MARCEL KORTH AND ELTON DORKIN | Men need to talk about health without fear of stigma

Every November 19, International Men’s Day celebrates the positive value men bring to the world, their families and communities. This year we encourage men to check on their health.

We men are notorious for avoiding healthcare facilities for ailments ranging from the life-threatening – such as HIV, prostate cancer, diabetes and mental health issues – to the more mundane, such as erectile dysfunction and even the common cold.

A Cleveland Clinic survey in the US found that 72% of men would rather do household chores such as cleaning toilets than go to a doctor, and 65% said they avoid going to a doctor as long as possible.

Delaying medical diagnosis and treatment can significantly complicate responses to medical challenges, with potentially deadly consequences.

In SA, men’s HIV coaching initiative Coach Mpilo estimates about 2-million men living with HIV are not on treatment. That doesn’t even start to factor in other major illnesses such as cancers and depression.

According to the World Health Organisation, of the 13 774 suicides reported in SA in 2019, 10 861 were men – four in five! This talks directly to mental health challenges and highlights the fact that seeking medical advice and care early is key for diagnosis and treatment.

Healthcare literacy is crucial – knowing about common disease symptoms and the importance of early diagnosis. More often than not, healthcare services are not targeted at men: from operating hours requiring time off from work to not feeling welcome at a clinic and the low levels of male care providers.

Then there are the more personal barriers. Men are often uncomfortable and scared. They worry about a bad diagnosis and what that would mean to them, their families and livelihoods. When it comes to HIV, for example, they have deep fears that keep them from testing and getting treatment.

There is also what some refer to as “superhero syndrome”, where men see themselves as strong enough to handle anything life throws at them.

Our social conditioning ultimately is creating gender norms that are harmful even to men themselves.

The first step is to get us talking about illness and health issues without the fear of societal stigma or judgment. A prime example is Anglo American’s adoption of the Coach Mpilo programme, which works in communities to support HIV-positive men in getting control over HIV and (re)gaining a healthy, safe, life again. The coaches help men reach a point where they can live openly and confidently with HIV without any of the fear and shame they might have felt initially.

In 2016, we aligned our HIV/Aids targets to the UNAIDS 90/90/90 strategy, which means 90% of people living with HIV know their HIV status; 90% of those diagnosed with HIV are receiving sustained anti-retroviral therapy and 90% of those receiving anti-retroviral therapy have viral suppression, meaning the viral load is so low as to be undetectable.

By 2021, Anglo American had achieved zero HIV/Aids-related deaths and an incidence rate of 0.01%. Removing stigma, building an environment in which men can come forward to get tested, and creating a supporting space for treatment have all contributed to men enjoying improved health and wellbeing despite their HIV status. The diagnosis no longer becomes a death sentence.

The significant spinoff is that the relationships of trust that form between the coaches and their teams open up space for entirely new conversations: what it means to be a loving and caring father, a supportive partner, money matters, how to recognise and deal with mental health issues and even how to become an active voice against the scourge of violence in many communities.

With the entry point of men looking after their own health and wellbeing, space is being created to engage around a range of topics. What if such spaces become safe spaces for us men to challenge each other on those attitudes, beliefs and behaviours that are harmful to us and those close to us?

It’s going to take some time but our men - and their families - deserve no less. That way we’ll truly have something to celebrate every International Men’s Day.

Korth is principal for Living with Dignity and GBV programmes at Anglo American. Dorkin is head of Health at Anglo American.