Back to Index
AIDS and Africa
when a country's population is reduced by 25 percent and its doctors,
educators, civil servants, police and military are not there to
it appears, the AIDS epidemic in Africa can no longer remain unacknowledged--either
by Africans themselves or by Western governments, which have essentially
written off the entire continent as best left alone. The denial
of AIDS was also true at the beginning of the scourge in the United
States, both by government officials, who waited an inordinate time
to appropriate adequate funds to address this modern plague, and
by the gay community, which didn't want to admit that certain forms
of sexual activity are high risk. In some things, Africa has learned
well from Western models--denial being one of them. African countries
waited too long to acknowledge the magnitude of this international
curse. Most of them have now reached the beginning stages of admission:
there's a problem out there, even if few are able to do much about
AIDS hoax and other perceptions
unspoken issue of African AIDS (which for the most part is transmitted
heterosexually) has often been connected to Western perceptions
of African sexuality. If Westerners say anything disparaging about
African sexual practices, the statement will be regarded as a racial
slur. As recently as 1995 the cover of an issue of Transition, an
African journal published in the United States, proclaimed "The
African AIDS Hoax," accompanying the thesis of the lead article
with the bemused face of an African woman who is watching two disembodied
hands slipping a prophylactic over an amply proportioned dildo.
The caption inside the magazine, which shows the entire photograph
(four women sitting at a table), embellishes the context: "Traditional
healers are given dildos and condoms to demonstrate safe-sex practices
to their patients." The cropped photograph of the woman on the cover
seemingly attests to the insignificance of AIDS in Africa. No problem.
Another Western hoax to exploit peoples of the global South?
author of the Transition article ("Outbreak? AIDS, Africa, and the
Medicalization of Poverty"), was especially concerned with Western
perceptions of African sexuality. Africans are no more promiscuous
than Westerners, he argues; the definition of AIDS, for Africa,
is different than it is for countries in the West. "WHO's clinical
case definition for AIDS in Africa ... is not based on an HIV test
or T-cell counts," he says, "but on the combined symptoms of chronic
diarrhea, prolonged fever, ten percent body weight loss in two months,
and a persistent cough--none of which are new or uncommon on the
African continent. These conditions are not sexually transmitted;
they are caused by environmental risk factors to which many Africans
are regularly exposed."
that by inflating the number of African AIDS cases, the West will
find it easy to justify testing new drugs in Africa, because Africans
are uninformed and therefore more likely to become willing guinea
pigs. He argued for alleviating African poverty rather than altering
the sexual practices of the continent's population.
There is no
question about the extent of African poverty. Civil wars, drought,
disease, disastrous leaders--all have contributed
their share to the backbreaking lives that many of the continent's
people endure. For most Africans, income hovers around a dollar
or two a day. Add to that corrupt governments, along with the flow
of profits from oil and diamonds into the pockets of military (and
civilian) governments, and the situation is not encouraging. These
chronic problems have also become convenient excuses for further
exploitation of Africans by Western corporations and individuals,
who are quite willing to take from the continent but give nothing
in return. In most civil wars, the diamonds and the oil get through,
just as the necessary military hardware gets sold to both sides.
And the average African's life becomes ever worse, so bad that even
the old days of the colonial era begin to look pretty good. There
are numerous current speculations that in many countries of the
continent, life expectancy will slip by twenty-five or thirty years.
fear that Africans will be exploited, become human guinea pigs if
drugs are tested for an AIDS vaccine, is premised on the assumption
that Africans are less informed than Westerners. Yet ignorance about
AIDS has been universal, continuing to this day, with Africans showing
no monopoly here. Until the last few months, the average American
believed that AIDS is no longer a problem anywhere because Americans
who are HIV positive are living much longer than before. Seemingly,
medicine has solved the earlier problems. This misperception is
simply a logical extension of earlier denial of the problem. Only
homosexuals, drug addicts, and Haitians (plus an occasional hemophiliac)
get AIDS, which means that it isn't a middle-class white problem.
Five years ago,
when I started returning to southern Africa on a fairly regularly
basis, little in the African media drew attention to AIDS. Government-controlled
newspapers in Zimbabwe, for example, which often detailed sensational
stories of sexual abuse (rape, pedophilia, sodomy), rarely mentioned
the existence of AIDS. What little coverage there was was buried
inside the paper or in the back pages, while the latest rape trial
commanded front-page coverage day after day. A similar denial of
the existence of AIDS operated within the general public. No one
talked openly about sexuality. No one, in fact, ever died of AIDS.
The latest death was always the result of tuberculosis or the other
diseases of poverty mentioned in Geshekter's article.
major concern (and the causal issue for Western myopia about AIDS)
is promiscuity. To acknowledge in 1995 that millions of Africans
were dying from AIDS was to admit that those people are sexual beings.
Inhibiting discussion of the frightful existence of AIDS in Africa
was the fear of saying something offensive.
the United States, the legacy of Puritanism survived the sexual
revolution of the 1960s and '70s, ironically because of the outbreak
of AIDS a decade later. Africans and Asians--traditionally not Christians--have
regarded sexuality without the inhibitions of the West, which is
to say that sexuality and religion in many parts of the world have
been mystically and even pragmatically connected rather than separated,
as they have been in the West. Might not Christianity be described
as a religion of denial and therefore consistent with the denial
Before the advent
of Islam and Christianity, many Africans were animists, ancestor
worshipers. Millions of Africans still are, though they may also
profess to being Christians or Muslims. If you worship your ancestors
and therefore assume that your own descendants will pay homage to
you, then you must procreate. Children are an absolute necessity
if the linkage with the ancestors is to remain unbroken. If you
do not have children, if you do not procreate, then your ancestors
will curse you. No wonder, then, that it has been all but impossible
to convince many African women (and others in the world who are
animists) that birth control should be practiced, since it goes
against inherent beliefs. Such traditions also imply that when infant
mortality rates are high (as they always have been in Africa), you
must have as many children as possible so that some will survive,
outlive you, and produce their own children.
typically ignorant of these beliefs, which can be simply restated:
if you must have children, then there must be sexuality. Hence,
also, polygamy, since traditionally men died in warfare and there
were more adult women than men. Procreation is at the heart of much
of African sexuality--not pleasure, which is at the center of Western
sexuality. To keep the ancestors happy, one marries not to sanction
passion or legitimize love but to channel sexual need and obligation.
In times of
rapid social change--urbanization, family breakdown, increased affluence
and mobility--sexual mores also change rapidly (sex with an increasing
number of partners, as we witnessed in the United States in the
1960s and '70s), but some attitudes remain the same. Though Hollywood
films and, most recently, American pornography have made Africans
aware of Western sexual obsessions in a way earlier generations
were not, traditional sexual practices may not always have changed
that much. An American friend of mine who married an African woman
thirty years ago tells of the first time he kissed his wife's breasts.
"No, no. For baby," she told him. The example is significant.
To be more direct,
despite our belief that foreplay, including kissing, is universal,
for much of traditional Africa, sexual activity is intercourse only.
And no foreplay meant, and continues to mean, no lubrication, which
means a greater possibility of a man's passing the AIDS infection
to a woman during intercourse. The term in southern Africa is "dry
sex," supposedly asserting masculine dominance. Thus, in contrast
to the United States, in Africa more women than men are HIV positive
(55 to 45 percent). One man may infect several women, all of whom
may be his wives. He himself may have been infected by a prostitute
in the area where he works to make money for his wife or wives at
home; or simply by a casual relationship with a woman, who, even
if she does not derive her livelihood from prostitution, still may
have had several sex partners. Do these cultural and religious practices
make Africans more promiscuous than Europeans and Americans? Certainly
not, though today they entail elements of higher risk. Just as Americans'
awareness of safe sex brought the sexual revolution to an abrupt
halt, one can speculate that the same will eventually be true in
Africa--except that the casualties on the African continent are
going to be much greater than in the United States. We are only
at the beginning of the AIDS catastrophe. Even by 2010, we may not
have reached the epicenter.
It should come as no surprise that one group of Africans--the continent's
writers--has tried for years to highlight the deadly risks of unprotected
sex. Those who say that nothing good has ever come out of Africa
are clearly unfamiliar with the continent's art, music, and literature.
When governments were still refusing to admit that AIDS existed,
the writers were playing the role that African writers have always
played: critics of their societies. In the early to mid-90s, plays
that openly dealt with the issue were presented in South Africa.
One of Zimbabwe's award-winning writers, Alexander Kanengoni, used
his story "Effortless Tears" as the title for his collection of
short fiction published in 1993. Two novels of the same time pioneered
the issue of AIDS in African fiction:Confessions of an AIDS Victim,
by Carolyne Adalla, published in Kenya in 1993; and Waste Not Your
Tears, by Violet Kala, published in Zimbabwe in 1994. More recently,
the floodgates have opened, and dozens of Africans are writing about
works--by Kanengoni, Adalla, and Kala--are quite different from
the AIDS fiction that appeared at the beginning of the U.S. epidemic.
The fact that the two novels were written by women is particularly
revealing. Kanengoni's "Effortless Tears"--the most accomplished
of the three--is about the burial of George Pasi, the narrator's
cousin. "Almost everyone ... knew that George had died of an AIDS-related
illness but no one mentioned it," the narrator explains in the opening
paragraph. "AIDS finally caught up with us." He continues, mentioning
"sealed wards" in the country's hospitals, "teeming with people
suffering from AIDS," but the primary issue is that "AIDS had finally
knocked on our doors," an especially revealing statement for 1993,
when almost nothing was said publicly about AIDS anywhere in Africa.
The elders connect the scourge to the country's ongoing drought,
"the strange doings of this earth." The cattle are thin but no thinner
than George at his death, both victims of "an invisible enemy that
had sneaked into our midst and threatened the very core of our existence."
Yet by the story's end, the curse on the land (the drought) and
on man (AIDS) is projected onto the living, who will have to deal
with both the drought and the epidemic. "We were not weeping for
the dead. We were weeping for the living."
one of Zimbabwe's so-called literary writers and the author of works
regarded as "difficult" for the average Zimbabwean reader. By contrast,
both Confessions of an AIDS Victim and Waste Not Your Tears are
popular fiction, written for readers interested in sensation. Both
novels touch on prostitution as well as the fast pace of city life
vis-ê-vis more traditional village life. Both novels chronicle
the events that lead to the main character's (a woman's) infection.
of an AIDS Victim takes the format of a lengthy epistle, written
in installments by Catherine Njeri to her friend Marilyn, in the
Netherlands. Catherine learns that she is HIV positive because of
a blood test required for graduate study in the United States. The
letter traces her process of self-awareness, as she describes her
sexual experiences during the past six years. Though didactic, it
is totally convincing, a warning to others to avoid the casual relationships
with men that have led to her downfall. Waste Not Your Tears is
much more a finger-pointing account of a young girl's intentional
infection by her HIV-positive older lover, who wants to entrap her
so she will take care of him during his declining days. Roderick,
the villain, bears a number of similarities to cads in Western romances.
He's lazy, vindictive, and abusive. Above all, he knows how to manipulate
the system--an AIDS clinic in Harare--where he seduces Loveness
and more or less enslaves her for his sexual needs.
tells us about her numerous sexual relationships, as well as her
more lengthy relationship and love for Brian, who impregnates her.
When her parents prohibit her from marrying Brian because of his
differing tribal origins, Catherine searches for a more satisfactory
lover. By the time of the blood test for her visa, she has been
Alex's lover for three years. Informed of her infection, Alex not
only becomes verbally abusive but beats and abandons her. Her attempts
to convince him to be tested are futile; he would prefer not to
know if he is HIV positive because he might have to alter his sexual
Loveness' love/hate relationship with Roderick--after he has infected
her--approaches masochism. When she becomes pregnant, all that Roderick
can think about is that a woman might finally bear him a son (his
earlier six "wives" bore him daughters). The baby is, indeed, a
boy but dies almost immediately from AIDS. That hardly matters,
for Roderick now knows that Loveness can produce male babies, so
he quickly makes certain that she becomes pregnant again. Fortunately,
the second pregnancy is naturally aborted, yet Loveness continues
to have intercourse with Roderick, justifying these unions because
at least he won't be infecting anyone else. In the aftermath of
complications from her miscarriage, however, she nearly bleeds to
death because Roderick refuses to take her to a hospital. After
his death, Loveness acknowledges her fate, determined to live "each
day as it comes, as positively and effectively as she can."
At the end of
Confessions of an AIDS Victim, Catherine--who refers to her story,
her several affairs, as "a fairly normal life for a girl in Kenya"--awaits
her inevitable decline and her own death. From her friend in the
Netherlands, she borrows a metaphor to describe the increasing worldwide
plague: "I can't help likening the AIDS infection to the underground
trains. I can envisage many people boarding the trains daily from
various stations all over the world. Their destinations? These underground
trains will take those aboard to their graves, swiftly if I may
Central to each
story is the African woman's second-class status, particularly with
regard to sexual activity. What's an African girl going to do, especially
one with any curiosity and an awareness of the limited future for
women who remain in the bush? As Catherine tells us, "AIDS has come
to exploit the low status of the women in African society. Even
by the family, the girl is treated as being more lowly than the
boy. She is just an investment, a flower that will blossom in spring,
yield dowry and wither in autumn. She grows up to be a wife whose
rightful place is in the kitchen, with due submission and allegiance
to the husband."
Earlier in her
story, Catherine talks persuasively about the necessity of African
mothers educating their daughters about human sexuality. But tribalism,
she asserts, is also a cause of the female's lowly status. Despite
Catherine's university education, her parents prohibited her from
marrying the man of her choice. Still, Catherine suggests the changes
that will be necessary to bring an end to the African woman's second-ranked
status: an end to group circumcision, "where the circumcision blade
is never sterilised between each individual circumcision"; an end
to the inheritance of "an otherwise healthy wife, after the death
of a husband possibly from AIDS"; and, above all, an end to polygamy.
"I know of a man who had three wives and sixteen children. He contacted
the AIDS virus and somehow infected all his three wives. The man
died two years ago and has since been followed by two of his wives.
I guess the third is still on the underground train, with one foot
in the grave. Soon, sixteen children from one home will need an
Waste Not Your
Tears is equally relentless in its attack on men and their treatment
of women as objects of convenience. Roderick literally refers to
himself as a lady-killer. African women have had few alternatives
besides marriage and mothering, while the men have been free to
move from partner to partner. In one of the novel's most revealing
incidents, Loveness overhears her stepmother talking to her baby
girl: "'Useless, useless. What good are you? Withering up my breasts,
taking my nourishment. And for what? When I am old, you will be
taken up with your husband. You will look after some other parents
in their age. And me? Who will care for me? Useless."
what is to be done?
fact that AIDS is caused by sexual activity a myth?
No one can deny
the horrific extent of African poverty and the international community's
myopia about Africa's increasing needs. But these two women writers,
Adalla and Kala, offer a completely different view of African sexual
patterns than those proposed by Geshekter and the other deniers
of African AIDS. Both stories are competently written accounts of
women as victims, as losers in a system that perpetuates the double
standard, whether the men be husbands or lovers. Both novels contain
references to safe sex (condoms), but the men are not interested
in using protection. Furthermore, it would be difficult to imagine
African readers as being titillated by either story. Though Kala's
publisher told me that her novel has not sold well--because of its
AIDS theme--both writers intend their stories to be taken as warnings
that traditional sexual practices can no longer be tolerated.
ago, when I first visited Zimbabwe, the beggars I encountered in
the cities were the blind, discreetly begging for alms while silently
reading their copies of the Qur'an in Braille. During my more recent
trips, the beggars have increased exponentially; they are now typically
children, especially young girls ten, eleven, or twelve and their
younger siblings. Those I have talked to have told me that their
parents have died of AIDS and that they beg to provide for their
younger brothers and sisters. These young girls have suddenly become
heads of households. Some churches in the United States and Europe
are assisting them, but the begging on the street will only increase
as huge numbers of adults between the ages of sixteen and forty-five
die from AIDS.
information about AIDS in Africa has reached the unimaginable level.
At the beginning of this year, there were 1.1 million orphans in
Uganda because of AIDS. In Ethiopia, there were 700,000; in Zimbabwe,
360,000. It's going to get much worse, as millions of HIV-positive
adults continue to die, leaving more and more orphans. And the figures
about HIV-positive adults in many countries in southern Africa keep
getting worse. Twenty-five percent of Zimbabwe's adults are estimated
to be HIV positive. That's for the entire country, though for the
cities the figures are estimated to be much higher--50 percent in
Harare, the capital, for example. AIDS can no longer be kept hidden
away, out of the country's consciousness.
be done at this stage?
For those not yet infected, the recent campaigns about safe
sex are about all that one can expect. In Uganda and Senegal, where
the governments have made a concentrated effort to raise people's
awareness of the epidemic, there has been measurable success. NGOs
in some countries have also been successful in their attempts to
expose and stem the growing horror. The Woman and AIDS Support Network
in Harare, for example, has been selling a book called We Miss You
All, the autobiography of a Ugandan woman named Noerine Kaleeba,
whose husband died of AIDS. The lengthy account of her husband's
disease and death sells for the equivalent of ten American cents
and is therefore within the budget of most African women. With each
copy, the Woman and AIDS Support
Network includes a copy of its latest newsletter, with a condom
attached to it.
For those who
already have AIDS, even the ongoing battle to convince Western pharmaceutical
countries to license drugs so they can be available to Africans
cheaply may not solve the problem. American AIDS victims spend thousands
of dollars a year, taking sophisticated drugs to prolong their lives.
Most countries in sub-Saharan Africa have only a few dollars to
spend on each person for medicine per year. Few Africans are rich
enough to pay for the drugs themselves. If the medicine could somehow
be made available for no charge at all (should pharmaceutical companies
and Western governments be so enlightened), the medicine would still
be unsuitable for many people. An African woman who is pregnant
or breast-feeding may not have the basic nourishment to sustain
her own health, let alone take a battery of toxic medicines.
That may leave
only one real hope--the rapid discovery of an AIDS vaccine to prevent
future infections. Though several vaccines are currently being tested,
some of those in clinical trials are not for Africans, who have
a different strain of HIV than Westerners. Geshekter and others
have worried that Africans may be used as guinea pigs for such trials.
Edward Hooper's recent study, The River: A Journey to the Source
of HIV and AIDS, also picks away at a festering issue: was AIDS
transferred to human beings because of a medical error? Hooper's
compelling narrative speculates that some chimpanzee livers used
to culture polio vaccine forty-five years ago were infected with
HIV. When massive polio inoculations were undertaken in Africa,
HIV may have been introduced. Though Hooper's speculations have
been largely discredited, it doesn't help that for years people
have argued that AIDS is a Western plot to control African populations.
Nor do the recent pronouncements by South Africa's President Thabo
Mbeki--that poverty is the problem, not the virus--help the cause.
Too many Americans
believe that AIDS in Africa has nothing to do with them. Let the
continent become what it will.
When did we
become so callous to human suffering? Now that our economy is stronger
than it has been for years and more Americans are living better
than ever before, does that become the cache for our own self-centeredness,
the sanction for ignoring the needs of the planet's forgotten? Sadly,
our affluence has resulted in nouveau greed. There are billionaires
in proximity to where I live who don't give a penny to philanthropy.
And our own government--because of the pressures of congressmen
and senators--has cut foreign aid to the lowest levels in a generation.
Our nation's affluence has become an obscenity; history will not
treat us favorably.
when a country's population is reduced by 25 percent and all the
doctors, educators, civil servants, police, and military are not
there to keep order? Will this have nothing to do with our national
security--let alone our sense of human dignity? Will the child militias
simply take over all these countries (not solely in Africa but in
parts of Asia where AIDS is ravaging with equal fervor)?
It is not unreasonable
to expect a massive influx of illegal immigrants as soon as the
conditions of daily life begin to reach zero in many of these countries.
That won't be in 2010 but well before that. There's already a brain
drain going on in many areas of Africa, but this outpouring of immigrants
is going to be somewhat different, as hundreds of thousands of Africans
who are not infected realize they have no choice but to flee a sinking
ship. Are Europe and the United States ready for such a massive
influx of new immigrants?
In Jean Raspail's
futuristic novel The Camp of the Saints (1973), a flotilla of decrepit
ships approaches Europe with 800,000 Indian passengers, fleeing
the squalor of their lives. One sentence will suffice to set the
context: "As the decks sprang to life with their myriad bodies--men,
women, children, steeping in dung and debris since Calcutta--as
the hatchways puked out into the sunlight the sweating, starving
mass, stewing in urine and noxious gases deep in the bowels of the
ships, the stench became so thick you could practically see it."
No matter from what perspective the current African AIDS epidemic
is examined, it's a tragic story that is about to get worse, much
clinics in Harare where children are dying of AIDS, talking to orphans
on the street, I can't help thinking that our slow response to this
major catastrophe isn't far removed from Western attitudes about
Africans 150 years ago. In the nineteenth century, we needed Africans
for our plantations in the South. Entire communities were decimated
by the slavers, leaving those who survived (children and the aged)
to fend for themselves. AIDS is the new version of slavery, devastating
the entire continent. What's any different? Western corporations
still get rich because of oil and diamonds and other resources,
but little of the wealth is returned to the African continent. We
are still willing to exploit Africa but do little to help in its
worst hour of need. To paraphrase Alexander Kanengoni, we should
not be weeping for the dead but for the living.
R. Larson is professor of literature at American University and
president of the African Skies Library Foundation.
Please credit www.kubatana.net if you make use of material from this website.
This work is licensed under a Creative Commons License unless stated otherwise.