CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by Patrick Mawaya, Malawi, November 1998
THEME = AIDS
A silent war is currently reigning in
Malawi, fought without the use of sophisticated weapons.
The war started with the discovery in 1979 in the USA,
of the HIV virus which causes AIDS.
The pandemic continues to spread, virtually unabated
The 1998 Human Development Report by the United Nations Development Programme (UNDP) states: "At the end of 1997, nearly 31 million people were living with HIV, up from 22.3 million the year before. This tremendous increase reflects the epidemic's momentum, with 16,000 new cases a day. It is now estimated that 40 million people will be living with HIV in 2000, under two years away. Of the 16,000 cases a day, 90% are in developing countries; 40% are women and 50% are between 15 and 24 years old."
The Malawi National AIDS Secretariat/World Bank Study completed in July 1997, indicated that close to 700,000 adult Malawians are infected and of these, the highest proportion are urban-based young adults in the important sectors of education, industry, health and the military. The case distribution between sexes is almost 1:1 and the majority age range affected is between 24 and 49 years. Earlier projections appeared unrealistic and exaggerated. However, today, almost every family in Malawi has been affected by HIV/AIDS.
In Malawi, AIDS is spread by heterosexual relations. Women are the main victims because of their low status in traditional society, which makes it difficult for them to insist on safe sex with their partners or husbands.
Another cause is prostitution. Many women and young girls go in for this trade, because of poverty. This form of commercial sex is becoming common among schools girls, who go out with "sugar-daddies" to get money. These "sugar- daddies" prefer younger women and teenagers. According to a female student: "Most female pupils in secondary schools are affected by HIV/AIDS. Most of the girls go out with the "sugar-daddies" because they're not satisfied with what they receive from their parents or guardians."
Those women who work during the night as "commercial sex workers", also work during the day as secretaries, copy- typists and messengers, mostly in the civil service. Their night "activity" is intended to supplement a meagre income, frequently less than US $50 a month. It should be remembered that basic commodities cost three times more than wages.
So-called "rest houses" are an integral part of Malawi's prostitution trade. These rest houses are not for stranded travellers, but for the sex trade. They are situated near bars and drinking places, and contribute to the spread of AIDS. As a seasoned journalist says: "People don't talk much about HIV/AIDS anymore, and yet more and more people are dying of it. The government wants to control the situation but at the same time, lets people move about freely. Putting it quite simply, these rest houses are brothels. You find them even in the rural areas".
HIV-related illnesses and the deaths which can follow, deepen the already existing poverty, and drives people into debt. People are struck down in the prime of their working lives, and the combination of loss of income and the cost of caring for the sufferers has been a devastating blow for millions of households. Many children are left orphans after the death of one or both of their parents. Malawi has currently over 600,000 orphans. Sister Teresa Andrade is a Sister of the Missionaries of Mary Mediatrix and is in charge of St. Mary's Rehabilitation Centre for Orphans. She says: "We expect the problem of orphans to get worse. Everyday, there are more and more children coming to us and we are forced to turn them away because we do not have the facilities to deal with the demand."
Households headed by children and young adults have begun appearing in Malawi, and this is proving to be too much for the traditional systems of coping with such a situation. For instance, a friend of mine, working as a secretary with UNDP, is looking after 17 orphans, belonging to her deceased sisters and brothers. How can she possibly cope?
Just as poverty fuels the epidemic, the epidemic also intensifies poverty. Malawi is witnessing a shortage in skilled labour, overstretched budgets, a decline in production after years of investment in training and education, and HIV/AIDS has become one of the main development challenges facing the people of Malawi.
The first AIDS cases were diagnosed in Malawi in 1985. The Ministry of Health then instituted HIV blood scanning, prior to transfusions. This became the basis of the country's first short-term plan (1987). During the planning and implementation of the first medium term plan (1989-1993), the focus was broadened to include information, education and communication (JEC) strategies. The focus of the second medium term plan (1994- 1998) has been the establishment of a multi-sectoral approach to the epidemic.
The evaluation and reviews of strategies, indicate the high level of awareness of the epidemic. However, the rate of new infections is still high, especially in women in the younger age groups of 15 to 24 years.
The strategy that will characterise the National HIV/AIDS Programme for the coming years, will be as broadly participative as possible, with an emphasis on consensus-building, mobilising the entire population in the fight against HIV/AIDS, strengthening national and multi-sectoral capacity to respond effectively to the challenge. Such an approach will stimulate national and local discussion about many of the issues raised by the epidemic.
In 1991, the Malawi Catholic Bishops' Conference designed a pilot AIDS Home Based Care Programme (HBC). It started in 1992 in four dioceses. The programme's overall aim was to reduce the spread of HIV infection, by providing people and local communities with appropriate information and support (short-term plan). In the long- term, it was geared towards the way people behaved. The Programme has now been extended to all seven dioceses.
The Programme uses the well-defined church infrastructure of the Small Christian Communities. Its activities include: identification of patients, orphans, the elderly; providing appropriate care; creating awareness of, and educating people about HIV/AIDS; initiating small income-generating activities as a means of sustainability; counselling, spiritual care and referral to health institutions; formation of support groups and volunteer training; initiating and promoting the making of Wills. The HBC Programme has so far trained over 9,000 volunteers.
Mr.Gracian Namanja is National HBC Coordinator for the Bishops' Conference. He says that behavioural change is the only sure way to reduce and stop HIV transmission. Everybody's got to join in the fight, beginning with those who are already infected and directly affected by HIV/AIDS, and then extending to families, local communities, religious and non-religious organisations, farm estates, factories and all institutes of learning. The fight against HIV/AIDS cannot be left just to the health facilities.
Other initiatives include the formation of a Malawi Network of People Living With HIV/AIDS (MANET), which was established in 1998 and which now has 28 groups spread throughout the country in all three regions. The groups go under such names as (thus giving an idea of the work they are engaged in): AIDS Committee; AIDS Support Group: Community AIDS Team; AIDS Information and Counselling Centre; Home Based Care Volunteers; People United To Save Humanity From HIV/AIDS; Youth Ambassadors. They are based in hospitals and health centres.
A Workshop was organised by the United Nations Action Against AIDS (UNAIDS) in Lilongwe from 28 September-1 October 1998. The theme was: "Towards Consensus and Action: Enhancing Advocacy and Strategic Planning Skills for HIV/AIDS Programmes in Malawi."
Anti-AIDS clubs have been formed in schools and for young people not in school. These clubs aim to disseminate information relating to HIV/AIDS. The clubs are supported financially by the United Nations Children's Fund (UNICEF)-Malawi.
The Media and AIDS Society in Malawi (MASO) has launched a newspaper aimed at maintaining widespread awareness on the extent and impact of the epidemic. The paper will also promote better understanding of AIDS/HIV, and will offer its pages for informed debate on ways and means of combating the epidemic. MASO also urges journalists to write about AIDS and inform the population.
Some say there is lack of political interest and good will on the part of the government to address the situation. In fact, most of the HIV/AIDS Programmes currently being run in Malawi, are donor- funded. Although the AIDS scourge is serious, the government has not provided enough funding - the health sector, especially, is on a downward trend. With the current economic crisis and the high cost of living, Malawi is not sure of winning the "silent war". We shall continue to lose our young men and women.
END
CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
PeaceLink 1999 - Reproduction authorised, with usual acknowledgement