Religion and HIV
by Abbie Van Sickle
There is a growing momentum for churches to become involved in the fight against HIV/AIDS. Essentially they have no choice as increasing numbers congregants or their loved ones die and nowadays, according to one pastor, "you see more people at the cemeteries than at the soccer stadiums."
Says Debbie Mathew, director of the AIDS Foundation of South Africa; "I think the churches are becoming more comfortable because it's such a common thing now. You also find now they're having to bury so many people who've died of AIDS in their own congregations."
Last month, members of the South African Council of Churches pledged to work diligently to stop the spread of the disease at a national conference hosted by the Nelson Mandela Foundation last month.
Faith-based organisations are also starting to meet regularly under the auspices of the University of Natal's HIV/AIDS Network to discuss how they are going to address HIV/AIDS.
"When you compare our faith-based efforts with those of other African countries that have been more vocal and taken a more proactive approach, I think you can say we've been slow to catch on with faith-based groups and prevention," says Professor Suzanne Leclerc-Madlala, an anthropologist at the University of Natal.
"There is a real misunderstanding with the idea of the ABC [abstain, be faithful, condomise] message," she said. "It seems to be seen as an 'either or' campaign - either you promote condoms or abstinence as the answer. That approach derails us right away. That simply limits our options. We can use both."
Although not all faith organisations are combining those prevention options, several organisations in KwaZulu-Natal are working to combat the spread of HIV, including evangelical churches, the Shembe Church and the Catholic Church.
Using methods ranging from traditional ceremonies to medical clinics to training community members to educate others, the organisations are taking the first steps in faith-based prevention efforts.
"A lot of (faith-based organizations) have come a long way in understanding they can preach abstinence but that a lot of women in South Africa are not in a position to make informed and healthy lifestyle decisions," Mathew said.
"People might try and deny it, but our youth are sexually active," she said. "There are many people, particularly men, who have more than one sexual partner. This is not going to go away over night."
One of the churches that has pledged to work to prevent the spread of HIV is the evangelical Durban Christian Centre.
Down a corridor, deep within the church, is the Help our People Everywhere (HOPE) Centre Clinic. Smelling faintly of disinfectant, the small waiting room is filled with people. A young woman sits, holding a sleeping infant on her lap. An older, tired-looking woman tries to entertain a toddler with a shiny green bag of Simba chips. The clinic offers free HIV test, information about her AIDS medication and counselling.
"The people who come to us need someone to speak life to them rather than condemning them," said Pastor Vusi Dube, who runs the centre with his wife, Taki, a medical doctor. "They know they'll not be cured of HIV, they just need to be loved."
Dr Taki Dube exudes efficiency. Brimming with enthusiasm, she rails off a list of the centre's accomplishments. Started in 2001, the clinic has a staff of eight nurses, four doctors, a social worker and 15 counselors who serve on a rotating schedule six days a week. Working as volunteers, they provide free HIV testing, counseling, primary care, hospice care, orphan placement, education, morality promotion and support groups from their office.
Taki says the centre's strong focus on prevention also sets it apart from most other faith organizations. "Most churches are focusing on home-based care and not prevention and support groups," Taki said. "Every organization must focus on where they can do the most good. Many people who come to us are not dead yet; they're not dying. They're living with HIV and we try to help."
"Our services are free," adds Vusi. "It's accessible to everyone. We're meeting with communities from around the city. We see ourselves as a place between the hospital and home for people who often have nowhere to go."
Starting as a feeding scheme for the city's homeless, the HOPE Centre now runs a four-part program aimed at uplifting people in all aspects of their lives.
Every day more than 300 people get free meals and about 20 people get tested for HIV. Counsellors are preparing to launch a third HIV support groups. Already offering programmes for the employed and the unemployed, the third group will focus on couples where at least one partner is HIV-positive.
"We make people realize that being HIV positive does not mean that God condemns you," says Mmangaliso Zondi, the centre's administrative manager.
One of the main tenets of the programme is abstinence, and Zondi says Uganda's successful abstinence campaign show abstinence is an effective way to curb the epidemic.
"We don't stop people from using condoms," Zondi said, pointing to a box of condoms sitting on a filing cabinet in the office. "But we don't encourage their use. We hope many people will choose abstinence. It's 100 percent effective in prevention."
To raise awareness of the benefits of abstinence, the church sponsored an Abstinence Walk from Port Shepstone to Pietermaritzburg, last year.
Another powerful faith-based organisation in KwaZulu-Natal, the Church of the Nazareth, or the Shembe Church, has also taken up HIV/AIDS - but advocates traditonal practices to prevent HIV infection.
Abstinence is the only answer, and church members are forbidden to use condoms.
"We are preventing AIDS through the Bible," said Enoch Mthembu, a committee member for the Shembe Church. "People must behave with morality at all times. There should be no difference between your behaviour at a shebeen or at a church."
Although the church has no formal clinics or support groups, Mthembu says the church encourages abstinence by educating members about the risks of sex and virginity testing.
Abstinence among men is regulated by traditions that require the men to pay lobola after sleeping with a woman. Among women, virginity testing, which is performed by older women each September, is the most effective technique, he said.
Mthembu said he believes working within traditional tribal structures and faith are the most effective ways to prevent the spread of the disease.
"Government information is not enough," he said. "Love Life and other campaigns don't really reach people like they should."
Although Mthembu accuses other religious leaders of stigmatising those with HIV/AIDS, he says unmarried church members who are infected with HIV are "an embarrassment".
Married people who become HIV infected "create a scandal because that means they've been sexually active outside of their marriage", Mthembu adds.
"If churches were doing the right things, we wouldn't have this problem with HIV," he says. "Where do people get this disease? It all comes back to moral issues and how people behave.
"Now, when you go to the cemeteries, you see more people there than at the soccer stadiums," Mthembu said. "It didn't used to be like this."
While the Shembe Church is just beginning to address the AIDS pandemic, the Catholic Church has been a major force for several years in coping with post-infection care, says Liz Towell.
Active in the HIV/AIDS field in the area around Durban for nearly 20 years, Towell manages Sinosizo, or "We Care," a programme that works to provide community-based HIV/AIDS relief to 10 townships in the Durban area.
"We're not reaching everyone, not by any means," she said. "But we're making a difference and it's always a 'choose life' strategy for the Catholic Church."
"Choose Life" boils down to a strict abstinence, no-condom approach to prevention. Focusing on the alleviation of poverty and malnutrition is also crucial in order to stop the spread of the disease, Towell said.
"Poverty, unemployment, AIDS, the three are always linked," she said. You have to address all of these in order to make an impact."
Sinosizo is sponsored by the Catholic Archdiocese of Durban AIDS Care Commission, and based in offices in Chatsworth and Amanzimtoti. Active since 1987, its mission is to empower communities with the skills to care for those with HIV and knowledge to prevent infection. Since 1995, the programme has offered home-based care, and currently serves about 1 000 clients.
Towell says she is relieved that the church has kept its policy on abstinence. South Africa's attempts to use condoms as an effective prevention have failed, she says, whereas abstinence is the safe, easily understood way to stop the spread of HIV.
However, she accepts that the strategy isn't always easy to put into action as many female clients depend on men for their food and shelter and these men don't always agreed to abstain.
Even among the church's volunteers, the strategy doesn't always work. There's a massive turnover rate for volunteers because many don't practice what they preach.
"We just went to a funeral yesterday for a woman who'd been a volunteer here for 5 years," Towell says. "She got HIV and she died."
Despite the daily sadness that she faces, Towell, like the workers at the HOPE Centre and in the Shembe Church, remains hopeful the faith-based projects can help stem the tide of HIV by working from the ground up.
"In fighting AIDS, it's vital to look at the development of the community as a whole," says Towell. "If some place has been an informal settlement for 30 years, we've got to take a holistic view to stop the spread of HIV."