INTRODUCING THE STUDY
1.6. Literature Survey
1.6.2. The History of HIV and AIDS in Zimbabwe
While a number of publications on HIV and AIDS in Zimbabwe were available, few scholarly studies on HIV and religion exist. The work of the medical doctors, Mary Bassett and Marvellous Mhloyi, in an article entitled, ―Women and AIDS in Zimbabwe: The making of an epidemic,‖98 traces the history of AIDS in Africa and Zimbabwe. The authors identified the role of trade, migrant labour, and urbanisation in fuelling the heterosexual spread of HIV in Africa. The findings were further discussed in the light of the political economy of family structures that exposed women to the risks of contracting HIV and the connection between AIDS and sexually transmitted infections in Zimbabwe. While the authors mentioned important
96 Prince, ―Introduction to special issue,‖ v.
97 S. M. Joshua, ―The Catholic response to HIV and AIDS in South Africa with special reference to KwaZulu-Natal (1984-2005): A historical critical perspective.‖ Unpublished PhD Thesis, University of KwaZulu-Natal, (2010).
98 M. T. Basset and M. Mhloyi, ―Women and AIDS in Zimbabwe: the making of an epidemic,‖
International Journal of Health Services 21 (1991), 143-156.
28
dates in the history of the HIV pandemic in Zimbabwe and Africa, religious influence on women and AIDS in Zimbabwe does not receive prominence. The scope of the study was epidemiological but it also made reference to cultural practices such as patriarchy. While appreciating the critical issues being raised there, the present study will take the position that churches play a role in responding to the HIV pandemic, both positively and negatively. The present study will use the research findings from the Roman Catholic, Anglican and United Methodist churches in Manicaland to show that while religion has exposed churchwomen to the risks of contracting HIV, churchwomen were key players in rendering AIDS-related care to others.
In a similar way, Simon Gregson, a demographer, together with his colleagues working on the dynamics of the spread, effects and control of HIV pandemics in sub- Saharan has published extensively on HIV prevention in Manicaland, Zimbabwe. In a paper entitled ―Recent upturn in mortality in rural Zimbabwe: Evidence for an early demographic impact of HIV?‖99 Gregson et al. focus on the demographic impact of HIV infection in the Rusitu Valley of Chimanimani district and Honde Valley of Mutasa district, located in Manicaland province. The study initiated in 1993, which indicates a connection between religious affiliation and HIV-related mortality, concluded that religious affiliation was a key factor. Apostolic Church members in Honde Valley were less prone to contracting HIV because they ―follow a more restrictive behaviour code, which includes abstinence from drinking alcohol, extramarital relationships, medicines and modern methods of family planning.‖100 The inclusion of religious affiliation was of interest to the present study. Gregson et al.
however, focus attention on the escalating mortality rate and not on church responses to HIV and AIDS in detail. The present study differs from that of Gregson et al. by drawing attention to what the Roman Catholic, Anglican and United Methodist churches have done and failed to do in responding to HIV and AIDS in the province of Manicaland.
99 S. Gregson et al., ―Recent upturn in mortality in rural Zimbabwe: evidence for an early demographic impact of HIV?‖ AIDS 11, (1997) 1269-1280.
100 Gregson, ―Recent upturn in mortality in rural Zimbabwe,‖ 1273. See also a study by the Blair Research Institute/Oxford University, The early socio-demographic impact of the HIV-1 epidemic in rural Zimbabwe (Harare: Blair Research Institute 1996).
29
In 1999, Gregson et al. published another paper on the religious dynamics of HIV- related demographic changes entitled, ―Apostles and Zionists: The influence of religion on demographic change in rural Zimbabwe.‖101 Gregson et al. dedicated their time partly on Honde Valley whereby Apostolic and Zionist churches exist alongside Western missionary-initiated churches including the Roman Catholic, Anglican, and United Methodist Church. Using research targets from Honde Valley and Rusitu Valley, Gregson‘s study concluded that HIV-related mortality was reportedly high among members of Western mission-initiated churches. This was connected to moral laxity whereby ―avoidance of sin is largely a matter left to individual conscience and absolution can be obtained through confession and prayer.‖102 In contrast, HIV-related mortality among members of Spirit-type churches was reportedly low. The main reason being that
…members of these churches are more likely than other people to follow church teachings on avoidance of pre-marital and extra-marital sex and are therefore at lower risk of acquiring HIV infection—despite the potential for rapid transmission posed by the multiple partner aspect of polygamous marriage systems.103
Thus, Gregson et al. concluded that religion exerted both positive and negative influences on a person‘s sexual behaviour. However, the observations fell short of precisely stating what actions the churches carried out in responding to the pandemic.
A number of papers published on HIV prevention in Manicaland make reference to behaviour change being a factor to the decline in HIV prevalence in the province. In a paper entitled ―HIV decline associated with behaviour change in Eastern Zimbabwe,‖ Gregson et al. concluded that behaviour change translated in the decline in HIV prevalence in Manicaland from 23,0% in 1998-2000 to 20,5% in 2001 to 2003.104 According to Gregson‘s study, change of behaviour involves delay in sexual debut, reduction in multiple sexual practices, and consistent condom use in casual partnerships among the sample of participants. Whereas the study observes that a
101 S. Gregson et al., ―Apostles and Zionists: The influence of religion on demographic change in rural Zimbabwe,‖ Population Studies 53, 2 (1 February 1999), 179-193.
102 Gregson, ―Apostles and Zionists,‖ 188.
103 Gregson, ―Apostles and Zionists,‖ 190.
104 S. Gregson et al., ―HIV decline associated with behaviour change in eastern Zimbabwe,‖ Science 311 (3 February 2006), 644-646.
30
change in sexual behaviour could precede any observed decline in HIV prevalence, religion was not explicitly discussed in detail as a moderator of sexual behaviour either positively or negatively. The present research study will suggest that in the short term, the Roman Catholic, Anglican and United Methodist churches increased the risk of people contracting HIV by generally pursuing a moralistic stance against the use of condoms. This study will also take the position that in the long term, the moralistic messages passed on by the churches on prevention of HIV could have yielded positive results. The churches could have reduced the prevalence of HIV by preaching messages that focused on abstinence and delayed sexual debut among the youth and a reduction of casual sex among the married.
Halperin et al. were among those researchers whose studies sought to explain why Zimbabwe experienced a further decline in HIV prevalence in 2006. In a paper entitled, ―A surprising prevention success: Why did the HIV epidemic decline in Zimbabwe,‖105 Halperin et al. arrived at the conclusion that several factors were responsible for the decline in HIV prevalence in Zimbabwe. Important for the present study was the observation made by Halperin et al. that the churches in Zimbabwe had been one of the channels responsible in making HIV prevention and AIDS information accessible to the general public. Other factors include a dramatic economic decline from 2000 onwards leading to reduced occurrences of casual sex, high levels of secondary education and marriage, and people‘s direct witnessing of AIDS-related mortality under home-based care in homes as opposed to clinics.106 While this study was national in scope and did not restrict itself to the situation in Manicaland province, its findings speak to the present study. There was however no mention of the specific churches and the way in which religious views on the use of condoms affected the findings. The present study was aware that churches, including the Roman Catholic Church, were generally conservative about the use of condoms in the prevention of HIV. This study therefore explored church-led HIV prevention messages by tracing the divergent views on the use of condoms emanating from the ecclesiastical hierarchy and grassroots members of the Roman Catholic, Anglican and United Methodist churches in Manicaland.
105 D. Halperin et al., ―A surprising prevention success: Why did the HIV epidemic decline in Zimbabwe,‖ Plos Medicine 8, 2 (February 2011), 1-7.
106 Halperin, ―A surprising prevention success,‖ 4-5.
31
Further to the above, Gregson et al. sought to establish the extent to which national HIV prevention programmes led to a decline of HIV prevalence in Manicaland. Their study, published in 2011 and entitled, ―Did national HIV prevention programmes contribute to HIV decline in eastern Zimbabwe? Evidence from a prospective community survey,‖107 explores the effect of national HIV prevention strategies on HIV prevalence in Manicaland. In Zimbabwe national HIV prevention programmes under the State‘s Ministry of Health and Child Welfare (MOHCW) include abstinence, faithfulness to one sexual partner, safe sex or the use of condoms, prevention of mother to child transmission and voluntary counselling and testing.108 Gregson et al. attribute the decline in HIV prevalence in Manicaland between 1998 and 2003 to the conduct of safe sex by women who attended public HIV prevention meetings, the increased exposure to relatives dying of AIDS-related diseases, and the unemployment of men leading to changes in social norms and HIV prevention programmes initiated in schools in the early 1990s.109 Conclusions drawn from the study by Gregson et al. were quite similar to those of the 2006 publication mentioned above. A major concern however was the absence of any discussion of HIV prevention strategies undertaken by the various church bodies. It was therefore the intention of this present study to investigate the role played by the churches in their support or opposition to HIV prevention strategies initiated by the State in Manicaland.
Mandy Marshall and Nigel Taylor‘s paper entitled, ―Tackling HIV and AIDS with faith-based communities: Learning from attitudes on gender relations and sexual tights within the local evangelical churches in Burkina Faso, Zimbabwe and South Africa,‖110 also has relevance to the present study. Using case studies from three African countries including Zimbabwe, their study indicated some shortcomings of the churches in the response to HIV. Marshall and Taylor could state: ―It is not only
107 S. Gregson et al., ―Did national HIV prevention programmes contribute to HIV decline in eastern Zimbabwe? Evidence from a prospective community survey,‖ Sexually Transmitted Disease 38, 12 (December 2011), 1-8. The term community refers to a society or people who live together and share a common life.
108 MOHCW, National HIV/AIDS policy for the republic of Zimbabwe, (December 1999), 9, 10, 15, 16, 24-27. See also NACP, AIDS: Questions and answers, (Harare: UNICEF, 1993). See also NACP, Living with HIV and AIDS, (Harare: UNICEF, 1994).
109 Gregson, ―Did national HIV prevention programmes contribute to HIV decline,‖ 4-8.
110 M. Marshall and N. Taylor, ―Tackling HIV and AIDS with faith-based communities: learning from attitudes on gender relations and sexual rights within local evangelical churches in Burkina Faso, Zimbabwe, and South Africa,‖ Gender and Development, 14, 3 (November 2006), 366-374.
32
in its lack of response to the crisis that the church is struggling. At the same time, it is failing to lead by example on matters of sex, gender relations and HIV and AIDS in its own behaviour.‖111 The observation that some of the mainline churches in Zimbabwe focus their attention more on evangelism and personal ethics and give little attention to developing life skills and issues of human sexuality is particularly relevant to the present study. The findings of Marshall and Taylor however were set within a particular theological tone and did not identify specific cases. In addition, they pointed to some of the inherent weaknesses of church-led HIV interventions.
While taking note of some of their findings, the present study carried out further detailed investigations on the church responses to the HIV pandemic using as its study cohort three mainline churches in Manicaland.
According to UNESCO, culture is described in terms of ―the ways of living, working and playing is often presented as a reason to resist change and people regularly hide behind it to justify negative behaviours for instance, promiscuity.‖112 Culture defines the way in which male and female members of the family, community and society at large are socialised and interact. In focusing on the effect of culture on HIV and AIDS in Zimbabwe, Jovonna Rodriguez has made the important observation that:
In Zimbabwean culture, the community is the priority. In order to maintain a sense of community, old traditions are followed. The issue of sex, marriage, polygamy and importance of fertility all dictate gender roles and expectations. These same issues need to be re- examined and modified in order to for improvement to occur regarding AIDS and other sexual transmitted diseases. Once sexual expectations change, the rate of infection will begin to decrease as social pressures weaken.113
In her study, Maureen Kambarami used a hermeneutic of culture, femininity and sexuality to argue that women in Zimbabwe have a great risk of contracting HIV because of the practice of patriarchy, which thrived on female subordination.114 The
111 Marshall and Taylor, ―Tackling HIV and AIDS with faith-based communities,‖ 368.
112 V. Kernohan, ―Interrogating culture in addressing HIV, gender and sexuality,‖ Exchange on HIV and AIDS, sexuality and gender: Informing practice, (Two-2010), 8.
113 J. Rodriguez, ―AIDS in Zimbabwe: How sociopolitical issues hinder the fight against HIV and AIDS,‖ Emory Endeavours in world history, (March 2007), 6. Paper downloaded as pdf.
114 M. Kambarami, ―Femininity, sexuality and culture: Patriarchy and female subordination in Zimbabwe,‖ Africa regional sexuality resource centre in collaboration with Health System Trust, South Africa and University of Fort Hare, (September 2006).
33
paper generates important insights that are useful to the present study, including how a religion such as Christianity can reinforce patriarchy. As Kambarami goes on to declare:
To exemplify, Eve‘s alleged creation from Adam‘s rib has made women to occupy a subordinate position in the church as well as in the family. Women are therefore viewed merely as second class citizens who were created as an afterthought.115
While Kambarami‘s findings are valid in appreciating the dilemma faced by churchwomen in the context of HIV, there remains a need to document the experiences of Christian women in their day-to-day engagement with the AIDS pandemic and thus gives valid grounds for the present study.
Similarly, Pascah Mungwini, in ―Shona womanhood: Rethinking social identities in the face of HIV and AIDS,‖116 has highlighted cultural understandings that undermine women‘s value and in turn make them vulnerable to HIV in the Zimbabwean context.
The findings are relevant to the present study because they indicate that some Christian women in Zimbabwe have become their own oppressors. Such women are accused of being guilty of undermining laws that are meant to liberate them from cultural and religious tendencies that increase their vulnerability to contracting the HI- Virus. While HIV-positive women want to bear children as a way of expressing their need for survival, some members of society have always exerted pressure on women to be married and produce a child. Mungwini further argued:
As a result of these expectations numerous stories are told of women who have created illicit affairs (sexual) for the sake of having a child, affairs that stop immediately the woman realises she has fallen pregnant. Now in the face of HIV and AIDS pandemic the pressure that these traditional expectations place on women is not only constricting on what women can do but has become dangerous too.117
AIDS might have been responsible for male deaths leaving behind a trail of young widows and orphans. Based on personal experience, the researcher indicates that there
115 Kambarami, ―Femininity, sexuality and culture,‖ 4.
116 P. Mungwini, ―Shona womanhood: Rethinking social identities in the face of HIV and AIDS in Zimbabwe,‖ The Journal of Pan African Studies 2, 4 (June 2008), 203-214.
117Mungwini, ―Shona womanhood,” 208.
34
has been a surge in numbers of single women in Zimbabwe and they are popularly known as ―single mothers.‖ Douglas Feldman also observed that AIDS is a cultural phenomenon by noting:
The way in which we as a species handle AIDS is a measure of our changing times, of our deepest fears, of our varying values, and of our collective inspiration. It is impossible to truly understand the role of AIDS in our lives unless we consider the social and cultural contexts of AIDS-related behaviour.118
Paul Gundani‘s essay entitled ―Church, media, and healing: A case study from Zimbabwe,‖ that was published in 2001,119 was written at a time when HIV had already made strong inroads into the entire Zimbabwean nation. In this essay, Gundani highlights how Zionist and Apostolic churches use the media to advertise their promises to heal ―all forms of ailments and suffering including cancer, hypertension, stomach problems, acute headaches, bad dreams, barrenness, unemployment, bad debts, and failure to prosper in life.‖120
In a time of AIDS, health seeking behaviours in Zimbabwe have prompted people to consult with Christian prophets, churches and traditional health practitioners.
However, Gundani‘s article avoids mentioning the words ‗HIV and AIDS‘ and yet its incurable nature has driven many individuals to seek places of healing. Gundani‘s observations are reminiscent of the spiritual healing carried out by Livingstone Nerwande in the Anglican Church in Manicaland in the mid-1990s as will be discussed later. Some healing prophets have reportedly claimed to cure AIDS. In Zimbabwe, some traditional healers have also discouraged PLHIV from taking ARVs and instead have assured their clients of complete healing. Media reports in Zimbabwe often carry incidences of some prophets who ―use unprotected sex as a form of internal cleansing thereby increasing the risk of spreading HIV and AIDS.‖121
118 A. Feldman. Culture and AIDS, (New York: Praeger, 1990), vii.
119 P. H. Gundani, ―Church, media, and healing: A case study from Zimbabwe,‖ Word and Word XXI, 2 (Spring 2001), 135-143.
120 Gundani, ―Church, media, and healing,‖ 136.
121 E. Siamonga, ―Hundred of worshippers dying as churches ban HIV and AIDS medication,‖
Newsday, Zimbabwe, (13 March 2011)).
35
Elesinah Chauke‘s article, ―Theological challenges and ecclesiological responses to women experiencing HIV/AIDS: A south eastern Zimbabwe context,‖122 also has relevance for this study. The paper published in 2003 made use of the methodology of oral history on women‘s experience of culture in relation to the HIV pandemic in south eastern Zimbabwe. The fact that culture is highlighted as being responsible for exposing women to the risks of contracting HIV, and that the Christian churches have done little to address this problem, is particularly relevant. However, this paper focuses on what the churches can do to assist women who have the potential of being infected and affected by HIV. The present research study differs from that of Chauke in the sense that it deals with how the three specific churches in Manicaland responded to HIV and AIDS from 1985 to 2007. Indeed, the present study is aware that all human societies, past and present, have suffered from infectious diseases and that the belief systems of many traditional societies contain elements that are compatible with the notion of contagion.123 A dynamic relationship between religion and HIV and AIDS exists. First it is critical understand how religion and public health can contribute to a fuller understanding of the epidemic. Second, it has to be established whether or not religion has a positive or negative influence on HIV prevention and mitigation.
Sophie Chirongoma‘s essay entitled, ―Women, poverty, and HIV in Zimbabwe: An exploration of inequalities in healthcare,‖124 focuses on rural women‘s anguish and struggle with access to healthcare facilities in the context of HIV. Insights on the decline of the public health sector in Zimbabwe caused by the introduction of economic reform programme (ESAP) in 1991 were of significance to the present study. The programme placed ―people under pressure and stress, which leads to their adoption of risky survival strategies. This makes them highly vulnerable to HIV infection and AIDS.‖125 Chirongoma mentioned the Roman Catholic Church in Zimbabwe and the Catholic Relief Services (CRS) for their support in AIDS-related
122 E. Chauke, ―Theological challenges and ecclesiological responses to women experiencing HIV/AIDS: A south eastern Zimbabwe context,‖ in I. Phiri et al., (eds), African women, HIV/AIDS and faith communities, (Pietermaritzburg: Cluster Publications, 2003), 128-148.
123 C. S. McCombie, ―AIDS in cultural, historic, and epidemiological context,‖ in D. A. Feldman (ed), Culture and AIDS, (New York: Praeger, 1990), 9-27.
124 S. Chirongoma, ―Women, poverty, and HIV in Zimbabwe: An exploration of inequalities in health Care,‖ in I. Phiri and S. Nadar (eds), African women, religion, and health: Essays in honour of Mercy Amba Ewudziwa Oduyoye, (Pietermaritzburg: Cluster Publications, 2006), 173-186.
125 Chirongoma, ―Women, poverty, and HIV in Zimbabwe,‖ 180.