I had the privilege of attending 2 days of civil society meetings of HIV/AIDS non-government organizations this Wednesday and Thursday.
They were a fantastic opportunity to get a snapshot of the HIV/AIDS epidemic in the country and learn about Malawian responses.
I arrived with the WUSC-Malawi Country Director on Wednesday morning. I had been forewarned that time is viewed differently here, so I wasn’t surprised when, at 9:30 (Meeting was scheduled to start at 9), the facilitator announced that 3 meeting attendees were running late and asked if it would be ok if we waited another 45 minutes for them?
Consensus was reached that we would wait. The meetings officially opened after 10.
Something I have learned quickly about meetings here is that they always start and end with a prayer.
*A word on the prayers: They seemed a bit odd to me at first and I was quite skeptical of the practice. I must say that I am now quite enjoying the prayers.
Although I may not experience the act of prayer in the same way as most attendees (i.e. my spiritual belief system is not founded solely in any one religion and does not translate into taking the bible literally), I love the act of taking time to consciously and collectively set positive intention for the task at hand. I also enjoy the expression of gratitude. *
After the prayer and introductions, the facilitator announced that we would take our first break as it was 10:30 and many people hadn’t eaten or taken tea since breakfast! We then took a 30 minutes break although we had yet to dive into the substance of the meetings.
About 5 minutes into the first presentation, the power cuts. The room immediately starts getting even hotter and we continue the presentations in the dark. By the end of the day, the power has gone off more times than I can count. This is becoming an increasing trend… but more on that later.
Some interesting things that I learned about HIV in Malawi:
-The infection rate has dropped in the past years from approximately 12% to 10.6%.
-Young women ages 15-24 are increasingly vulnerable to contracting HIV as the practice of transactional sex increases. The ‘sugar-daddy’ phenomenon is alive and well here as women have very little economic power. Many women will date and sleep with older, educated and wealthy men in return for the 3 C’s (Cash, Car, Cell Phone). Given the economic and traditional gender power disparities, it is difficult for women to negotiate condom use.
· -In the same vein, HIV is also very present in educated, wealthy men. At the meetings, an out-spoken and fiery female representative from Malawi’s National AIDS Commission highlighted the irony of having a room of mostly educated, well-off men identifying ways to decrease HIV infection in the country. She said that perhaps instead of trying to think of ways to empower economically disadvantaged women to negotiate condom use, the attendees should have a drink together after the meeting and consider what they should do in their personal lives to slow the spread of the virus. I wanted to stand up and applaud but opted to sit quietly in my seat instead. In another glorious moment she admits to personally be unable to use a female condom with her husband despite her relatively high economic power. She questioned out loud how she could expect a young, impoverished woman in a rural area to convince her partner to use a female condom when she herself could not.
· -The practice of having multiple, concurrent sexual partnerships is a major contributor to the spread of HIV. In addition to a primary partner, many people (mostly men) are also having other sexual relationships. These vast sexual networks fuel the spread of the virus. Many people also select sexual partners based on if they ‘look like’ they have HIV. Others assume that they are already HIV positive and make riskier decisions accordingly.
· -Although there is little data on this, ‘Minorities’ (the equivalent for the LGBTQ – Lesbian/Gay/Bisexual/Transgender/Queer/Questioning…), and more specifically in this context Men who Have Sex with Men) are a very vulnerable group in Malawi. It is imagined that they are at high risk of contracting HIV and prevalence is estimated at 21% although there is not any ‘official’ data given that homosexuality is illegal. Biological factors as well as difficulty in accessing services (due to the illegality) make this a very grave issue.
· -The state of gender inequality in Malawi, including Malawian women’s lack of sexual and reproductive health rights has had a horrific impact on young women as far as HIV is concerned. Cultural practices such as Chiharo (widow inheritance), kulowakufa (widow cleansing), fisi (initiation sex), chimwanamaye (spouse swapping) and bulangete la mfuma (pimping of a young virgin to a visiting traditional leader) fuel the spread of HIV in Malawi.
As you can tell, HIV is my area of interest, but I will spare you from more details as there is a strong possibility that you don’t find this as interesting as I do!
Needless to say, I was very touched by the passion and engagement of meeting participants. I am very excited to work on the advocacy team that will carry many of the issues going forward.
I am also ashamed that I had my first moments of emotional reaction to trying to operate in a different context. In pre-departure training, we were briefed about how it can be emotionally challenging when things don’t work out the way you believe they should when working in a different culture. A few times, I found myself feeling angry and frustrated at the process and speaking frankly and out of emotion. I don't think it showed as I managed to keep it professional, but I am still not ok with it becauseI know better than to do that. It is completely unacceptable. I am trying to be gentle with myself and take it as a learning experience, but it is difficult. I have spent some time reflecting on how it felt to become emotionally drawn into such a situation so that next time I can take a minute, breathe and then determine how to be most effective.