Prevention

“And even I was changed,” Justin said to me. We were sitting outside in the surprisingly crisp morning air, side by side on a concrete slab, talking HIV and AIDS prevention, as you do. Justin is an HIV and AIDS peer-educator in Lilongwe, Malawi’s capital, and he’d taken a little time out of his day to answer all my flowing questions. And coming to Malawi, and about prevention – I had questions.

local news.

Alongside Orphan and Vulnerable Children, and even Home Based Care, the P of ‘prevention’ can seen a little second rate. I mean, how do you even measure how many people don’t get HIV? In fact, how do you even prevent the transmission of a virus which spreads most often in lifes most secret places? In the sex we have and the drugs we use and abuse? I wasn’t skeptical so much as not-quite-as-interested. Posed against adorable orphan children, a training manual just isn’t as impressive. Needless to say, I’ve changed my mind.

praying patients from the HBC program.

You see they say ‘prevention is better then cure’ for a reason. And I often walk the streets of Malawi with one thought running over and over again in my mind. It’s 1 in 7. That’s the modest statistic. A statistic which takes a different face when it is just that, a face – a mother and child, a man in a suit, a mini bus driver, a father, an uncle, a teacher, a student, a barefoot grandma, the sweet newborn. The laughing, the driving, the serving you at the counter, the smiling, the begging, the crossing the street. One in seven people, how can that be? And that lists the infected but not the affected. The affected would be 1 in 1. It would be all.

beautiful orphan kids.

I’ve seen firsthand the awful face of HIV. The wasting away. The skin disease. The tuberculosis. The malnourished. The suffering. I’ve sat with orphans, and watched many, many a barefooted parentless child start life with tremendous burden. I’ve driven past the rows and rows of coffin shops. About that, no more needs to be said.

the effects of HIV.

And HIV is not a quick fix. If there were no new infections as of even tomorrow, then it would still be another 20 years before the orphans of today would cease to need our care. There is still a missing generation, the leaders, teachers, parents and working adults of Malawi.

HIV often leaves only the very old & very young.

But what most the world seems to miss, what I missed for the longest time, is the true and simple fact of this: HIV is preventable. You don’t drink it in the water, or catch it in the air. It is entirely, and in every way preventable. It doesn’t have to be this way. The future does not have to contain it. And prevention is thus entirely and in almost every way, the answer. This reality does not need to be any longer.

I hope for a world where he has parents!

HOPE for AIDS takes a ‘from the inside out’ approach. Because, like most things when it all comes down to it, the spread of HIV is a heart issues. And like all heart issues, the answer is always Jesus.

for this little one.

Not making sense? Stick with me. The virus is spread in a number of ways – through breast milk, blood transfusions and drug use, most types of body fluids -  but let’s focus on the main route, through sex. God designed sex, and He’s all for it. In the right context, and in the right way – in a monogamous, committed, marriage relationship. If all the sex in the world was had in monogamous, committed, marriage relationships, then HIV would not be an issue. It’s as simple as that.

me. with a tan.

Understanding Gods way really is the best way. And understanding Gods best, really is the best prevention. And prevention really is in every way, better then a cure.

if you haven't noticed by now, I have a thing about blurry photos.
I see a lot of beauty in them.

There is not a lack of ‘prevention’ out there. People have been ‘preventing’ in Malawi, and in the rest of the world, for decades. There are posters, and leaflets and ads on TV. There is health class and clinics and billboards and more. And it’s not working, because it’s outside in. Because it's one in seven. Because quite crudely, you can’t force people to change their sexual habits.

blurry background kids.
the future of Malawi.

Think of prevention, on the HOPE for AIDS front, like a tree with two branches. The first, is Peer Education. Annually, HOPE for AIDS runs a two week training program, in which two selected individuals – usually one girl and one boy – from each community/ village come, and be trained. They are trained on all sorts of topics, including HIV, organization, leadership, theology and what the Bible has to say about identity, manhood, womanhood, disease, social issues, peer pressure, so many things. 

sweet little darling.

The youth, now known as ‘Peer Educators’ are then sent back into their communities, with quite the job to do. Now equipped with the skills, they first lead other youth in their church through a 10 week program,  covering the same topics – and then, at the end, they as a cohort run a community-based ‘AIDS awareness event’. This event, I’m told, has taken all sorts of forms. Organized sporting events (they love their soccer and netball), dramas, you name it they do it – something to get their whole community involved, participating and talking about HIV. 

little faces looking at me.

At this event and around this time they then extend the invitation of the program to the wider community, and they come. They come sometimes in an overwhelming number, to hear about HIV, to hear about the heart behind the Gospel, to hear about prevention. Because in Malawi, everyone knows someone, a lot of someone’s, who have, or have had, HIV. And then finally, once the community program is complete, the Peer Educators have the opportunity to write a proposal to HOPE for AIDS, to provide them with a small grant to continue their prevention work. One team, for example – wanted to buy a drum, so when they went into their village they could beat it, attract the children, and continue to share their important message.

a picture of food & education.

But, does it work? I sat down with the ever patient Kondwani, co-ordinator of Prevention in Malawi and we chatted for over an hour. “God has done more then what I was expecting myself”, he admitted, describing the impact as “overwhelming”. It really has been a case of God taking the faithful little and multiplying. There are stories of young girls, commercial sex workers, who have gone through the community program and had their lives transformed, becoming key members of their church and youth groups. He has had chiefs commend him on the program, having noticed the change, the positive change, ripple through their community youth. Kondwani tells me that often the Peer Educators rise up to become leaders in their communities, in their church’s, in the fight against the virus, and as my interviewee even stated himself, “and, even I was changed”. And that’s because, I repeat – it’s a change from the inside out.

this photo is not relevant to anything.
I just found it in a Malawi cook book.
& I think its hilarious.

In Malawi, there is a great secrecy about sexual matters. They are not discussed in the home, or between parents and their children. And if you’ve ever tried to have that kind of conversation with your mum or dad, it’s not too hard to see why. But because of this, amongst other things, HOPE for AIDS also recognizes the need to target parents, and adults, as well. This is especially important as most new cases of infection occur within the married, and thus have their roots in unfaithfulness. And this is where the second branch of Prevention comes in, the Adult Marriage Course. It’s about making faithful Christian marriages the role models, in their communities but most importantly, in their own homes. It’s about teaching the value of marriage, the meaning of love, the risks associated and what Gods view is, Biblically – on all these things and more.

the answer? the cross.

And again with this analogy, at the bottom of the Prevention tree is the roots of the Gospel. Of Gods plan. Of what it means to be a man, to be a woman, to be faithful, to be loving, to be loved, to be in a relationship, to be forgiven, to be born again, to be trustworthy and to trust.

there is hope.

It’s an inside out approach where billboards and placards have failed. It’s the future of health, spiritual and physical, it’s prevention – the future of Malawi. It’s adults who will grow old and strong, it’s children with parents, it’s a nation with leaders, it’s schools with teachers, it’s a growing economy, it’s a country with hope. It’s Home Based Care Programs and Orphan Day Care centers closing down, no longer needing to exist.

her husband died of HIV.
this child has no father.
HIV is preventable.

The all important p of Prevention, where even he was changed.

orphan feet & likuni phala.
i dream of a day this is no longer needed!