Thursday, June 16

Two months in Malawi: HIV theater

We are in Malawi for Demetra. She applied to and was accepted by the University of Washington’s Global Health Opportunities Program, so rather than spending the summer in Helena or on a reservation, she earns her credit by performing a community health assessment of Mangochi and developing and implementing a program that meets one of its particular health challenges. For obvious reasons, I am not doing that. I’m not even allowed in the hospital with Demetra because in the patriarchal culture, they’ll ignore her and treat me as the doctor even when she’s the one with the white coat and stethoscope.

So, while Demetra will tell me at lunch and in the evening about her time in the wards and meetings with the district health officer, my personal interactions with the health system of Malawi have been limited until this Sunday when I arranged for us to attend a university troupe’s performance in a local village that taught the people about HIV.

The stage was the shade cast by an ancient tree. It was theater in the round because the audience crowded around on all sides and had to be parted when characters entered and exited. The smallest children sat in the front while their older brothers and sisters and parents stood behind them to guarantee everyone a view.

I do not know if there was an official title, but it could have been called “An HIV Carol.” On the eve of his wedding to Shakira, Kenny is visited by three spirits. The first, the Ghost of HIV Past, reveals that Kenny’s mother passed HIV on to her son in the womb. The second, the Ghost of HIV Present, did something I did not quite catch because it was all in Chichewa. The third, the Ghost of HIV Future, reveals the future where Kenny does not deviate from his current path, and Shakira dies young. So inspired, Kenny amends his ways to seek treatment and protect his new wife from the infection.

In the second play two men, one with a stutter and the other with a bum leg, suspect each other of having HIV until they learn that such disabilities do not imply HIV and, furthermore, that even if it did, it cannot be transferred by sharing a meal.

It was a success, in some respects. The people seemed to enjoy it well enough. They laughed when Shakira’s body was brought out and when the one with a bum leg stole the other man’s bread when his eyes were closed during the prayer. They didn’t drift away after the plays began. Sixty men and women were tested for HIV and received counseling on their results. Perhaps, too, it aided in making the discussion about HIV public.

In other respects, it was less successful. Between plays there was a quiz on HIV with soap and condoms as prizes for correct answers. Maybe one in five got their answer right. When the plays were done and we returned to the truck, kids no older than ten had their hands stretched out and asked for condoms, leading one to wonder if they really knew what they were for. Follow-up visits to offer further testing and assure that those who tested positive had visited the hospital are rare because the funding is not there.

It’s a young program, only three years old. I hope that it gets the continuing support it needs from the community and donors to maintain it and continue helping people.

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