Reflections on AIDS

Seeing as December 1 is World AIDS Day, I thought I would mark the occasion by commenting on my experiences with HIV/AIDS here in Zambia.

The statistics are staggering. 17% of Zambians, one of every six people, has the virus. This resulted in nearly 100,000 deaths in 2005 (think what the reaction would be in North America if we had 3000 September 11s annually) and the life expectancy has dropped below 40 years. It is estimated that 1 in 5 children have lost at least one parent to aids (people speak of either single or double orphans here; single orphans having only lost one parent, and double orphans losing both). AIDS has ravaged the whole country, but it is the urban areas that have suffered the most. Although less than 40% of Zambians live in urban areas, 54% of those suffering from AIDS live in cities. In most predominantly rural areas the prevalency rate is somewhere between 10-20%. In Lusaka it is estimated that over 30% of the population has AIDS.

When I arrived I expected to hear a lot more about AIDS then I have. I know of three people who have AIDS out of all the people that I have met. One simply does not talk about such things because of the stigma related to being identified as HIV positive. There are many others who I guess must be positive but I'm sure that I'll never know definitively.

Anti-AIDS clubs are a regular feature of most schools here now. At my schools, though, I'm not sure exactly what they do to oppose AIDS. I have been involved a little bit with the Anti-AIDS club at Chimwemwe School, helping them practice poems and songs. Sure they sing songs and say poems about fighting AIDS but I don't think that this has had any impact on the school or the wider community.

A more positive development seems to be Peer Education - where youth are trained to talk to other youth about issues regarding HIV/AIDS. My host brother is involved in one such program so I've heard much about it. This seems to have much more potential for success, however its ability to disseminate beyond the original participants depends greatly on the abilities and hard work of the peer educators. When you depend on 15 year olds to carry your message, success is not guaranteed. Naturally some will be eager and want to spread the information they have learned. Others will probably be lazier, or will just get information wrong. Peer education, I believe, is a very positive step in the right direction, but it is not without its flaws.

There are also numerous billboards throughout the city with facts about AIDS. For example, there is one with a picture of a small girl with the headline written in bold "Sex With Me Does Not Cure AIDS." This is apparently a common misperception. Yet, while there may be many of these billboards, there are far more advertising beer with such slogans as "For A Man Who Knows What He Wants" while depicting a man dancing with a scantily clad woman in a bar. Seems like a good message in a country wanting to fight AIDS.

AIDS, and its effects, are not something that is always apparent. You don't see people walking down the street and know that they have AIDS. It is silent and unseen, but at the same time colours every aspect of society. You have to read between the lines in order to see its effect on people and on the nation. For example, I had some students who were single or double orphans. There are lots of reasons why parents die, but in this country there is one culprit that is more likely than others. There are other ways that you can see AIDS without seeing AIDS - people are sick, people are at funerals, etc.

It is clearly hypocritical for Westerners to condemn Africans for their "loose sexual mores" while our media constantly portrays sexual images, uses women as objects only worthy because of physical beauty and while study after study shows that youth are involving themselves in sexual activity. I saw one study published in a local newspaper here that suggests that North Americans actually have sex at a younger age, on average, than Africans. Young Zambians are certainly having sex, but so are young Canadians, young Americans, young Brits, and so on. The idea that Africans are some how wild, sex hungry savages should have been left in the Victorian Age and has no place in the 21st century.

This is not to say that there is not much to criticize about sexual morality here, especially in an age when AIDS is so prevalent. I am reminded of the Independence Day celebrations at school where while teenage girls were dancing boys would run up and stuff money into their bras or back pockets, where girls would gyrate to traditional dances, and where sexually explicit behaviour was, if not celebrated, certainly condoned. And this was at a school that prides itself in fighting AIDS. I don't want to come here as an outsider and proclaim that Zambian traditions are evil and must be abandoned. It does seem, however, that some reforms must be made. When 1 in 6 people have a deadly disease, and more contract it every day, clinging to traditions that encourage women to dance in sexually provocative manners or practices where girls are trained how to be a proper woman and then dance topless in front of the village men, seems to be ridiculous. I'm sure everyone who has read "The Lottery" in school could recognize the comparison.

One thing that I have noticed is how many young women here have kids - in a Grade 10 class that had 5 girls, 3 had kids. One of my Grade 8s missed most of the term to take care of her sick child. Clearly many people are having sex, and are doing so at a young age. The message of abstinence, abstinence, abstinence may sound good at the church meetings (and these are all church going youth) but clearly doesn't make a difference in the realities of their lives. I don't want to bash the benefits of abstinence and I hear that it is making some difference, but unless babies do indeed come from storks, one merely has to count the number of unwed mothers to see that the message really is not sinking in. I certainly don't want to blame the mothers either. While the mothers are the ones carrying around the kids, the males who helped produce the child are rarely anywhere to be seen. There are also many older men who will buy nice presents for their young girlfriends in exchange for sex, many women who are forced into prostitution by poverty, and many young girls who would be heavily pressured by their boyfriends.

A fundamental problem in the AIDS pandemic is the power dynamic between males and females. For a woman it is very difficult to say no if a man desire to have sex. I heard on the news the other day that 57% of women here have been sexually abused. Basically, three out of five. There was a story in the newspapers recently from Southern Province. A grade six girl was raped by an older man. Instead of pressing charges against the man, the girl's parents then forced her to marry him. Even if a woman practices abstinence, and then is faithful to her husband, she can still contract AIDS if she has the misfortune of having a philandering partner. Hence the change of the motto from "Be Faithful to One Partner" to "Be Faithful to a Faithful Partner."

The future is bleak and I don't have much, if any, optimism. I hear that the prevalence rate is not increasing as quickly, and in some demographic sectors, is decreasing. This is good news. More and more people are going for VCT (Voluntary Councilling and Testing) and are getting ARVs (anti-retro virals). There is still a long way to go. Less than 0.5% of the rural population has gone for testing and the number in the cities is only around 1%. The relationship between men and women is not changing and neither are male attitudes about sex.

If I sit in the back of the bus on the way to work I can see 12 people in front of me. Then I look at each row of three people. According to the odds, an average of one in each row has HIV/AIDS. They are probably a mother or a father, and some day their child will join the swelling ranks of single or double orphans. Their child will have to go live with their grandmother, will suffer the trauma of losing a parent, will have a disruption in their education, might be sick themselves.

This is AIDS. You may not see it, but it is there. All you see is the results - crowded hospitals, parentless children, poverty, funerals. One in three. This will happen to one in three people that I meet here in the city. Maybe not today, maybe not tomorrow, maybe not even next year or in five years. Nevertheless, they remain on death row with no chance of appeal.