Interview: Tagwira Valerie by Lizzy Attree

Lizzy Attree interviews Valerie Tagwira
Author of The Uncertainty of Hope (Weaver Press: Harare, 2007)
London, 3 September 2008

Interview with Valerie Tagwira, author of The Uncertainty of Hope (Weaver Press: Harare, 2007) and Lizzy Attree, London  03/09/08

This interview is now published within the collection: Blood on the Page: Interviews with African Authors writing about HIV/AIDS by Lizzy Attree (Newcastle, Cambridge Scholars Press, 2010)

see also:

This collection also contains interviews with Vivienne Kernohan aka Violet Kala, Charles Mungoshi, Luta Shaba, Stanley Nyamfukudza and Tendayi Westerhof as wel as many South African writers.

This interview is published here with the permission of Lizzy Attree and Valerie Tagwira.

Lizzy Attree: Why did you choose to write a novel that featured HIV and AIDS so centrally?

Valeri Tagwira: Well, the disease is now so much a part of our lives. I’m sure every Zimbabwean has had some experience of HIV/AIDS, whether directly or through family members and friends. It not only affects personal situations but the economy as well. It’s associated with sick leave which is also a cost to employers. And, it places a huge burden on the health system.

LA: You presumably acquired insight into these experiences when you were working as a doctor in Zimbabwe. Tell me a bit about what kind of work you did and where you worked.

VT: I did my housemanship at Harare and Parirenyatwa Hospitals. That took two years. Then, I worked for two and a half years at Gweru Hospital. I was, by then, a more mature doctor and I worked in Obstetrics and Gynaecology, as well as Casualty, and the Medical and Surgical wards as a government medical officer. I remember how prolific the HIV and AIDS deaths were. On arriving at work, my first task was to write out the death certificates for patients who’d died during the night – often five or more. In addition, there were always patients who you were trying to treat who never got better. I found that quite depressing. Daily I was faced with people who were ill and who were looking to me to do something for them, when the means were not there. And while I was managing patients, I was also trying to manage the family – because I had to explain things to the relatives… I had to talk to them and counsel them about home-based care, once I reached the point when I couldn’t do anything more for the sick person. I found that difficult. There was a lot of emotional overload but I had to go on. I just had to insulate myself against getting too emotionally involved with my patients and sort of create a distance. So, HIV was a huge part of my medical practice while I was working at Gweru Hospital.

LA: Was there any pressure…? I’ve heard stories about doctors being told not to write the cause of death correctly, so they’ll put TB instead of HIV or AIDS-related…  Was there ever pressure, first from the hospital, but also from relatives for you to do this? Did you feel that you couldn’t say that someone had died from HIV/AIDS?

VT: Well, when somebody has AIDS they are prone to opportunistic infections and illnesses. What kills them is not exactly AIDS – it’s pneumonia, TB, meningitis – something secondary. So we would put the primary cause of death – say meningitis – with a secondary cause, immuno-suppression. There was pressure not to write the acronym or word ‘AIDS’ on the death certificate, so we always put it down as immuno-suppression.

LA: So you didn’t feel that you had to lie in any way?

VT: Well, indirectly, but was more for reasons of confidentiality because it is usually a senior male member of the family who collects the death certificate, not necessarily the wife or the one who is closest to the dead person. If it’s a woman who has died, it still tends to be a male relative, a senior member of the family, who collects the death certificate. So, we always had to maintain a degree of confidentiality. Whether people would work the death out as being AIDS-related, I can’t say.

LA: While you were at Gweru, did you notice a change in people’s reactions to words like HIV and AIDS?  Did people become more open or did AIDS remain a hidden cause for a lot of those deaths?

VT: It really depended on the family that you were dealing with. Sometimes you would explain matters to the immediate care-givers – with the consent of the patient, of course– for their own protection, as they were entitled to know. (As a medical practitioner, you are duty bound to disclose their status to their partner, say the husband or the wife.)

I got into a tricky situation once when I was treating a baby with pneumonia, an opportunistic type of pneumonia called PCP. I suggested to the mother that we should test the baby for HIV. The child was about three years old and was not getting better. The mother was upset. She felt really insulted that we could suggest that her child might be HIV positive. She told us that she knew herself, she knew her morals, and her husband’s, and there was no way the baby could have HIV. She told us that if we could not treat the baby, she would take it elsewhere, and she did. So, there are situations when you can’t do anything … but the child had the classical symptoms of a possible HIV infection…. florid oral thrush, and other clinical symptoms that are quite good predictors of a positive HIV test.

LA: Was there an issue around the provision of ART or AZT? Were you able to give that to any of your patients or did that change over time?

VT: I think that changed over time. While I was working in Zimbabwe, I hardly ever had the experience of anti-retrovirals in government hospitals. I left the country in July 2002, and there was hardly any use of ARVs then. There was talk of using Nevirapine to prevent mother to child transmission, but it was mostly drugs coming from donors. These were controlled and targeted at specific obstetric projects at specific hospitals. The few patients that I saw who were on anti-retrovirals were private patients in General Practice.

LA: Let’s return to your novel, The Uncertainty of Hope. Having chosen a relatively controversial subject, how has the book been received in Zimbabwe?

VT: From reports and feedback, I would say it’s quite positive. But, initially, when my family knew that I was returning to Zimbabwe for the book launch … everyone told me not to do so because it was too risky. I went anyway, and nothing happened [laughs]. It was fine. The fact that the novel won a National Arts Council prize at the beginning of this year is an indication that the book is not as controversial as we might think or that it is striking a chord with some people …

LA: Were your relatives afraid of its allusions to its HIV content or to Murambatsvina?

VT: The latter. In March 2007, there was a lot of media coverage about opposition party members being assaulted. Morgan Tsvangirai was assaulted. There were reports of people being assaulted at the airport and having their passports confiscated. I went home for the launch around this time, so the political climate was a bit tense. I remember somebody saying to me, ‘Oh you won’t get out of the country!’  But nobody, no men in dark glasses followed me around!’ Lots of paranoia, but nothing tangible to indicate that the book was causing any offence.

LA: You say in Uncertainty that HIV had ‘become everyone’s problem’ is this view widely held in Zimbabwe or do people still stigmatise individuals and disassociate themselves from people with HIV?

VT: I think there’s still a lot of stigma attached to HIV and AIDS. It’s certainly better than it was when I started my housemanship in 1998. Then, it was difficult to even have a conversation about HIV and AIDS, either with patients themselves or with their caregivers. But by the time I was in Gweru in 2002, it was different. Today, I think people are more open. I remember someone saying recently, ‘Now people can actually ask each other “Oh, have you taken your tablets this morning?”’ Family member look after their sick relatives and home-based care has developed. People are more aware that you can’t just pick up HIV and AIDS from being in proximity to someone, and that it can happen to anyone. There isn’t that same level of stigma as there was, say in early 2000. But stigma still exists because a lot of people would rather keep their diagnosis to themselves and only tell those people who need to know. This seems fair – as long as they’re not putting anyone at risk.

LA: That takes me to a question about testing. You suggest that friends’ testing encourages other friends to do the same, as with the two women, Katy and Onai, in the story. Is this something that happens at grassroots level: the leadership has never, to my knowledge, encouraged testing in this way?  It sounds as if people test and keep it secret. I’ve even heard of people who test regularly in order to continue sleeping around. Did you want to encourage a different model of behaviour?

VT: Yes, I think so. When I wanted to go for an HIV test, I was scared, but I talked a friend who was very supportive, and we went together. Talking to other women, preparing to go for testing, is a positive thing, especially when you have a friend who has been through the experience who can support you. I felt it was something that should be encouraged regardless of what the result might be.

As a gynaecologist, I work with women and I talk to them about sexual health. They echo the sentiment that men are very reluctant to be tested. I’ve also met Zimbabwean women in the UK who tell me that  no man will agree to go with them to be tested. I don’t know whether I can generalise, after all I’m dealing with women who require such services.

LA: Tell me, why did you choose literature, through your novel, to discuss AIDS? Did you feel that it would be more effective?  To me it’s intriguing that someone who can make a practical, professional impact or intervention would also see literature as a useful or convenient mode for talking about those issues.

VT: First, I wanted to write was because it is something I’ve always wanted to do. But when I entered medical school, studying took over and I lost the motivation to write, as other things appeared to be more important. Years later, I had a bit more time on my hands, so I thought, ‘Oh well, maybe I could start writing now. But what should I write about? [laughs] It seemed only natural that I would write something that involved health, and women, because that’s my area. Then Operation Murambatsvina happened and I thought, ‘OK, this will affect women and children. It’s probably going to worsen the situation of people who are already impoverished either because of their health, through HIV/AIDS or just through general poverty and unemployment.’ When I started the book, it was initially more about domestic violence and health-related issues.

LA: Now, having written Uncertainty, do you think it has been an effective mode of communicating issues or was it more of a personal journey?

VT: Both really. For myself – thinking through and exploring issues at a social level was important, but I also wanted to try and show how poverty, AIDS, unemployment, domestic violence … can affect people’s health. I’ve often thought that one can be too optimistic about just how much a book can influence people’s behaviour or awareness, but this is not a reason not to write. When we were doing community medicine, way back in medical school, we were also taught how the media – TV, newspapers and literature – could be used as a means of health education, whether it be among adults or in schools. So, yes, I had a conviction that my book could be used to create awareness …

LA: Was it perhaps easier to write from a distance – the UK?

VT: Maybe if I had been at home, I would’ve censored myself. You do sort of feel safe when you are writing from here. But I had to keep talking to people at home because situations in Zimbabwe deteriorate so rapidly that if I tried to picture what I’d seen when I was last there in 2004, it would have been inaccurate. But I was fortunate in that I went home in June 2005, so I was able to talk to people, to observe and polish up the story to make it more representative of what was actually happening.

LA: Is Mbare an area you already knew well or did you situate your novel there because of the events that occurred during Murambatsvina?

VT: I know Mbare quite well. I went to boarding school in Mucheke from 1988 to 1990. I would travel from Kwekwe to Mbare where our school buses would pick us up. The train would arrive quite early, so we’d be in the market for most of the morning.

LA: Quite a formative period.

VT: Yes. Going to the market to shop for maputi, and other things that one could take to boarding school/ I also had friends who lived in the area and sometimes we’d pop over to their house, and one of my friend’s aunties had a stall at the market. Later, when I was working in Harare, I used to go to Mbare market for fruit and veg and so on, so I was quite familiar with the place over a long period.

LA: Have the market women recovered from Murambatsvina?  Is there still a market there?

VT: I’m not really sure. I know they said they were going to re-build the market but I’m not sure if they have. The idea was to clean up the area, refurbish the place, and then allocate stalls in a more orderly manner. Still,  I wouldn’t think that a new market would  hold the same number of people or even the same people. After all, a lot of people became destitute or were displaced. But I’m not really sure what has happened.

LA: When I first read Uncertainty, I thought a lot about Ama Ata Aidoo’s Changes – do you see the similarity?  Two central female characters experiencing and enduring various marital issues … It’s a very different book because it involves infidelity, and there’s a Muslim theme… I wondered if you had read Changes and whether you see any comparison?  And are there any other African authors who have influenced you?

VT: I haven’t read Changes but it sounds as though I should. I wouldn’t say anyone inspired me  – it was just a story that I felt I had to write. It was inspired more by events at home and the plight of women than anything else.

LA: But do you read a lot?  Do you read African writers at all?

VT: I went for a long time without reading anyone; I was too busy studying!  But lately I’ve been reading Chimamanda Ngozi Adichie, and recently I read Sefi Atta’s Good Things Will Come. I’ve read short stories by Zimbabwean writers: Pettina Gappah, Brian Chikwava and others in Irene Staunton’s short story collections from Weaver Press. I’ve also read Charles Mungoshi and Yvonne Vera. Not much – here and there really.

LA: A lot of your novel focuses on the violence of a husband, Gari, towards his wife, Onai Moyo, and is particularly vivid – did you see violence as an issue in itself or one that fuels the prevalence of HIV?  Because although Gari dies of cirrhosis of the liver, it seems clear that his death was connected to AIDS as he had so little resilience. But it’s a very indirect approach. Is violence a driving factor in the continuing spread of HIV?

VT: Wow! I never thought of it in those terms as I was writing. I’m not sure how prevalent domestic violence is in Zimbabwe now. There is, of course, the domestic violence bill,  which suggests that it is recognized as a real problem in the country, a problem that a lot of men get away with. The traditional model dictates that a man can discipline his wife as he chooses. In so far as its relation to HIV and AIDS is concerned, I would say it could be a factor that pushes the rates up because a lot of women remain in bad relationships simply because they’re under the influence of controlling husbands or they’re afraid to leave. But it is hard to say when somebody gets infected, or at what stage of the relationship. The use of force in relationships, and just having women feeling helpless and not being in control of their lives, can make women stay in high risk situations. Also, sexual assault, even by strangers, carries a risk of HIV.

LA: I suppose infidelity is another factor.

VT: Well, infidelity tends to be acceptable in Zimbabwe, as long as it’s the man who is unfaithful. If it’s found out that a woman has not been faithful to her husband, she will be dismissed from the home a.s.a.p. But if it’s the man… the general advice is that one has to stay because ‘that’s what men are like’. If you want to leave your husband because you’ve found out that he’s been unfaithful, people are more likely to encourage you to stay than to leave – an attitude that doesn’t help at all.

LA: I thought that in Uncertainty you were able to show a range of opinion from different women, young and old. Some of the younger women are quite progressive in terms of what they think about bride price and so on. Did you do this deliberately in order not to appear too didactic or morally directed?  Some writers use novels to give one particular message, but I think your book stands out in that it gives a range of different opinions, although you can generally tell which are the more favourable messages.

VT: I didn’t want to push just one point of view. I wanted to look at different situations. And, I was also trying to be realistic. I remember I used to argue with my mum a lot [laughs] as we had different views about a lot of issues. She was more traditional, more conservative, but I shared the views of a lot of my friends. These are generational differences that do exist, so it would have been inappropriate for me to just focus on one point of view. This does not happen in real life.

LA: Have you read, for example, Luta Shaba’s Secrets of a Woman’s Soul, or Tendai Westerhof’s book, Unlucky in Love. Both are written in the first person and have a distinct message about how to survive. First, what do you think of these books and second, what do you think of their approach – does it work? Or does it seem a little too simplistic perhaps?

VT: [laughs]  Regrettably, I haven’t read them, I’ve only read about them on the internet and heard people talk about them. I understand they were about personal experiences. I think, however, that writers should be left to choose their story and decide how they want to present it. Take Tendayi’s book, for instance, if that was her own personal experience; that was how she experienced it, so I don’t see how the book could have been different. I haven’t read it so I can’t analyse it, but I do think it’s the writer’s prerogative to write as they wish. At the same time, you have to write something that is appealing to readers [laughs]. It’s tricky.

LA: Would you say a complex message is usually more successful or does it create confusion amongst readers as to the purpose of the story? Do readers look for a message in fiction?

VT: When I read fiction, I look for a message, and I think a lot of people do. I guess, pushing one message might work, but if you’re looking at presenting life in Zimbabwe, where life is so complicated and there are so many things to talk about, where one person can be affected by so many things, I don’t know how you could narrow those experiences down to a single message. It probably depends on the topic or the setting.

LA: So in some ways you’re coming down on the need to reflect the complexity of experience?

VT: Yes, the complexity of Zimbabwean experiences… because you’re not just being affected by the food shortages, your husband could be dying of AIDS, you’ve got no food for the children, you’ve got no job… Unfortunately, a lot of personal experience is bad at the moment. I hope that if I write another story about Zimbabwe, it won’t be exactly the same! [laughs]  Talking about queues, shortages and maybe worse!

LA: I have several questions. What you would want write next?  Are you writing anything at the moment, and if so what’s it about?  And a question about the happy ending through which you make Uncertainty a very hopeful, positive story – do you continue to have that strength of hope? I mean how do you feel about the future?

VT: Well, at the moment, I’m working on a collection of short stories, when it will be finished I don’t know, I just play it by ear. I’ve also started working on something about Zimbabwe. I won’t say much about it now in case it doesn’t work [laughs] because it’s all doom and gloom. Yes, the Uncertainty of Hope had a positive ending, but now I’m not sure of the future because so much remains uncertain. When I wrote the book, I thought things couldn’t get any worse. But they did [laughs]. So if I’m to write another story about Zimbabwe, I will have to try and take it from a different angle, otherwise it’s just going to be too similar to Uncertainty.

LA: This should be the end of the interview, but I meant to ask you about the beggar figure, Mawaya, or maybe about the men in the book generally, because we’ve focussed on the women in this discussion, but the men are quite different. Everyone ranging from the terrible Gari to lovely John, but the beggar figure was particularly intriguing. I wonder if there was any Shakespearean or Dickensian influence or was he a folk figure of someone doing penance for a wrong past? Is he a common Zimbabwean figure or does he derive from other sources?

VT: It was a tradition from a long time ago, a sort of penance – kutando botso – something you would have to do, if you insulted or assaulted or disrespected your mum. I just took this man and gave him a psychological problem, following the death of his wife, with him taking all the blame for it, and then deciding that this was the penance, he wanted to pay. But it was also a sort of a flawed idea because when somebody is mentally disturbed or distressed, perception of reality can alter. He was just somebody that I developed to make the book a little bit more interesting. Initially, [laughs] I had wanted he and Onai to have a romance of some sort … but it wouldn’t have really worked. Oh no!  It would have been more like a fairytale.

LA: Well, he does resolve her life in a way.

VT: He does resolve her life in a way, but the concept of a penance came from something that used to happen a long time ago, not in recent times. I put it into the head of somebody who was mentally anguished and tried to see how he would adapt it to his own situation.

LA: Well it was an intriguing idea, especially as it helped to resolve the ending happily.

VT: I read a review recently in a South African paper online where somebody was suggesting that my world must be very small [laughs] because everyone seems to know everyone else in the novel [laughs].

LA: Especially in those towns where people are living with just bits of cardboard in between their houses.

VT: But if they did not know each other, their world would be entirely arbitrary.

LA: Well, let’s end there. Thank you very much.