Fighting HIV/AIDS in Malawi

By Donald Schell

Malawi 2009


The truth is that, we the youths

Are engaging in casual sex

And to protect ourselves

From HIV/AIDS, we need

Realistic advice

From our Parents/Church leaders

I imagine we’d be surprised to see this poster in a diocesan office. But my wife, Ellen, and I saw it visiting the Anglican Diocese of Southern Malawi in Africa to meet with the Diocesan Health Officer. Ellen is the International Programs Director for GAIA (Global AIDS Interfaith Alliance) and the Diocesan Health Officer (a full-time public health worker with substantial experience in Malawi’s ministry of health) wanted to discuss GAIA and diocesan program looking for common goals.

The poster and the diocesan health officer both witness to a powerful force that’s changing African Christianity (and Islam). Malawi Christians and Muslims know health issues (particularly AIDS, malaria, TB, and maternal mortality in child birth) are fundamental religious issues. U.N.AIDS says there are 550,000 AIDS orphans in Malawi. Others estimate it’s as high as a million out of a population of 13,000,000. In Malawi, as in much of sub-Saharan Africa, the group most at risk for HIV infection is married women who are faithful to their husbands. Every thirty seconds a child in Africa dies of Malaria. The problems are stark.

Still I wondered why we don’t have posters like the one we saw in our churches in the U.S. The average age for first sexual experience in the U.S. is 15, the same as in Malawi. Forty percent of births in the U.S. are to unmarried mothers. Our epidemiology in sexually transmitted diseases isn’t the same as Malawi’s, but the risks our children are taking are quite similar.

Another poster in the bishop’s office offered a drawing of a Christian clergyman in collar and a Muslim sheikh cheerfully going together for HIV testing. It challenged religious leaders to set the example for their congregations by getting tested themselves and then telling everyone in the congregation to get tested as well.

Trying to tell the truth about sex is changing the African church. Our rhetoric back home says something else because African Christians talking honestly about LGBT people in their congregations lags behind U.S. and European churches and society, but that honesty is coming to Africa too. One Anglican priest we talked with remarked that he’d read in the newspaper that there were “10,000 gay people in Malawi.” With a population of 13,000,000, we’d guess that Malawi has more gay people than that. But what we in the U.S. need to hear was where that priest took the news story. “What would Jesus do for those people?” Jesus would listen to them,” he said, “to understand their experience and then find a way to welcome and serve them.”

Another priest talked of friends who had bravely come out as gay in support of a 2002 national referendum to decriminalize homosexuality. The referendum failed, but that priest said, “I listened to those good people and learned that they’ve known they were attracted to people of the same sex from the time they were children. It’s something about how God made them.” That priest is doing doctoral studies in Malawi on the experience of gay people in Africa. “We have to listen as Africans and tell the story of African gay people. This question is not about people in foreign countries. It’s our own people, our family members, and our friends.”

The American secular and church press typifies African Christianity as a religion of fervor and doctrinal rigor (or rigidity). Of course the real picture is much more complicated.

In visits to Malawi as a volunteer driver, interviewer, photographer and sometime theological consult with GAIA I’ve heard countless stories of seemingly fundamentalist churches and church leaders reaching out in caring support of HIV positive people in their congregations and in their wider communities. American Christians have much to learn from this crisis our sisters and brothers in Africa face. Their earliest response to AIDS (as in the U.S.) was denial and stigmatization, but what we see and hear now again and again is that compassion is displacing judgment as simply and decisively as in Jesus’ parable of the Good Samaritan.

My wife’s work brings her to Malawi at least annually for extensive visits with GAIA’s community-based, grass roots, development oriented projects and programs. On this, my third visit accompanying her, we visited GAIA villages to talk with the network of caregivers for housebound people living with AIDS. We met an old man in his new, mud-brick, grass-roofed house, a house the caregivers built for him because his old house was in danger of falling down around him. He’d lost his wife and all his children. Many of the GAIA caregivers are AIDS widows themselves.

We drove long dirt roads across tea plantations to see GAIA’s mobile clinics in action. We met a woman who was HIV positive but because she had the drug treatment during birth, her son was born HIV-negative. She told us of her great sorrow that her husband still refuses to get tested. As in the U.S., one of the biggest social challenges facing Malawi is empowering women and creating a new society where women and men face one another as equals.

Ellen has seen Malawi churches and mosques come a long way since her first visit here in 2002. The AIDS epidemic was largely not talked about in preaching because sex wasn’t talked about in church. Deaths that have touched everyone in Malawi have changed things here. Change comes imperfectly and haltingly, but it keeps coming. Of course the church’s familiar dilemma is that the epidemic forces us to acknowledge that we’re all as fallible as ‘those sinners’ in the town markets or bars. With brave exceptions like the poster in the Anglican bishop’s office, churches mostly don’t want to talk about condoms. Most church leaders leave condom promotion and distribution to the government. But in so many ways, change keeps coming.

What will it take to change things in the U.S.?

Both of my previous visits, I participated in a U.S. National Institute of Health funded study on the response of religious institutions to the AIDS crisis in Malawi. University of California, San Francisco partnered with GAIA for this three year series of over three hundred in depth interviews with national religious leaders, local religious leaders and local lay participants in churches and mosques, and people living with AIDS (not necessarily connected with the congregations). My own interview assignments included two Anglican Church leaders (as different as two leaders could be on their approach to AIDS) and a Muslim Sheikh. Our pool included Roman Catholics, Anglicans, Baptists, Living Waters (a new Malawi denomination) and Muslims. We transcribed the hours and hours of interviews and back home in San Francisco the research team met monthly to discuss what we were hearing, analyze data, and prepare to report back to the religious leaders in Malawi and to share findings in U.S. and Malawian publications.

I’m repeating myself to say it, but I kept wondering as we read our Malawi data what American congregations are doing to do to make our church’s response to sexual choices honest, genuinely moral, and engaged with people’s real experience.

This trip we gathered the leaders we’d interviewed for two daylong conferences to report back what we were hearing and discuss with them what next action steps they saw their churches and mosques might take. From the research team our presenters included UCSF faculty member Susan Kools, GAIA President Bill Rankin (whom some Café readers will know as the former Dean and President of Episcopal Divinity School), UCSF faculty member Sally Rankin (principal investigator on the NIH study), UCSF faculty member Sharon Youmans, and me.

Susan’s expertise is adolescent behavior and development. She’d overseen a smaller study in Malawi interviewing youth and talking with religious leaders about the youth. Her interviews confirmed that the average age for first sexual experience is 15, just as in the U.S. She also reported that a significant minority (about a third) of girls in Malawi said their first sexual experience was not fully willing, in a range that began with pressured or coerced and extended to rape. Susan talked about the human dilemma that our bodies develop faster than our brains, that judgment and restraint functions in the human brain don’t complete their formation until we’re in our mid-20’s. The group’s first articulated response was, “Well then, we must be more determined to teach pre-martial abstinence.” When more realistic voices among the leaders were quiet, Susan protested that it wasn’t enough to give our children nothing but our ideal for their behavior. Why should they pay for adolescent mistakes with their lives? She spoke of ‘our children’ because we worked consistently to put our own U.S. dilemmas alongside those of the Malawians. The research team was learning alongside the Malawians. So we could ask about ‘our response’ and ‘our children.’ And I ask it again to Café readers – how are American churches addressing adolescent sexuality?

Bill Rankin, GAIA’s president, made the theological argument that victimization of women and children in the epidemic is a justice issue, and he described it alongside our American experience of two and a half centuries of facing up to the injustice written into our Constitution, with its denial of full human rights to slaves and women. Bill showed a PowerPoint slide of Rosa Parks. A Malawian Baptist woman told us later, “we learn of Mrs. Parks in school here.” Bill showed a slide of Martin Luther King speaking at the Lincoln Memorial and said, “This great leader was showing us a way to justice and he was assassinated.” He showed a slide of Nelson Mandela. There were murmurs of pleasure and approval, and then when the slide of Barack and Michelle Obama came up, the conference cheered, and Bill said, “we’ve still got a lot of work to do, but change is happening.”

With America’s slow path to justice and freedom as background, Bill argued that for Malawi, justice requires churches and mosques to acknowledge that women’s physiology makes them more vulnerable to HIV than men. They pay for their husband’s infidelities with their lives. As one Baptist past put it, “If you have an affair and then come home and refuse to use a condom, it’s like putting a gun to your wife’s head.” Women are infected and dying, children are orphaned and dying because women in Malawi are not honored and respected as fully as men’s equals

A happy surprise breaking another Western stereotype was the deep conversation between Christian and Muslim leaders that marked our two conferences. HIV/AIDS is making connections in the practical work of compassion and life-saving teaching, and that practice of compassion is (at least partly) blurring differences of doctrine and bringing common humanity in God into focus.

In two full days of conference, what I heard was the Holy Spirit’s painful, exhilarating work of change. AIDS, telling the truth about the epidemic itself, and the work of service and of letting go of judgment that it brings are changing churches and mosques in Malawi.

The African church is learning to talk about sex, to tell the truth about human experience, and in some important ways, it’s ahead of us in America. There’s still plenty of denial and hope for simple answers and idealized righteousness in the mix, but the epidemic doesn’t allow Malawians the luxury of wishfulness. I hope and pray that Africa continues to move toward a godly embrace of LGBT people, but I also pray that American Christians find a way to face the challenging questions of sex and sexual behavior.

The Rev. Donald Schell, founder of St. Gregory of Nyssa Church in San Francisco, is President of All Saints Company.

Past Posts