Malawians unite in battle against Aids

Kids from Chadongo village play while their mothers talk to the Mother Buddy. Picture: EMMS

The congregation is jammed in, with more people round the gaps that pass for windows and doors. Only the clergy – there are two rows of them, including the archbishop, who is wearing trainers but no socks – get chairs.

Tina Banda gets to her feet. She runs Mziche, a Presbyterian Church scheme to tackle HIV in poor, isolated communities such as Lweya. Mziche brings together churches from all denominations – there are more than 100 in Malawi, and 80 per cent of the population are members – to tackle it head on.

Theological differences are put aside as the congregation whoops and cheers her description of the newly recruited “mother buddies”, HIV-positive women who have given birth to healthy babies who will be role models and educators for others.

There is an exuberant welcome for Emms International, the Edinburgh-based charity funding Mziche. Then an ancient fellow in a grubby anorak shakes everyone’s hand. (It turns out that he is the head man of the village.) Accompanied by an electronic keyboard, the tin roof rattles with singing and dancing. Joining in is not optional. Several people photograph the scene with their mobile phones.

It wasn’t always like this. Some 11.3 per cent of the population of northern Malawi has HIV or Aids, which is around the national average. Since the first case was diagnosed, in 1985, 46,000 people have died, leaving 770,000 orphans. At the moment around a million Malawians are living with HIV, in a country where life expectancy is 55. These two numbers are not unrelated.

Under Hastings Banda, the country’s long-time ruler, the country was in denial. Current leader Joyce Banda is making all the right noises but with her government mired in the Cashgate corruption scandal, there is a limit to what she can do, leaving non-governmental organisations (NGOs), churches and donors such as Emms to fill the gaps.

It took a long time for Malawi’s churches to step up to the plate. “There was a stigma in church and we saw many people who were not involved,” recalls Charity Nyirenda who oversees Mziche. “The mentality was that the church was about the word of God and salvation. Some used to say we needed the holy spirit to descend on us. Instead, we had to start talking about HIV.”

In 2008 the Presbyterian Church in northern Malawi, which was funded by missionaries from the Free Church of Scotland in 1875 and is still going strong today, began a laborious process of self-examination. Ministers, preachers, priests, church elders and village leaders gathered in tin-roofed churches and concrete health clinics across the region to ask themselves: what is causing HIV to move through our community? Is it polygamy, which is technically illegal but widespread? Is it other traditional practices such as “widow cleansing”, where a woman whose husband dies is “cleansed” by having sex with other men? Could a church ritual spread the virus?

Nyirenda points the finger at “the holy needle”. A huge, bent hat pin, this is blessed by the bishop of the Zion Christian Church in South Africa then used to prick people who are HIV positive, to “cure” them by letting out bad blood. Sterilisation plays no part in this ceremony. Other remedies advocated by this church’s leaders are eating mayonnaise and drinking special teas.

Then one of the Zion Christian Church ministers was diagnosed with HIV. Encouraged by Nyirenda and her colleagues, he turned down the holy needle and mayonnaise. Instead he is taking the anti-retroviral drugs (ARVs) which the Malawian government now gives to everyone who is HIV positive. The blessed hatpins are still around, but they are now boiled before use. (Nyirenda describes this, mournfully, as “a step in the right direction”.)

Every church has made changes. Evening prayer vigils, which gave the congregation a chance to get up to no good under cover of darkness, have been moved to daytime. The “housekeepers” some ministers had living with them in the manse have moved out. And, with their own houses in order, the churches can spread the message from the pulpits into their congregations.

Take Lweya Presbyterian, five dusty minutes away from the Lutheran church. Here the altar cloth proudly proclaims a twinning arrangement with Monkton/Prestwick North. Six mother buddies stand up in front of the congregation – in effect coming out as HIV positive – and describe the work they are doing with pregnant women. Further into the two-hour service the minister, Reverend Partings Goa Nyasulu, underlines their message. “We aim to reach out to all people,” he tells the congregation, which is sitting on wooden benches. “This is not just spiritual, it is physical as well.”

Over the three years it is funded by Emms, Mziche’s aim is to reduce the number of women transmitting HIV to their babies and improve the quality of life for women with HIV, many of whom live on less than 60p a day. To do this, they need more than mother buddies and ministers. They need men.

As all pregnant women in Malawi are tested for HIV, it is seen as a women’s problem. “Aids has worn a female face in Malawi, it’s blamed on women,” says Lazarus Harawa from Mziche’s parent organisation within the Presbyterian Church. “Men are very closed. Some of them get ARVs without their wife finding out.” Despite their own status, when their wife comes back from the clinic with a positive diagnosis, there is hell to pay. “That’s when the shouting starts.” Husbands often abandon their wives to cope with HIV, and the baby, on their own.

More women than men in Malawi do have HIV but Lazarus has an explanation. “Men can have two or three wives and girlfriends,” he says. “But a woman can’t marry three men.”

To tackle this issue, Mziche is urging couples to be tested for HIV together. As an incentive, women who bring their husbands to the antenatal clinic go to the top of the queue.

It seems to be working. In Chadongo, further along the bumpy road from Lweya, the drama group performs a graphic song and dance about diseases transmitted during sex. They have also devised a play about a couple who need to be persuaded to take the HIV test. The village head man and teacher look on approvingly and clap vigorously.

In the audience are Dyness Msumba and Miriam Phiri. They have been meeting with mother buddy Gladys Mkandawire who lives in Chadongo. Mkandawire and her husband, who is also HIV positive, have six healthy children. Unlike many with the virus, she has told her family, friends and now several sweaty white strangers about her status. “I’d like to encourage others,” she says. “I want to tell pregnant women who are HIV positive that they can have a baby who is HIV negative.”

ARVs alone will not rid this generation of Malawians of HIV. Mkandawire and her army of mother buddies just might.

Twitter: @MsABurnside

• Emms International’s Christmas appeal aims to raise £250,000 to fund the Mziche project in northern Malawi over three years. www.emms.org/appeals/mziche-project-life-without-hiv-christmas