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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


   


 

INCREASED LEVEL OF UNDERSTANDING OF HIV/AIDS AMONG JOURNALISTS AND MEDIA PROFESSIONALS

A PROJECT OF

THE UNITED NATIONS EDUCATION AND SCIENTIFIC, CULTURAL ORGANIZATION

(UNESCO)

http://aids-africa.unon.org/events/Dr.Patrick%20of%20Kenya%20doc.doc

“THE IMPACT OF CULTURE AND RELIGION ON HIV/AIDS REPORTING”

 PRESENTED

AT

A REGIONAL WORKSHOP FOR WOMEN JOURNALISTS

 

PAPER PRESENTED BY:

PRF. P.R. KENYA

 

EXECUTIVE DIRECTOR

INTERNATIONAL CENTRE FOR HEALTH

INTERVENTIONS AND RESEARCH IN AFRICA (ICHIRA)

P.O. Box 59921, Nairobi, Kenya.

5TH MARCH 2002

1.0             INTRODUCTION

Acquired Immunodeficiency Syndrome (AIDS) is a tragedy of devastating proportions in Eastern and Southern Africa. The lives of infected individuals, their families and communities, the companies and agencies they work for, and the society as a whole are all affected by the HIV/AIDS pandemic.

Today over 70% of all the people now living with HIV in the world, 28.1 million men, women and children – live in Africa south of the Sahara, and 83% of the world’s AIDS deaths have been in this region. Although Africa accounts for a mere 10% of the global population it is home to the largest number of PLWHAs. The year 2001 recorded an additional 3.4 million new HIV infections in Africa.

Since the very start of the epidemic, HIV in sub-Saharan Africa has mostly spread through sex between men and women.  However, women are more heavily affected in Africa (where they constitute 55% of all infections) than in other regions.  Four out of five HIV-positive women in the world live in Africa.

An even higher proportion of the children living with HIV in the world is in Africa – an estimated 87%.  There are a number of reasons for this.  First, more women of childbearing age are HIV-infected in Africa than elsewhere.  Secondly, Africa women have more children on average than those in other continents, so one infected woman may pass the virus on to a higher than average number of children.  Thirdly, nearly all children in Africa are breast-fed.  Breast-feeding is thought to account for between a third and half of all HIV transmission from mother-to-child.  Finally, new drugs, which help reduce transmission from mother-to-child before and around childbirth, are far less readily available in developing countries, including those in Africa, than in the industrialized world.

In Kenya, at least 250, 000 HIV + women give birth each year and going by current data at least 30% of them infect their babies with HIV resulting in about 75,000 HIV + children. Making Nevirapine available to HIV+ mothers will cut the number of new infections by about half. This could save the lives of over 35,000 babies.

Perhaps there is no other news-subject that has confounded media house mandarins, editors and field reporters in recent times than HIV/AIDS. There are many reasons for this. At the onset of HIV/AIDS epidemic in Africa in the early 1980s, the talk about HIV/AIDS was relegated to medical professionals and was only reported in the news media only as a sensational story with potential only of attracting audience and customers. The media also became an important vehicle of transmitting misinformation on how contagious HIV/AIDS was. Indeed all HIV/AIDS patients throughout the first decade of the epidemic were treated like Ebola patients due to this misinformation.

1.1       Function of the Media

The primary objectives and responsibilities of journalists, men or women in the current HIV/AIDS pandemic are to educate the public on how to protect itself from the HIV infection by highlighting the modes of transmission and methods available for protection and hence prevention and control of the pandemic. 

Those whose HIV status is negative to be encouraged to retain this status, and to support those whose status is positive by urging them to careful so as not to spread the virus and to maintain hope through positive living.  The media professionals have been viewed as being influential in building awareness across different sectors of society on HIV/AIDS and the importance of being careful in sexual behaviour and practices.

Providing accurate, factual information to the public about HIV/AIDS.

Research has shown that in a number of countries, there are high levels of awareness on the existence of HIV/AIDS (over 90 percent in some countries).  However, some misinformation exists, what is the definition of awareness?  If awareness is having ever heard of words such as “HIV” or “AIDS” these would not be necessary and sufficient for behaviour change.  For behaviour change to take place, knowledge about transmission modes and the main methods of prevention in Africa (1) Abstention, (2) Reduction of sexual partners, (3) Faithfulness to ones partner and (4) Condom use must be very high in the population (above 80 percent).  Journalists, women or men, as a standard procedure, need to present articles or news items on HIV/AIDS containing essential information and data on prevention methods, including information on where to seek assistance such as testing and counselling.

   


 

Advocacy for accountability and responsibility in the HIV/AIDS prevention and management arena.

There is a great deal of vulnerability inherent in any population faced with devastation such as that facing people living with HIV/AIDS on daily basis.  In the first place a gap exists in the provision of treatment that society can depend on.  It is easy to take advantage of this situation and exploit this gap by introducing medications of no proven value.  The media however, has to stand vanguard to the needs and interests of those who are affected and infected with HIV/AIDS to ensure that this type of situation does not rise.  Many gaps or opportunities of exploiting those infected and affected in our communities exist, for instance the property left for orphans and widows by their deceased parents or husbands respectively can easily be taken away from them by relatives through manipulation in a society where the media is dormant or ignorant about such type of possibilities.

1.1       Function of the Media

2.0       ACHIEVEMENTS

Studies and surveys indicate that the media has played a key role in achieving the present levels of HIV/awareness on the continent. The radio has been particularly singled out as the most accessible of all media channels in Africa followed by newspapers and television. However the terminology “awareness” used in the context of a health problem needs definition. It is important to note that the much-publicized “high AIDS awareness” is a misnomer. Strictly speaking from an epidemiological viewpoint, awareness must include not only knowing that a disease exists but also knowing how it is spread and how it can be prevented. But most important of all is having a high index of perception of risk to be able to apply that body of knowledge to change behaviour and avert ill health.

3.0       CULTURAL IMPACT ON AIDS REPORTING

3.1       The Cultural and Moral Shock of AIDS in Africa

The first reports on HIV/AIDS that begun to filter in Africa through mainly the Western media sort to ascribe blame to certain subcultures or races in the world. The noble epidemiological analysis of infection patterns and trends of HIV/AIDS in a population were misconstrued to mean for example that HIV/AIDS was a homosexual disease. When in fact the good intentions of the epidemiologists was purely for informing policy and programme implementers on the likely intervention measures to curb the spread of the epidemic.

Because HIV/AIDS was entirely a new health problem in the world and Africa in particular, any sensational reports claiming to reveal its origins reverberated throughout the continent. Cases of HIV/AIDS patients in Africa could therefore not be readily accepted given the many misconceptions that were abound regarding those at risk of contracting the disease.

3.2       Education and Awareness Campaigns: The Impact of the Germ Theory versus Witchcraft

A major problem with AIDS education and awareness programmes in Africa is that they do not address issues that affect learners and the target audience.  They focus on scientific messages about the cause of HIV/AIDS and the origin.

This tends to be academic and relevant only to the Western personal behaviour, this is superficial and ineffective.  It does not include the traditional view, which interprets the disease and its causes in terms of the cultural world of taboos, obligations and witchcraft. Sickness and disease are almost invariably considered to have external causes not the viruses, germs and microbes identified by medical science. Very often, the external cause is thought to be an ill-willed, malevolent human agent who uses the powers and forces at the disposal of a witch or sorcerer.  The external cause can also lie with ancestral spirits offended by the violation of certain taboos or failure to observe rituals.

In the case of HIV/AIDS, this traditional interpretation of a sickness and its cause draws strength from the inability of Western science to come up with a cure. The deep-rooted view that sorcery and witchcraft are the root causes of HIV/AIDS manifests itself not just among the rural people, but also in those from urban and well-to-do settings.  The educated are no strangers to it, neither are those who follow the major world religious traditions. People from all classes and categories seek to discover the source of the ill will that brought sickness in the belief that once this cause has been identified; appropriate remedial action can be taken.

None of the educational and awareness programmes takes this cultural perspective into account.  Indeed none seeks to interpret HIV infection in terms, not of the malevolence of external witches but rather the witchcraft (evil) that is within African belief systems. Studies indicate that no educational programme in eastern and southern Africa takes sorcery or witchcraft seriously and uses this to encourage pupils to protect themselves against HIV infection.

To date no attempt has been made to approach the problem from within.  Consequently, there is lack of headway, with the frequent complaint that wide diffusion of knowledge about HIV/AIDS is not leading to behaviour change. A critical problem posed by HIV/AIDS education regards educators.  It has been observed that they shy away from dealing with the basic issues of adolescent sexuality. When they broach the subject, they are only content with an abstract presentation of themes and principles. In the process, the educators are unaware that there is a communication gap between them and young people.

3.3       The Cultural –Gender limitations

The traditional African and even the modern religions’ gender ascription of roles for men and women in society continue to impact on the effective media coverage of HIV/AIDS issues on the continent. It is a fact that women are disproportionately affected by HIV/AIDS in Africa, indeed over 53% of all those living with HIV/AIDS on the continent are women. Another large number is either affected as spouses of those living with HIV/AIDS or as care givers to those suffering from the epidemic. Yet not many women are in positions of influence either as newsmakers or media professionals. They continue to be under represented on the editorial boards of leading media houses in Africa. More often than not issues on gender or even HIV/AIDS for that matter have to pass through the male dominated editorial boards before seeing the light of day.

3.4       Structural obstacles to gender representation in the media

It must be noted here that the media is part of a society where the traditional role of women in the home was clearly defined. When women continue to have problems accessing higher education and by extension college training a process is already underway to undermine their voice in the media. The media houses are obliged to only recruit from the so few qualified cadres of women given the structural obstacles that they face in acquiring an education. The inherent failure of the African education systems to provide an enabling environment for girls to perform better in natural and health sciences aggravate the situation.

3.5       Culture and Sexuality in the African Context and Impact on Media

3.5.1   Taboo system as an obstacle to HIV/AIDS media reporting

In Africa HIV/AIDS is mainly a sexually transmitted disease. Matters to do with sex are traditionally taboo topics in the traditional African communication. They are thought to be private subjects not befitting public discourse. While sex is and will always remain a private affair, its direct product- HIV/AIDS is of increasing public concern given its far reaching and devastating effects on societies in Africa. This is where the dilemma for the media lies. You can not for instance discuss HIV/AIDS without mentioning sexual behaviours of those at risk of contracting HIV.

The print media can easily get away with discussions of intimate sex topics since theirs is an impersonal channel. However, those in the audio and visual electronic media have an uphill task. Thus they have to delicately balance the accepted social etiquette of public speaking by their largely conservative demographically mixed African audience and the true and saddening picture of HIV/AIDS and its direct link to sexual behaviours in society.

Broaching the subject of sex and condom use in relation to HIV/AIDS on TV or radio can especially be very discomforting for a mixed audience of a visiting father or mother in law together with the son or daughter in law and his/her adolescent children in a family living room. It is therefore not uncommon for the hosts to switch off the channel on which such a programme is being aired to avert a sense of guilt and shame

3.5.2   HIV/AIDS reporting

The cultural context in which HIV/AIDS reporting is done is of utmost importance. In societies where the inherent gender inequalities have undermined access of women to certain kinds of media, particular attention should be paid to the choice of media and the language of communication.

It is true that many women have no ready access to newspapers compared to men. Many women in many African countries of Africa have more access to the radio than to other channels of media. But even then, men still control or are the owners of those radios and their wives in many instances only listen to them at the mercy of their husbands. The dependency of women on men economically undermines their access to some of the available media channels.

The low literacy levels of women mean that the language of communication has to be factored in this reality. The many official languages of communication in leading media houses are out of reach of common people and more so women. Local dialects and languages as a means of preaching the HIV/AIDS gospel must be used as a panacea to the communication problem.

3.6       Stigmatizing Language and HIV/AIDS Reporting

Cultures find their expression through language. The experience so far from HIV/AIDS reporting indicates that the media has unwittingly participated in the stigmatization of the people living with HIV/AIDS. Certain words even in the English language when used in relation to HIV/AIDS convey negative attitudes. For instance the use of words like scourge and plague in reference to HIV/AIDS paints the disease in a negative light and stigmatizes the infected. Likewise, referring to the infected as victims or carriers of HIV is insulting. In Africa, some communities have coined words to refer to HIV/AIDS. In Uganda for instance, they refer to it as ‘slim.’ While this might suit the Ugandan situation, there are worries that this leads to a lot of suspicion whenever a slim person happens to be in the audience. Like the Nigerians say, “An old woman is never at ease when dry bones are mentioned in a proverb.”

3.7       Cultural/Political Interests and the Politics of HIV/AIDS in Reporting

The media in Africa are thought to be guilty of spreading moral panic. Although as mentioned elsewhere in this paper some information is derived from professionals, the way it is reported may single out certain sections of the population for blame.

In this regard, moral panic is orchestrated when patterns of behaviour private or public come to be selected by the mass media as unusual or symbolic of a threat to the fabric of society. In Kenya for instance, social groups who do not practice male circumcision like the Luo or who practice polygamy and or wife inheritance have been identified as constituting special risk groups in the context of HIV/AIDS and face the danger of being targeted by the media for special treatment. In this perspective the mass media would be seen as a crucial component of an interactive relationship between event, news making and political and professional actions that stigmatize such social groups through amplification of fears associated with HIV/AIDS.

It is therefore a Herculean task for the media to balance facts as in the practices that may enhance the spread of AIDS and which even the national HIV/AIDS strategic plans of many countries in Africa aim to eradicate and the deep feelings of attachment to those practices by their audience. This deep sense of belonging expressed through cultural rites is a casualty of blanket condemnation of cultural practices. Indeed people become defensive when the subject is broached. Politicians particularly take advantage of the people’s traditional sense of belonging and stage mock popularity contests manifested in their public pronouncements in support of these practices. Yet they are the darling of the media and they will often get better media coverage on such issues further complicating the war against AIDS.

It is also vital to note that while programme managers and government operatives are quick to condemn certain practices that are always taken up as news items by the media no mention is made of the positive cultural practices that help stem the ravages of the epidemic. It is a fact that to date the leading care providers to those living with HIV/AIDS are the traditional care givers i.e. the extended family and the community. No credit is given for these gestures.

So far there is no attempt to incorporate the traditional African approaches of dealing with disasters. There is a body of knowledge in Africa traditional coping mechanism like the use of aunts, aged people and the sages to counsel and guide members of the community. These must be explored since the modern counseling schemes may not be suitable where a large number of people need counseling services in remote corners of the various countries of Africa. The media has a duty to generate debate on these issues.

HIV/AIDS is also a very emotive subject in some countries like South Africa and even here in Kenya. Whereas some people in the government might see it as first and foremost a poverty issue others maintain that it is a health problem that impacts on other sectors of the economy. The challenge for the media is to navigate around these conflicting interests which in some cases may be very political and therefore ‘hot’ news subjects and give a fair and objective view of the right position. Programme implementers and government operatives are also under pressure to show to the public that after sinking so much funds in HIV/AIDS indeed there is something positive happening. The media then have a role to go beyond what is given for public consumption and find the underlying basis and or motive of some public pronouncements over this or that in the field of HIV/AIDS.

   


 

4.0       RELIGION AND ITS IMPACT ON HIV/AIDS REPORTING

4.1       Sexuality and Religion in Africa

Some scholars of African culture and religion like Prof. Mazrui have argued that an African is a child of triple heritage. That Christianity, Islam and the traditional African religion have all impacted on the spiritual psyche of the African personality. No where has this argument proved true than in the area of HIV/AIDS interventions.

Churches in Africa have for long argued that HIV/AIDS is an affliction of the sinners. While the originators of the church in the Western world quickly came to terms with the epidemic and recognized prevention measures like use of condoms, churches in Africa and in particular Kenya continue to condemn the use of condoms. Some have in fact burned them in public to make their point. The trouble with this is that the media so far has been stuck in its traditional role of reporting as it is not stopping to evaluate consequences this kind of actions have on the sexual behaviour of respective faithfuls of the participating denominations.

Some examples however stand out in contrast to the Kenyan situation. In Uganda for example, according to the Minister of Finance Mr. Ssendaula, the church quietly agreed that it would not publicly discredit the prevention measures advocated by the government and other stakeholders. This it was argued was aimed at encouraging a plurality of ideas and multi-interventional approach to achieve the required synergy to reduce the spread of HIV/AIDS.

4.2       Religious Triple Heritage and Impact on AIDS Reporting

Christianity and Islam have their own codes of conduct, which invariably lie at the core of these religions. Some churches for instance have a firm grip on their folks such that the decrees given from the church’s hierarchy are followed to the letter. Holy Scriptures describe afflictions of various kinds that could befall the faithful were they to deviate from the laid down code of conduct. It is therefore little wonder that those infected with HIV are thought to have strayed from the good word of the Lord or from the teachings of the holy prophet Mohammed-peace be upon him.

The traditional African religion has various cultural rites that are a must for the members of those communities. Those living with HIV/AIDS are therefore suspected to have failed to adhere to some of these rites and rituals

4.3       Religion and the Moral Imperative of AIDS Reporting

Depending on the religious background of the reporter covering HIV/AIDS issues, certain parts of his/her analysis are bound to reflect this background. Where this may not be the case, the background of the media house owners may impact on the story lines containing HIV/AIDS issues. For instance, some religious leaning media may decide to black out any issues on HIV/AIDS or where they cover them they may be laced with religious overtones. For instance it is expecting too much to hope that a Christian newspaper or radio/TV station will air condom use messages to its audience. In the same vain a reporter whose religious background is for example Catholic may feel constrained discussing condom use, abortion of a foetus conceived from rape etc. for fear of contradicting his/her pastor.

4.4       Holier than thou Attitude

In the Western societies homosexuals were stigmatized in the early stages of the epidemic by the mass media, fundamentalists and politicians to such an extend that provision of health care for seropostive and AIDS patients was hindered. However they were not entirely to blame. Early AIDS researchers in the US described AIDS as a gay related disease!

It is important to point out however that in Sub-Saharan Africa where HIV/AIDS is mainly transmitted heterosexually the concept of stigmatization may go beyond identifiable fringe groups to encompass whole ethnic entities and cultural practices.

5.0       CONCLUSIONS AND RECOMMENDATIONS FOR WAY FORWARD

The media have been viewed as being influential in building awareness across different sectors of society and the importance of individuals being careful in sexual behaviour and practices. While this has had a limited effect in attitude and behaviour change, there are experiences that have shown that their contribution can be invaluable and indeed powerful in determining behaviour change. Although certain cultural and religious impediments still stand in the way of effective media reporting on HIV/AIDS there is hope of dismantling these barriers through joined stakeholder efforts like this UNESCO workshop.

In this regard there is need for the media to appreciate the inter relatedness of culture and religion on one hand and a people’s behaviour on the other to be able to meaningfully influence their attitudes. In addition there is need for:

ř                Training media practitioners in the basic concepts of HIV/AIDS

ř                Advocacy and lobbying for regular allocation of space and airtime in the mass media

ř                Publication of reference materials for the media

ř                Establishing of a network on media and HIV/AIDS and prevention

ř                Humanizing the statistics and demystifying the epidemic and sex

ř                Getting more women to report on HIV/AIDS issues

ř                Advocating for gender sensitivity in HIV/AIDS intervention programmes

ř                Giving a cultural and religious touch to the analyses of HIV/AIDS articles and advocating for an Afro-centric approach to the management of the disaster

ř                Presenting the public opinion on the disease

ř                Presenting a holistic picture of HIV/AIDS

ř                Educating society on the need for community based structures in HIV/AIDS prevention and management

ř                Advocating for accountability and responsibility in the HIV/AIDS prevention and management