World AIDS Day – The Power of One

Today is the 20th annual World AIDS Day, a day set aside to remember those who have died of HIV/AIDS and those who are living with HIV/AIDS. It’s also a day to remind ourselves that we all are affected by this disease. Today, many of us are wearing red ribbon pins. Many of us have placed red ribbon photos on social networking sites. Many of us will be attending HIV/AIDS breakfasts or seminars. Many of us are blogging about HIV/AIDS.

Do any of these events really matter? Roughly 35 million people worldwide are infected. 14,000 people become newly infected every day. Will wearing a red ribbon or attending a breakfast change that? Sometimes, the pessimist in me says no. But then I look around at the various activities going on and think differently. Never underestimate the power of small actions. Never underestimate the power of one.

At Davidson College, groups of students are making a difference. For several years now, the members of Warner Hall, a women’s eating house at Davidson, have hosted the Red and Black Ball, a charity event for HIV/AIDS. This year, the proceeds will benefit Metrolina AIDS Project in Charlotte and Thyatira
Hospital in Mwandi. The members of Warner Hall also help Metrolina AIDS Project in other ways. Recently, I joined them on a Saturday morning to make condom packets – small bags containing condoms and information about getting tested for HIV – to be distributed at local bars and clubs.

Students at Davidson College make condom packets for Metrolina AIDS Project

This effort, though, is not solely an extracurricular activity. In a mutually beneficial partnership, the students in my Biology course on HIV/AIDS cooperate with Warner Hall on some of these projects. Together, we have sponsored screenings of movies like 3 Needles, volunteered at a local HIV/AIDS benefit triathlon, collected toys for the annual Metrolina AIDS Project holiday party, and organized speakers and symposia. Academic and extracurricular activities are wonderfully joined.

Volunteers getting ready for their assignments at a triathlon to benefit Metrolina AIDS Project

None of these events, individually or even in total, will end the AIDS Pandemic. But each and every one of these events does make a difference. Maybe one person will receive a condom packet and, as a result, not become infected. Maybe the money sent to Mwandi will help provide care for a child in need. Maybe one person who listens to a seminar will enter a career of public service. Maybe all of us will be a little more aware.

Today, I’m wearing my red ribbon. Today, I’m blogging about HIV/AIDS. Today, I’m attending an HIV/AIDS breakfast. Today, in some small way, some almost imperceptible way, I’m making a difference. We all can make a difference. Never underestimate the power of one.

Social Components of HIV/AIDS Transmission in Mwandi, Zambia

I'm Dominique Maietta.

Mwandi is a relatively rural village in the South-Western corner of Zambia. The town is home to the Mwandi Christian Hospital, which has a catchment area of approximately 25,000 individuals. During the summer of 2006, I traveled to Mwandi in order to study the psychological and social components associated with HIV/AIDS there. Here I will talk about some of my findings.

The incidence of HIV in the village is around 30-40% and the percentage of HIV positive people is larger within the Mission Hospital patient population according to interviews with medical officers on the hospital staff. The majority of the interviewees expressed their feelings that economic hardship is a major social component of the spread of HIV in Mwandi, just as it is in the rest of Sub-Saharan Africa. Despite the influx of education and knowledge regarding HIV and it’s spread, including mandatory classes in the schools and public service campaigns around the country, the low financial status of the Mwandi community is the root cause for many of the risky behaviors associated with HIV transmission, such as multiple partners and non-use of condoms. This need to engage in risky behaviors appeared to be a particular problem for women and girls who have no other way of making an income other than through sex. Sex for them is not about emotion, but instead about survival.

The problem of poverty affecting HIV rates in Mwandi has further been exacerbated by the construction of a new paved road linking this relatively rural village to other towns and countries. The relatively recent accessibility of Mwandi to the outside world has introduced truckers and migrant workers as passer-bys to the village, and thus created a uniquely new set of problems for HIV transmission in Mwandi. These migrant individuals provide both a source of income for the impoverished village, but also a ready supply of HIV positive individuals to transmit the disease to villagers. As one social worker explained to me, when people come, they come looking for women. Thus the presence of the road, and the truckers from neighboring countries provide a source of income for destitute women and girls with no other means of providing income for their families. Interestingly, the use of sex for money in Mwandi is not so much acceptable, but merely a behavior that occurs, and according to one nurse I spoke with, “this is one of the poorer parts of Zambia, and if a woman has to keep her family, especially if her husband is not around, she will do it somehow”.



Gender disparity issues, then, apart from womanizing on the part of men, is also seen as a major social component of HIV transmission in Mwandi. While men have the power and social standing to hold jobs and make money, women and children have no similar means of providing for their families. Furthermore, although some male orphaned heads of household are given governmental support such as fishing nets which can be used to make a living, young females in similar situations are given minimal support. Thus when husbands die or children are left orphans due to the death of their parents, (generally as a result of AIDS), there is little those children or women can do to raise money other than to fall back to prostitution.

The lack of finances for much of the Mwandi community was also linked by many of the people I spoke with to excessive alcohol consumption, which contributes to promiscuous sexual behavior among Mwandi townspeople. A majority of village leaders perceived that the paucity of jobs and alternative activities in Mwandi village led to the abuse of alcohol followed by unscrupulous sexual activity, (especially by men), which in turn exacerbated the already present problem of HIV transmission. The custom of casual sex and multiple partners was prevalent among men before the HIV pandemic, and is viewed in Mwandi as the “normal mode of boy existence”. This acceptance of male promiscuity also appears to be a key contributor to the continuance of HIV transmission in Mwandi. Lack of sexual control exerted by women, (especially wives), combined with a lax view of expected fidelity in men has resulted in a growth of HIV transmission as husbands will sleep with several partners, become infected, and then infect their wives.

Although it was generally recognized that women lacked the social dominance and power necessary to prevent their husbands from suffering the results of their risky behavior, there were conflicting views as to whose behavior was “responsible” for the spread of HIV. Many of the male interviewees implicated the social behaviors of young people and prostitutes in the spread of HIV. In Mwandi many traditional family cultural values are being challenged with the introduction of the “modern life. As a result, many perceive that young people and their rampant and unprotected sexual behavior is a major social problem contributing to the spread of HIV. This behavior is most often the result of children behaving in a manner mimicking their adult counterparts.

Thus, in Mwandi, extreme poverty combined with alcohol abuse, accessibility to outsiders, and a lack of role models attempting to change behavior are the main factors contributing to the spread of HIV. As the village and the rest of the world becomes more aware of these social factors, changes can be gradually made to stop those underlying social behaviors that support transmission of HIV. Already in Mwandi village leaders have begun to address the issues of poverty and gender disparity by supporting religious and governmental run support groups and clubs to promote sustainable income by women there. Furthermore, use of traditional drama has been incorporated in order to increase public knowledge about the connection between underlying social factors and the spread of HIV in order to stop the cycle of transmission. Although there is much work to be done, the residents of Mwandi are moving in the right direction to combat the social facets contributing to HIV transmission in Mwandi.

The Plight of AIDS Orphans

Since the 1980’s, our knowledge of HIV has expanded greatly. However, in developing countries this information is either lacking or has not been taken to heart by the people who live in these cultures. One of the main reasons people are so clandestine in conducting conversations about AIDS is due to the fear and stigma attached to the word. AIDS orphans have a particularly difficult experience. An AIDS orphan is defined as someone who has lost one or both parents to HIV/AIDS. These children struggle to obtain even the basic necessities of every day life.

Children whose lives become entangled with people infected with HIV/AIDS have a difficult time coping and understanding their situation. Currently, there are more than eighteen million children who have been orphaned as a result of losing someone to HIV/AIDS. More than an estimated twelve million live in sub-Saharan Africa. Although inaccurate, the projected number of orphans as a result of HIV/AIDS in Zambia was 710,000. Zambia had fifty seven percent of all orphans nationally in 2005. In sub-Saharan Africa more than 55% of people living with either HIV or AIDS are women and young girls. However, these numbers are severely inaccurate for reasons which range from reporting to people failing to get tested. The children often suffer physical and emotional neglect long before the passing of their parents. Many of these children observe their parents wilting away right before their eyes. This would no doubt present a traumatic experience for anyone. In speaking with the only social worker in Mwandi, I was told that many of these orphans suffer abuse and exploitation at the hands of the very people who are entrusted to care for them. Other children experience what is known as the “sugar-daddy/momma” phenomena. This occurs when young children perform favors, which are usually sexual in nature, for older adults. It is not uncommon for these children to have several sugar daddies/mommas. Many of these adults infected with HIV believe that by having sex with a virgin they would somehow cure themselves of the disease. Both the social worker and the head clinical officer stated to me that these children undergo a great deal of psychological distress. Many of the children must be treated for bouts of depression, anger, as well as anxiety. Orphaned children often experience greater anxiety and depression when they are separated from their siblings and placed in different homes.

HIV/AIDS has put such a strain on the family structure and had such an impact on household situations, that establishments like the Orphans and Vulnerable Children’s Center has become a necessity in Mwandi, Zambia. In Mwandi alone, there are an estimated one thousand three hundred orphans or vulnerable children. With thirty-five percent of the Mwandi population infected with HIV/AIDS, the number of orphans in the area is certain to rise. These establishments have provided a safe haven for AIDS orphans for approximately four years. The OVC met some opposition from townspeople when the idea was first brought to the forefront. Now a few members of the community assist the OVC by bringing firewood for the oven. In many cases, the one meal that the OVC provides on a daily basis is the only meal some of the children will eat all day. The objectives of the OVC are to provide nutritional support by utilizing the feeding a program that provides one meal a day for children ranging in ages from six months to fifteen years old. The Orphan and Vulnerable Children Center also provides children with a daily multivitamin, to keep them from becoming ill often. They also assist in the continuance of good health and hygiene, by conducting health checks as well as teeth cleaning. Children in the OVC who are HIV-positive are given extra food and must get monthly checkups at the local hospital, the UCZ Mission Hospital. Although the program is designed to feed well over one hundred children, there are still many children in Mwandi who go to work and school with little to eat. The director, Fiona Dixon, of the OVC in Mwandi has implemented a vegetable garden as a means of assisting the feeding program. They have also begun selling extra tomatoes in the village in order to raise more money for the OVC.
Clothing has also another problem that confronts children in the rural area of Mwandi. Most of the clothes children wear are third or even fourth generation clothing. The criteria for receiving clothing and becoming a part of the feeding program, consists of being listed as one of the following: a double orphan, child-run household, single orphan-no father, single orphan-no mother, or a vulnerable child. However, the OVC is more than just a place where children can come and eat. This past August, the center began a bathing program in which the children were afforded the opportunity to shower every Saturday with soap. In Mwandi, soap is a luxury item that many parents and guardians can not afford. The OVC also received containers filled with hygiene bags that consisted of soap, toothpaste, a toothbrush, nailbrush, a towel, and a face cloth. The OVC also covers the educational costs for some of the children to attend school in either Mwandi or Sesheke. These costs include items such as boarding fees, school fees, uniforms, shoes, as well as stationary.

It also serves as a place where the children of Mwandi can gather and enjoy recreational and educational activities. Many of the children play football, known in the United States as soccer. I had the opportunity to play soccer with a group of young boys one day. As I played, I had to remind myself that these children were potential AIDS orphans and that they could possibly have HIV themselves. I found that these children were living with loss and possibly HIV to be incredible because they seemed to be so happy playing and interacting with their peers. Later on, I was astounded to be informed that the children at the OVC are not told of their status if they are HIV-positive until they are eighteen years old. This is the harsh reality of AIDS orphans in Mwandi, Zambia with the OVC as their only refuge.
The orphans must undergo a great deal of emotional and physical hardships after the loss of one or both parents to AIDS. Plainly put, HIV/AIDS orphans are not stable. Many of them tend to be rough in nature and do not relate well with their peers. In their formative years AIDS orphans tend to be very agitated. Overall, AIDS orphans need to be seen as more than damaged goods. The discrimination they face on a daily basis needs to be put to rest, and their rights need to be acknowledged and enforced. Unless these steps and many others are completed, there will be a generation of young people who are affected financially, emotionally, and socially. Their status may also play a role on the future of politics.

My name is James Hammonds. Thanks for listening.