Marseille 2007
| Abstract #103 - Questioning the role of Culture and Traditional Practices in HIV Transmission: NGOs involvement in changing unsafe local practices in Malawi | ||||
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Session: 28.7: Religion and traditional practices (Parallel) on Tuesday @ 11.00-12.30 in 5 Chaired by Veronica Noseda, Herve Richaud Authors: Presenting Author: Ms Birgitte Bruun - London School of Hygiene and Tropical Medicine, United Kingdom |
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| Additional Authors: Ms Lise Rosendal Ostergaard, Mr Jeffrey Victor Lazarus, | ||||
| Aim: Issue: In sub-Saharan Africa, the spread of HIV can be associated with so-called traditional practices. For this reason the idea of changing existing practices into something presumably safer has received considerable attention in external development aid and many non-governmental organisations (NGOs) try actively to change these practices. This work is sometimes based on an underlying asumption of static local cultures. However, it is unclear what role such practices play in the spread of the epidemic and how local communities will accept the idea of modifying them. Project The Adventist Development and Relief Agency (ADRA) Denmark and its partner ADRA Malawi were the first NGOs in Malawi to address local traditional practices that carry the risk of transmitting HIV. In Malawi, there are a number of local practices which can be regarded as unsafe such as unprotected sex or contact with blood through widow inheritance (Chokolo), sexual cleansing (Fisi), initiation ceremonies for boys and girls and dry sex. This project, which has recently received its sixth consecutive Danish Government grant, is unique in its outreach and its culturally-sensitive approach. It targets 1,200,000 people in Malawi and is focused on information, education and communication activities about HIV/AIDS prevention and family planning, including condom distribution, all conducted by village-based volunteers. The messages are developed with the local communities and communicated through popular television and radio shows, drama, group discussions, concerts, poetry, dances and songs as well as leaflets and cartoons in three local languages. Lessons learned Unsafe traditional practices, such as certain sexual rituals, are addressed through workshops. Talk of changing them sometimes faces resistance from local authorities and counsellors who fear losing their authority over the young people. ADRAs response to such situations has been to stimulate collective reflection on the negative consequences of these practices through activities which involve, rather than challenge, local cultural norms. One of the results is that people have started to refer to the risk of getting HIV as a legitimate reason to avoid certain otherwise common relations e.g. widow inheritance and sexual cleansing. It seems as though there is a tendency to use the fear of AIDS to open up new ways for people to manoeuvre in their social relations, potentially leading to wider social change in the communities. There is, however, a danger in focusing too much on traditional practices as HIV transmission in sub-Saharan Africa often takes place in the much less spectacular circumstances of everyday life. It is not traditional practices as such that are the main drivers of HIV, but unsafe sex. A consequence of this is that where unprotected sex and blood contact take place it is meaningful to address it, but as an issue of unprotected sex rather than as tradition, ritual or culture. | ||||
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