How has the Catholic Church responded to the AIDS pandemic in Southern
Africa since the discovery of the HIV virus 30 years ago?
How has the
scenario changed in a nation where well over 5 million people are living
with HIV and AIDS - the highest number of infected people in any
country?
What are the prospects and the challenges?
What about the
Church’s role in caring for the sick and the orphaned?
These are just
some of the issues that will be discussed and analysed at a Conference
entitled “Catholic Responses to AIDS in Southern Africa, 30 Years After
the Discovery of HIV”.
The Conference took place from Sunday 20th to Tuesday 22nd
at St. Joseph’s Theological Institute in the South African Kwa-Zulu
Natal region.
Amongst the participants were Cardinal Wilfred Napier, Fr.
Michael Czerny, Sr. Alison Munro, Bishop Kevin Dowling and others who
have been in the front line in the battle against AIDS and in caring for
the victims for many, many years.
Vatican Radio
spoke to Kevin Dowling, Bishop of Rustenberg, who has been asked
specifically to address the gathering on “Catholic Responses to HIV and
AIDS in a Rural local church”.
Bishop Dowling, who serves in
Rustenberg’s sprawling squatter shack settlements spawned from the
reality of industrial Platinum Mines in the area, speaks of the
shockingly high infection rate amongst these people who are the poorest
of the poor.
Bishop
Dowling, who is the founder of the “Tapologo HIV/AIDS Project and
Hospice” in Rustenberg has been witnessing the AIDS pandemic in his
country up close since being appointed to the Diocese of Rustenberg in
1991.
He explains that the context in which he works and serves is
rather particular in the sense that the area in which the Diocese is, is
predominantly rural, but it is also the venue of the Platinum Mines
which have brought about mass migration from poorer rural areas in South
Africa. In addition – he says – for many years the policy of the Mines
has been to recruit workers from other countries. “So you have mine
workers housed in hostels and huge migration of many people,
particularly destitute women from rural areas”.
These people, he
explains, set up homes in shacks of zinc and wood, in terrible
conditions. They are all illegal so there are no services provided. This
results in a lethal combination of extreme poverty, desperate people
and mine workers who have left their homes to work away on the mines for
many months. Thus the HIV infection rate, as a result of the
socio-economic culture effect, is very high in the area and it is
increasing.
Bishop Dowling says the realisation of the consequences of this reality is what drove him to start his Tapologo programme.
Bishop
Dowling specifies that official statistics show that around 28 percent
of the South African population is infected by HIV, however in the
particular context in which he works – a 1997 survey showed that 44.9
percent of all pregnant mothers tested positive – and ever since, it has
averaged between 49 and 52 percent at the Primary Health Care Clinic.
He
stresses the link between poverty and the disease and speaks in
particular of the impoverished women who live in the illegal shack
settlements around the Mines who are forced into prostitution to feed
themselves and their children.
He calls it “survival sex” because the
only means they have of surviving is to engage in sex for money with
those who have the money, and they are the men who are employed at the
mines or are contract workers and who have jobs. On the other hand,
these are men who have left their families behind in other countries or
in rural areas and spend months alone in the hostels.
So you have this
combination of desperate women, men who have money but who don’t have
their wives with them. It is this socio-economic cultural reality –
Bishop Dowling says – that is responsible for the dangerous lifestyle of
these women who just want to survive.
As he prepares to speak at the
conference, Bishop Dowling reflects on the reality of HIV/AIDS in South
Africa 30 years since the discovery of the virus.
He speaks of the
uniqueness of the South African situation because, he says: “the first
10 to 15 years from the discovery of the virus were lost to our response
as a country because we were totally engaged in the horrendous struggle
against apartheid”. So from the 1980s to when Mandela was released, and
then to 1994, everything was focused on the struggle for democracy.
Meanwhile, he points out: “this disease was growing and developing into a
major epidemic beneath the scenes”.
So he says, “We lost precious time.
It was only post 1994 when we suddenly began to face the fact that we
had a huge number of people desperately ill and dying, including
children”.
And it was only much later that the country began to deal
with the crisis.
Bishop Dowling says there was also denialism in the
country.
“So by the time we came together as a nation to deal with it,
we had about 5 million people infected and dying”.
The Church’s
response, he says, was obviously to work within the communities. Trying
to develop home-based caring projects, and so on. The major change came
when US President Bush’s “Emergency Plan For Aids Relief”, called
PEPFAR, 10 years ago started to fund faith-based organizations involved
in Aids programmes providing antiretroviral drugs and supporting
church-based programmes. That, says Dowling, marked a major change and
shift in perspective.
“Then the South African government came on board
as well, and since then a great deal more commitment has come into this.
So Antiretroviral Drugs – ARVs – have enabled us to save people’s lives
and to keep them well and able to work, support their families, and so
on. That has been a major shift”.
Bishop Dowling says that “the
biggest problem we have now is the massive orphan problem, the
child-headed households. We have about 2 million aids orphans and we
have yet to experience that tragedy in its fullness”.
Also, although
the ARVs have had an immense positive impact on reality, Bishop Dowling
says that not everyone is receiving them. People are still dying. The
big problem is that in his diocese, for example, the settlements are
illegal and so the government does not provide services like schools or
clinics. There is an awful lot or work still to be done.
And what
has happened regarding the Church programmes , like his own – is that
PEPFAR has come to an end. “As from May we get no more money from the
American Government. So the challenge has been to find ways to transfer
our patients to the Government sector”.
But he says: “the government is
already overwhelmed: they don‘t have enough staff or clinics – they
can’t take the 1,850 patients that I have. And therefore what we are
trying to do is develop a partnership with the government where we would
try to find funding for the running of the hospice and the other
programmes, but the government would give us the drugs”.
As regards
the Conference, the bishop says he will be appealing “to what has been a
very important element in terms of the Church’s justice mission and
ministry in the Church and world. And that is to be sensitive and to
continue to read the signs of the times”. This, he says, “is precisely
what we didn’t do as a nation in the early years of the epidemic. We
were absorbed in one sign of the time: the struggle against apartheid –
we were not recognising another sign of the time”.
“I am appealing to
us as Church: Where are we now in the epidemic? What are the
challenges? What is the major sign of the time that particularly calls
out to us as Church in terms of our commitment and relationship with
Jesus, the inspiration we derive from the Gospel and the principles of
Catholic Social Teaching which need to guide the actual creative
practical responses we make on the ground”.
“What is the most
challenging sign of the time where we need to be pre-eminently engaged
at the present time and going into the future?"
Bishop Dowling says
he would suggest “it is the holistic appreciation of the total
social-cultural context of the aids orphans and child-headed households.
Because that particular suffering, especially when it is linked to
situations of extreme poverty, dehumanizes children in a terrible way,
and takes away completely any hope they have of growing to the fullness
that Jesus wants for them”.
“I believe as Church” – Dowling says -
“that we should be pre-eminently in programmes which try creatively and
constructively to address that issue in the communities and with the
communities”. Working in relationship with our people in the
communities, so they can be inspired by us, by our vision, by our
principles. And with them “to look at what can we do, even with limited
resources”.