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Health workers blame cultural practices

Health workers are blaming the spread of HIV/AIDS on traditional beliefs and practices and are taking steps to transform these beliefs.
Charles Banda

The Southern African country of Malawi, with a population of about 12 million, is grappling with the AIDS pandemic. Malawi's National AIDS Commission estimates that up to 15 percent of Malawians are HIV positive.

Practices that are being re-examined include those of wife inheritance, sexual cleansing and initiation. In the case of wife inheritance, a widow remarries
a relative of her deceased husband. Supporters of the custom say it helps the woman avoid promiscuity, and that it may even appease the spirit of the deceased, preventing punishment from being visited on the family.

But the prevalence of HIV in Malawi has transformed wife inheritance into a potentially fatal practice, where the widow or the inheritor could be infected.
Health Minister Dr Hetherwick Ntaba says most of the country's tribes practice this custom. But he is quick to point out that senior government officials, and
AIDS activists, are waging strong campaigns against wife inheritance, and other customs which promote the spread of HIV.

Ntaba and health officials have been warning Malawians against traditional practices that are potentially harmful.

"Malawians should do away with all cultural practices that promote the spread of HIV/AIDS." Those who continued to follow these traditions, he added, should
ensure that all parties involved in an instance of
wife inheritance were tested for HIV.

The Malawian health minister also questioned the morality of this custom, saying: "The main factor behind wife inheritance is nothing but greed. Greedy male relatives of the deceased husband are the ones who are quick to inherit wives, so that they can also inherit wealth."

"This outdated custom is more about wealth inheritance
than wife inheritance. The practice is all about
property grabbing," he added.

Human rights activist and University of Malawi law lecturer Ngeyi Kanyongolo agrees, saying the practice could be avoided if more husbands prepared wills that
benefited their wives. "If spouses write their wills before their death, property grabbing would come to a stop and women would easily say 'no' to wife
inheritance," Kanyongolo explained.

Women interviewed appeared divided over the custom of wife inheritance - some calling for its abolition, and others saying it should continue. One woman who refused to be inherited is Shira Mkandawire, who lives in Ndirande Township - a suburb of Malawi's commercial capital, Blantyre. For her, this meant rejecting the advances of her late husband's brother.

"Although I needed the financial support to educate and take care of the three children my husband left behind, I refused to have one of my late husband's
brothers or relatives inherit me," said Mkandawire. "The relatives of my deceased husband are very promiscuous, and there is no way I can accept marriage
with them. My love was for their brother and not them," she added.

But 43-year-old Ellena Zulu of Mchinji, a district on the border between Malawi and Zambia, had a different story to tell. "My husband died eight years ago in a road accident after we had had four children. A month after his burial ceremony, his relatives asked me if I was ready to be inherited by one of his brothers. Two of his brothers were married and only one was single. I told them that I was ready to get married to the one who was single," says Zulu.

She adds that she is living happily with her new husband: "I chose to be married to him because I knew that it was difficult for another man to marry me
after I had four children with my first husband."

Another cultural practice responsible for the spread of HIV is sexual cleansing, which occurs after funerals, burials and initiation ceremonies. It is also practised on widows, as it is thought that these women become "unclean" after the deaths of their husbands - and remain so until they have had intercourse with a sexual cleanser, or "namandwa". Both widow and cleanser run the risk of contracting

An AIDS counsellor in the southern district of Nsanje, Victoria Piriminta, says health authorities tried to convince people to stop the custom - but to no avail.
So, the officials attempted a different approach.

Changes have been introduced into the initiation ceremonies that help Malawian youths make the transition to adulthood.

In the past, teenage boys and girls were taken to separate camps in the bush for circumcision and
traditional counselling. Boys were circumcised with one knife, something that could easily lead to the spread of HIV. At the end of the initiation ceremonies, they were also encouraged to have sex with any partner of their choice, to demonstrate their adulthood.

According to Chief Sagawa of the Yao People in Mulanje district, near Blantyre, these practices have changed. Traditional counsellors have discarded the knife in favour of a new approach.

"Instead, traditional counsellors pinch the foreskin of the teenagers' penises," says Sagawa. "Furthermore when they are graduating, we don't advise them to have sex as a way of proving their adulthood. Instead we admonish them to refrain from sexual unions, till they get married," he adds.

Sagawa praised the National AIDS Commission (NAC) for holding training workshops for traditional counselors in villages, in an effort to discard harmful cultural practices.

"Every year, traditional counsellors go for workshops on HIV/AIDS. They, in turn, teach teenagers who go for initiation ceremonies the importance of abstinence and condom use," he says.

NAC Executive Director Bizwick Mwale has praised ethnic leaders for their cooperation in the fight against AIDS. He believes the success of the NAC's
programme for altering cultural practices can be attributed to community involvement in deciding which approaches to take in the initiative. Mwale says that non-governmental organisations, health institutions and other bodies are currently analyzing research on the success of the initiative.

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