A Lion Cannot Hear Its Own Roar

            The title showed up in a listing of common proverbs from Botswana from a Google search. I don’t know whether or not it is a real proverb in Botswana, or what it’s supposed to mean, but I think it communicates the theme of this entry effectively. Just as a lion can’t hear its own roar, people often have a tendency to get tunnel vision, and become so lost in their own thoughts—their own roaring, if you will—that they forget to consider perspectives different from their own.

            I think that this happened to me last week. When I was asked to read a bunch of literature stating that HIV/AIDS prevention and testing of patients should be referred to traditional healers, since mainstream medicine’s approach wasn’t effective in reducing the incidence rate, I dug my heels in and refused to accept that idea.

           To me, the use of scientific inquiry to answer questions about our health is fundamental. As a pre-med student, that is what I aspire to spend the rest of my life doing. So, I couldn’t fathom the idea of having this usurped by a practice that wasn’t based on evidence, but on something that is indiscernible and immeasurable. However, after I heard my classmates speak on the issue, I realized that I was overreacting. The idea of incorporating traditional practices of health care in the mainstream modern system may be vital to reducing the incidence rate of HIV in Botswana.

This is in large part because, even with the current advent of modern medicine, most people in Botswana turn to traditional healers first when they are ill. There is a wide mistrust of medical professionals, especially since all of them are foreign-educated because Botswana is just now building its first medical school (which we will get to visit while there!). So, it isn’t physicians who are the first line of defense and treatment for those with HIV—it is traditional healers. By incorporating these healers, whose opinions are widely respected and whose advice is followed, into the system of support for those with HIV, it will be possible to convince more people to get tested and to get treatment earlier. Furthermore, prevention techniques may be more readily employed by individuals who put more stock in the counsel of traditional healers than they do of government officials and physicians.

Last week, I was too busy hearing my own roaring to stop and hear what others had to say—and to recognize that they had valid points.

This week, the reading focused on the topic of identity, especially as it relates to gender and sexuality. There are two very important points that struck me from this reading: the HIV/AIDS epidemic in Botswana is not just a heterosexual phenomenon, and gender roles are deeply ingrained in the Tswana society, in a way that is difficult to comprehend as an outsider.

First, this week was the first time I’d heard anyone mention homosexuality in Africa. Researchers commonly use the term “Men who have Sex with Men” (MSM) for this group when discussing HIV transmission. However, it should be noted that HIV can be transmitted from one woman to another during sex. For my purposes, I am going to call it homosexuality, although it could be any number of labels. What resonated with me most about this reading is that while in America, HIV/AIDS is considered a disease that is basically a problem of the LGBT community (as horribly insensitive as that sounds). Yet, in Africa, and specifically in Botswana, there has been great reluctance to have it associated with anything other than heterosexuality. The MSM cohort is not at all accepted socially in Africa, and many of these men have to hide this aspect of their lifestyle from others for fear of discrimination, blackmail, or abuse. The same applies to women who sleep with other women.

In fact, this entire group of people is completely invisible. They aren’t publicly ridiculed or harassed for leading “unacceptable” lifestyles. They aren’t purposely ignored or ostracized. It seems to me no one is willing to admit that they exist. As a result, the African LGBT community essentially has no label—at least not a mainstream one. In fact, one African Man of the MSM group even stated that he belonged to a third gender. He did not consider himself a man, but he also didn’t consider himself a woman. He felt he was something else entirely. This is a very different conceptualization of self than can be seen in the West with regards to homosexuality. As such, I think this is another case of roaring too loudly. Until people in Africa recognize that they have an entire group of people that they are ignoring, they won’t be able to accomplish many of their goals with regards to HIV incidence.

Secondly, this week’s reading questioned my personal conceptualization of STDs. Personally, I have always felt that STDs, especially HIV, are conditions framed by choices—the choice to have unprotected sex, the choice to inform sexual partners about one’s HIV-positive status, and the choice to get tested and treated. At least in America, making smart choices can help you avoid HIV to a large extent. However, after reading many interviews and accounts of teens and young adults in Botswana, it is clear to me now, that choices aren’t always available there, especially not for women.

Based on these readings, it is clear that men in Botswana hold all the power. Whether it is during a school project or in a marriage, women defer to men in all aspects of life. There was one particularly powerful image where schoolchildren were asked to pose in a stance that conveys power. All the boys looked straight at the camera with their arms crossed over their chests or in a pose imitating Rodin’s Thinker. In stark contrast, all the girls posed with their heads down, and posture slightly hunched over. To them, a powerful woman was submissive.

In the context of sexual experiences, this submission means that women don’t always have the choice to ask a partner to use protection. Far too often, they don’t even have the choice to consent to sex at all. Furthermore, this power dynamic isn’t simply a psychological barrier for women. Young men firmly believe that they must have the power in relationships with women, especially those of a sexual nature, and that they can even use violence to get what they want if they feel it is warranted.

Personally, I think HIV/AIDS will continue to be a problem until the playing field is leveled. As long as women don’t have power over their lives, especially over their own bodies, they won’t be able to protect themselves. And, as long as men aren’t checked in any way, they won’t feel the need to use protection. I don’t mean to say that men are the problem here and that the oppressed women have all the answers. I just mean that until men are taught to respect women and respect their wishes, there won’t be any respect for the act of intercourse.

In essence, a lion cannot hear its own roar.