3.3 Anthropological Issues 45
3.3.4 Traditional Cultural Practices in an HIV Climate 52
Another aspect of great concern in the HIV scenario is the issue of traditional cultural practices. A study in Kenya8
Omwega (2001) argues that the Kenyan government, churches and families were in denial about HIV infection (because of the stigma attached to HIV) until two years ago. It is estimated that at least seventy people die each day as a result of HIV Wagiri (2001) contends that female genital mutilation (also known as female circumcision) contributes to the subservience of women and the spread of HIV because it is carried out in less than aimed to highlight the challenges of some of the traditional cultural practices of women in the fight against HIV infection. The National AIDS Control Council (NACC 2000) believe that within the age range of 15-24 years, females were found to have twice as many HIV infections as their male counterparts. Otieno (2007) concurs that the early exposure to HIV among women leads to early deaths usually by mid-twenties to early thirties, and believes that the pandemic is being fueled by ignorance and traditional cultural practices that are deeply embedded in society for centuries, despite the danger they now pose with the spread of HIV and AIDS. Otieno adds that Kenya like most African countries, is rich in its various cultural practices, and that Kenyans believe that if cultural practices are violated, they will perish.
8 Otieno T N (2007) The Dilemma of Kenyan Women: Questioning Tradition in the Battle against HIV/AIDS.
Chapter Three Indrashnee Devi Appalsamy Literature Review: Scanning the HIV and AIDS Scenario
D.Ed Thesis: An insight into the experiences of educators living with HIV and AIDS in the context of schooling
and beyond 53
hygienic conditions by women who are not trained. The danger in this practice is the possibility of HIV transmission, but for a community in denial of HIV, the practice is all the more dangerous.
Marrying girls off at a young age, according to Kimani (2002), may appear awkward and inhumane, but this practice is widely followed among ethnic groups in Africa. Kimani further explains that the danger here is that men who marry these young girls are much older and a teenage bride is probably a second or third wife, thus promoting polygamy and the spread of HIV. Leclerc-Madlala (2003) agrees with Kimani’s view in that African culture encourages young women to marry older men. The NACC (2000) concurs that the African tradition of polygamy often poses difficulties in prevention strategies against the spread of HIV and AIDS. Okongo (2001) concurs with the above views saying that it is difficult to manage the spread of the virus in a monogamous relationship, but the situation becomes more complicated where multiple wives are involved, and this polygamous, submissive role played by women for many centuries is posing a huge threat to their health and the spread of HIV.
South Africa’s neighbour Botswana has one of the highest prevalence’s of HIV in the world (Botswana 2003), estimated at 37% of adults aged 15-49. A survey9
9 See Effects of HIV-related stigma among an early sample of patients receiving antiretroviral therapy in Botswana. AIDS Care, November 2006.
was done with people who were recruited from three private clinics in Botswana by their caregivers. The people in this survey were interviewed on issues of HIV-testing, stigma and discrimination. The respondents in this study explained their fear of an HIV-positive diagnosis, hence the reluctance in getting tested; this fear was also related to the stigma and discrimination associated with HIV. The survey revealed that stigma and discrimination were huge obstacles to getting tested and seeking treatment; from this survey it was noted that 94% of the participants kept their HIV positive status a secret from their communities; 69% withheld this information from their own families and 47%
stated that HIV affected their ability to work, resulting in frequent sick leave, and fear of job-loss.
According to Botswana’s Strategy (2004), stigma is a key barrier to HIV testing and treatment in African settings, and this should be recognised as a major target for intervention. Botswana’s “opt-out” policy as stated by The Ideal (2004, cited in The Economist 2004) was introduced in 2004 and intended to reduce AIDS exceptionalism by making HIV testing a routine part of all medical interactions and allowing patients to obtain results without others knowing. This initiative, according to reports (LaFraniere, 2004: Rolling out, 2004), suggests that the numbers of patients undergoing testing and enrolling in ARV therapy has increased significantly. The high HIV prevalence amongst females is attributed to the female anatomy, and they are often referred to as carriers of the virus.
The unequal status of women have put them in a predicament concerning HIV, according to a study done on African-American women10
Here in South Africa, women live in a patriarchal society, and are generally labeled as carriers of the disease. This claim is highlighted in a study done in a black township in CapeTown
. Murray (2007) says that statistics reveal that African-American women are 23 times more likely to be infected by HIV compared to European-American women. She believes that factors like socio-economic status, self- esteem issues, the myth that HIV and AIDS only affects gay men and a false sense of security with their partners, are responsible. The study also revealed that African- American women represent 64% of female HIV and AIDS cases, and that blacks in the United States maintain one of the highest rates of HIV and AIDS infections in the nation although they are just 13.4 % of the population. In my view HIV is considered to be a colour-blind, classless virus, the spread of HIV is strongly related to life-style choices, ignorance about the transmission of the virus and the stigma and discrimination related to this ignorance.
11
10 See Murray’s article (2007), New HIV/AIDS study seeks to include African-American women.
11 See Rohleder & Gibson (2006), ‘We are not fresh’: HIV positive women talk of their experience of living with their ‘spoilt identity’.
to explore how women experience and deal with AIDS stigma under conditions where they have little formal support. The study found that after the women in the study received their HIV positive diagnosis, they viewed themselves as dangerous,
Chapter Three Indrashnee Devi Appalsamy Literature Review: Scanning the HIV and AIDS Scenario
D.Ed Thesis: An insight into the experiences of educators living with HIV and AIDS in the context of schooling
and beyond 55
dirty and contagious. The women took on an image of a “spoilt identity”, which was difficult to manage in the social context in which they lived. While they attempted to do so, its effects were at times overpowering, leaving them with an overwhelming feeling of loneliness and sadness. The study also reported that HIV remains a highly stigmatised condition that affects the deviant “others”.
The KwaZulu-Natal province in South Africa is considered to be the worst hit by the HIV and AIDS epidemic (ELRC Report 2005; Motsemme 2007). This is evident from a study12 by Motsemme (2007) in the township of Chesterville13
For any programme to be effective, there must be monitoring and evaluation, anecdotal evidence often critisises programmes that are not monitored and evaluated as ineffective.
A study
in Durban. In this study Motsemme explains the plight of the women she interviewed in a township, which is one of the poorer ones. The township has acquired the status of one that “harbours HIV and AIDS”, and people from there are considered to be dangerous, polluted, and potential carriers of HIV. Motsemme further adds that such sentiments reinforce notions which tend to fuse poverty with women, thus linking them to symbolic and physical pollution.
Her study alludes to linking such people as hyper-vigilant and self-conscious about anything that may link them to this “death-promising virus”, including speaking about HIV and AIDS in “veiled and masked” forms.
HIV and AIDS has become feminised and racialised, with women always being blamed as carriers of the virus. McFadden (2004: 12) agrees:, ”…the dominant discourses of disease and sexuality have traditionally portrayed the Black female body as the essentialised vector of “evil” and “promiscuity”.
14
12 See Motsemme N. (2007), ‘Loving in a time of hopelessness’: On township women’s subjectivities in a time of HIV/AIDS.
13 Chesterville is a township in the city of Durban in the province of KwaZulu-Natal in South Africa.
14 See Sex, sexuality and sickness: Discourses of gender and HIV/AIDS among KwaZulu-Natal women.
South African Journal of Psychology; Sept 2004, Vol.34 Issue 3, 487-505.
by Hoosen & Collins (2004) suggests that education programmes have not reached enough people, and are not sufficiently effective. They emphasise that future AIDS programmes need to challenge discursive practices that disempower women.