The Origins of AIDS
Page 12
Thousands of mulattoes were born of these loveless unions between Europeans and their ménagères. Their fate would depend upon recognition by their father. About 10% were recognised, in which case the fathers would take them back to Belgium at the end of their term, and they would never see their mothers again. The others stayed with their mothers who might have been given a small sum of money for that purpose. The poorest would end up in specialised orphanages set up by Catholic missions. Mulattoes were treated as Africans by the colonial segregationist system, while being rejected by the Congolese as foreigners.15–17
It was not until about 1910, when small cities were created in which the African male population was much larger than the female, that prostitution appeared in which African men were having sex with African women for money or gifts. These women were usually unmarried or divorced. For some of them, becoming a prostitute was a kind of liberation. They would move to the cities, away from family and societal constraints and values, free to behave as they wished. To this day, it is noteworthy that the Lingala word ndumba can mean either a prostitute, or simply an unmarried woman no longer dependent on her relatives. In Congolese French, this became femme libre, a free woman, who had broken away from the control of her guardians, whether husband or kin, and whose life depended on her own intelligence and resourcefulness.
How did soon-to-be-free women manage to reach the city, given the stringent regulations on female migrations described in the preceding chapter? Some convinced a man to marry them and ditched their husband as soon as they got their papers. In other cases, a fake marriage sufficed. The woman showed up at the district office and produced false documents attesting that a bridewealth had been paid. It was possible to get married without the husband being present.18
From these early days, the practice of prostitution in central Africa differed from what was commonplace in Europe. Apart from a few cases where husbands benefited from one of their wives selling sex (they showed up at the European customer’s house, pretending to be angry and asking for compensation to avoid a scandal), free women had no pimps, either in the 1920s or at any subsequent time during the colonial era or after decolonisation. Until 1960, there were no brothels and clients were not picked up on the street. Male clients visited prostitutes where they lived, and the women provided more than sexual services. This was a low-risk type of prostitution, as defined earlier, or semi-prostitution as it was called by some authors.4
Venus’s curse
Sexually transmitted diseases have long been recognised as a marker of sexual promiscuity, often associated with transactional sex. Much later, it was understood that these common infections greatly enhanced the efficacy of heterosexual transmission of HIV, and that prostitutes and their clients were at the centre of the transmission dynamics of both the traditional STD and the novel one, HIV/AIDS. Here we will see that prostitution and STDs were intricately related at the time that HIV-1 managed to emerge in central Africa.
In the early days of the colonial health system, STDs were the number two priority, after sleeping sickness. They represented a serious health hazard for Europeans, as the treatments for syphilis were not very effective. Furthermore, STDs were seen as a threat to the demographic stability of the colonies. Untreated gonorrhoea or chlamydia in women can lead to obstruction of the tubes and infertility. Syphilis among pregnant women often causes a spontaneous abortion, premature delivery or stillbirth. The colonisers needed to guarantee the long-term availability of the African manpower needed for public works and private companies, and were very concerned about the declining population of Gabon, parts of the Belgian Congo and other areas. Thus, although not very effective, efforts were made early on to control the spread of STDs.
In Léopoldville, Europeans drove prostitution in its early stages, especially the petits Blancs (‘little Whites’): the mechanics, bakers, butchers and other small traders. As early as May 1909 and again in November 1913, edicts regulating prostitution were issued, aimed at protecting Europeans through the registration, regular medical examination and compulsory in-hospital treatment of prostitutes found to have a venereal disease. The approach used in Belgium was transplanted into its new colony but few if any of these regulations were actually implemented on a significant scale. In Boma, the hospital’s 1909 report mentions that thirteen prostitutes came twice a week for STD screening (however, later reports noted that it was difficult to enforce this regulation and that very few prostitutes could be examined regularly). The same year, the medical officer in charge of the Hôpital des Blancs in Léopoldville complained about the deplorable moral situation, noting that more than half of the ninety European civil servants in Léo were currently being treated for syphilis. In 1921, an edict made the treatment of STDs compulsory, and the patients could be forced to remain in hospital until the end of treatment. This was reinforced ten years later, when another edict made the treatment and reporting of a number of infectious diseases (including STDs) not only compulsory but also free.4,12,19–23
In Cameroun, as early as 1921, it was recognised that prostitution was a major factor behind STD transmission. European-type prostitution was thought to exist only in the port city of Douala. The following year, perhaps more realistically, it was acknowledged that prostitution existed in other urban centres as well, often involving women who had paid back the bridewealth to their husbands, thus becoming free and independent. In 1923, the commissioner issued a decree regulating prostitution. Prostitutes had to be registered at the local police station and provide information about where sexual services were dispensed. A sanitary carnet was required, and check-ups were to be done at 14:00 every Saturday in designated dispensaries. Brothels needed to be authorised by the administration, which was akin to legalising prostitution. Fines (1 to 50 francs) or jail terms (one to five days) were to be imposed on offenders. However, just a few years later, in a small book about the ‘venereal danger’ in Cameroun, a public health official noted that the regulation of prostitution was rather ill-advised and ineffective, given the large number of sex workers. In its first post-war report to the United Nations in 1947, France formally had to answer more than 200 questions, one of which concerned prostitution. The law of 1923 with its weekly check-ups was mentioned, but without any information about whether this was actually implemented. There was not a single brothel in Cameroun at that time.5,24–27
In 1909, sanitary check-ups were made compulsory for prostitutes in Brazzaville, and in 1912 about fifty showed up each week. The 1927 report for French overseas territories mentioned that in Brazzaville sex workers had to go for a weekly examination and those with an STD were to be hospitalised during treatment in order to limit transmission. Interestingly, the regulations were at least partially implemented: in 1931, serological surveillance of prostitutes showed that 52% had a positive ‘syphilis’ serology. As will be explained later, it is possible that some (or many) of these positive tests were caused by another disease, yaws, which is not sexually transmitted. In 1933, an STD clinic was opened in the Brazzaville hospital, and many of the patients were sex workers. By 1954, health officials were more pessimistic (or realistic?): prostitution was said to be flourishing so much in urban centres that any kind of control was futile.28–33
In 1932–3, in the Adoumas district of Gabon, the birth rate was measured at 16 per 1,000 while the overall death rate was 41 per 1,000, implying that the total population was shrinking by 2.5% each year. A similar decrease was observed in the Mimongo district next door. This was attributed to a high incidence of STDs. Antisyphilitic drugs made up half of the budget of Gabon’s national pharmacy, which prompted a behavioural investigation by medical officers. A non-traditional form of prostitution was noted to have emerged during colonisation because the cost of bridewealth had increased so much that only older men could afford to marry, creating a demand from younger men for commercial sex. The cash needed to pay head taxes was also seen as a contributing factor.34–35
As early as 1928, as an explanation f
or the high incidence of syphilis and gonorrhoea, health officers in Oubangui-Chari reported that prostitution was very common in Bangui and other centres, and suggested that prostitutes should be registered and undergo weekly examinations. The 1945 report noted that prostitutes were moving between towns, following seasonal variations in demand, but that this trade was not tolerated in the villages. As a result, STDs were much less common in rural areas. Soldiers in urban centres and administrative posts were noted to be regular clients of sex workers.36–37
Construction of the CFCO railway became a major driver of prostitution in AEF. In Oubangui-Chari, between 1925 and 1932, 41,780 workers had been recruited, sent by boat to Brazzaville after walking all the way to Bangui. On the river boats, only 12% of the men were accompanied by their wives. In the railway workers’ camps, there were eleven men for each woman. The consequence was utterly predictable: prostitution flourished in and around the many camps between Brazzaville and Pointe-Noire, and STDs became epidemic. On pay day, most of the money went to paying debts to sex workers incurred over the previous weeks.38–41
Prostitution in Léopoldville
Now let us get closer to the heart of the matter, the very area where HIV-1 managed to expand and diversify. Given the huge gender imbalance, large-scale prostitution appeared early in the history of Léo, and was already noted by colonial officers and Catholic missionaries as being a major problem in 1925. In 1928, out of 6,000 adult women in Léopoldville, only 358 were living with a husband. Starting in 1930 the Belgians levied a tax on the ‘healthy women theoretically living alone’ in what was certainly one of the most pragmatic actions ever taken with regard to prostitution. Adult women living with a spouse or with relatives were exempt from paying this tax, as were women with two or more children. In 1946, out of 28,000 adult women in Léo, around 5,000 (18%) paid the 50-franc tax, tripled to 150 francs ($3) the following year, equivalent to ten days of wages for the average worker. In Stanleyville, more than 30% of adult women paid this tax in 1945, which represented 20% of the city’s total revenues.4,11,42–47
This fiscal category of free women not financially dependent on a man was a mixed bag and encompassed genuine prostitutes or semi-prostitutes, concubines, petty traders who made a living in the informal sector, as well as grey areas in between. The semi-prostitutes had small, changing sets of ‘lovers’ or clients who ordinarily gave them ‘presents’ in return for sexual favours granted regularly over a period of time rather than strictly cash payments in return for intermittent sexual encounters. These ongoing relationships were understood by both parties not to be exclusive, there was no intent to have children, and the parties lived in separate residences.45
The colonial administration was tolerant towards prostitution, because it facilitated its day-to-day operations. Initially, many men were brought to the cities as workers for a limited time, and it was easier to send them back to their villages after a year or two if they had remained alone and satisfied their sexual needs with a local free woman, than if they had a wife and kids established in the city. The gender imbalance described in the previous chapter, and the ensuing urban prostitution, were parts of a system which required a high degree of workforce mobility. The same mobility was expected of Europeans, typically hired for a renewable three-year term.
By the mid-1940s, Emmanuel Capelle, the territorial officer in charge of Léopoldville, described its moral situation as ‘pathetic’: given the huge surplus of males, the market for commercial sex clearly favoured the women, making it a sellers’ market. In her research about the women of Léopoldville in 1945, Suzanne Comhaire-Sylvain, a Haitian anthropologist married to a Belgian, noted that prostitution was not limited to single women, and that some married women or teenagers still living with their parents sold sex on a part-time basis to supplement the family income. In Elisabethville, prostitution was also rampant; many recruits had been introduced to the trade by their own mothers, sisters and even grandmothers, all of whom benefited from the substantial income generated by this activity.44,48,49
Henri Bongolo, a former sergeant of the Force Publique who served in the medical unit that went all the way to Burma during the war, was one of the first Congolese administrators of Léopoldville. In 1947, he described how everything to be done in the capital was expected to be associated with some kind of remuneration: ‘there is no longer anything which is sentimental or disinterested: commerce everywhere’. At the same time, Father Van Wing, a Jesuit scholar, noted that ‘producing and earning money had become the main leitmotiv, in urban as well as rural areas’ and that ‘the importance given to spiritual matters decreased in proportion to the increase in the love of financial gain’. Reading this was a revelation, for I had long thought that this attitude, so widespread in the Kinshasa I had known for more than thirty years, was a by-product of the materialism of the Mobutu regime. Not at all!50,51
Bongolo described how the customary institution of dowry, which in essence represented a pact between two families guaranteeing the stability of the union between a man and a woman, had been corrupted by money to the point where it often became a purely commercial transaction. Some families were asking up to 10,000 francs ($200) of bridewealth to be paid in cash, a fortune for most potential candidates (a few years of wages). Why? Because such families were already getting a substantial income (600 francs per month) from their daughter selling sexual services to better-off men, including but not only Europeans, and they naturally asked for substantial compensation for a marriage that would cut off this source of income. Rather than being ashamed of their daughters selling sex, for many parents prostitution became a goal, a good way to increase the whole family’s standard of living. Bongolo attributed this situation not just to women having freed themselves from their traditional customs but also to the huge surplus of men in Léopoldville, which gave women the upper hand. The status of prostitute was so attractive that married women often thought this would be a good idea for them as well. They became free women.
The development of prostitution in Léopoldville had followed tribal lines, through networking between free women in the capital and their upcountry relatives. The Baluba women were especially prominent. In 1958, a quarter of Baluba women in Léo were unmarried. In Elisabethville, at the other end of the country, Baluba made up 26% of the population but accounted for 43% of the free women. Thirty years later, university students in the same city were still calling prostitutes ‘Mama Kasaï’, from the region of origin of the Baluba.52–53
In the only document of the colonial era that attempted to quantify prostitution, public health physicians described a programme for the control of STDs in Léopoldville. Demand for transactional sex was driven by the gender imbalance, aggravated by the custom of observing a long period of marital abstinence after a woman gave birth (walé), a traditional family planning measure. The supply was driven by the income of sex workers being two to three times higher than that of other women. Clinics provided STD screening and treatment. A card was stamped to prove that the free woman had attended the regular mandatory screening. Since the clinic was located in the Barumbu district of eastern Léo, the card became known as the Carte de Barumbu.54–55
Through these registration and screening efforts, the medical officers estimated that there were 5,000 to 6,000 women in Léo for whom prostitution was the sole source of income, to which should be added an indeterminate number of part-time sex workers (married women, students living with their parents). In the first nine months of 1958, the two STD clinics registered 4,321 femmes libres, presumed to be prostitutes, so the 5,000–6,000 total estimate does not seem far-fetched. In other words, almost 10% of the 60,000 adult women in Léo were involved in the sex trade, and there were 50 sex workers per 1,000 adult men. By comparison, in the early 1990s there were between 10 and 20 prostitutes per 1,000 adult men in Cotonou, Yaoundé, Kisumu (Kenya) and Ndola (Zambia). In other words, in the late 1950s there were up to five times more sex workers per capita in Léopoldville than in othe
r African cities today.56,57
The voice of Congo
In 1945 the monthly La Voix du Congolais was launched, the first publication in the country written by and for Congolese. It was heavily subsidised by and, according to many, subservient to colonial power. The opinions expressed were not representative of the general population, but only of the évolués who subscribed to the periodical. The évolués were the Congolese who had ‘evolved’ through education or assimilation and accepted European values and patterns of behaviour. They spoke French, held white-collar jobs and were primarily urban. Many articles were published concerning prostitution, which all of the (male) writers naturally abhorred. Apart from its immorality, the most deleterious impact of prostitution was a falling birth rate, which concerned not just the colonisers but the colonised as well. Traditional life had centred on the survival and prosperity of the clan rather than the individual; women who became infertile because of prostitution could no longer contribute to this important task.18,58–62