The Church and AIDS in South Africa 30 years after the discovery of HIV

2013-01-20 Vatican Radio

(Vatican Radio) 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 takes place from Sunday 20th to Tuesday 22nd at St. Joseph’s Theological Institute in the South African Kwa-Zulu Natal region. Amongst the participants are 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’s Linda Bordoni 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. Listen to the interview…

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”.