Risking Death for Survival: Peasant Responses to Hunger and HIV/AIDS in Malawi

Beginning in 2001, smallholder peasant households in Malawi faced two life-threatening risks: AIDS and famine. Malawi registers the 8 highest HIV/AIDS prevalence in the world (UNAIDS 2004) and is one of the continent’s least urbanized countries with 85 per cent of the national population living in rural areas. Much of the countryside has a reputation for being ‘deep rural’ in the sense that it is characterized by a patchy road network and poor physical, economic and social infrastructure within a culturally conservative context of village-based traditional tribal leadership. Between 2001 and 2003 the countryside experienced widespread hunger. Speculation about possible links between HIV/AIDS and famine inevitably ensued. De Waal and Whiteside (2003) argues that a ‘new variant famine’ surfaced in the context of a rural population predisposed to food insecurity by the prevalence of AIDS morbidity and mortality. It would be impossible to conclusively prove or disprove this thesis. Certainly, the deteriorating welfare status of the Malawian rural population amidst the rising prevalence of HIV/AIDS prior to the famine can be amply demonstrated (e.g. Ngwira, Bota and Loevinsohn 2001, Frankenberger, Luther, Fox and Mazzeo 2003). This paper explores the interacting effects of HIV/AIDS and famine. Based on key informant interviews, focus group discussions and a random survey of 141 households in three villages as part of a CARE International study carried out in Lilongwe rural district, Central Province between December 2003 and March 2004. Villagers’ coping strategies and social responses under the combined duress of HIV/AIDS and famine are highlighted. The spread of AIDS in Africa has generally been associated with political upheaval and geographical mobility. For some time, rural farming populations were considered relatively ‘safe’, tucked away from harm. The differential between rural and urban HIV prevalence seemed to confirm this view. However, in Malawi the gap between high urban and low rural HIV prevalence is now closing despite the ‘deep rural’ image of the countryside. As the AIDS pandemic widens and deepens, the changing vulnerability profile suggests that rather than asking what processes are responsible for its spread, we need to ask who is most vulnerable and why. The issue of agency within specific modes of livelihood contexts begs attention. Some of the proliferating literature on AIDS now hints at the need to consider HIV as an ‘occupational hazard’ for particular economic categories of people. This hazard may not accord with intuitive reasoning. Campbell’s (2003) comparison of South African miners, youth and prostitutes discovered that prostitutes were in fact the least vulnerable to HIV infection because of their professional insistence on using condoms, unlike the youth and miners who adopted a macho ‘devil-may-care’ attitude towards unprotected sex. Allison and Seeley (2004) document similar attitudes amongst the Kenyan fishermen whose hyper-macho group identity, nocturnal absences from home and mobility subjected them to high HIV exposure. This paper is focussed on the agency of another livelihood category, which broadly constitutes a social class at the very centre of Malawi’s political economy namely, the smallholder peasant farming population. We