In rural Malawi, where 60 per cent of the population live below the poverty line and 50 per cent of children are stunted, Chikamana is nothing out of the ordinary. Yet this village was recently the scene of an extraordinary event that doctors fear will cause, in a few years' time, a "super-peak'' in the Aids epidemic that is ravaging Malawi as it struggles to build a durable democracy.
In the space of a few months, 400,000 of a population of only 11 million flocked here from all over the country after an old man - invoking the ancestral spirits central to Malawian culture - dreamed that a potion brewed from the bark of a local tree would cure all ills.
People who drank the brew, it was said, would not only be cured of Aids but would pass the cure on to anyone with whom they had sex. A single dose would guarantee lifelong immunity to the virus and thus make safer sex unnecessary.
Lorries loaded to breaking- point converged on Chikamana in their scores day after day, parking side by side with ministerial Mercedes. Thousands of civil servants left their desks. Salaried workers threatened to go on strike unless provided with transport. Mothers obliged their children to drink. No one was too poor, or too proud, to sample Billy Chisupe's brew: one Western aid agency's entire Aids staff - counsellors included - took time off to try the red liquid.
With as many as 10,000 people crowded into Chikamana on any given day, the village became a health hazard, even though the Red Cross set up tents and the government trucked in water, dug latrines and sent troops to keep order. Terminally ill patients were carried from hospital by relatives who then fell ill themselves with dysentery and diarrhoea. "It was a complete nightmare,'' said the district health officer, Peter van Bommel. "Some people were dying before they drank; some after. Many were too sick to go home and had to be admitted to the hospital here. It was difficult for the government to find a position: not only had people spent a lot of money getting here, but traditional medicine plays such an important role in Malawi. So they said people were free to come, but warned that the cure had not been proved.''
With HIV infection hovering at 13 per cent, Malawi has overtaken Uganda in the Aids league and ranks second to Rwanda in sub-Saharan Africa. In urban areas, one in three sexually active adults is said to be HIV-positive. More than 85 per cent of prostitutes are infected, and the government estimates the number of Aids orphans will climb from 220,000 last year to 615,000 by 1998.
Malawi is not short of miracle "cures'', but none has had the impact of Chikamana's "Mchape'' brew. "Drug Amuri'' is the big draw along the shores of Lake Malawi, where fishermen always have cash in hand. "Drug 2000'', which claims to cure any disease, advertises its powers on national radio. But in the ninth poorest country in the world, Billy Chisupe's brew had a special attraction: it was free.
Three years ago, Malawi had an annual per capita gross national product of $210. Today, as structural adjustment and drought combine to prevent the poorest Malawians from meeting even their most minimal needs, that figure is down to $160 (pounds 104) and prostitution is no longer confined to bottle-stores and border crossings where truckers from Tanzania wait, sometimes for days, to have their papers processed.
"We know where to find the commercial sex workers,'' said Maggie Nsukwa, manager of an information and counselling centre run by the British charity Action Aid in the town of Mponela. "But today some women are doing it secretly - renting a house for sex just to feed their children. In the last year or so, carers looking after Aids patients in the hospital here have been offering themselves to vegetable sellers in the market to be able to eat while away from home. There was a time when one or two people were dying in the market every day and the vendors were spending most of their time attending to those funerals.''
Eighteen months into the multi-party system that replaced the puritanical one-party regime of Hastings Banda - a man who found ballroom dancing "disgusting'', banned sex education and denied that Malawi had an Aids problem - the government's will is strong but its structures and resources hopelessly inadequate. The National Aids Secretariat is only partially staffed, having seen its funding cut by more than 50 per cent this year, and outside its Lilongwe headquarters has not a single full-time employee. Much of the burden of the epidemic therefore falls on donors: Action Aid alone finances almost 30 projects in Malawi.
Although Aids awareness is high - well over 90 per cent in urban and rural areas - the epidemic has had negligible impact on behaviour. "Aids is so related to poverty and Malawians are getting poorer and poorer,'' said Dr van Bommel.
"How then can you talk about changing behaviour?''Reuse content