THE HISTORICAL CONTEXT OF HIV AND AIDS IN ZIMBABWE
2.2. AIDS in the Context of Other Earlier Epidemics
Generally speaking, the reaction of the public to HIV and AIDS in Zimbabwe is somewhat similar to the way society has responded to earlier epidemics that affected
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African communities. Rosenberg suggests that epidemics such as AIDS are a social phenomenon and have a dramaturgic four-fold form and thus observed: ―Epidemics start at moment in time. Proceed on a stage limited in space and duration, following a plot line of increasing and revelatory tension, move to a crisis of individual and collective character, then drift towards closure.‖206 At the onset of an epidemic, there is the presence of denial and stigma. As the epidemic progresses people accept it and eventually develop solutions. Kenneth Doka has linked AIDS to four great epidemics.
He notes that the epidemics have included the diseases of bubonic plague or Black Death (sixth and thirteenth centuries, 1894-1902), the influenza disease (1918-1919), and their intermittent epidemics, as well as outbreaks of such diseases such as yellow fever, typhoid and cholera.207 Black Death or the bubonic plague is an earlier epidemic that has been discussed in detail in the light of HIV and AIDS. A major characteristic of an epidemic is that it kills vast numbers of people. For example, between 25-75% of the population of Western Europe perished as a result of the bubonic plague from 1337 to 1350. The same epidemic claimed the lives of 13 million people in Eastern Europe between 1918 and 1922.208
Georg Scriba discussed the plague in Martin Luther‘s time and compared Luther‘s reaction with contemporary responses to HIV and AIDS. Scriba notes that Black Death was an epidemic that ravaged Europe, beginning in the middle of the fourteenth century and continued throughout the late Middle Ages to the middle of the seventeenth century. It is estimated that some twenty million Europeans lost their lives due to this epidemic.209 The way in which society in general and religion in particular has responded to earlier epidemics has a bearing on the responses of Christian communities to HIV and AIDS. There are in fact a number of similarities between the behaviour of those infected by Black Death and PLHIV. As Luther stated:
206 Rosenberg, Explaining epidemics, 279.
207 K. J. Doka, AIDS, fear and society: Challenging the dreaded disease, (Taylor and Francis: London, 1997), 3.
208 Doka, Aids, fear and society, 3.
209 G. Scriba ―The 16th century plague and the present AIDS pandemic: A comparison of Martin Luther‘s reaction to the plague and HIV/AIDS pandemic in southern Africa today,‖ Journal of Theology for Southern Africa 126 (November 2006), 67.
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Some keep it a secret that they have the disease and go among others in the belief that by contaminating and poisoning others they can rid themselves of the plague and so recover. They enter streets and homes, trying to saddle children or servants with the disease and thus save themselves. So these folks infect a child there, a woman there, and can never be caught.210
The initial response of society including Christian communities to the plague in sixteenth-century Western Europe was one of panic and confusion with some people choosing to minister to the needs of the sick while others fled to nearby cities.211 The public response to a pandemic five centuries ago indicates that such diseases were held in dread because of the massive effects they wielded on families, communities and society in general. Doka noted: ―These diseases wiped out families and communities. They profoundly altered social institutions. They were epochal events that altered the very course of history. The bubonic plague provides many examples of this.‖212
In Africa, sub-Saharan Africa is one of the regions worst affected by HIV and AIDS in that it wiped out entire families and communities and left behind a trail of orphans.
According to The 2008 report on the global epidemic, in 2007 sub-Saharan Africa had twenty-two million PLHIV, which was two-thirds of the global total of thirty-three million.213 The origin and nature of the virus primarily determined the character of the African epidemic. In addition, the epidemic in sub-Saharan Africa has also been shaped by multitude of circumstances that took place, often with routes far back in the past.214 Among the factors identified are: (a) its demographic reach, referring to the expansion of Africa‘s population in the twentieth century due to advance in medicine;
(b) advances in transport and human mobility; (c) gender inequalities; (d) the widespread prevalence of sexually transmitted infections, the lack of male circumcision, as well as the lack of economic opportunities for women and the disparity between age of partners; (e) the presence of poverty, and the blame for the pandemic based on class. Poor women were at high risk because they had fewer
210 M. Luther, ―Whether one may flee from a deadly plague,‖ (date of publication given as 1528) in G.
Wienckle and H. Lehmann (eds), Luther’s works 43, Devotional writings (Philadelphia: Fortress Press, 1968), 132-133.
211 Scriba, ―The 16th century plague,‖ 67.
212 Doka, Aids, fear and society, 4.
213 UNAIDS, The 2008 report on the global AIDS epidemic, (Geneva: 2008), 39.
214 Iliffe, The African AIDS epidemic, 60.
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options to use condoms with elderly men. As a result, poverty was seen as an effective incubator.215
The denial of HIV and AIDS by society has been seen to be similar to earlier responses to the Black Death. Doka has observed that society was not ready to accept that pathogenic agents caused Black Death. Instead, there was a perception that the disease was, ―…divine punishment for heresy‘s sin and vice. …In any case, the plague spurred a populace away from medicine, which seemed so unhelpful, to the church, which would now minister to body and soul.‖216 Similarly, Rosenberg noted that the moralisation of an epidemic is a historical phenomenon:
For most previous centuries that framework was moral and transcendent; the epidemic had to be understood primarily in terms of man‘s [Sic] relationship with God; consolation was grounded in submission to the meaning implicit in that framework.217
The present research study will illustrate that church leaders and lay members of the Roman Catholic, Anglican and United Methodist churches in Manicaland tended to understand HIV and AIDS in moralistic terms. Indeed, statements issued by the church leaders during the period under review often pronounced that immorality was the main factor that fuelled the spread of HIV.
The public response to the plague in sixteenth-century Western Europe showed a mixture of reactions. One of the most common reactions was that of blaming Black Death on others. This tendency to blame others is also manifest during the HIV and AIDS era. Similarly, as in the time of Black Death, a pattern of apportioning blame on others became a hallmark of AIDS denial and stigma. As Scriba observed:
Within the church HIV and AIDS was often seen as a punishment from God for the sins of mankind [sic], and the clergy called for a moral regeneration of society against immoderate eating and drinking, immoral sexual behaviour, excessive luxury, and congregants were called to repentance.218
215 Iliffe, The African AIDS epidemic, 61, 62, 63.
216 Doka, Aids, fear and society, 5.
217 Rosenberg, Explaining epidemics, 282.
218 Scriba, ―The 16th century plague,‖ 68-69.
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Apportioning blame was not only confined to the churches, but was also common among members of the general public. At the time of Black Death, ‗others‘ were seen as being responsible for causing or spreading the disease. In line with this assertion, Scriba stated:
There were also those who believed that the spread of the disease was caused by the outcasts of society, the beggars and the poor or the Jews (in the case of Germany), and popular fury would turn against them.
They were accused of poisoning the wells and in some areas, were massacred for that.219
Doka also traced the links between social conditions and the spread of pandemics and linked the bubonic plague to the massive entry of refugees into Europe during the sixteenth century.220 In the past fifty or so years, southern Africa, including Zimbabwe, has experienced wars of liberation and various situations of political unrest that have led to the vast movement of refugees. Within Zimbabwe, the large movement of people due to the war of liberation during the 1970s, as well as the most recent socio-economic strife, has fuelled the spread of HIV. The rise of cholera that devastated parts of Europe in the nineteenth century was blamed on poor countries because cholera existed where sanitation was poor. As a result, the poor suffered disproportionately. As in AIDS, the victims were blamed for their own fate.221
Whatever the situation, apportioning blame for the disease has had an adverse effect on those interventions aimed at the eradication of the epidemic. During the bubonic plague, the resentment and hatred by those who succumbed to the epidemic towards the authorities was rife. Authorities were suspected of either developing the disease or facilitating its spread. The denial of the epidemic among certain classes of people during the time of the bubonic plague might have certain parallels with that of AIDS in Zimbabwe. In Poland for example, at the national level there was often talk of death from a short illness and blame was placed on the doorstep of strangers.
Physicians were accused of seeking to kill the poor including in the US and the rest of
219 Scriba, ―The 16th century plague,‖ 69.
220 Doka, Aids, fear and society, 6.
221 Doka, Aids, fear and society, 9.
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Eastern Europe.222 The responses to HIV and AIDS by the Roman Catholic, Anglican, and United Methodist Church could also have been affected by blame.
Apart from drastically reducing the population of Europe, in the time of the Black Death epidemic ―some villages became depopulated and eventually disappeared, and several towns declined substantially.‖223 Similarly, the devastating effect of HIV made the Shona speaking people of Zimbabwe to give different labels to AIDS.
Consistent with this assertion, Aquilina Mawadza observed: ―One of the words used to refer to HIV/AIDS in Shona is mukondombera which means ‗plague.‘…AIDS in Shona is shuramatongo, which means an ‗abandoned homestead, a cursed place, or a scene of catastrophe.‘‖224 Earlier epidemics including Black Death devastated individuals and families and in a similar fashion AIDS claims the lives of spouses and parents, sexual partners and HIV-positive children. While however Black Death was a disaster for some, to survivors it brought benefits, including a rise in wages, a drop in house rental prices and in the cost of food.225 Similarly, it could be stated that HIV and AIDS interventions by the churches in Manicaland have attracted huge amounts of foreign funding. As a result, the AIDS ‗industry‘ has become a large employer of people who work in AIDS-related service organisation including NGOs, churches and FBOs.
While epidemics throughout history were often eradicated through collective interdicts, differences in the understanding of HIV and AIDS, especially among the religious and medical fraternity has undermined progress in responding to epidemics.
Consistent with this observation and in relation to the cholera epidemic of 1832, Rosenberg showed that, ―…the picture of a consistent if occasionally awkward coexistence between religious and rationalistic or mechanistic styles of thought was characteristic of mid mid-nineteenth-century Anglo-American society.‖226 Measures taken to deal with the cholera epidemic were similar to responses to HIV and AIDS.
The experience of the city of Florence was typical of many others in the control measures that were introduced and widely used across the rest of Europe. These
222 Doka, Aids, fear and society, 9.
223 Scriba, ―The 16th century plague,‖ 69.
224 A. Mawadza, ―Stigma and HIV/AIDS discourse in Zimbabwe,‖ Alternation 11/2 (2004), 423-424.
225 Scriba, ―The 16th century plague,‖ 69.
226 Rosenberg, Explaining epidemics, 286.
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included: (1) the rigorous policing of human movement from plague-infested regions;
(2) the compulsory burial in special pits of those who had died from the plague and the destruction of their personal belongings; (3) isolating the sick in pest houses and the quarantining their families; (4) introducing special taxes to provide free medical services and food for people in isolation; (5) providing subsistence to those whose livelihoods had been wrecked.227 Lessons from Luther‘s time indicate that some members of the Christian community, as well as those of general public cared for people who were attacked by diseases. In a similar way, the present study sought to investigate the way the Roman Catholic, Anglican and United Methodist churches in Manicaland responded to HIV and AIDS.
Responses to epidemics also possess a history of different degrees of collaboration or the lack thereof between the various churches and the State. The present study reveals that the open use of condoms as prophylactics became one of the contentious issues upon which religious leaders disagreed with the State. The churches blamed the Government of Zimbabwe for encouraging sexual promiscuity. Rosenberg notes that such disagreements were historical and were consistent with those of responses to earlier epidemics:
During the first decades of this century, for example, public health workers who urged the use of condoms and prophylactic kits to prevent syphilis met some of the same kind of opposition their successors in the 1980 faced when they advocated distributing sterile needles to intravenous drug user.228
Similarly, it should also be stated that some church leaders from the Roman Catholic, Anglican and United Methodist churches in Manicaland could be viewed as ‗heroes‘
for promoting abstinence and faithfulness as the only means of reducing HIV transmission. Generally, either not having sex at all or practising safe sex can reduce the spread of sexually contracted HIV. The present research study will indicate that Christians did not speak with one voice on the matters of HIV prevention including the prophylactic use of condoms. While the State and some FBOs including the
227 S. Watts, Epidemics and history: Disease, power and imperialism, (London: Yale University Press, 1997), 16-17.
228 Rosenberg, Explaining epidemics, 289.
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churches in Manicaland carried out HIV interventions, there were always a number of limitations. Hence, according to Rosenberg this trend is historical:
AIDS has, in particular, forcefully reminded us of the difficulty of providing adequate care for the chronically ill in a system oriented disproportionately towards acute intervention—and of the complex linkages between disease categories, hospital policies, and reimbursement formulas.229
Consequently, the present study is a historical analysis of church responses to HIV within the socio-economic context of Zimbabwe. In the section that follows attention will now be drawn to the AIDS epidemic in sub-Saharan Africa