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South African bishops to fight AIDS silence

Special Report Writer
New York

Archbishop Buti Tlhagale laments that he spends so much time going to funerals. In his archdiocese of Bloemfontein, in the Orange Free State of South Africa, there are weekly burials that attract up to 2,000 people.

“Everyone knows what the person died of, but no one speaks of it,” he said, not even the priest. “The specter of AIDS is stalking Southern Africa, decimating its population across generations, across cultural and economic classes. Alongside the corpses that it claims is left a surging population of orphans, many of them infected or at risk from the killer disease.”

Yet at burials throughout the country there is “a conspiracy of silence” that will not name the stalker, according to Tlhagale. At funerals no one wants to embarrass the family of the person who died, he said. “We’re paralyzed. People think it is a curse -- ‘you have bad blood’ -- if you catch this disease.”

The Catholic bishops of Southern Africa are hoping to end the silence. With the support of U.S.-based funders, the Southern African Catholic Bishops’ Conference is embarking on a major push to bring a fuller awareness of AIDS and to help counter its devastation.

The invisibility of HIV/AIDS is a national phenomenon. Tlhagale points to South Africa’s former president and liberator, Nelson Mandela, whom he remembers mentioning the disease in passing only once in a national address. He blames the “taboos around sex” in the nation and in the church and said that “priests and nuns need to get over their own hang ups about sex.”

According to Bishop Kevin Dowling of Rustenberg in Transvaal province, the nation had been so focused on its liberation from apartheid rule, and later on building democracy, that it barely noticed the growing infection, Dowling said. When the rock of apartheid was lifted, underneath it lay “incredible layers of poverty, inequality and injustices” -- all of these the breeding ground for the spread of HIV/AIDS, he said.

Tlhagale and Dowling traveled to New York in February to meet with the Catholic Medical Mission Board, which has announced the earmarking of 25 percent of its special health care projects budget over the next five years for the Southern African Bishops Conference. NCR met with the bishops at the mission board’s headquarters in New York.

The board made its unprecedented commitment in conjunction with Bristol-Myers Squibb’s $100 million “Secure the Future” foundation, a private-public coalition that is funding sustainable, community-based solutions to stemming AIDS and ameliorating its suffering, particularly among women and children. The project will target South Africa and four of its neighbors: Botswana, Lesotho, Namibia and Swaziland.

Two-thirds of the estimated 34 million people infected with HIV/AIDS live in sub-Saharan Africa and experts predict that more than 70 percent of all new HIV infections will occur in the region. Women comprise more than half of the infected adults in the five nations targeted by the health care project. Currently more than 100,000 children are living with HIV/AIDS in the five countries and the disease has orphaned 200,000 children.

The mission board’s $5 million donation to the bishops’ conference will come under the auspices of the Princeton, N.J.-based Bristol Myers Squibb project and will fund programs approved by the bishops in accordance with Catholic moral teaching, according to the board’s executive director, Terry Kirch.

The South African bishops, who oversee 29 dioceses with 3.5 million Catholics, 11 percent of the nation’s 43 million citizens, want to counteract what Tlhagale calls the current “depression and frustration” gripping the region stemming from “an experience of helplessness over AIDS.”

Tlhagale said that one action the church can take is to develop a liturgy for people living with AIDS. The health crisis requires that the church look at the healing messages of the Old and New Testaments and “not just at the justice passages.” If the nation remains focused on truth and reconciliation and an end to violence, but does not work to eradicate AIDS, it is only dealing with “peripheral issues,” Tlhagale said.

Dowling wants a healing liturgy that uses water, oil, prayers of purification and the laying on of hands. Such symbols are important, he said, as most South Africans view AIDS as a struggle against an evil force. In a nation where parents desert children with AIDS and where families are torn asunder by the disease, it is paramount to have a ritual that proclaims God’s unconditional love, he said. Dowling hoped that such a service would break the silence over AIDS and help to build a community of caring and shared responsibility.

A liturgy around AIDS has yet to be formulated. The bishops’ conference has spent the last six years establishing a Catholic AIDS Office and coordinating the efforts of the Catholic Institute of Education to teach about HIV/AIDS in all schools. In a few months the bishops plan to publish a pastoral letter on the crisis.

“I hope that the bishops can sit down and apply their minds to the concrete situation that cries to high heaven, instead of just invoking a teaching,” said Tlhagale, who served as general secretary of the bishops’ conference from 1995 to 1999. The archbishop said he hoped that the letter would take up the issues of pre-marital and extra-marital sex as well as the rights and responsibilities of spouses.

The church has been criticized for opposing the use of condoms when most people say, “Condoms are there to prevent death,” Tlhagale said. The condom question is far from settled, he said, noting that there could be individual cases where their use might be justified, but that the bishops must address the whole church community and not individual cases.

The level of tension in families with AIDS is far greater than the clergy know, the two prelates acknowledged. Tlhagale praised the courage of women, noting that “some face death with their eyes open,” while others who say no when their husbands ask for sex risk being thrown out with no place to go and no help for their children. “It is very difficult for a woman to deny sexual relations when a man demands it,” he noted.

Church-sponsored home caregivers and AIDS counselors have also to struggle against advice given to men by many traditional healers. Frequently AIDS-infected men are told to sleep with virgins in order to rid themselves of the virus. A distraught woman in Dowling’s diocese approached a church worker when her infected husband was told by a traditional healer to have sex with the couple’s 6-year-old daughter.

Tlhagale said that healers need to be “brought on board” in a nationwide dialogue over AIDS. He sees their role as similar to that of the priest, namely to provide psychological and spiritual counseling to help the sufferer accept and cope with the disease -- “not to teach that taking some herb will end it.”

Both bishops are encouraged that the government is eager to have the church’s help in tackling AIDS and is prepared to fund some of the church’s educational efforts. “The government is clearly desperate,” Tlhagale said. The government needs to call on civic, labor, religious, educational and nongovernmental organizations if it wants to avoid losing 20 percent of its population to the AIDS pandemic, he said.

Dowling said that none of South Africa’s large mining houses has mounted an aggressive campaign against the disease, even as AIDS attacks men aged 30 to 55, the ages of most miners. In his own town of Rustenburg, where platinum mining is the key industry, Dowling said that on any given day 400 men with AIDS are patients in the local, mine-sponsored hospital.

The bishop also faults the government for its huge outlay of funds to develop South Africa’s own anti-AIDS vaccine, a task which Dowling thinks could take decades -- time in which millions could die without benefit of drugs that already exist, but which the government has refused to import.

Statistics indicate that 25 percent of South Africa’s pregnant women are HIV/AIDS-infected and that the drug AZT, when given during the final month of pregnancy, has been shown to prevent the transmission of the virus to the baby. But the government has refused to import the drug, noting its high cost.

When AZT manufacturer, GlaxoWellcome, offered to sell the drug at a 70 percent discounted price in South Africa, Pretoria refused again, Dowling said. “This makes no economic sense. Now the government will have to provide for AIDS-infected babies and orphans,” the bishop said.

Tlhagale said the church must lobby the government with the facts -- medical, economic and demographic. He hopes that overseas assistance in the form of teachers and AIDS prevention personnel can help to educate workers in the field in South Africa. Despite its horror, AIDS has given the Catholic church and other ecumenical and interfaith groups “a beautiful opportunity to cooperate with the government and each other -- if we can rise to the occasion,” Tlhagale said.

South Africa HIV/AIDS Statistics
Currently: 3.5 million people are HIV positive
In the next five years:
5.6 million will become HIV-infected
2.1 million people will have died
18% of the workforce will become infected.

National Catholic Reporter, March 3, 2000