I’ve just got back from the first of this years Lent Lectures, Berdine van den Toren speaking about The Struggle Against AIDS in Africa.

Berdine works for the Church Mission Society, and with her family spent over eight years living and working in the relatively unknown Central African Republic.

The basic facts about HIV and AIDS in the country are shocking. The average life expectancy, thanks to the pandemic is about forty, and effectively an entire generation has been wiped out, leaving quite often grandmothers looking after the children – many of whom are HIV positive themselves.

The country, like many in Africa is crippled by ongoing fighting, and suffers from corruption and many of the social and political issues that encourage the pandemic elsewhere on the continent. Berdine looked at some of these.

There is a great stigma attached to being HIV positive, as a result people will often not admit that they have the infection. The example Berdine gave was of the woman who they employed to help in their house. They paid her what they regarded as a fair wage, as a result the woman was supporting twenty other people on the wage.

However her husband was working in another part of the country. He came back, very ill, with many of the symptoms of AIDS, but as with so many deaths, his cause of death was listed as the disease that killed him, without mentioning AIDS. Berdine suggested to her that she should also take a test, but the woman they employed wouldn’t do it. She said that if she took a test, and Berdine knew the result, she wouldn’t be able to get another job, as Berdine would have to tell the next employer, and nobody would employ someone who was HIV positive.

Berdine then talked about some of the cultural issues, and more importantly the attitudes of the people in the west to these issues. As she highlighted, people in the west are usually quick to judge the people of Africa for not changing, and yet in the west we have similar widespread problems that relate to our cultural norms. Where Berdine currently lives in Oxford, like many places, there are major problems with young people getting drunk on the estates, drink related problems in the city centre, and so on. Taking the same attitude the west is taking over the African cultural norms, we should remove the problem by stopping alcohol from being available, but it is endemic to our culture. Equally with smoking, we know that it will prematurely kill thousands of people, and that our health service will have to spend massive amounts of money treating people for the effects, and yet it is such an accepted part of our culture, despite the obvious negative financial impact on our country we don’t really try to stop it. In much the same way, the AIDS pandemic spreads through culturally endemic behaviour, and trying to change that is much the same as trying to change culturally endemic behaviour in this country, or anywhere else.

Perhaps the most shocking part of the talk was when Berdine was talking about how AIDS is spreading through the instability in the African countries. Firstly, AIDS is being used as a weapon. Soldiers, knowing that they are HIV positive will rape women in areas that they have captured – the results being obvious. Secondly, with the large scale violence, and the daily possibility of getting shot, people tend to not be concerned about a disease that could kill them years later. As a result the pandemic spreads.

In the Central African Republic there is also a real problem with HIV in universities. Education is seen as a way out of poverty, however poorly paid lecturers at the universities will sometimes require bribes in order to give good marks to their students. If the students can’t pay in money, they pay in other ways…

Whilst she did finish with some more positive stories, of the work that is going on – a teacher who now feeds sixty AIDS orphan’s breakfast every morning before school for example – the sheer magnitude of the problems, and the complexity of the causes are hard to ignore, and even harder to solve.