HIV in Malawi

HIV is a major epidemic in Malawi.  An estimated one million out of a population of 15.4 million people have HIV, and it is the leading cause of death in Malawi (avert).  This epidemic started in 1985.  The president at the time, Hastings Banda, had puritanical beliefs where he banned discussion of sex, making it hard to educated people about safe sexual habits and ways to prevent disease.  This caused people to have unsafe and unprotected sex, leading to a large spike in HIV cases (avert).  Social and cultural habits have made it hard to prevent HIV.  The people believe that it is natural and safe to have unprotected sex,  so it is hard to convince them they need to use protection in order to prevent the spread of HIV.  Malawi also has six main languages, so it is hard to convey the same message in different languages to people of different cultures and ethnicities (avert).  Malawi is also what we would consider a third world country.  They don’t have the money or resources that a western country has to educate people on how to have safe sex, or provide free condoms for protection against aids.  In the lecture we talked about women transmitting HIV to their children.  Women naturally breastfeed their children, especially in poor areas where they cannot afford formula.  They can give their children HIV if they breast feed, but they either don’t understand, or can’t afford to change.  Some may also be confused by organizations like the World Health Organization.  They tell mothers to breastfeed for a year, but then tell mothers not to breastfeed when they have aids.  This may lead mothers to not trust western medicine, and they could go back to their local customs, which will further spread HIV.  NGOs like PSI and Banja La Mtsogolo have both made programs to distribute millions of free condoms, as well as female condoms.  Between 1992 and 2004, the use of contraceptives increased from 7 percent to 28 percent (avert).         

One anthropologist working in Malawi is Nicole Hayes.  She received her PhD from Boston University in 2011.   Her research covers how colonialism, globalization, and democratization have lead to the spread of HIV by creating a competitive sexual economy.  Many people in Malawi have multiple sexual partners because of this sexual economy, and she researches how this affects men and women differently.  She is also doing upcoming research on the government’s HIV policy, including HIV/AIDS education.

http://uwaterloo.ca/anthropology/people-profiles/nicole-hayes-bennesch

Avert.  “HIV & AIDS in Malawi.”  Accessed August 9, 2013.   http://www.avert.org/aids-malawi.htm – contentTable0

University of Waterloo.  “Anthropology.”  Accessed August 9, 2013.    http://uwaterloo.ca/anthropology/people-profiles/nicole-hayes-bennesch

This Post Has 4 Comments

  1. J. Brodie Timms-Fryer says:

    The anthropologist, Nicole Hayes, employs a sort of explanatory model approach with the problem of HIV/AIDS in Malawi. She is operating under the theoretical model that the culture in that particular area has a profound effect on the spread of the disease. She is extrapolating and investigating other aspect aside from the direct transmission of the disease. She delves into this competitive sexual economy by explaining that colonialism, globalization, and democratization has created such an economy that in turn propagates the spread of the disease. The perceived conclusion is that this leads to many sexual partners which would thus drastically affect the frequency of the disease in this region and would also affect men and women in differing ways.
    In this case, anthropology served to elucidate underlying causes in the propagation of HIV/AIDS in Malawi. By looking into the cultural aspect of this disease in the given context, it became clear that there was a propensity for promiscuity that was driven by external long-standing factors in this society. This information would be integral in developing the necessary programs and formulating the right aid to better prevent the spread of the disease. Furthermore, Nicole Hayes is slated to research in the government’s HIV policy and HIV/AIDS education which is a logical step given the information she has derived from the culture.

  2. Hassan Ahsan says:

    Hi Aaron,

    The term ‘sexual economy’ immediately rung up as an anthropoligical term to me immediately demonstrating the usefulness of medical anthropology in assisting health professionals improve their communication and treatment of chronic diseases such as HIV. As HIV is more prevalent in third world countries,it makes me wonder if it is culture, sexual liberties or a combination of such factors that contributes to the spreading of this disease. Such a question can only be answered through research and investigation, which must be done by someone with a medical understanding, such as by a medical anthropologist. Though doctors can provide biomedical explanations for global health problems, a medical anthropologist can use their speciality lens to investigate cultural norms and taboos associated with health problems such as HIV. For example, homosexual sex is such a taboo in many conservative countries that it is rarely acknowledged despite its positive association with HIV. In such cases, it is imperative to find the most culturally acceptable way to disseminate information about HIV so that people dont feel labeled or pointed out. Tools such as cultural awareness and research allows international NGO’s develop more efficient strategies for creating education tools (as you recommended)to provide better dissemination. Some examples may be to provide information by going village to village and finding someone who is proficient in the local dialect to establish a trust factor. It may even involve creating relationships with local healers or shamans in order to give authenticity to the medical information education.

  3. Molly DeMarr says:

    After reading through your post and thinking about the term “sexual economy” I now have a new found knowledge of the term and see how exactly Hayes can research that. I think that her approach to the causes of the large spread of the disease will then hopefully make some sense of the government’s HIV policy and how exactly the country educates its citizens. Taking all realms of the culture and country itself into account really shows how useful the medical anthropological approach can be. From your post, I can see how difficult educating a nation about a scientific issue can be when the entire nation doesn’t speak a universal language. This leaves me to question if Malawi provides public education to all or if there are areas who do not receive schooling that is provided by the government. I think that in order to decrease this health issue, it all begins with education on a global scale. Although you cannot force a universal language on an entire nation, I would think that there would be some citizens from every area with a different dialect/language that have enough knowledge to listen and understand some sort of teacher in order to learn of this illness and how to begin to manage it. These natives could then travel and spread their knowledge to those who understand their same language. This would be a timely process and eventually seeing results would depend on whether or not the citizens of Malawi comply, but it would be a start.

  4. Anthony Jurayj says:

    In order to prevent to spread of HIV and other STDs, campaigns must be initiated in order to allow for awareness and education on the topic at hand. In a situation such as this, anthropologies are crucial in determining exactly what the most efficient approach would be. For this particular situation, it would be most influential if the impact was started from within a culture of malawi. Because of their many dialects of language, it could be hard to educate people on a universal level. But by working with the culture and allowing people to believe that contraceptives are helpful in prevention, and educated people on other ways to prevent exposure as well as give more knowledge on the topic of HIV/AIDS. By using the skill set of culture clinical anthropology, anthropologist can use this approach to better understanding the culture and therefore better help that culture understand the disease. Examples such as Hastings not allowing people to speak about sex makes it disrespectful if someone were to run into their culture and start speaking directly to people about sex, and therefore people would not consider that person (although they are trying to help) a credible source of information, and would even consider it disrespectful. In order to better treat the problem, you must treat the culture.

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