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Speakers, sights show AIDS costs

Special to the National Catholic Reporter
Durban, South Africa

The worldwide fight against HIV/AIDS has once again highlighted that we are all the “keepers of our brothers and sisters,” South Africa’s former president Nelson Mandela declared as he officially closed the 13th international AIDS conference held in Durban, South Africa, earlier this month.

Mandela’s reference to the story of Cain and Abel followed a week of intense debate about the responsibility of the First World to help developing countries deal with treatment and prevention of HIV/AIDS. The role churches have played came in for both praise and criticism - praise for the heroic work dealing with AIDS patients and for a recent pastoral statement by a regional clergy group, and criticism for some churches’ insistence on abstinence, not safe-sex practices, as the best way to stem the epidemic.

It was the first biennial AIDS conference to be held in the Third World, and the venue had a marked impact on the proceedings.

Scientists say South Africa has the fastest-growing HIV/AIDS infection rate in the world, and the province of KwaZulu Natal, where the conference took place, is the region worst hit. According to medical statistics, for example, 33 percent of all women attending antenatal clinics have the infection.

Putting a face on a disaster

Many of the foreign journalists covering the conference used the opportunity to report, firsthand, on the devastation caused by rampant HIV/AIDS. They sent back heart-rending stories of children heading families of even younger siblings left orphaned by AIDS and gave a face to what has been merely statistical information about the spread of the epidemic in Africa.

In one conference session, a judge of South Africa’s highest court held delegates spellbound as, tears flowing down her face, she told of close friends who had died of the infection.

Judge Yvonne Mokgoro of the Constitutional Court, a Catholic who is prominent in her home community of Mafikeng, was the opening speaker at an official satellite conference on AIDS and the law.

She said that HIV/AIDS is an epidemic that calls for an “extraordinary” response. “It is a war that we are fighting,” she said. “We have to take drastic steps.”

The elegant, normally highly composed Mokgoro could not keep back tears as she recalled the story of a man she knew well who was fired from his job because he had AIDS. When his young, pregnant wife arrived home from work on the day he was dismissed, she found him “hanging by his neck from the rafters of their single-room house,” with a suicide note next to him addressed to his “beloved wife.”

His wife has since died of AIDS, and their child, now 4, is HIV-positive.

Mokgoro, whose court will hear its first HIV-related case in August, said it was important that lawyers and judges be educated to understand the many issues relating to HIV/AIDS and human rights.

Referring to the theme of the conference - “Putting Third First” - she said the global tragedy of HIV/AIDS demanded that the world accept a rearrangement of its priorities. “We need to put the Third [World] first,” she said, “instead of always putting the First [World] first, no matter how devastating the outcome.”

This theme was strongly pushed by many delegates and local people campaigning for cheaper and more accessible HIV/AIDS drugs who made it a major focus of the week.

Early in the conference, Ronald Bayer of New York’s Columbia University said global inequalities meant that it was no longer the limits of medicine that defined how effective the fight against infectious disease would be, but rather “the inability to afford treatments because of resources.”

Officials from Médecins Sans Frontières, the doctors’ association that provides medical assistance in developing countries, added, “Our physicians are enraged. They are becoming hospice workers because there are no drugs to treat people.”

At the start of the conference, several thousand marched through the city center streets calling for affordable treatment for people with AIDS, for women who have been raped and for pregnant women who are HIV-positive.

Heading the protest was a group of religious and political leaders, among them Archbishop Denis Hurley, former head of the Southern African Catholic Bishops’ Conference, and the Anglican Archbishop of Cape Town, Njongonkulu Ndungane.

The marchers’ complaint about the high cost of treatment particularly in the Third World and the effect of its unavailability was taken up by many speakers.

Director of the U.N. program for HIV/AIDS, Peter Piot, said spending on HIV/AIDS had to be increased dramatically to meet even the most basic need for care, prevention and treatment.

Piot also added his weight to the campaign to cancel the debt owed by the poorest countries, saying this was the only way these countries could begin to fight HIV/AIDS. This campaign -“Jubilee 2000” - has the full backing of the Catholic and Anglican churches in South Africa who say it is economically and morally essential, and that cancellation of debt has strong biblical roots.

Commenting after the conference on the role played by the churches in fighting the epidemic, Mary Crewe, director of the Centre for the Study of Aids at the University of Pretoria, South Africa, said the churches and other faiths were both a help and a hindrance.

Doing valiant work

Many churches were doing valiant work caring for the dying and for AIDS orphans, but there was also “great hostility” directed at the churches from the AIDS community, who viewed the churches as part of the problem, Crewe said.

“The churches have a great deal of power, and their refusal to talk about HIV/AIDS and sexual behavior in a compassionate, nonjudgmental way has alienated many. Young people are saying that if the churches continue their present stand on sexual behavior and condoms, they will lose the right to pray for the dead,” Crewe said. “They say, ‘The churches cannot come and pray for us when we die if they have not given us the means to stop getting infected.’ ”

Crewe said the churches needed to stop their obsession with abstinence and with condemning condoms. “It is quite unrealistic to keep preaching that all that is necessary is to ‘say no.’ ”

A welcoming home

“What good is saying no to a young woman whose migrant worker husband already has HIV/AIDS?” she asked. “South Africa has the highest rape statistics in the world. What difference will saying no make to the women who are raped?

“Research clearly shows that a young man’s highest risk of contracting HIV/AIDS is when he marries, because within marriage the couple would not worry about ‘safe sex,’ ” Crewe said. “Given the incredibly high infection rate among young women, this is a recipe for rapid transmission even within marriage.”

She welcomed a major pastoral letter, issued on the eve of the conference by KwaZulu Natal church leaders on the role the church should be playing in response to the pandemic.

The letter has the support of an unprecedented range of church leaders including those from the religious mainstream such as the Catholic, Anglican, Greek Orthodox, Dutch Reformed, Salvation Army and Methodist churches, as well as more charismatic and Pentecostal churches - and, unusually, the African traditional churches.

A spokesman for the church leaders said their statement was drawn up partly in response to the problem that many people infected with HIV/AIDS experienced the church as hostile. Judgmental sermons are common, and people with HIV/AIDS are often blamed for their condition by other members of their congregation. This is little different from the broader community, where several people who disclosed their status have been killed.

In their letter, the church leaders say that along with a healthy diet and exercise, faith in God and peace of mind will help people with the virus to live longer. However, peace of mind is hard to achieve in communities “where fear forces people to conceal their illness.”

“The church should be a welcoming home for people with AIDS by ensuring that they are aware of God’s love for them,” the leaders urge. “Consequently, churches should educate their congregations not to reject people with AIDS, but rather accept and support them, even encouraging employers to keep them employed as long as possible.”

Of all institutions, say the church leaders, the church is perhaps best equipped to offer education, advice, support and practical care. “It also has the strength that faith in God brings.”

Among the tasks for which the church is uniquely placed, they say, is the education and training of family members on how to care at home for people with AIDS and for AIDS orphans.

The signatories - among them six Catholic bishops and archbishops of dioceses in the province - say as Christians they believe that lifestyles and behavior can change and add that the church must help young people in particular to do so by providing “open, honest and challenging education” about sex and relationships. “Adult members must provide living examples of faithful lives and not just utter fine words.”

They also say that the church can play a crucial role in changing society to stop the economic and sexual exploitation of women by men. “We can also help men to realize it is only when women are respected and valued that men themselves will be truly fulfilled.”

National Catholic Reporter, July 28, 2000