Mchape fever

BMJ 1995; 311 doi: (Published 09 September 1995) Cite this as: BMJ 1995;311:678
  1. R Voysey,
  2. J Gray

    A strange epidemic has been sweeping through Malawi over the past few months. People are flocking to Machinga, a small village in the south where Billy Chisupe has a cure for AIDS. Mr Chisupe had a dream. His ancestral spirits told him of the tree whose bark could be used to make mchape, a cleansing drink. This magical tree is invisible to all but Mr Chisupe. One cup of the brown infusion will cure HIV infection; three cups on consecutive days cures AIDS. The drink is free but donations are accepted.

    In a country where one in three of the urban population is infected with HIV there has been a desperate rush to clutch at a possible cure before it is too late. People are more than willing to pay the cost and endure 20 hours in the back of a crowded lorry from our district of Chitipa in the north west of Malawi.

    A booming economy has resulted. Limited water supplies mean that water is sold by the cupful to the queues of people waiting under a hot sun. Plastic cups to drink the mchape make a good profit. If your car gets stuck in the mud it will cost you five kwacha for every person who helps to push you out. Watering the road at night ensures these entrepreneurs a steady income.

    The ministry of health will not condone the cure publicly but its ministers and employees are flocking to Machinga in private. Tacit support is also provided—in the interests of public safety—with the provision of pit latrines, deliveries of barrels of safe water, and even a bore hole.

    I am sure that mchape can do little harm. It might even help psychologically. But the rumours are much more harmful. Mr Chisupe's messages about changes in lifestyle to prevent reinfection, which are supposed to accompany the mchape, have been lost. Instead we hear that mchape makes you immune to the virus—a kind of vaccination. What is more, you can immunise the next person you have sex with. This is a licence for carefree sexual behaviour with disastrous consequences. Bar girls are replacing the question, “Do you have a condom?” with “Have you had mchape?”

    These rumours can only undermine the work of the AIDS control programme. That is why scientific trials should be carried out and if the cure cannot be proved Mr Chisupe's mchape must be withdrawn. time, the AIDS epidemic, like the queue for mchape, continues to grow.—R VOYSEY and J GRAY are district health officers in Malawi

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