Wash Post article re: medical anthropology
Wash Post article re: medical anthropology
Kenyan women reject sex 'cleanser'
By Emily Wax, The Washington Post
The women of this village call Francise Akacha "the terrorist." His breath fumes with the local alcoholic brew. Greasy food droppings hang off his mustache and stain his oily pants and torn shirt.
HE'S ALWAYS the first one in line for the village feast, tucking into a buffet carefully prepared by the women of the village like he's diving into the ocean, no restraint. He's too skinny and has, as the women point out, terrible taste in clothes. His latest hat is a visor styled from shabby paper stolen off a local cigarette billboard.
But for all of his undesirable traits, Akacha has a surprisingly desirable job: He's paid to have sexual relations with the widows and unmarried women of this village. He's known as "the cleanser," one of hundreds of thousands of men in rural villages across Africa who sleep with women after their husbands die to dispel what villagers believe are evil spirits.
As tradition holds, they must sleep with the cleanser to be allowed to attend their husbands' funerals or be inherited by their husbands' brother or relative, another controversial custom that aid workers said is causing the spread of HIV/AIDS. Unmarried women who lose a parent or child must also sleep with the ritual cleanser.
The custom has always been unpopular among women. But in midst of an AIDS pandemic, which has led to the deaths of 19.6 million people in sub-Saharan Africa, having relations with the cleanser has become more than just a painful ritual that women must endure. Cleansers are now spreading HIV at explosive rates in such villages as Gangre, where one in every three people is infected.
Areas that still practice the tradition have the highest rates of the disease, and health workers say the custom must be stopped. It's a striking example of how HIV/AIDS is forcing traditions to be questioned and changed as the disease ravages Africa.
"We don't want it and we won't accept it anymore," chanted Margaret Auma Odhiambo, as women ululated in agreement in her village, a lush rural farming community about a nine-hour drive northwest of the capital, Nairobi. "I refused it once and I will keep refusing it."
WOMEN GAINING STRENGTH
Twenty years ago, women -- even when they formed social clubs that frequently started projects to sell goods -- often could not question customs like cleansing, for fear of being beaten or having their property stolen.
But as HIV/AIDS started killing husbands in greater numbers, these women's groups, which were mainly social alliances and a way to make extra money, began to turn into powerful and political widows' groups. As their husbands perished, the widows were largely left to make money for the village and help care for the swelling number of orphans left without food or financial support.
In Odhiambo's village, the women said 30 percent of them were telling the cleanser to go away. They have formed a group called Standing Idle Does Not Pay, or Chungni Kimiyi in Swahili, a phrase that has become a mantra among women in the surrounding villages. They want the cleanser to go.
A cleanser is typically the village drunkard or someone considered not very bright. The job is seen as low class but essential to "purifying" women. Village elders say the custom must be carried out or the entire community will be cursed with bad crops. The cleansers are paid in cows and crops, as well as cash.
Odhiambo, a friendly woman with curly black hair and shiny black skin, recently stood with her group discussing the issue as the warm smells of a feast of fish, vegetables and maize meal they had made wafted through the village.
Like the predictability of the sun rising, the cleanser, Akacha, popped by, his bottle of local brew in hand.
Odhiambo watched as the cleanser served himself some of the food. Then she started talking to him about finding another job.
"Your services are not required any longer," she said, as her friends gathered to cheer.
"How many women have you slept with?" she asked, smiling and trying to prod the information out of him.
"I can't know," he sniffed. "I don't want to know."
"Do you know your HIV status?" she asked.
"That one I don't want to know," he said.
"Today, you sleep with this one, the next day another, the next day someone else," Odhiambo said, sitting next to him and trying to convince him of the danger. "Do you use a condom?"
"Never," he responded. "They won't be really cleansed if the condom was there."
Akacha has been forced to discuss the issue because more and more villagers are dying. Still, Akacha said he believes he provides a valuable service.
"It's not bad for me since I get to be with the beautiful ladies," he said, chuckling over his plate of food. "The woman like it 'cause who else would be with them? They can't stay alone with the spirits. They need me."
The issue has become so tantalizing that village elders are currently debating what to do about the custom. Meanwhile, health care workers and human rights agencies argue that they actually have no need for such services in the world of HIV.
"It's a custom that must be stopped," said Janet Walsh, deputy director of Human Rights Watch, which released a report on the issue in March. "Condoms are never used; they say it has to be skin-to-skin to work."
In Africa, women are six times as likely to contract HIV as men, mostly because of rape and customs like cleansing, in which one man can spread the disease to hundreds of women.
A STAPLE IN RURAL REGIONS
Cleansers can be found in some rural parts of Uganda and Tanzania as well as the Congo, where traditional religions exist next to fluid versions of Christianity and Islam. They are also a staple in Angola and in villages across West Africa, specifically in Ghana, Senegal, Ivory Coast and Nigeria, according to African aid workers who have been trying to talk to people in these countries about the HIV risk that cleansers present.
The tradition dates back centuries and is rooted in a belief that a woman is haunted by spirits after her husband dies. She is also thought to be unholy and "disturbed" if she is unmarried and abstains from sex. She must be cleansed, therefore, to attend funerals or remarry.
"The older generations need to change," said Nancy Oundda, a nurse with the African Medical Research Foundation , which works with the widows' groups and children orphaned by AIDS in this region. "Their attitude will change with education, and if they realize what this tradition is doing."
The foundation has donated a donkey, hoes, a cart and materials to the women so they can transport their bricks to market and make money to support themselves, a key to being able to refuse the cleanser and also avoid being inherited, along with their property. The group also provides seminars on HIV to the widows and village elders and prods leaders to abandon traditions such as cleansing. It also pays school fees for 300 orphans to take the burden off of the widows.
So far, the widows said, the education is working, and they reported being far less worried just knowing they could say no.
"I am so fat and happy without these men harassing me!" said Tabitha Anyango Odero, a widow who was pressured to be cleansed and inherited until she fought back and said she did not want to die of AIDS. "Look how clean my house is now. Look how healthy I am now. I love my widow group."
On a recent afternoon, Odhiambo gathered with a group of women putting on a short drama about refusing to be cleansed or inherited. Polygamy was also questioned in the skit, because men spread HIV/AIDS to their wives at alarming rates.
'HIV IS SHAKING THE WHOLE WORLD'
In the skit, a woman's husband dies of AIDS and she refuses to be cleansed or inherited until the men take an HIV test.
"I am clean like water," says the cleanser.
The audience exploded in laughter.
"Then take the test," replied the woman.
But in the end a village elder forces her to be cleansed and inherited, and she dies of AIDS.
"HIV is shaking the whole world," a character says, as the play concludes.
Men in the audience -- sitting in some chairs set up under a large tree -- laughed and clapped and shook their heads in agreement.
"Slowly, by slowly, we must change," said Dalmas Ongan, 62 who wore a three-piece gray suit and a straw hat and said he loved the play. "We used to say we would die for our traditions. Even me, I used to say cleansing was good. But I think this attitude helps nothing. We all may die if we don't stop this one."
© 2003 The Washington Post Company
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