Zambia: Only I Remain

Despite efforts to educate the public and prevent transmission, Zambia’s HIV-infection rate hovers at 14%. Having lost her family to the pandemic, Voices of Our Future correspondent Chinemu has vowed to be an agent of healing and change.

Zambia 2013

By Corine Milano

April 26, 2012

Also published at World Pulse

“I’m on a personal campaign to encourage women to get tested and to replace ignorance with knowledge; shame with liberty.”

UN Photo/Martine Perret

That Sunday, I came back from church feeling happy and looking forward to a visit with my brother at the orphanage. Before heading to the Mother Theresa’s home where my brother had been for almost a year, I rushed to the makeshift kitchen attached to my grandmother’s two-room house to get something to eat. As soon as I had finished, my granny called out to me. I hurried to her room to find her sitting on her old mattress sobbing. She hugged me tightly, in a way she hadn’t for a long time, and I couldn’t understand her gesture.

Wasala weka! Wasala weka!” cried my granny as she held me tightly to her chest. She was saying, “Only you have remained!”

Still, I couldn’t understand. I loosened myself from her; she cried uncontrollably. It wasn’t until my aunt came wailing my brother’s name that I understood: My only surviving brother, Philip, had died. I stood motionless, tears running down my face. Memories of my late mother, father, and two other siblings flooded me as if their deaths had just happened.

I was now the only surviving member of a family of five.

My brother first became sick at the age of two, after my parents died. First to pass was my father in 1992, then my mother in 1993. The only explanation offered for my brother’s illness was that he was too young to cope without motherly love.

Despite Granny trying to fill my mother’s shoes, we lacked many basic necessities and my brother’s condition deteriorated, leaving Granny no option but to take him to Mother Theresa’s home, a Catholic orphanage that also offers medical care. For a year I only saw my brother once a week. During his first six months at the orphanage, his condition improved and we were hopeful. But as his one-year anniversary at the home approached, he died.

At the funeral home, I overhead some women talking about how AIDS had wiped out my family. They were questioning where my mother had contracted the virus and were accusing her of promiscuity.

Nimatenda,” they said, meaning ‘It’s AIDS.’ “Look at how the husband died and now the children.” One woman, signaling in my direction with her eyebrows, said, “Maybe even this one is dying, too.”

Their conjectures greatly disturbed me. Throughout my brother’s funeral I was troubled, wondering how Mother, of all people, could have died from AIDS.

The women’s gossip instilled fear in me, and I started to believe I could be HIV positive and could die at any moment. Each time I saw I had lost weight I thought I was nearing my death day. To learn more about the disease, I started reading a lot of booklets on HIV/AIDS, about how it’s transmitted, and how it has no cure.

Later, I approached my granny on the topic and told her what I overheard during my brother’s funeral. She looked agitated and quickly changed the topic. AIDS was not something that was openly discussed. I let it go, but I did not give up.

Weeks passed and again I asked her about my family’s death. Her explanation was that my parents and three siblings had been bewitched by jealous relatives. This wasn’t the first time I’d heard such an explanation. Most deaths in my community were blamed on witchcraft.

For weeks I persisted until Granny finally confessed that the doctor at the orphanage had told her my brother had AIDS, though she never believed it.

“I knew my daughter. She could not die of AIDS. She was too decent to die of the disease,” Granny told me. “That’s what doctors do if they can’t find a disease; they always say its AIDS.” She warned me not to share the doctor’s remarks with anyone and assured me that I was not next to die because she had taken all precautions to prevent witches from reaching me.

This was the scenario in Zambia when the HIV/AIDS pandemic was discovered in the 1980s. No one openly talked about AIDS, and those found with the virus were stigmatized and regarded as promiscuous. Most people died silently without knowing their HIV status for fear of discrimination and name-calling.

Politicians too were reluctant to speak out on the growing pandemic. President Kenneth Kaunda’s announcement in 1987 that his son had died of AIDS was a notable exception and a milestone in breaking the silence. However it was not enough to curb the stigma there and then. In a culture that supports gender inequality, HIV prevalence is especially high among women and young girls. Women are taught never to refuse their husbands sex nor to insist on condom use. According to the AVERT HIV & AIDS report, a Zambian behavioral survey showed around 15% of women reported forced sex, although this may not be accurate since many women do not disclose this information. Women are also forced to hang on to promiscuous husbands because they lack the financial muscle to survive independently. Additionally women become sexually active earlier than men, with partners who are much older and who may have already had a number of sexual partners. Apart from being vulnerable to infection, women are the worst affected. They are the ones that bear the burden of HIV positive children, nurse their husbands, and most times look after orphans. I personally checked a local clinic to see how many men take their children in for their routine tests, and among thirty women, only one man had taken his son to the clinic.

The dawn of the new millennium coincided with the enactment of the national AIDS bill in Parliament. The National Aids Council was established to coordinate the actions of all segments of government and society in the fight against HIV/ AIDS and is in charge of guiding the implementation of the National HIV and AIDS Strategic Framework (AVERT Zambia).

Within this framework, the council launched the Prevention of Mother to Child Transmission (PMTCT) program. Though the HIV virus is mostly transmitted through unprotected sexual acts, children who are born from infected mothers are at high risk of getting infected at birth and through breastfeeding, as was the case with my siblings. The project aimed to test all expectant mothers for HIV and put those found positive on antiretroviral drugs (ARVs) to weaken the virus and prevent the babies from infection during birth. The project proved effective and today every clinic that offers prenatal care has to provide counseling and testing to all expectant mothers.

When the PMTCT program started, most women shunned the services. When I was expecting my first child I saw some women refuse even the counseling services. Such incidences forced the government to introduce mandatory counseling to encourage mothers to undergo testing, although testing still remains voluntary for all expectant mothers.

PMTCT programs today have made headway. According to the UNICEF 2010 HIV/AIDS report, the number of women who have received testing for HIV has jumped from 12% in 2004 to 95% in 2009. These statistics show that women are learning more about the virus and prevention, resulting in reduced mortality rates in Zambia.

In addition, in 2004 late President Levy Mwanawasa introduced free antiretroviral drugs, including pediatric drugs, to prolong the lives of infected children.

Despite the introduction of PMTCT and better access to ARVs, there are still incidences of newborn infections where expectant mothers fail to adhere to treatment during pregnancy.

Despite all the government efforts to combat the HIV virus and protect future generations, the infection rate in Zambia has still remained high, hovering around 14% of a population of 13 million. High levels of poverty where over 65% of people survive on less than a dollar a day, alcohol abuse, and cultural pressures are the major contributors to the high infection rates.

There is much work to be done and many NGOs see women as the agents of healing and change. They have embarked on empowering women financially and academically, and the government aims to ensure 40% representation of women in Parliament to ensure that the voices of women are heard. All these efforts are yet to fully materialize and I look forward to a day when women and children will be truly liberated from the HIV/AIDS scourge.

To honor my late family, I have opted to speak out on the virus. Change begins with me. I am on a personal campaign to encourage women to get tested and to replace ignorance with knowledge; shame with liberty.

Chinemu, the author of this post, told her story with the help of Corine Milano, the managing editor of WorldPulse. Milano is reporting on HIV/AIDS, malaria, and TB in Zambia on a trip with the International Reporting Project (IRP).