UBC Reports | Vol. 50 | No. 8 | Sep.
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
“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
“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.”