|Forum: Caught in a Dilemma? HIV/Aids, Gender and the Media|
Over 22 millions people have died of AIDS related illnesses in the last 20 years and more than 42 million people are currently infected with a virus which was unknown in 1980 (UNAIDS 2002). While HIV/AIDS is the largest health issue currently facing the world, the epidemic is a gender issue. Statistics prove that both the spread and impact of HIV/AIDS is not random.
It disproportionately affects women and adolescent girls who are socially, culturally, biologically and economically more vulnerable than their male counterparts. These power imbalances between men and women are accentuated by various traditional practices that contribute to the spread of the disease such as female genital mutilation, and the early or forced marriages of girls. It is clear that gender roles and relations have a significant influence on the course and impact of the HIV/AIDS epidemic in every region of the world. In short, HIV/AIDS is not only driven by gender inequality, it entrenches gender inequality and, as Noleen Heyzer, Executive Director of UNIFEM has said, in the case of HIV/AIDS, “gender inequality is fatal’.
Despite over twenty years of multi-faceted strategies designed to stop the spread of HIV/AIDS the pandemic continues unabated. It is becoming increasingly clear that while there remains no cure for AIDS and no vaccine, and effective treatment remains widely unavailable to the poor, “the greatest weapon in humanity’s armour to contain the pandemic remains humanity’s most unique characteristic – communication” (Panos, 2003). Whilst the mainstream media is only one of the numerous communication channels available to any given country in their fight against HIV/AIDS, it is undoubtedly one of the most important. Unfortunately, however, because of its own lack of awareness of the links between gender and HIV/AIDS, the media has often been part of the problem rather than the solution.
In many cases, rather than promoting a holistic human rights-based approach to addressing the pandemic, the media has contributed to the hype and hysteria, as well as sexist stereotypes surrounding HIV/AIDS. They have reinforced stigma and prejudice by encouraging the view that AIDS is a disease of sinners and prostitutes; that women are to blame for contracting the virus, and that they are responsible for the growing misery of AIDS orphans. While the media representation of men in relation to the epidemic has been similarly prejudiced, often male gender issues have been subsumed under aspects of race, class and cultural prejudice.
Moreover, practices prevalent in certain parts of the world such as having sex with a virgin to ‘cleanse’ infected older men of the disease, or banning young women from having sex are occuring with no critical comment, debate or provision of information to help dispel the frightening myths that surround them. As Martin Foreman, former Director of the Panos London Global AIDS programme has highlighted, “whether they actively seek to do so, the media either fuel the epidemic through sensationalism and poor or unethical reporting, or help to restrain it by promoting information, understanding and behaviour change.
The media shapes attitudes and influences the national agenda for good or for ill; it educates or misinforms; it investigates or ignores malpractice; and it raises or ignore questions of cultural values that lie behind the epidemic”. The mass media has found itself caught in a dilemma over HIV/AIDS as to whether its role is simply to ‘convey the facts’ or play an advocacy role, and it is a dilemma that is linked to a broader, long standing debate over the role of the media in development and society – is the role of the media to convey what is, or what could be?
From the perspective of most media activists, the answer is simple – that the media has a critical role to play in stimulating public debate and dialogue and in challenging the kind of long established social norms that contribute to gender inequality and the spread of HIV/AIDS. The media is not simply a vehicle for information dissemination. Information is crucial but so too are the ways in which it is passed on and which voices are granted credibility.
For HIV/AIDS, where gender and other forms of inequality play such key roles, the media should ideally provide a forum in which a plurality of voices, particularly those of the people living with HIV/AIDS (PLWHA), is heard and discrimination and stigma are challenged. With the recent changes in the mass media environment connected to globalisation, privatisation and the deregulation of media industries, there are both challenges and opportunities for HIV/AIDS action. Whilst the mass media is increasingly driven by the profit logic resulting in a highly commercial media prone to sensationalism, there is the potential for recent changes to bring greater pluralism, access to information, democratisation and responsiveness to communities’ needs.
It is in working with the media to realise this potential, that HIV/AIDS, gender and communication activists have a key role to play. Whilst it is vital for all civil society to have the right to free speech protected by law, this right is meaningless unless PLWHA and the communities in which they live have the tools and the capacity to make themselves and their perspectives seen and heard. In addition to facilitating access to the mainstream media, there is a need to encourage the development of local or alternative media which can also contribute to fostering an environment where the voices of those most affected by the pandemic are heard.
Communication continues to hold the key to containing HIV/AIDS transmission and coping with the effects of the pandemic. As much as HIV/AIDS is a devastating threat to the world, it also presents enormous opportunities for better understanding the gender dynamics that are contributing to the spread of the disease, for frank discussion on sexual and reproductive rights, and for a human rights approach to dealing with the pandemic. But this can only be achieved if those who communicate about the disease are well equipped to understand and convey these issues.
As WACC prepares to launch a new long-term programme on communication and HIV/AIDS in Africa, this issue of the Monitor addresses some of the key questions surrounding HIV/AIDS, gender and media though the voices of two women who work on HIV/AIDS in very different national contexts.
Kristine Greenaway is currently working with Canada's Department of Foreign Affairs and International Trade in Ottawa after a term with the World Council of Churches in Geneva, where she worked on a number of issues, including HIV/AIDS. Kristine has been active with WACC since 1989, having served as Vice President for the North American Regional Association of WACC and as a member of the Central Committee. She has a B.A. in French literature, a post-graduate diploma in communication arts, and an M. Ed. in Adult Education. Kristine is a member of The United Church of Canada.
Mass media coverage in Canada of the HIV/AIDS pandemic can be summed up in two words - Stephen Lewis. He draws attention because of his role as the UN Secretary-General's special envoy for HIV/AIDS in Africa. He holds attention because of what one reporter has called his "stunning oratorical skills". Norman Webster, writing in the Montreal Gazette (Jan. 17/04) said of Lewis, "He might be the finest orator in English on the planet...a magician of the language, almost eerily articulate." Webster reports that in 2000 Lewis wrote about a visit to a hospital in Swaziland that "If Dante were alive today, he'd recast the inferno."
It was Lewis who was the catalyst for one of the biggest HIV/AIDS stories covered by Canadian media in the past few months, a story that has been echoed worldwide - the Canadian government's decision to legislate changes to enable export of lower cost pharmaceutical products to developing countries (November 2003). In a story published in the Toronto daily, the Globe and Mail (Oct. 2/03) reporters Heather Sutcliffe and Paul Knox wrote that "It was a plea from Mr. Lewis that prompted federal cabinet ministers to go public with the new plan." They quoted Lewis as saying that he hoped Ottawa's move would prod countries to take similar steps.
Fortunately, Lewis doesn't miss any opportunity to point to the rate in infection of women. Journalists follow his lead when he tells Canadians that in Botswana more than half of all women between 27 and 29 have HIV. The Montreal Gazette picked up on that statistic and used it as a hook to cite the findings of a survey issued in 2003 by the Nelson Mandela Foundation that "a stunning 39% of black African woman age 25 to 29 were infected without access to anti-retro viral drugs, most of these are doomed." (Jan. 17/04)
If Lewis' voice dominates and drives the media coverage of HIV/AIDS in Canada, it's not the only voice. David Agnew, President of UNICEF Canada , wrote in an article published by the Vancouver Sun that "Across the African continent the number of orphans is now estimated to be 11.5 million, most attributable to AIDS." He goes on to say "It's difficult to succinctly convey the impact of AIDS in southern Africa. Words like pandemic are accurate, but clinical...calling it a disaster gives the false impression of sudden crisis, when it has been years in the making, and still has years to play out." The words he finds are "Like some kind of horribly destructive whirling dervish, AIDS is careening through these societies, chewing up lives, families, traditional structures and leaving behind a human landscape as bleak as a clear-cut forest. The detritus includes the orphans..." The stories he tells to bring his words alive by giving than a human face are these of two Zimbabwean girls Melody 12 and Patience 13, and both at risk of becoming sex trade workers to feed themselves.
However, both Agnew and Lewis are at pains to point to what can be and is being accomplished in response to the HIV/AIDS pandemic. They talk about successful initiatives by UNAIDS, UNICEF and World Food Programme. Agnew was also careful not to paint the AIDS orphans he met as helpless victims. "...the orphans are struggling to make the best of their often-wretched lives. Despite hunger (and) the indignity of having to beg for an exercise book or a pencil, almost without exception they continue to go to school and use precious evening hours learning to read and write."
Even if much AIDS coverage focuses on stories from Africa, there have been two revealing high-profile media stories recently about the impact of HIV/AIDS on Canadian lives. In January 2004 there was a flurry of sensationalist coverage of an alert issued by a hospital in Quebec. Officials at Sainte-Julienne's Children's Hospital were trying to contact the families of 2600 children who were operated on by a doctor they had learned was HIV positive at the time. Panic ensued. Accusations of irresponsible medical practice flew.
The surgeon in question, Dr.Maria Di Lorenzo, who had pioneered life-saving surgical procedures for babies contracted her infection from a patient. Questions in the media centred on whether her supervisor should have disclosed her condition. Public opinion was divided.
The ethics and necessity of disclosure were also at the centre of another big media story focused on HIV/AIDS in Canada. In January 2004, Cardinal Turcotte of the Archdiocese of Quebec (?) announced that all candidates for priesthood in that archdiocese (?) would have to undergo HIV testing. A press release issued by the Canadian HIV.AIDS Legal Network noted that "under Canadian law, no employer has the right to impose mandatory pre-employment HIV testing and it is also against the Human Rights laws of all provinces to demand such information because to do so amounts to discrimination based on disability." (Jan. 26/04) Although the Quebec Charter of Rights and Freedoms allows exclusions if "justified by the religious nature of a non-profit institution" the Legal Network says "clearly being HIV negative is not a necessary requirement to be a priest." "Everyday that passes without action to educate people about...why discrimination is unjustified, exposes even more people with HIV to unnecessary exclusion." Because Quebec is still dominantly a culturally Catholic society, this story received a lot of media coverage.
However, the story of the impact of HIV/AIDS in aboriginal communities is not being covered in the media. It was a relative who works for the Canadian government's Ministry of Indian Affairs who first told me of the high incidence of HIV/AIDS in native communities. Later, a web search turned up little on the subject but what I did find was media-savvy. The Canadian Aboriginal AIDS Network has prepared an "HIV/AIDS, Fear, Discrimination Public Service Announcement Campaign" which features audio recordings available to national and local radio stations. The web page featured four audio messages: a 15 year old Inuk (Eskimo) whose mother died of AIDS when he was four; an Ojibway who tells how he used to believe if you were infected with HIV/AIDS “it was your own fault”; a 34 year old Métis (white and aboriginal mixed ancestry) living with HIV; and an Inuk Elder (Leader) who "recently passed into the spirit" but recorded a message against discrimination before she died.
Calling attention to untold stories such as this one is the perennial challenge for advocates, as is ensuring balanced, respectful coverage. There are ways of doing it. The first and most obvious way of getting a wider range of stories and more informed coverage in mainstream mass media is to enlist the Stephen Lewises of this world who, by sheer force of character, knowledge, and oratory, impose not only the story but also the angle, tone, and key messages.
It is also possible to draw attention - though perhaps without the benefit of in-depth subject knowledge - by working with high-profile entertainment and sports figures. On the website for Canada's Much Music television network (high ratings with 12 - 25 age group) for February 15, 2004 I found the story of the lead singer of Beautiful Garbage, Shirley Manson, who has just been named patron of Scotland's biggest HIV charity, Waverley Cared. The story notes Manson had earlier joined Elton John and Marcy J. Bilge as spokes people for MAC's 2002 VIV GLAM IV lipstick campaign to raise money for the MAC AIDS Fund. A representative of the Waverley Trust Fund said, "We are very excited (to work) with Shirley to raise awareness of HIV..."
The use of celebrity spokes people for causes though is not without its problems. Even the target audience for these celebrity endorsements have questions about this approach. On the same Much Music web page, next to the Manson story, is the question for the "Weekly Poll": "Does celebrity endorsement work on you?”
John Pungente, a Jesuit priest, has been a quiet force behind the scenes at Much Music in the past few years. A well-known media teacher and advocate now working with CHUM, the owners of Much Music, he only occasionally appears on-camera but undoubtedly has been a catalyst to bring stories such as the one on HIV/AIDS to the screen.
(http://www.comminit.com),a Vancouver-based service supported by organizations such as the Rockefeller Foundation, BBC World Service Trust, the European Union, FAO, the Panos Institute, and UNAIDS. There I found the report "Media Coverage of Women and HIV/AIDS" published by the Women's Edition project of the Population Reference Bureau, an American non-profit, non-advocacy organization that "informs policy makers, educators, the media and concerned citizens working in the public interest around the world." The report "examines the epidemic's impact on women and girls from the perspective of women journalists. In July 2000, PRB gathered senior journalists from 10 countries for a seminar...The journalists subsequently produced special supplements in their newspapers and magazines as well as radio programs that highlighted local and international aspects of the epidemic." Excerpts from these stories are published in the report.
Effective media awareness advocates have learned a third lesson. "Don't lecture. Model." Rather than critiquing mainstream media journalists from the sidelines, it is better to create campaigns that show what you mean by respectful, informed stories, PSA's, and ads. There are skilled church-based communicators today who are taking full advantage of their access to church-sponsored media such as magazines, newspapers, television programmes, and websites to set an example. The United Church of Canada has been awarded the North American Associated Church Press Award of Excellence for a Feature Article for Hugh McCullum's article "Africa's Looming AIDS Apocalypse" published in the United Church of Canada Observer (October 2002). The same issue of the Observer also earned the ACP Award for Magazine Design.
Multi-faceted advocacy and information campaigns are today's alternative media initiative of choice for many who want to draw attention and enlist support for the issues related to the HIV/AIDS pandemic. The United Church of Canada has launched a campaign dubbed "The Beads of Hope" which combines education initiatives at the congregation level and fund raising through the sale of beaded symbols made people in Africa living with HIV/AIDS. A visit to Canada's Parliament buildings in Ottawa by the denomination's Moderator in early March 2004 was designed to attract media attention to the Beads of Hope campaign. Putting this campaign on the national media agenda was designed to simultaneously reinforce the credibility of the campaign among grassroots church people and use the grassroots support for the campaign to impress politicians as they prepare for national elections.
An impassioned, media-wise spokesperson, a colourful demonstration of popular support, compelling first-person stories, can offer hope and show how efforts of groups and individuals are making a difference. Avoid the disabling effect of stories that are relentlessly despairing. Show people living with HIV/AIDS as active participants in projects. People will get involved if they believe it will make a difference. Awareness, inspiration, respect, and hope are the key words of any successful mainstream or alternative media campaign.
Judith Smith Vialva is director of the Cape Town-based Southern African Media and Gender Institute (SAMGI) - an NGO that works on media and HIV/AIDS issues, among others. Judith has a long history working in the field of media and gender and is a prominent activist. Her interest in women, youth and the role that media plays in the dissemination of information, is evidenced by her active participation in many forums, including print and broadcast media. Judith has always insisted on peace building throughout her work despite having lived through the legacy of apartheid.
When your Minister of Health and the President of the country are not in agreement on the issue of HIV/AIDS it becomes very difficult to get the reporting right in the first place. Recently a lot of the reports in the media have covered the silence on the part of President Thabo Mbeki particularly during the state of the nation speech at the opening of parliament on the 6th February 2004. Activists and other civil society spokespeople have vocalized their concerns about our President’s failure to address the HIV/AIDS issue.
Our Health Minister, Dr Manto Tshabalala-Msimang, has recently been quoted offering alternative remedies following the failure of government to implement a strategic plan for management, care and treatment of HIV/Aids. No information has been given about a plan to educate and equip more doctors to administer, prescribe and monitor AIDS drugs.
The main advocacy group for HIV/AIDS is the Treatment Advocacy Campaign (TAC). Much coverage has been given to this energetic group of activists, particularly their effective campaigns that have been launched over the past few years. Zackie Achmat, National Chairperson of the TAC, has recently been nominated for a Nobel Peace Prize for his commitment to the cause.
The usual pictures and stories are of starving poverty stricken people and more often than not, a spokesperson telling their story. Many of these stories only reach the mainstream print media after the patient has died. Children’s stories are usually of abandonment and denied access to schools and after care groups.
Generally the South African media’s reporting has been of a sensationalist nature. A lot of the coverage has covered the cost and availability of anti-retrovirals. Many families are unable to afford this treatment and sufferers are left at the mercy of the opportunistic infections that assail already weakened immune systems.
The mass media has failed to take up an excellent opportunity to address the issue of stigma particularly in light of a recent rape and murder of a HIV/AIDS activist. Ms Lorna Mlosana was murdered on 13th December 2003 after telling her rapists that she was HIV positive. This was an opportune time for the media to take up the issue of stigma particularly given that another murder of an AIDS activist 5 years earlier was mentioned in the same report. Gugu Dlamini, a nurse who lived in KwaZulu – Natal was stoned by her community when she publicly disclosed her status.
Issues of concern to PLWHA, especially women, should be represented as an issue that affects all of us and not only affecting marginalised groups such as poor or disadvantaged people. Presently many reports underpin or support a ‘them and us’ syndrome – the have and the have-nots. Preferably, I would like to see the media reporting on HIV/AIDS in the same sympathetic manner that occurs with cancer reports and stories. Cancer stories seem to elicit a feeling of empathy and compassion. Cancer, like HIV/AIDS, can happen to anybody. Stories of HIV/AIDS give the impression of a dirty history, a sort of punishment for doing something bad, and generally a just dessert. Journalists and reporters should give voice to the people most affected by the epidemic and not only the spokespeople on these issues. The human story is frequently diluted when it is spoken through a third party. Many women (mothers, grandmothers and aunts) assume the responsibility for the care of sick relatives whilst they themselves are suffering the ravages of the disease. Media has an opportunity to invite Social Services to speak out on plans for support and assistance to PLWHA, for example.
We as activists need to approach journalists in a more forthright but friendly manner. Often journalists have to report on these difficult issues using sources containing medical jargon, which unless you are a medical practitioner, is difficult to understand. Male journalists in particular need to be educated and sensitised around these issues, as they seem not to directly approach it, but to skirt around this important topic.
Mostly the reports and stories are written by women and are located in the women’s pages or health sections. We can further assist media reporters by providing them with information and being available as sources of facts and figures. We could offer journalists information about issues in our communities as well as the activities taking place at policy level.
This will provide a much needed diversity of voices in the media. We can also provide collaborative training/awareness raising sessions with journalists where we work together to improve the style and method of reporting.
Alternative media can provide a platform for the voices that are not heard in this epidemic. It can serve as a source of information regarding the virus, health complications and management tools that can be used in the daily lives of PLWHA. Alternative media is more accessible to the communities most affected by the epidemic and has the potential to be a strategic method of informing and educating people. Community media practitioners should be encouraged to make use of the resources of NGOs and CBOs, particularly those working in the communities and the field of HIV/AIDS. Once again, this will reach the primary source of people who can offer first hand and constructive information and also provide the affected and infected communities with a voice.