LGBT Malawians face discrimination and hostility when seeking healthcare

Dressed in a red checked shirt and a pair of camouflage shorts, sporting his signature mohawk hairdo, 18-year-old *Precious is already seated in the Centre for Development for People (CEDEP) office where we are supposed to have our interview.

He has never faced a reporter before but looks eager to share a personal story he rarely talks about in a society where people like him are often considered outcasts. “I realised I was gay at the age of 14 while in secondary school,” said Precious. “My family knows I am different, but no one has ever approached me to find out about my sexual orientation. I suspect some members of my community know I am gay as I have received some death threats because people think I am evil.”

When asked about his experiences trying to get medical care at a health facility, Precious’s eagerness to speak evaporates. “I had sexual health issue that required medical attention. I was disappointed with the way the nurse at the health facility handled the situation. After the routine diagnosis, she asked me if I was homosexual. I said yes because I wanted help. She told me that I was evil and my future was doomed because God does not allow that,” Precious said, his head bowed.

“She then called her colleagues to come and see me. They took turns pouring insults on me. One of them openly said I did not deserve medical attention. Instead I should be arrested for indulging in homosexuality, which is an offence. I was totally upset and I left the clinic for a drug store so I could treat myself,” he added.

Precious’s case is not an isolated one – many LGBT Malawians face similar discrimination and hostility when seeking healthcare at public and private facilities in the country.

Equal access programme

CEDEP, an organisation that works to promote minority rights in Malawi, is trying to change that. Maria Ngulube is the Projects Coordinator for Linkages, a project CEDEP and other organisations are implementing in Malawi to ensure equal access to health service for everyone, including the LGBT community. “We have had cases of the community complaining of maltreatment at the health centers and clinics, so the project decided to engage the health workers themselves,” said Ngulube.

CEDEP and its partners have trained more than 50 health workers in Malawi since the programme started in April 2016. The programme, which Ngulube plans to expand, offers guidance in how to address the specific health needs of sexual minorities.

Ngulube says the religious beliefs and affiliations of health workers and the institutions where they work often contribute to LGBT discrimination. Alongside public hospitals, which are few in number, much of Malawi’s LGBT population accesses healthcare at church-owned facilities operated by the Christian Health Association of Malawi.

Fatsani Kalino is a health worker at Bwaila Referral Hospital, a public facility in Lilongwe, where she works on HIV testing and counseling within the STI department. She describes the pervasive stigma that existed around treating sexual and gender minorities before CEDEP’s training programme began. “Sometimes we were regarded as LGBT health workers. If colleagues learned that we treated an LGBT member, they said it means we are promoting sin, so for fear of being labelled, health workers indeed were shunning them.” Kalino said.

She said CEDEP’s trainings have softened some of the stigma around treating LGBT patients.

Another CEDEP-trained nurse, who requested anonymity, said Malawi’s LGBT community faces discrimination when seeking medical treatment due to lack of knowledge and the fact that only a few medical practitioners are trained.

“Somehow religion plays a role, as many faith groups condemn the LGBT community, saying they are sinners. If their sexuality is known, they end up being excommunicated from church, and in that case anyone associating with them is considered a sinner. That is why many health workers find themselves in a dilemma between doing their job as a professional and being a spiritual being,” the nurse said.

On average she said she treats between 40 and 80 sexual minorities each month. “The CEDEP training has helped us to treat clients without stigma and accept them as anyone else, but I wish the society accepted them so that they may be using the social services freely,” she added.

*Chisomo, a gay man, says access to healthcare among LGBT people in Malawi has improved somewhat since CEDEP’s health worker trainings began in early 2016. “We are now being directed to those that have been trained on how to deal with marginalised groups,” Chisomo said.

His boyfriend James says cases still exist where LGBT people go to the hospital for medical assistance and are humiliated and ridiculed for their sexual orientation. “I wish for the day Malawians will accept us as we are. Being gay or lesbian in this country, you risk being excommunicated from church, fired from work, banished from home even getting arrested,” James said. “I would like to urge the organisations fighting for our welfare to offer training to more health workers for a fairer healthcare treatment to everyone.

Being gay is a ‘nightmare’

*Mercy 18, describes being lesbian in predominant Christian Malawi as a nightmare. “I realised I was attracted to women when I was in secondary school. I have never had any feelings for the opposite sex. No one can change that. So I plead with churches and everyone concerned to let us be and to accept us. Give us healthcare like anyone else regardless of cultural beliefs and religion,” she said.

In December 2016 the Episcopal Conference of Malawi held a protest march asking the government to enforce laws that criminalise same-sex relationships and homosexuality, arguing that they threaten traditional family values.

Under Malawian law, consensual sex between men is punishable with 14 years imprisonment. In 2010, two men received the maximum sentence for allegedly holding a public engagement ceremony commercial city of Blantyre. The sentence attracted international condemnation with some Western donors withdrawing support to Malawi. The couple was pardoned after serving five months of their sentence after then UN Secretary General Ban Ki-moon met with Malawi’s then president the late Binguwa Mutharika. Malawi’s government has since suspended prosecutions under its anti-sodomy laws. Despite the moratorium, inequality in access to health services among LGBT people remains high.

Churches perpetuate homophobia

Malawian journalist Suzgo Chitete produced a documentary focusing on the plight of sexual minority groups in Malawi in early 2016. Chitete thinks that no matter how much the government is willing to protect sexual minorities; churches will still be able to perpetuate homophobia and discrimination against LGBT communities.

“The moratorium on sodomy laws is a step forward. But again, in a society where the moral compass is dictated by religion the political leadership cannot easily stand against such a dominant view for fear of losing public support,” he said.

Chitete suggests “We need more dialogue on the issue. Concerned stakeholders should engage religious institutions to be tolerant to diversity. The church must not preach love, peace and harmony and yet perpetrate discrimination.”

According to a recent report by the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), homosexuality remains illegal in 72 countries worldwide. Of these, 33 are in Africa, four of which prescribe the death penalty for people who engage in same-sex sexual acts. Even in African countries where same-sex sexual relations are not officially illegal, LGBT people often face marginalisation, discrimination, violence and death based solely on their sexual orientation.

*Names have been changed to protect their identity

Reporting and images by Mirriam Kaliza from Lilongwe, Malawi

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