But a stubborn adherence to superstition and risky traditions persists, hampering efforts to lower the number of AIDS-related deaths and with new HIV infections still high among young people and key groups, according to United Nations data.
“Conventional medicines can prolong your life, but our people have a lot of attachment to traditional healers and doctors,” Martin Chongo, acting health director for the district, told the Thomson Reuters Foundation.
Roots, leaves, bark and indigenous medicines are routinely used in Zambia to treat illness and cure sexually transmitted diseases such as genital warts, herpes and chlamydia.
Healers usually cut patients’ skin with a razor then apply home-made remedies directly to the flesh: a practice that carries a risk of blood sharing and infection.
The same razors are used again and again.
Chongo said it would be insensitive to discourage traditional medicine but he has summoned traditional healers to a health summit, urging them to stop re-using razors.
“We are not sitting idle but it is a difficult issue as a health authority,” Chongo said in an interview.
He is typical of officials who must walk a delicate line in Zambia – embracing the best that modern medicine offers to control the epidemic, while tiptoeing around questionable local conventions or challenging risky behaviour.
“Unfortunately, in the villages they have their own cultural beliefs,” said Stephen Shajanika, a district health director.
“The government does not come into conflict with the people. We try to encourage everyone. It’s a way of life. It’s a democracy.”
Polygamy is common, multiple partners the norm for men, and unprotected sex the biggest carrier of the virus.
Avert, an AIDS education charity, said 90 percent of new Zambian infections follow unprotected straight sex.
But with many men enjoying multiple partners, and practicing unprotected sex, HIV – and misinformation – continues to spread.
Belief in satanism is one reason. Witchcraft is behind it – visitors might be false prophets bearing false information.”
With three wives and an open manner, one chieftain says he is both a modern leader and a man of convention.
“We need traditional and modern methods then we could maybe reach the extremities we are not currently curing,” he said.
An academic study published last year by the University of Namibia found that up to 80 percent of Zambians used traditional medicine for their primary healthcare, using trees, shrubs and climbers to treat a range of diseases.
It said most healers were men and 90 percent had inherited their remedies from older family members, while the rest said they came from dreams and visions.
AIDS, though, said the chieftain, was a foreign import that for now lies beyond the reach of herbal remedies.
“We don’t know how or where it came from. We don’t know who brought it. Zambia was a clean country,” he said.
“Gonorrhea and syphilis – they are simple diseases that are treatable in traditional ways by drinking the roots of trees.
“With gonorrhea – it’s gone. With syphilis – it’s gone. This HIV-AIDS, even if you look for the roots, even if somebody says they can treat it, it’s a lie.”
He said chieftains like him had modernised their ways, and no longer practiced “cleansing”, a tradition whereby a man inherits and has sex with his brother’s widow.
“That’s all been stopped,” he said.
Sex with children was also in his sights.
Headmasters must report to the chief each December with a precise tally of pregnancies at their schools in a drive to cut under-age sex and mother-to-child HIV transmission.
“We want a girl child to be in school, not with a baby,” he said. “We had some bad practices and we are still frightened, we are still afraid – but we are very serious when it comes to our children.”
Patricia is one such child.
Three months old, she was born to an HIV positive mother, in a family of two wives, one husband and four children.
Her HIV status is not yet known so a local NGO, DAPP Zambia, has put the baby on precautionary anti-retroviral treatment to stave off possible infection. Her mother Matilda is on the same drugs.
Matilda, 38, is the only HIV positive person in her village, a handful of thatched huts with a dust track rutted by ox carts.
How did the first wife, 53-year-old Muleya, react to the second wife’s diagnosis?
“There is no division … In fact it united my wives even more,” said Spector Sialukowa, 55, gathered with his family outside their hut in the village of Zubadenda.
“Look at her,” said Sialukowa, smiling at his younger wife. “She’s beautiful and looking really quite well now. There is no fear here.”