Whether it’s here or back in the UK, the question of how to heal a divided country is key, writes Susan Dalgety
Thoko pulled her cardigan tighter. It is winter here in Malawi. The daytime temperature is around 22 degrees, a warm summer’s day in Scotland, but to Malawians, it’s cold.
“Most people know someone who is HIV,” she says, her white nurse’s tunic stark against her dark skin. “It’s part of life now.
“It didn’t use to be like that. When I worked on the Johns Hopkins’ HIV project, with women who were diagnosed positive, their reaction was terrible. They were angry, or depressed, or both. Some would scream and cry, some would stay very quiet. They all thought they would die. But it’s part of life now.”
It is part of Thoko’s working life too. Since taking early retirement from her job with one of Malawi’s private hospitals, she has opened a small clinic near her home in a township on the edge of nation’s capital, Lilongwe.
“We are the first stop for people who are sick,” she explains. “We do testing for malaria, for blood sugar, pregnancy and HIV.”
“There are not enough government clinics and most people don’t have private health insurance, so clinics like mine are a big part of the health service.
“When someone comes and asks for an HIV test, I have to counsel them first. I tell them that if they are positive, they have to go to a hospital for treatment. I tell them they have to abstain from unprotected sex.”
She stops and laughs, “no-one can abstain from sex.
“And I tell them it is not the end of the world. There is far less stigma now, and if they take their medication, and eat well, then they will live as long as me.”
HIV was once a death sentence in Malawi. Hundreds of thousands died as the virus took hold in the 1980s, decimating large swathes of the country’s economy, particularly its professional class.
It is still a major problem, with an estimated 1,100,000 people living with HIV, and approximately 770,000 children orphaned by the disease. Women are disproportionately affected, with teenage girls most at risk of infection. But thanks to an unlikely hero, George W Bush, Malawi is on track to control the epidemic.
Sixteen years ago, President Bush signed off the US President’s Emergency Plan for AIDS Relief (PEPFAR), which has seen billions of dollars invested in 50 countries across the world, including Malawi, to tackle HIV.
There are now 14 million people on anti-retroviral treatment (ARVs), paid for by successive US governments, compared to 50,000 when the programme started.
In Malawi alone, more than one million people take ARVs every day, making it one of Africa’s leading countries in controlling the epidemic. Self-testing is now common, giving people the privacy they crave, and Malawi was the first country in the world to adopt Option B+, a measure to stop mother to baby transmission.
Of course, America did not achieve these remarkable results on its own. The UK and Scottish governments have played their part, as have organisations such as Edinburgh’s Waverley Care.
Crucially, the Malawi government is one of the most progressive in sub-Saharan Africa in tackling the epidemic. In 2004, when South Africa’s President Thabo Mbeki was still describing ARVs as “poison” and dismissing the link between HIV and AIDS, Malawi’s President Muluzi agreed a comprehensive HIV strategy, and a year later his successor Bingu Mutharika launched a nationwide plan to deliver free ARVs for all, so saving countless lives.
Little wonder, then, that the outgoing US Ambassador to Malawi, Virginia Palmer, recently described Malawi as a “leader in its HIV response.”
The cheerful diplomat made unexpected global headlines this week. As Thoko and I were discussing HIV, unknown to us, a few miles away, Ms Palmer was under siege.
She is leaving Malawi soon after a four-year tour of duty, and was making a farewell visit to Dr Lazarus Chakwera, leader of the MCP, Malawi’s main opposition party, when their meeting was unexpectedly disrupted.
“It was my farewell call and I was saying thank you for the friendship and for the important role that he has done for Malawi over the four-and-a-half years I have been in Malawi,” she explained later.
“Just as we finished the meeting, apparently rocks were thrown and the police responded with teargas.
“There was teargas flying around, but my security people came and we proceeded out without incident.”
Ms Palmer may have batted away the episode, but the country’s newly re-elected President, Peter Mutharika, brother of Bingu, took to the airwaves a few hours later to warn Malawians that he believes Dr Chakwera is hell bent on ignoring the recent election results, which saw him lose narrowly to Mutharika.
“His goal is to create chaos and civil unrest using the lives of unsuspecting, innocent Malawians to take over the government by violence and force,” he intoned from behind a rather large desk. “This will not be allowed,” he added, before telling us that he had ordered the police and army to “protect innocent Malawians and their properties from those who want to cause violence and disorder”.
Sitting here in the early morning sun, listening to birds sing and crickets chirp, it is hard to believe that the country is facing “violence and disorder”, or that Dr Chakwera is planning civil unrest. He is more a disgruntled loser than the leader of a coup.
Malawians are a warm, welcoming people. “Or passive,” laughs my new friend, 23 year-old writer, Nthanda Lizzie Manduwi who is probably the most talented young woman I have ever met.
In a country where there is no government support for the creative industries, she has already self-published one book – a guide to growing up in Malawi – and she is a blogger, a TV star, and a budding film-maker. Oh, and she has two novels in the works.
By day, she works for the Malawi Revenue Authority, but in her spare time she is building a network of creative young Malawians, determined to change their country for the better.
“We want change. But we need to recognise the concerns of the urban people are different from those in the villages. That is why Mutharika won, I saw that coming because he was serving the rural people’s interest, the interests of the majority.”
“We need to bridge the two, how do we bring everyone together?”
The age-old question, asked by politicians and campaigners, faith leaders and citizens, traditional leaders and revolutionaries, the world over, since time began. In Malawi, as in the UK. How do we bring everyone together?
You can read Nthanda’s blog here – www.byntha.com