Tertius Wessels, managing director of the company Corridor Empowerment Project, which manages the Trucking Wellness programme for the National Bargaining Council for the Road Freight and Logistics Industry.

“[We] will only be able to determine this at a later stage when drivers present with symptoms, usually [after] 8 to 12 weeks depending on how quickly they seek healthcare, which is low amongst men. Therefore being able to identify them this early would be difficult,” he said.

“Our opinion is that [the condom shortage] would have had a definite impact on these communities as this is a high transmission area and we cannot afford not to ensure availability of basics like condoms, as this will lead to a possible increase of HIV infections amongst drivers and sex workers.”

It is not uncommon for there to be shortages of commodities such as condoms and anti-retroviral medication across South Africa, according to Eugene van Rooyen, the Western Cape area manager for the Sex Workers Education and Advocacy Taskforce (Sweat). Sweat is an organisation that supports South African sex workers, while also advocating for and delivering services to them.

“It logically follows that when such shortages occur, it puts the population at higher risk of contracting or transmitting HIV and other sexually transmitted infections,” said Van Rooyen.

“The unavailability of condoms causes the same risks to sex workers as it does to any other sexually active people, including married women. The clients of sex workers are usually in a relationship or married to somebody. If they contract a sexually transmitted infection from a sex worker or anybody else as a result of the unavailability of condoms, they will most certainly infect their romantic partner/s, as they do not normally use condoms when they have sexual intercourse with their wives or regular partners.”

Van Rooyen noted that though truck drivers are often associated with the geographical spread of HIV and other infections in African countries, they are not the only profession at risk of this. 

“Truck drivers have for many years been thought to be associated with the geographical spread of HIV and other infections in African countries,” he said. The reasons for this are:

• Truck drivers are constantly moving through large geographical areas;
• They are sexually active;
• They are economically empowered in comparison to the local populations of the areas that they travel through; and
• Their work takes them away from their families.

“It would be short-sighted to single out truck drivers in particular in this manner, as there are other professions which also make people more at risk to contracting and spreading infections, such as pilots, airline staff, migrant workers in construction [and]mining,” said Van Rooyen. DM