Inter Press Service - June 9, 1999
Chee Yoke Heong

This, they say, might help make more headway in fighting the spread of the illness in this mainly Muslim country of 22 million people. More than half of Malaysia's population comprises ethnic Malays, who are often Muslims as well. Thus, data from the health ministry shows that between 1986 to 1998, Malays make up some 73 percent of the total number of reported HIV cases and 55 percent of AIDS cases. The Malaysian AIDS Council estimates that about 300 to 400 cases of HIV/AIDS a month are reported.

To to enlist Islamic tenets in this battle, the Council hosted last week a seminar on the role of Muslim religious leaders and institutions in influencing people's behaviour.

Officials took heart from the high turnout of Malaysia's top religious leaders who had previously shied away from such meetings, but who came to listen to Ugandan officials talk about how Islam helped curb the pandemic's spread in their country.

The presence of the 9 Malaysian muftis was "a sign that our religious leaders are taking on a more active role in combating the HIV epidemic," said deputy health minister Wira Mohd Ali Rustam.

This means the ministry will support efforts to intensify public education on AIDS among religious institutions, as well as hold seminars to raise awareness of the problem, he says.

Getting messages about HIV/AIDS prevention across to the wider Muslim community often gets entangled in sensitive cultural and religious issues not least the use of condoms for prevention.

As in the case of Malaysia, and in Uganda about 10 years ago when it first embarked on its anti-AIDS campaign, the teachings of Islam were sometimes misconceived as barriers in what preventive measures health officials advocated.

But the Islamic Medical Association of Uganda (IMAU) has had success in reducing the incidence of HIV/AIDS cases in the country, based on the recognition that religious leaders, as trusted members of the community, are likely to be more effective in mobilising Muslims in halting the pandemic's spread.

IMAI's success has been documented by the United Nations as a model for HIV/AIDs education and prevention.

According to IMAU's Chairman Dr Magid Kagimu, the campaign took off after Ugandan President Yoweri Kaguta Museveni, declared the HIV/AIDS problem a national issue in 1987.

At the time, 30 percent of all pregnant women (a group regarded as best to detect for infection) tested HIV-positive. Within a few years, the percentage of Ugandan mothers with HIV declined in some cases by almost half.

"We all knew about the preventive measures needed to stop one from getting AIDS, but the support given by the top leader allowed others to accept them and bring discussion on HIV/AIDS in the open and started the process on how to actually prevent the problem within the Muslim community," Magid told IPS. This struggle soon came to be known as the 'jihad' against HIV/AIDS. The 'jihad' concept, which means fighting for something good, was given another dimension to be adopted by each Muslim.

This personal 'jihad' against the disease incorporates the two Islamic tenets of abstinence and staying faithful to one's married partner/s.

The most controversial issue faced by IMAU was the acceptance of the condom as a preventive measure. It was regarded by the religious communities, including the Catholic Church, as something "against religion".

For a long time, religious leaders simply refused to talk about the condom and resistance against it was so strong that condom advertisements had to be stopped.

They said condom use promotes sex outside marriage and therefore was against Islamic law, adding that it was not 100 percent foolproof anyway and cannot solve the HIV/AIDS pandemic.

But IMAU said that advocating the Islamic principles of abstinence and fidelity alone may not ensure that the disease. This is because as a secular state, Uganda does not apply Islamic laws that would discourage infidelity or sexual activities among unmarried people -- as seen in number of pregnancy cases among teenagers.

After much debate, both sides agreed that there are provisions within Islam that provide for a variation from its laws under certain conditions.

Magid used the analogy of a person trapped in a stranded ship where the only food available are forbidden in Islam. With no willful disobedience of the Islamic teachings, eating of such food would be accepted for survival reasons. He also pointed out to the religious leaders that despite the availability of alcohol, which is not banned in Uganda, most Muslims do not drink. Similarly, knowing about condoms does not mean that a Muslim is going to have promiscuous sex.

"We agreed that we should not leave out condom use as a preventive option in the education of the community. However, the religious leaders should stress that teaching about abstinence and faithful marriages are their main mandate and that they must continue with that," Magid said.

In Uganda, the promotion of condom use is left to the Ministry of Health and the imams do not feel their role as teachers of Islam is compromised.

"There were a lot of issues (in HIV/AIDS prevention) and condom is only one of them. The imams know of the reality and they recognised something needed to be done, but they are not legitimising its use," Magid explained.

He added that the imams do not agree that one should resort to using condoms, but to stop someone from accessing the product is to expose the person to the risk of contracting the disease or infecting someone else with it.

Much of the success of the anti-HIV/AIDS campaign in Uganda was attributed to the many discussions and dialogue that IMAU held with religious groups, which are a channel to the families, according to Magid.

IMAU has also found women more effective in giving education about HIV/AIDS, because they are more able to talk to other women and teenage girls than men are.

At the same time, women are very vulnerable to the pandemic if they depend on men for their material needs.

"Most women find it very difficult for them to separate from their husbands if they suspect them to have HIV as they depend on them. Maybe if they have enough economic power, they can say 'no' to sexual advances. Marriage is a form of economic security for some of these women," Magid pointed out.

Joe Selvaretnam, a lawyer with the Malaysian AIDS Council/Law and Ethics Committee, says the Ugandan experience can help guide Malaysia in fighting HIV/AIDS within the Islamic context.

"This is but the beginning of a journey. How long it will take remains to be seen, but we have made the first step," he said. (END/IPS/ap-he-cr/cyh/js/99)
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