Why is there so much AIDS in Africa?

This question has been asked many times to missionaries as they go back on their Stateside Assignment.  Ruth Grayson an IMB missionary to the people of Swaziland attempts to give some insight on that question.

During our stateside assignment we have learned that many Americans are in a kind of a fog in understanding why AIDS has hit Africa so hard.  I've decided that I'll help you understand that a bite at a time in the next several emails. 

 

In America AIDS is associated primarily with homosexuals and intravenous drug usage, though it is becoming an increasingly heterosexual (male-female relationships) disease.  But in Africa 95% of people with HIV/AIDS get it from male-female relationships. 

 

One factor is that some African traditions cause AIDS to be passed on more easily.  For example, when a young man pays lobolo (bride price, usually an agree-upon number of cows) to the bride's family, he is essentially buying her fertility.  So, in a period of time after the marriage, if she hasn't become pregnant, it is traditionally acceptable for her sister or another female relative to take her place and try to get pregnant with the groom. The resulting baby would then belong to the bride.  It's traditional surrogate pregnancy, if you will.   Of course, if one of them has AIDS, all 3 end up with it, not to mention there's perhaps a 50% chance of the resulting baby having it.

 

Then there's the tradition of "widow inheritance."  When a man dies, his brother is expected to take in the widow as his wife, adding her to his wives.  The purpose is to provide support for the widow and her children in the absence of her husband, especially since few women in Southern Africa have skills or education to get jobs and provide for themselves.  And it even sounds Biblical, doesn't it?  But the results sure aren't.  If the husband died of AIDS, the widow then infects the brother, and he infects the other wives, not to mention the future babies.

 

I tell you this to help you pray more intelligently for Africa.  Pray that the people will yearn for God because of the AIDS crisis, and that they will keep the good traditions, but leave those that are destructive.  

Another cultural aspect that is causing the spread of AIDS in Southern Africa is the very widespread practice of polygamy (when a husband has more than one wife at a time).  It is very common for a man to have 2-3 wives, or even more if he is more wealthy.  And actually, polygamy is also tied into another AIDS-spreading factor, migrant labor. During apartheid in South Africa many tribes were forcibly relocated to areas of land that tended to be quite poor.  Often there were few natural resources, and the land tended to be drought-prone.  This meant that the African people could not depend on the land to sustain their families like it had for hundreds of years. So they had to send many of the mothers and fathers of the families to the big cities or the mines with the faint hope of finding jobs so they could send back money to the families remaining in the remote homelands. It still plays out like that today, even though apartheid is officially finished.  In Swaziland the economy is quite poor, and jobs are quite rare.  So it is common for the husband to leave his family's homestead to try to find a job in nearby South Africa or in another part of Swaziland.  This means he could be gone for months at a time.  The natural result is that he finds another wife or girlfriend near his new location, or maybe he visits prostitutes.  Then, when he returns home to his family, he brings AIDS to his wives and possibly to the babies that come after that.  

 

We frankly don't have much hope for the sense of morality to improve in Southern Africa without massive conversions to Jesus.  Please pray that the Holy Spirit will move in people's hearts in a massive way.

Another factor in the spread of AIDS in Southern Africa is the lack of female empowerment and the extreme dominance of males in the society.  Most females in Southern Africa traditionally do not stand up for their rights, including in sexual matters.  They do not know how to negotiate for what they want.  For example, men rarely want to use any sort of birth control, such as a condom.  In fact, it has been found that about 80% of Swazi people age 15 and up know about condoms, but only about 30% actually use them.  If a woman insisted on her husband using a condom, he would likely beat her; she would be insinuating that he had been unfaithful to her....which he probably had!  Also, many men feel like they have a right to beat or rape their women, and many also feel like they have a right to sexually abuse or rape their children or nieces.  In fact, it is common for men to feel that they have the right to have sex with whomever they want to, whether or not the other party consents. 

 

Why don't the men stop this behavior?  They believe that they can't help it....that a man MUST have sexual relations.  Myths about that persist as well.  Swazi culture itself allows men more sexual freedom than it allows women; the men are not looked down on very much for behaving like that.  Even if they are brought to court for the way they have treated a woman, they are likely to get away with a light sentence, if any.  And when a woman is abused by her husband, she has no "safe house" to which she can go, but is basically forced to stay at home with him and endure a bad situation.  Traditionally there is no divorce in Swaziland.

 

Here's an example of how this male dominance can play out in a family's health.  In one well-to-do African family, the mother became concerned when she observed her pre-teen daughter losing weight.  Upon being tested, she was found to be HIV positive.  When asked by her mother who her partner had been, she answered, "my older brother."  When the older brother was asked by the mother if he had a partner other than his sister, he replied, "Yes, the house girl" (the house cleaner).  Upon gathering the entire family of four and accusing the house girl of destroying her family with threats to kill her, the house girl laughed and said, "It's your husband."  Then the mother realized that she herself, unwittingly, had also become a victim.  In the course of time the entire family died.

 

Pray for the women of Southern Africa, that they will come to know their Heavenly Father, who loves and values them more than any earthly father ever could.  And pray that the men of Southern Africa will also become believers and will increasingly recognize women as their equals, not beings to be used and thrown away.

 

Also pray for our team of missionaries ministering to the Swazi people.  We need God's wisdom to determine team policy on helping AIDS orphans, especially to be able to do it without creating long-term dependency on foreign funds and other problems in the future.

It's kind of hard to talk very much about AIDS in Africa without using some sexual terms, since 95% of AIDS transmission in Africa is through male-female sexual relationships.  So I'll have to rate this prayer email PG-13.

 

Many myths add to the spread of AIDS in Southern Africa.   For example, "traditional healers" are the traditional African herbal doctors that consult the dead "ancestors" for advice and medicine to cure someone, or even, in some cases, to give curses to the enemies of their clients.  It is common for a traditional healer to claim to be able to cure AIDS...and many people believe them, and then fork out the hefty price for the "cure."  However, at best, the "cure" only helps the symptoms temporarily, and, of course, the clients eventually die of AIDS.  It's interesting that some traditional healers claim to have the cure for AIDS...and then die of AIDS themselves.

 

Some of you have heard of the common belief that a man can cleanse himself of sexual diseases, including AIDS, by having sex with a virgin.  These virgins are commonly young girls, even preschoolers.

 

In rural areas you can find people that are suspicious of condoms and believe that they have worms in them when they get wet.

 

There is also the belief that "good" women are expected to be ignorant about sex and should be passive.  In fact, ignorance by men and women about natural female body functions leads to sexual practices that increase the rate of infection by HIV. 

 

Ignorance about how infection is spread adds to the problem.  For example, the family of an AIDS victim that is caring for her at home might be encouraged to use medical gloves to avoid infection.  However, the family may not understand that the gloves should be used just one time for the greatest protection.  Then, with repeated uses and washings, the gloves might develop tears or cuts.  But the family may not understand that the gloves in that condition won't protect them from the patient's bodily fluids.  They are simply trusting the gloves. 

 

It is common for people to believe that if a man doesn't have sex, the following could happen:

    His private parts will shrink and become weak.

    His blood will become salty.

    He will become stubborn (I wonder what women think about that one.)

    He will become dumb (!!!)  This has to do with the blood rushing to the brain.

 

There is also a stigma attached to AIDS.  People commonly believe that an HIV carrier has been unfaithful.  A wife who finds out she has AIDS will likely be blamed by her husband, saying that she must have had an affair, even though he most likely was the one that brought it into the family.  But there are many innocent victims, such as the wives of such men and their children.  Even so, people are afraid to admit in public, or even to their families, that they are HIV positive, since they might be ostracized or even killed by the community or their own families.  This has happened.  This stigma also causes people to avoid getting tested for the virus; they decide it's better not to know.

 

So pray that the Swazi people will learn correct ideas about AIDS and related matters.  And pray for our team members that are trying to teach them.

 

There are also many myths believed about God.  Pray that the people will learn about the TRUTH.....Jesus.  That's the real crisis all of us must face.

Here are some more cultural customs and attitudes that tend to cause the spread of AIDS in Southern Africa.

 

Sugar Daddy.  Know what that is?  Nope, in Southern Africa it's not a candy.   It's a middle-aged man who is  providing material favors to a younger, teenaged girl for sexual favors in return.   Why do the teenage girls allow that?  Well, remember, they don't know how to stand up for their own rights.  They grow up thinking it's their duty to give in to men.  And they may actually be afraid to say no to these older men, especially when they are so often men with some sort of power.  An example is male school teachers.  With the poverty of the masses complicating the situation, the school teacher might offer to pay for her school fees, school uniform, or whatever thing might get her interest...even a new dress.  Of course, there ARE fine school teachers, but this is certainly a trend.  Charlotte Cearley, missionary in Mozambique, told me that teachers sometimes require bribes, including sexual favors from the students or their mothers, before they will pass them.  So, is it any wonder that teachers have one of the highest rates of AIDS in the region?  Actually, this attitude of entitlement can be found among men with any amount of power, including policemen, those in the armed forces, and, yes, even pastors.  I call this the Big Chief Syndrome; especially in the rural areas, the people generally tend to think that whatever the "chief" (the person in power) wants, he should get. 

 

Also, young teenage girls are often given in marriage by their parents to older men, who tend to have more money (a potential plus for a poverty-stricken family).  Of course, those men also tend to have more wives AND are likely to already be HIV+.  But actually, the bride's future isn't so bright, since younger teenage girls are even more vulnerable physiologically to getting AIDS than their older girlfriends.

 

Another custom is that of circumcising teenage boys. The period of initiation for boys entering puberty has several positive aspects to it, such as instruction on proper sexual behavior before and after marriage and instruction about society's expectations of them as new men. Though in Swaziland the custom of circumcision during initiation has died out, it is still carried on in several other people groups in Southern Africa.  As the boys are gathered in a group for the lengthy tradition, the elder in charge may go from boy to boy, using the same unsterilized razor blade. So AIDS can then get passed on that way.

 

Speaking of razor blades, this is what Jean Phillips wrote me.  She and husband Gene were long-time missionaries in Zimbabwe and are now short term missionaries in Botswana.    

 

When we were in Zimbabwe, all the people in two different chief's domains (in our area of work) were required to go to a certain witchdoctor whom they called in.  This was to find out "who" was causing some problems in the area.  One of the things the witchdoctor did to each person who came before him was to cut them with a razor.  He used the same blade on person after person.  One of the men whom he was getting ready to cut protested, "You're going to give us all AIDS."  His reply was, "Oh, no.  I have a strong spirit that cleanses the blade after each cut."

 

So you see, God's light really needs to be turned on in their minds and hearts.  We can really see why Satan is called the Father of Lies.  But God is more powerful.  Pray for His miracle in their hearts. 

 

Though I have previously touched on a few economic factors that increase AIDS in Southern Africa, here are some more to clarify your vision.

 

The unemployment rate in the region is quite high.  (In Swaziland in the year 2000 it was 45%.)  There are many reasons for this, but here's one line of thought.  Education tends to be academic and generally not practical; much "learning" is done by rote.  Then, for those happy ones that manage to graduate, many are not prepared with practical skills to begin their own small businesses.  They are then dependent on employment by those who DO have businesses, most of whom are not black Africans.  So they are perpetually on the low rung of employment.  They feel lucky to get jobs as just part-time gardeners or house cleaners.  But even those jobs are few.  This all adds to the high frustration level and hopelessness among many youth and young adults.  They become more desperate.

 

Desperation and poverty has caused many teenage girls and young women to turn to prostitution, which, of course, spreads AIDS.  Also, there is a high number of street children.  Why are they there?  Sometimes their families simply don't have enough food to feed all of the children, and so some are turned out to live on the street and do the best they can to survive by begging.  Others are there because of simple rebellion against the authority of their parents.  It's very easy for them to slip into lawlessness or promiscuity, spreading AIDS as they do so.

 

Poverty is also one reason that so few women have access to medication that can lessen the chance of transmission of AIDS to their unborn children.  But even if the medication for this and for prolonging life for AIDS patients was free, you'd still have to deal with other roadblocks.  For example, I understand that the medication generally should be taken with food and at certain times.  This could be quite a trick for people that tend to look at the sun to know the time; many are too poor for watches.  Also, many are too poor to have food to eat 3 times a day.

 

So a poor economy adds to the AIDS problem, but then the AIDS problem burdens the economy even more, causing a downward spiral.  The wage earners and power holders in society are generally those that are in the age group most often infected.  Imagine how it can affect a society when half of the teachers, policemen, and those in the armed forces are HIV positive.  It also drains family finances and those of the entire community; think of medical costs, funeral costs, days off work because of illness and caring for ill family members as the disease progresses.  Then, because there is less money in the home, more children have to drop out of school.  (UNICEF says that 39% of the school-aged children in sub-Saharan Africa are not in school.)  And so the cycle of ignorance, poverty, and desperation continues.

 

But I know that God can work in individuals in the midst of their poverty, just as He has done since the birth of mankind.  And He is!  Pray that God will lift their loads, but also that their desperation will cause them to look to Him for salvation.  Pray that the Christians will be able to present the Gospel to many before their deaths.