A Flea Market Economy
by Lauren Hasek
We cautiously followed the man as he stepped away from the street. He moved elegantly through the small shantytown. Vendors woke from their mid-day slumbers and eagerly pressed towards us, goods in hand. We ducked beneath an aluminum overhang to enter a large three-sided structure built on an uneven cement slab. At either end, tailors sat at worn, wooden Singer sewing machines, cradling brightly colored fabrics in their hands, finished skirts and shirts hanging overhead. Between them, women sat behind rows of tables, stacked with folded chitenjes (elaborately designed fabrics worn as wrapped skirts). The vibrant cloths were folded into small rectangles and placed neatly next to one another, forming rows of bold colors and ornate patterns. Some of the women made great efforts to hassle each customer, eagerly unraveling any fabric our eyes would linger on. Others remained passive, watching as we ran our fingers over the rows.
A series of meek cries caught our attention. A baby tossed its tiny fists as its mother tugged at its cloth diaper, fastening it with two rusting pins. He was trapped between reams of fabric, comically resembling a turtle on its shell. His cheeks were sunken into delicate dimples that quivered as he breathed. His belly ballooned. The mother’s tired eyes followed us closely.
Let us say that hypothetically, that mother is HIV positive. It is not an uncommon scenario in Lilongwe, Malawi, where 20 percent of all pregnant women have been infected. Despite a decrease in instances of positive HIV diagnosis since 1998, the national HIV prevalence has remained at 11.9 percent since 2007, although it has been shown to be as high as 17.1 percent in urban centers throughout the country. With the ninth highest infection rate globally, Malawi is a large contributor to the growing percentage of new infections occurring in infants and young children. Without intervention there is a 20-45 percent chance an HIV-positive woman in Malawi will pass the virus to her child during pregnancy, delivery, or through breastfeeding.
Over the past decade, Malawi has been inundated with HIV education programs; despite the success of near 100 percent awareness across the country, there is no evidence the HIV prevalence has changed. Unfortunately, what women are being told and what nearly all of them have been found to know, often contradicts what they see occurring in their communities. Prolonged breastfeeding for up to three to four years is still very much an ingrained aspect of Malawian rearing practices. In a country where poverty is prevalent, breastfeeding ensures a child is receiving a meal regardless of economic constraints; the guarantee of food outweighs any perceived risk of mother-to-child infection. As a result, the reduction of prolonged infant feeding is heavily dependent on first increasing the accessibility of alternative feeding methods. Until poverty is reduced, those with economic constraints will pursue the feeding option that offers the most immediate benefit to the health of their child, regardless of the known risks.
The average Malawian citizen is far more educated concerning HIV-related risks than the average American. However, education alone cannot transcend the barriers to preventative actions amongst the Malawian people. Conquering the drastic global health care disparity begins by liberating the flea market economy that dominates much of the developing world. Until some degree of monetary freedom is achieved, no amount of education will change the calculated decisions women make to improve their immediate situations.
Aide work makes us smile and warms our hearts, but it inevitably but it does nothing but place a Band-Aid on a gaping wound. Improving the global health disparity begins not with foreign clinics and eager aide workers, but rather with mobilization of the populations themselves and providing communities with the opportunities and resources necessary to actively improve their own socioeconomic situations.