Lifecycles: A Story of AIDS in Malawi.

2003 52m prod Human Scale Productions, p Doug Karr, Norman Phiri, Walter Forsyth, d Doug Karr, Sierra Bellows, ph Doug Karr, s Sierra Bellows.

Lifecycles: A Story of AIDS in Malawi is an intelligent and clear-eyed look at the plague that is devastating sub-Saharan Africa. For Westerners, whose minds have been conditioned by the 30-second sound bite, AIDS is yesterday's news. There was, it seemed, a flurry of celebrity deaths in the 1990s, a short surge of activism, a brief flirtation with miracle cures subsiding to the tedium of long-term medication and then the West moved on to other things. To watch the continual promiscuous drivel that comes out of television--Friends, Sex in the City, et al--you'd think that AIDS had never happened, or that a cure really had been found and announced while we were watching another sexual farce.

But AIDS has not gone away. In the West it is only sleeping, gone undercover as it were, or at least under the media's radar. But in Africa it is a barefaced and relentless killer, wiping out an entire generation of that continent's professional class and taking the best efforts to reduce infant mortality and increase life expectancy of the last 50 years and reversing them to zero in a single decade. Directors Doug Karr and Sierra Bellows do not attempt to chronicle this depressing tragedy, nor is. their documentary designed to elicit the transitory emotions of monetary compassion and benign self-interest that characterize Western response to Third World dilemmas. Instead, they have sought to examine the African solutions to this pandemic and sketch for us a view of the African perspective on the future of AIDS.

Choosing Malawi (a relatively small former British colony bordered by Zambia to the west, Mozambique to the south and east and Tanzania to the north) as the vantage point to launch this investigation was either insightful or fortuitous. Malawi is not the worst-case scenario, Robert Mugabe's Zimbabwe holds that dubious distinction. Nor has it, like Uganda to the north, begun to see any noticeable downturn in the horrendous numbers of HIV/AIDS patients: an estimated 30 per cent of Malawi's 10 million people are HIV positive. As such Malawi represents the critical, but not yet terminal, face of AIDS in Africa. Further, there are no interracial or intra-political conflicts in Malawi to cloud the medical and social picture. Malawi is a remarkably peaceful society, at war neither with itself nor its neighbours. What you get when you look at AIDS in Malawi is the raw, undisguised face of a vicious killer and the heroic effort of those who seek to combat it.

They are a motley crew to be sure: prostitutes and farmers, politicians and widows, witch doctors and missionaries, all fighting a common enemy with whatever tools they have at their disposal, and a laughably inadequate armoury it is. We meet Dr. Stephan Luftl, head of Internal Medicine at Lilongwe Central Hospital, who notes that he has enough AIDS medication to treat 37 patients who can afford its cost. For the rest, the price that an AIDS patient in the West can afford is equivalent to a year's wages. There is anger and bitterness with the West over this inequity, but there is also resignation, merely another blow to a continent much maligned and forgotten.

We meet Maggie, an ordinary housewife until her husband died of AIDS. Her in-laws inherited his property, a common African practice, and she was forced into prostitution to make a living. She offers condoms to her clients, but most refuse, or if they accept, pay for her services at a greatly reduced rate. She tells her story stoically, without elaboration, and we are left to sketch in the inevitable results of her attempt to make a livelihood in the midst of such grinding poverty. We hear the Honourable Akele Banda, Malawi's minister of health, in his impeccable Oxford English, describe to us the parameters of a gender-oriented society, where women are expected to be submissive to male demands for sex, where the word "no" indicates shyness, not intent, and where abuse of positions of power, such as those held by teachers and politicians, for sexual purposes has led to a decimation in the ranks of these professions.

But despite the enormity of the problem, there are those who hope, and put feet to their good intentions. We meet Florence Nalibwe, a mother of three, infected by her husband and now HIV positive, who refused to sleep with her husband after her diagnosis unless he wore a condom so that she would not bring HIV-infected children into the world. In the face of her humble determination, her husband left her and married another woman. Florence is now raising her three uninfected children on her own. We meet Mac Mahone, a young man also HIV positive, who tells of how his experience with AIDS has taught him to live life more responsibly and positively; who states with quiet pride that after living HIV positive for 10 years, he has infected no one, and how he has great hope for his country now that people have begun to speak openly of this once silent killer.

But in Malawi, much ignorance remains. Some churches oppose the distribution of condoms, fearing that they promote promiscuity. Witch doctors continue to spread false declarations not only of cures, but even of the etiology of the disease, claiming that AIDS is a result of bewitchment. Poverty drives many to prostitution, and in Malawi prostitutes are 70 to 90 per cent HIV positive.

Such is the often alarming and sometimes hopeful picture that Karr and Bellows paint for us of AIDS in Africa. It is a thoughtful and disturbing look at the causes and effects of this devastating plague, offered to us without editorializing or sentimentality. The West would do well to consider how Africa, at present the front line of the battle against AIDS, deals with this scourge. We in the West have not yet seen the end of it.

Stephen Wise has taught on four continents and aims to complete the set while it's still available. His most recent assignment was in Lilongwe, Malawi.