As mpox fears stoke rumours in Zambia, church leaders and brothel workers are fighting stigma

Pastor Bingu Musonza, a Lusaka church leader, inclines his head to one side, scratching absentmindedly at the pages of his bible, as he casts his mind back to a darker time.

He is thinking about the 1990s: HIV was cutting a swathe through Zambia and close behind it, like a second scourge, followed a wave of cruel social stigmatisation.

Despite the fact that the science on HIV transmission made it clear that there was no danger, some of his fellow Christians refused to attend baptism services that shared the same water pools that had anointed AIDS sufferers, Pastor Musonza recalls, or shunned holy communion with people who had been diagnosed HIV-positive.

“When I heard of this new mpox, I feared the stigma could reappear, and we sought to work quickly, proactively,” he says. By “new mpox” he means the Clade 1 variant, a strain of the virus that began to spread unprecedentedly rapidly in 2024, sickening tens of thousands and killing hundreds in the neighbouring Democratic Republic of the Congo.

In August, a large-scale disease spike in the region and beyond precipitated the World Health Organization (WHO) to declare mpox a public health emergency of international concern. Significantly, reports suggested that in many cases the spread of Clade I mpox was driven, like HIV, by sexual contact.

“We learned our lesson from the AIDS era. If we don’t act to suppress the rumours and stigma, there would be damage to church attendance and societal unity.”

– Pastor Bingu Musonza

To date, however, Zambia has confirmed just two mpox cases. Still, that low case-count hasn’t stopped misinformation circulating on WhatsApp groups, where false claims of widespread mpox transmission are rife.

In a fit of what the clergyman describes as “baseless hysteria,” some congregants at his church, the Zion Christian Church in the Malawian capital, have avoided Sunday services, claiming fear of infection. “It’s mind-boggling, but this time we are prepared to combat the stigma among vulnerable populations,” he says.

Preach!

Across Zambia, he says, Christian leaders have banded together organically and informally to debunk a swirling misinformation campaign that is stoking fears of mpox.

Their methods vary: WhatsApp groups and church services are common – and perhaps obvious – avenues of engagement, but there are others. “I heard on the border in Solwezi, 580 kilometres from here Lusaka, three retired pastors too are volunteering to speak at bus terminals and public markets, encouraging locals not to discriminate against Congolese refugees,” Musonza says.

In Lusaka alone, Musonza numbers among a group of ten pastors of different denominations who have resolved to push back against the rumours, in hopes of checking the rising tide of prejudice they fear will be their consequence.

The clergymen are coaching administrators of church WhatsApp groups to block or delete fake viral messages and fearmongering pictures of mpox patients. In pastor-to-pastor meetings, they discuss the need to emphasise a particular set of messages: mpox is not carried by Congo refugees, they agree to tell their communities. It does not live in brothels and is not a preserve of any one ethnic group. The Zambia Ministry of Health and WHO are the legitimate sources of all current data on the disease.

“We learned our lesson from the AIDS era. If we don’t act to suppress the rumours and stigma, there would be damage to church attendance and societal unity,” Musonza says.  To him, it’s also a very personal endeavour. He saw how two members of his immediate family succumbed to AIDS in the late 1990s, shunned by loved ones.

Converts

Church-led efforts to beat back mpox disinformation are bearing fruits at the local level, says Willard Nakala, an evangelist with the Apostolic Faith Mission church in Lusaka, and an associate of Pastor Musonza.

He whips out his smartphone, and uses it to gesture as he speaks:  any church member in his group who dares generate or forward made-up imagery of non-existent Zambians visibly suffering from a supposed mpox infection is quickly reprimanded by other members of the church-linked WhatsApp group. If they don’t take heed, he says, they are expelled from all church WhatsApp groups.

Radical measures are needed sometimes, says Nakala, because stigma can be a runaway train. At the peak of the AIDS era, one group that was more heavily lumbered with stigma than any other  were sex workers. To date, there is a distorted belief that sex workers are the drivers of HIV transmission in Zambia – an idea that persists despite serological evidence pointing to multiple avenues of infection, he says.

Shylet Sozwana, 29, too young to recall the HIV crisis years of the ’90s, is a choir leader in Pastor Musonza’s church. She says the myth-busting drive convened by church leaders has changed her perception about disease, blame and stigma in general. She grew up in what she describes as an ultra-moralist religious family, in which diseases including HIV and Ebola were blamed strictly on certain social demographics.

“Before, I was one of those who forwarded untrue images about non-existent mpox cases in Zambia on our WhatsApp groups. I was publicly rebuked, corrected, demoted as a WhatsApp group admin. I relearned the facts, and went on to teach my parents, siblings, relatives – via the same WhatsApp – about the need to visit WHO and Ministry of Health websites before relaying any idiotic rumours,” she says.

Sex workers – scapegoated again?

With reports that mpox can be sexually transmitted making headlines amid the Clade I-associated surge, sex workers are again at risk of being blamed for a virus that can infect anyone.

Clerics including Musonza have reached out to workers in Lusaka’s informal – and, strictly speaking, illegal – brothels to talk myths and facts.

“We never imagined the pastors would approach us, sit down with us, and ask us to put mpox posters in the hallways of our brothels,” says Ndoda Phiri* owner of popular beer joint and brothel in the Garden Chilulu township, where poverty is rife and opportunities are few.

He stretches out a printed poster over the wall of the brothel’s booking room. It reads: “Practise hygiene, sanitise hands, mpox is not a refugees or sex-worker disease, treat all patrons respectfully. Last, wear a condom.“

Researchers at Fondation Scelles, a non-profit that fights human trafficking and sexual exploitation, estimated in 2019 that there were 9,285 people involved in prostitution at street level in Zambia. Refugees and undocumented immigrants from Congo, Malawi and Zimbabwe make up a significant proportion of them.

“When fake rumours of an mpox pandemic in Zambia began in August, I saw a steep decline in a number of patrons visiting brothels in our localities,” says Phiri.

When the church leaders reached out to deepen their anti-misinformation campaign, local brothels in Garden Chilulu Township jumped at the chance, says Phiri. Within his brothel-owners network, all agreed to put up the posters stating the facts.

“Before, I was one of those who forwarded untrue images about non-existent mpox cases in Zambia on our WhatsApp groups. I was publicly rebuked, corrected, demoted as a WhatsApp group admin. I relearned the facts, and went on to teach my parents, siblings, relatives about the need to visit WHO and Ministry of Health websites before relaying any idiotic rumours.”

– Shylet Sozwana, 29, church-goer

Brothels are an underground economy in Lusaka, and crucial for the survival of many women and men, says Ratidzo, a veteran sex worker in Garden Chilulu, who withheld her surname out of fear of being shamed. It’s not really an enjoyable job for the 30 ladies who work at her brothel, she says –.men can be drunk, aggressive, or underpay the ladies. “But sex work is money – for my kids’ fees, blood pressure medication, household food in this drought. If men don’t come to the brothel, our lives are ruined. It is what it is,” she says wrapping a traditional cloth around herself, and sweeping the brothel’s client rooms – one of the extra tasks she has taken on to earn more income.

“I am an immigrant and understand how unfounded mpox stigma can be bad for us women,” Tanya, an immigrant sex worker from Zimbabwe who works with Ratidzo, says. She explains she is not just a sex worker, but also a trader who comes across the border from Zimbabwe to Lusaka to source used shoes for resale at home. The shoes don’t pay enough, however, so being a single parent, she says she supplements her money by working at the brothel. She fears that if regulars like Israel Achimwene stay home out of fear of the virus, she will be left with a hole in her finances.

“Sex work is money — for my kids fees, blood pressure medication, household food in this drought. If men don’t come to the brothel, our lives are ruined. It is what it is.”

– Ratidzo, veteran sex worker, worried by a downturn in custom following the mpox scare

“I shied away from visiting the local brothel,” says Achimwene* a widowed high school teacher in Garden Chilulu. That was in August, he explains – fake rumours of an uncontrollable infection had taken hold in Zambia’s WhatsApp channels. But in November, he began to see the posters amplifying the facts. He says he has dialled back his fears and takes the normal hygiene precautions that he does for HIV or other STIs.

Local communities at the forefront

 “Normally when disease epidemics emerge, we wait for big, rich foreign NGOs to do it, but [this time] local communities are at the forefront of making sure mpox doesn’t create another AIDS-era wave of stigma,” remarks Mwansa Mbulakulima, a former Zambian lawmaker and HIV prevention advocate.

Zambia’s authorities, meanwhile, say they have “scaled up” efforts to combat the infection. With cases being recorded in nearby countries, Zambia has a “high risk” of “importing the disease”, Minister of Health Elijah Muchima told Xinhua, the Chinese state news agency, in September.

Across the country, 200 health care workers have been educated on how to manage the mpox cases that may arise. Test kits have been ordered for clinical surveillance, checkpoints at land borders and airports are being set up with surveillance equipment, while a public messaging campaign will be rolled out soon, he promised.

In Garden Chilulu, however, locals have learned to rely on the pastors. “We have not seen the state’s so-called public information sessions in our township yet,” Phiri says. “Our communities will wait on the government.”

*Name changed to preserve privacy