16 Days of Activism against Gender-Based Violence – a perspective from Hanover Park, South Africa

The African continent has the highest reported rates of violence against women. South Africa, in particular, has been identified as one of the most violent countries in the world. Gender-based violence (GBV) is a risk factor for some of South Africa’s most prevalent and serious health problems, including

  • HIV and sexually transmitted infections
  • unintended pregnancy
  • pregnancy complications, including miscarriages
  • substance abuse
  • and common mental disorders, such as post-traumatic stress disorder, depression, anxiety as well as suicidality.

The consequences of abuse can be carried from one generation to another. Abuse and violence undermine social cohesion and the social and economic development of a nation.

Today, 25 November 2020, marks the start of the #16Days of Activism Against Gender-Based Violence campaign. As an organisation focused on mothers and their children, we will be using this time to highlight GBV against pregnant women and new mothers, from our mental health service site in Hanover Park, Cape Town.

Hanover Park and surrounds

The majority of our clients reside in Hanover Park and immediate surrounding areas and are at a high risk of experiencing GBV due to a variety of factors. On the one hand, these women live in a volatile community experiencing gang violence on a regular basis – both in their homes, and on the streets. On the other hand, women in Hanover Park have low-socio-economic status and are often marginalised by society. It is extremely difficult for these women to exercise agency over their situation in their homes and on the street.

Our own peer-reviewed research* shows that one-third of the women for whom we provide counselling, experience gender-based violence in their homes – at the hands of their partners or other members of the household.

The PMHP Response

Since 2012, we have provided a comprehensive maternal support service at the Midwife Obstetric Unit (MOU) in Hanover Park. This includes information sharing with women, screening, counselling and psychological therapies, facilitated referrals according to need, and case management.

Our comprehensive, trauma-informed counselling service incorporates several possible ways to work with our clients to address GBV. These include trauma counselling, interpersonal and cognitive behavioural therapy, safety planning, social support and managed referrals, as well as follow-up care, with the opportunity for remote support sessions (Skype, telephone) according to clients’ preferences. In addition to this, our counsellors work very closely with a wide network of NGOs including shelters, food support organisations, social services and addiction treatment facilities so that referrals may be facilitated, as needed, while we maintain an ongoing therapeutic relationship with the women. Survivors of GBV often require continuity of care and ongoing psychological support to overcome the impact of the violence and to develop strategies to optimise the safety and wellbeing of themselves and their children.

Trust and safety

Our on-site counsellor at the MOU, Liesl Hermanus, together with our junior counsellor, Thanya April (who is currently working remotely), create a safe space for vulnerable pregnant and postpartum women. A significant amount of time goes into the foundational work of building the therapeutic relationship so that the client feels she can trust the counsellor. This then helps the client establish clear goals and have agency in working with the counsellor towards her own safety and wellbeing.

Resources and stories

Throughout the #16days campaign, we will be sharing informational resources for women experiencing GBV. These resources were created over the years and some have been adapted for the Messages for Mothers campaign as a response to the increase in domestic violence during the COVID-19 pandemic

Also, we will be using this campaign to share some of the realities of the lives of our clients experiencing GBV. In order to protect the anonymity of our clients, we will change names and identifying details and combine elements of more than one case into these stories.


*Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed-methods study (2018)
S Field, M Onah, T v Heyningen, S Honikman, BMC Women’s Health
DOI: 10.1186/s12905-018-0612-2

The impact of COVID-19 on pregnant women’s mental health

Women in our communities show enormous strength and resilience in looking after the wellness of their families under difficult circumstances. The COVID-19 pandemic has added to this stress.

While women are looking after the wellness of their families, it is of utmost importance that they also look after their own wellness and mental health. Pregnant women are particularly vulnerable to mental health risks. The  Covid-19 pandemic adds worries about the risk of infection, job security and financial constraints onto existing perinatal stress. Globally, incidences of anxiety and depression among pregnant and postnatal women are at an all-time high.

The Royal College of Obstetricians and Gynaecologists notes that “Pregnant women are not immune to the mental health impacts of the pandemic and may be more at risk given the many compounding factors, including the fear of becoming infected, transmitting the infection to her infant if infected, social isolation, financial difficulties, potential reduction in household help, insecurity, and the inability to access support systems. Particular attention should be paid to these aspects of maternal care.”

In response to the multiple challenges that expecting or new mothers face, the PMHP has teamed up with other organisations that work closely with mothers, and have resources and experience in supporting mothers, to form the Messages for Mothers (M4M) alliance. Together with Embrace, Grow Great and Side by Side we have developed culturally appropriate mental health messages to support mothers during these difficult times.

These messages include tips on managing stress, depression and anxiety as well as coping with family violence during the pandemic.

Throughout the coming week, we will be posting several mental health messages, which are compiled in this easy to print brochure.

Follow our social media channels to learn more:




Further readings:

“We all have something we can share and help with” – insights from Hanover Park, Cape Town, South Africa

This blog was written by our Clinical Services Coordinator, Liesl Hermanus:

I remember the day I met Aunty Avril, it was 21 April 2020. I recall phoning her and explaining how with Covid-19 and lockdown I was seeing an increasing number of clients at The Perinatal Mental Health Project support service at Hanover Park MOU appealing for assistance with food. Without asking for anything in return, Aunty Avril agreed to accept the women using our services for food support.

Taking into consideration that all clients are either pregnant or have recently given birth, Aunty Avril and I worked out a system whereby clients would have streamlined access to her daily hot food kitchen in order to bypass the long queues. I was immediately struck by Aunty Avril’s warmth and how accommodating she was towards our clients.

There’s always someone calling for Aunty Avril.

Now at this point all I knew about Aunty Avril is that she was feeding around 600 people daily in Hanover Park. One evening I decided to Google “Avril Andrews” and couldn’t believe all the articles and videos about the amazing work she has been doing. It was the first time I learned about her son Alcardo, who was gunned down in 2015 and that the organisation was started in response to his death.

There was one article in particular that caught my eye. The headline read “Hanover Park’s safety net for the needy: We’re here because Aunty Avril is here for us”. When lockdown was announced, Aunty Avril closed her daily food support programme but it wasn’t long before she started serving again. The article explains how she could not ignore the calls of the many hungry people outside her home during lockdown.

I decided to share the article with three friends who I knew would be moved by Aunty Avril’s story. These friends included Ismaiel Isaacs, a photographer and videographer who uses his work to document the lives of those living on the Cape Flats. Another friend, Nabeel Petersen, the Director of Interfer, which is a participatory and arts-based collaborative social enterprise that strives to positively co-disrupt systems of exclusion and hegemony. And then, Lamese Waterfield, a very good friend mine who is based in London, who works on projects that create change and impact. Lamese uses digital and technology to amplify messages and create social mobility.

Within minutes of sharing the article, Ismaiel responded saying he would like to support Aunty Avril. He wanted to tell her story and how she responded to the pain of losing Alcardo by starting the foundation. He suggested producing a video in collaboration with setting up a Back a Buddy campaign.

Initially, I could sense some apprehension from Aunty Avril, taking into consideration she had never met Ismail before and here he was wanting to document her story. Nevertheless, he was filming in Hanover Park the following day. I remember how Ismaiel had asked me to go around to Aunty Avril the day he sent her the final video. As Aunty Avril and I sat in her living room that evening, I recall her crying while watching the video saying, “it’s perfect”.

The Alcardo Andrews Foundation Task Force Team delivering cooked meals to different satellite stations in Hanover Park.

While all of this was happening, I decided to create a WhatsApp group. We named ourselves The Alcardo Andrews Foundation Task Force Team. It is amazing thinking about how the nature of our relationship evolved over time from being very professional in the beginning to now sending videos of us doing celebratory dances when we hit milestones in the group.

We have been able to activate several networks to raise funds to help Aunty Avril provide relief to those people in Hanover Park who are facing extreme hunger. In addition to funds raised and the attention the foundation has received, a very special relationship has been formed between five people who would never have come together if it were not for me meeting Aunty Avril on that day in April. There is one message that will always stay with me that Aunty Avril sent in the group, “I don’t have words to say how grateful I am to have met you. I lost my son four and a half years ago, but I’m blessed with sons and daughters that are coming alongside and supporting me. Thank you guys, I appreciate you.”

I am most grateful for the manner in which Aunty Avril engages with my clients, with such care, compassion and empathy. In fact, this is how she engages with most people including those calling out for food outside her home long after they have finished serving. I have never seen or heard of her turning anyone away, including my clients.

Liesl has teamed up with Aunty Avril starting the Alcardo Andrews Foundation Task Force Team

Despite our roles being very different, Aunty Avril and I are working together to strengthen and empower those clients who have been referred to her.

If there is one thing I have learned through working with Aunty Avril, it is that we all have something we can share and help with. If we mobilise around each other, we can push things a little further because nobody is coming to save us so we might as well do it ourselves … and we can.

The Perinatal Mental Health Project – response to COVID-19

Disclaimer: contents of this blog will be published in the departmental newsletter, Faculty of Health Science UCT,  in June 2020

In an effort to address the devastating effects of the COVID-19 pandemic and the subsequent lockdown in South Africa, the Perinatal Mental Health Project (PMHP) has been responding in several ways.

Messages for Mothers

Just before the lockdown, in collaboration with the NGOs Embrace, Ilifa Labantwana and GrowGreat, the PMHP launched a Messages for Mothers (M4M) campaign to deliver multi-media, multi-language, evidence-based physical and mental health messages relating to COVID-19 for South African mothers and caregivers. It addresses mothers’ unmet need for bespoke information relating to the COVID-19 crisis. In particular, the messages are specific to the population of women highly vulnerable to the social and economic consequences of the pandemic.

The messages are developed in response to questions and conversations emerging from the NGOs’ networks of mothers communicating on social media. Furthermore, messages are developed, over time, to address the changing logistics of home, parenting and service user contexts in which women find themselves.  In addition to the mental and physical health message pillars of the campaign, there are pillars on mindfulness and ‘parenting in the pandemic’. All messages are developed in consultation and peer-reviewed by several professional and academic experts working in the public service sector. The messages are regularly updated.

The M4M content has or will be used on several National Department of Health platforms.

  • The National Covid Whatsapp line has now included a “Pregnant” content stream under “Conditions” +27 60 012 3456 – available in five languages
  • The National Framework and Guidelines for Maternal and Neonatal Care during a Crisis:

COVID-19 response includes several mental health considerations for staff and mothers and has a core health promotion component.  For this, the first appendix includes the full batch of M4M messages. These will be distributed with the Guidelines and an audiovisual training package to NDOH committees, master trainers, professional societies, and provincial and district health authorities in June

  • The messages will be used on the NDOH’s zero-rated website
  • A national radio campaign, Sikhaba iCovid19, is including the messages in various formats and in several languages on national and community stations across the country.

Mental health service at Hanover Park

The PMHP’s mental health service at Hanover Park Midwife Obstetric Unit (MOU) has needed to adapt to the crisis. Clinical services coordinator and counsellor, Liesl Hermanus, continues to support her most vulnerable clients through limited face-to-face sessions at the MOU.  Where clients have access to a mobile phone and privacy, she has also been conducting counselling sessions telephonically, supplying airtime funds if needed. To supplement this, she has been using the PMHP WhatsApp line, to support women through regular interactions, as required.

Food insecurity and access to baby care supplies in Hanover Park

In low-income communities, such as Hanover Park, large numbers of people are now facing severe hunger and feelings of helplessness. Pregnant women and new mothers appear to be especially vulnerable, as they struggle to take care of themselves and their newborn babies with limited access to support from their families, broader communities and fewer opportunities for household income to be generated. Many clients, who are either pregnant or have just given birth, have been talking about the desperate hunger they are experiencing during this time.  Since April, the PMHP partnered with a local organsiation in Hanover Park, The Alcardo Andrews Foundation, which provides food to hundreds of people in the community on a daily basis.  Liesl has used their streamlined referral system so that her clients and their households can receive food. The PMHP is using its social media channels and networks, to support fundraising for the Foundation.

Liesl has also activated several other networks to raise funds and supply basic baby care supplies to mothers in need.

The Alcardo Andrews Foundation providing meals in Hanover Park

Messages for Mothers in the News

Find out more about Messages for Mothers on our website.

Mindfulness exercises for #MMHweek

It’s the last day of Maternal Mental Health Awareness Week

We are focusing today on

Mindfulness exercises

We know that the COVID-19 pandemic has left many people feeling disconnected with themselves. In light of this, M4M reached out to Sarah Foale, a mindfulness practitioner and parenting coach and she put together a few short mindfulness exercises.

If you find 3 minutes to spare today, please visit our Soundcloud channel to practice some very simple techniques to help you be present and comfortable with yourself in the moment.

You can listen to this and other exercises in multiple languages! Visit our website for details: https://pmhp.za.org/m4m-mindfulness-resources/ and share with a friend


How do you know if you are worrying too much? #MMHweek

It’s Day 6 of Maternal Mental Health Awareness Week and we are focusing today on

How do you know if you are worrying too much during #COVID19?

Everyone is worried during this difficult time of COVID-19. This is a normal way of reacting to a very abnormal situation. But, for some people, the worry, stress and fear can become too much. When is worry ‘just normal’ and when is it ‘too much’? Here are some pointers of how you can tell if you are worrying too much!

Messages for Mothers have been developed by a collective of individuals and organisations working together to create and curate simple content that answers the questions mothers have about #COVID19 and its effect on the physical and mental well-being of themselves and their families.

Managing family violence during #COVID19

It’s Day 5 of Maternal Mental Health Awareness Week and we are focusing today on

Managing family violence during #COVID19

Being at home during COVID-19 can result in an increase in violence towards women and children. During the COVID-19 pandemic, women in abusive relationships are at greater risk of experiencing violence. Throughout the day we will share some tips for coping if this applies to you!

Messages for Mothers have been developed by a collective of individuals and organisations working together to create and curate simple content that answers the questions mothers have about #COVID19 and its effect on the physical and mental well-being of themselves and their families.

Messages for Mothers during #MMHweek

It’s Day 4 of Maternal Mental Health Awareness Week and we are focusing today on

How do you know if you are depressed?

It is normal to be worried during this difficult time of #COVID19. Sometimes the worry or stress can lead to depression. But how will you know you are depressed? Throughout the day we will post some things to look out for!

Messages for Mothers have been developed by a collective of individuals and organisations working together to create and curate simple content that answers the questions mothers have about #COVID19 and its effect on the physical and mental well-being of themselves and their families.

Messages for Mothers on World Maternal Mental Health Day

Today is World Maternal Mental Health Day and day three of maternal Mental Health Awareness week in many countries around the world!

This is a great time to raise awareness of mental health problems during and after pregnancy, advocating for mothers affected by perinatal mental health problems and talk about why #maternalMHmatters.

Messages for Mothers have been developed by a collective of individuals and organisations working together to create and curate simple content that answers the questions mothers have about #COVID19 and its effect on the physical and mental well-being of themselves and their families.

Today our focus is on ‘Managing stress as a mother during #COVID19’

World Maternal Mental Health Day in times of a pandemic

The Coronavirus pandemic represents a time of great uncertainty. Many of us are anxious – for our children, our families, for ourselves and for our future.

In response, we have developed #MessagesForMothers together with a growing collective of mother-supporting organisations and individuals working together to create and curate simple content that answers the questions mothers have about #COVID19.

During #WMMHday2020 we will publish #MessagesForMothers on key mental health areas. These were created in consultation with a psychologist and psychiatrist working in the public health sector in South Africa.

Our mental health messages are designed for South African mothers. They may be helpful for care providers, family members and health workers in contact with mothers at this time.

The first set of #maternalMHmatters messages will guide you through:

7 ways to manage depression, anxiety or addictions during #COVID19


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