Adaptive strategies and coping mechanisms of families and communities affected by HIV/AIDS in Malawi

Abstract

"Ngozi is in her late 30s. She lives in a village in western Rumphi district of northern Malawi. Her husband was in the army and during his career as a soldier he travelled to neighbouring Mozambique several times while his wife stayed at his home village farming. The husband visited her once or twice a year and she received remittances from him. In the early 1990s she started falling sick regularly, became skinny and coughed constantly. Two sons born at this time died at birth. When she gave birth to her last born in 1994 she kept on bleeding for weeks and her condition worsened. In 1993 her husband came back to the village permanently but he fell ill only a few months later and died soon after. Ngozi was pregnant and had four surviving sons. While the wife said that her husband died of drinking bad water and stomach problems, her father in-law believed that his son died of AIDS which he contracted in Mozambique. In the village rumours said that no one would marry a widow suspected of being infected with HIV/AIDS. For her, life as a widow with five children demanded quite a lot. Her two eldest sons were sent to the capital, Lilongwe, to live with one of her brother in-laws. They visited her once a year during the school holidays. The other three children stayed with her but they often ate with her father in-law or one of her brothers in-law. She continued to cultivate the land but had not been able to harvest sufficient maize for several years due to her illness. Her two remaining sons assist her but they are too young to do all the work and still go to school. The wives of her husband s brothers support her from time to time. Also, she has spent a lot of money seeking help from traditional healers and hospitals. Though her children are being taken care of by her late husband s family, she is forced to keep on working on the land, pounding maize and fetching water for the household. While her father in-law says that she is free to go permanently and stay with her family, she does not want to do that as it means leaving behind her children as they belong to the husband s family (Mastwijk, 1999). This is one of many stories of the impacts of HIV/AIDS illness and death and of the coping mechanisms of households and families to adopt to the changes caused by the pandemic. Food security is compromised, income is lost, assets are sold, and children are dispersed. During periods of illness, Ngozi (and others like her) get some support from the wives of her late husband s brothers as well as from her own family which has even paid some of her hospital bills. The existence of these kinship relations in Malawian societies tends to cushion the economic and social shocks brought about by HIV/AIDS-related illnesses and death. The HIV/AIDS pandemic places tremendous strains on households and communities to care for those who are chronically ill as well as the orphans and the elderly. This paper looks at some of the coping mechanisms seen within Malawian families and communities as they respond to the HIV/AIDS pandemic. HIV/AIDS in Malawi is overwhelming. With an HIV prevalence rate of 14 per cent in the economically productive age group of 15-49 years, Malawi is one of the countries most affected by HIV/AIDS in the world1. The first case of AIDS was diagnosed in 1985. In the mid-1980s 2 per cent of pregnant women attending antenatal clinics were HIV infected; in less than two decades an estimated 35 per cent of pregnant women were infected (Kalipeni, 2001). According to the National AIDS Control Programme the prevalence of HIV in the economically productive age group is estimated at 26 per cent in the urban areas and 12 per cent in the rural areas. In the same age group, the prevalence of HIV in the northern region is estimated at 9 per cent, 11 per cent in the central region and 18 per cent in the south (Strategic Planning Unit and National AIDS Control Programme, 1999). According to Government of Malawi and World Bank, high rates of urbanisation and labor migration are the most important contributing factors to the high rates of HIV in the Southern Region (Government of Malawi and World Bank, 1998)."(pg 3)