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Government Extension Worker Harriet Magomero (left) talking to Ides Chitengu, an initiator for Kan’goma village in Malawi. Photo: Sabita Banerji/Oxfam
Rural Malawians respect and value the wisdom of village elders. Their opinions on disputes and general issues of daily life are traditionally sought in village assemblies. One or two elders in each village specialise in preparing young boys and girls for adulthood by conducting initiation ceremonies and giving them guidance on what will be expected of them. This is an opportunity to reduce a key area of risk of HIV infection, such as the use of shared implements in initiation ceremonies involving tattoos, circumcision or scarification. It also puts the initiators in a critical position to influence the sexual behaviour of each new generation.
John Adam, boys’ initiator in Mberenga village in Thyolo district, says his role is to guide young people towards “having respect for their parents, their elders, and themselves, and teaching them to treat their sisters and brothers with respect too." John became an initiator at the age of 25. He inherited the role from his father, and has three apprentice initiators working under him. Together, the four of them run initiations for boys aged 12–15 years. Each boy receives one-on-one counselling and group learning about what it means to be an adult.
“Most of the time, parents are not free to talk about issues of sex and HIV/AIDS all that easily.”
“Most of the time, parents are not free to talk about issues of sex, HIV and AIDS all that easily,” says John. “Frequently, I have parents coming to ask me to discuss these things, prior to the boy arriving for the initiation.” He feels that parents have largely accepted the realities of HIV and AIDS, even though the teachings would have been very different in their day.
The level of understanding and acceptance of messages about how HIV spreads, and how to reduce risk, is high among healers, birth attendants and initiators in Mulanje and Thyolo districts thanks to HIV and AIDS training organised by Oxfam. The training is designed to respect and involve the initiators' views as far as possible and at the end of the training, the initiators feel that their views are respected and that they ‘own’ the knowledge they arrived at together.
Many have adapted their practices to minimise the risk of HIV infection, ensuring that bodily fluids such as blood and saliva are not passed from one patient or initiate to another. The training has taught them that a fresh implement should be used for each initiate, and people are now encouraged to bring their own razor blade for ceremonial tattooing. They are also taught that circumcisions and caesareans are more safely conducted in hospitals. And for the more minor procedures, healers have learned that applying medicinal herbs with a clean stick is safer than treating wounds with saliva on a finger! Both healers and initiators have found that people from other villages are now flocking to them for their services, as they know that their clients are less likely to become infected.
But it is the role of the initiators as advisors to young people who are about to embark on the sexually active phase of their lives which is really critical in terms of affecting the progress of the HIV pandemic. “We had a lot of training ourselves, from Oxfam, and so we take this knowledge to the boys. We recommend to them that the best course is to abstain, but the reality is this is a difficult request, so we suggest using a condom,” says John Adam.
Before they received Oxfam training, the initiators would advise girls to try to get plenty of sexual experience before settling down with a husband. This encouragement for young sexually inexperienced girls – who are physiologically more prone to HIV infection – to have multiple partners in a short period of time, put them at huge risk of becoming infected. But now the initiators are instructing them to delay their first sexual experience and “not to be promiscuous”.
Getting this advice at such a critical period of their lives will not only help protect the girls and boys, but will also mean that the message is likely to be passed on to their own daughters and sons. The initiators’ enthusiasm for what they have discovered during the training, and their awareness of the benefits this has brought to the young people, is clear from the fact that they say what they need now is a refresher course, to catch up on new developments.