UBC Reports | Vol. 50 | No. 8 | Sep. 2, 2004

AIDS in Africa: Up Close and Very Personal

UBC student gets intense first-hand look at HIV / AIDS epidemic during summer seminar in Malawi

By Erica Smishek

If called upon to write that proverbial essay about how she spent her summer vacation, an uncommon one in Malawi, Africa, Madeleine Lyons would undoubtedly tell of attending five funerals in 10 days -- each death attributed to AIDS.

“AIDS is beyond a crisis, it’s beyond a pandemic, it’s beyond anything we have words for,” says Lyons. “There is death everywhere.”

Entering her second year of Arts at UBC, the just-turned 19-year-old was one of 20 undergraduates from across Canada who participated in the 57th World University Service of Canada (WUSC) Summer Seminar. The project paired students with their Malawian counterparts to carry out research on HIV / AIDS or sustainable agriculture and learn about Malawi’s strategy for meeting the United Nations’ Millennium Development Goals in these areas.

It was Lyons’ first time outside Canada, and it offered a profound first-hand look at poverty, racial and gender inequality, and the AIDS epidemic.

She calls it “the most unbelievable eye-opening experience of my life.”

During her six-week stay, the delightful and determined Lyons interviewed project leaders from both government and non-governmental organizations (NGOs) responsible for HIV / AIDS initiatives. She visited hospitals, clinics and maternal health centres to examine gender and equality issues affecting HIV infection as well as post-infection health care. And she spent 10 days living with a Malawian family in Dezda, a rural village decimated by the epidemic.

“Youth in these villages don’t exist anymore -- AIDS has wiped them out,” says Lyons, who stayed in a rusty tin-roofed hut with a married 50 something couple, their adult missionary son, and two 18-month-old grandchildren orphaned when their AIDS-stricken mother died of a secondary infection a week after their caesarean birth. The couple had also taken in three girls, aged 12, 14 (who is eight months pregnant) and 15, all orphaned by AIDS, as servants.

Located in southeastern Africa, Malawi’s population is estimated at 11.6 million; the average life expectancy for the total population is 38 years. Malawi has one of the highest HIV / AIDS infection rates in the world, with conservative estimates pointing to 15 per cent of the adult population -- one in seven -- infected.

“There is a lot of pressure to keep it quiet within the country,” Lyons says. “In the cities, you can actually say the word ‘AIDS.’ But in the villages, you can’t ask people if they have AIDS.

You use the word ‘illness’ but it becomes pretty apparent what they have when you see shingles, a common opportunistic infection, covering their faces and their children dying.

“They have no testing in rural areas. And in urban areas, nobody goes because nobody wants to know the truth. Without anti-retrovirals, it’s a death sentence.”

The UN Millennium Development Goal for HIV / AIDS is to stop and begin to reverse the number of new infections. The Malawian government promotes abstinence as the most effective method against the spread of HIV, while the church, a powerful lobby in the country, refuses to support the use of condoms.

Upon her arrival, Lyons was given nine condoms to distribute.

“Many of our Malawian counterparts made a very obvious point of throwing them away, saying they were practicing abstinence,” she explains. “Later on in the program, however, they would be in bed with their boyfriends. It isn’t having sex that is the problem, but saying one thing publicly and doing another privately just exacerbates the disease.”

In Malawi, the average age of a person’s first sexual experience is 15. Often this experience isn’t a choice but a reality of economic circumstances, especially in rural areas, as young orphaned girls use transactional sex as a means of generating income to support themselves and any siblings left under their charge, or cultural tradition. Fisi (“hyena” when translated), for example, is a sexual education ritual in which a group of young girls who have had their first menstrual period or are soon to be married are “initiated” with intercourse (often unprotected) by the same man, a disguised figure who strikes in the dark.

Not surprisingly, six women for every one man are infected.
While the Malawian government recently received $100 million from the Global AIDS Fund to support an anti-retroviral drug program, these drugs are distributed from only one hospital in the country and are currently given only to people in very advanced stages of the disease. Lyons says more money, more drugs and the infrastructure to distribute them are desperately needed.

“Anti-retrovirals are almost a miracle drug. They’re not a cure; but when mothers go on them, they can actually look after their kids; kids can actually go to school instead of working. You stand a chance at breaking the poverty cycle, breaking the hold of this disease.”

In recent news reports, a senior UN official warned that sub-Saharan Africa will have 20 million HIV / AIDS orphans by 2010.

“There would be groups of 20 or 30 kids at the side of the road, playing with footballs they had fashioned out of plastic bags that had been melted,” she says of the orphans. “Or they would be skipping with ropes made out of grass. There are so many of them, there is nothing for them to do.”

As in the case of the family with whom Lyons stayed, many female orphans are taken in as servants and work from dawn to midnight, cooking, cleaning, washing, gathering firewood, tending to younger children and to chickens, goats and cows.
“These girls were so badly treated, not by the grandparents, but by the other five grandchildren who came to visit. I saw them kicking dust in the face of the young girl who was pregnant as she knelt. They spit on her; they threw rocks at her.

“I saw things I never thought I’d have to watch. By the end, I couldn’t. It violated every single one of my code of ethics. The whole time this was happening to her, as the stones hit her, her face remained blank. She was embarrassed, you could see it in her eyes; ashamed of herself, ashamed that I was seeing this.”

Lyons, whose volunteer activities have included work with the Canadian Red Cross, War Child Canada and Save the Children, hopes sharing her insight of the HIV / AIDS epidemic will inspire youth in her own community to get more involved.

“I always had a passion for the issue, but how can you really get that across based on things in a textbook or statistics? Now that I’ve seen these things, I can show people the pictures. I can explain what it feels like to walk down the street, to see the orphaned children, to not see any adults, to see five funerals in 10 days.

“AIDS has become such a catastrophe that each and every person in the world, HIV-positive or not, Canadian or Malawian, needs to do their part, somehow needs to take action.”