Mission Issues

Thinking and re-thinking missionary issues

The Innocent Victims of AIDS

A very sad thing happened today. On Thursday evening I called our coordinator for our AIDS ministry to discuss a few issues with her before meeting one of our Home-Based Care groups on Friday. She told me that a family had been identified, a mother and father (both HIV-positive) who have recently had triplets. The children are one month old. The children could not be nursed as it is absolutely essential, when a mother is HIV-positive and nurses a baby, that the baby may not take any other food or liquid for the first six months, not even water, after which the child is put onto solids and then the baby may not be nursed at all anymore. With three children this is impossible.

However, when the family was found, the caregiver found out that the mother is feeding the children with thin maize porridge as she does not have money to buy milk formula. I was shocked when I heard this. On Friday morning I had a quick discussion with our coordinator about the situation and we decided that we would take responsibility for the children until they are at least six months old. We would buy the formula and bottles and everything else which is needed and will make sure that the children are fed properly. I went to a local pharmacy and arranged to have the correct formula ordered so that we could start caring for these children as from Monday.

At this point I need to share a remarkable incident, something which have happened to us a number of times in the past. Our budget does not really allow us to do things like this. Our income is too small and our expenses just too big. But we have learned to be open to the nudging of God when we need to do something like this and normally don’t spend much (and normally almost no) time on discussing where the money will come from. It’s not that my faith is so big. But God has taught us a few lessons over the past few years. In any case, when I arrived home on Friday and opened my email, I received a message that a group of students that had been with us in Swaziland had arranged to have money deposited into our account. At least now we know that we will be able to take care of the children.

And then, this morning, I got the news that one of the babies had died! Not because of HIV. Because of malnutrition. I was angry. I’d had a tough day, struggling to work through some bureaucratic red tape, both in South Africa and in Swaziland. But suddenly all my impatience seemed to vanish as I realized that these parents had lost a child, probably not because they did not care, but more probably because they lacked some basic knowledge and lacked the funds to be able to give their three children what they needed. I was angry at the injustice that seem to force certain people to do things that we would consider to be absolutely irresponsible. I was angry that we were not able to pick up this problem earlier.

The other two children are also suffering form malnutrition and have now been hospitalized. As soon as they leave the hospital, we will make sure that they are properly fed.

Last year I preached in a church (on World AIDS day). Afterwards I heard that a certain man who had been in the church was absolutely disgusted with the service, saying, amongst others, that AIDS was not his problem. The people who had it had made a choice and are suffering the consequences.

I wish I could take him to these children and ask him what they had done to deserve this.

Wednesday, June 10, 2009 Posted by | AIDS, Death, Disparity, Health, HIV, HIV & AIDS, Home-based Caring, Mission, Poverty, Short-term outreaches, Support teams, Swaziland | 6 Comments

Beating MCPs to beat HIV

I’m a computer fanatic, but there is no way that I can remember all the acronyms used in the computer world. The same applies for AIDS. It’s HIV, AIDS, VCT, PMTCT and MCP, to name just a few. This morning’s plenary session of the 4th South African AIDS Conference focussed, amongst others, on the problem of MCP. This is an acronym for Multiple Concurrent Partners. The debate in HIV and AIDS still revolves around methods to bring the number of infected people down. By the way, one of the top professors in micro-biology stated it clearly today that, in the fifteen years that he has been involved in research in finding a cure for AIDS, they haven’t really made much progress and he doesn’t think that any real progress will be made in the near future..
Coming back to MCP: The rationale behind this paper was that people in countries with a high prevalence rate of HIV infections, which include all the sub-Saharan countries, are not necessarily having more sex, but are having more sex with more than one sexual partner in the same time period, hence the term Multiple Concurrent Partners. (I don’t fully agree that this is the only important reason for the high HIV prevalence rate in Africa, because I’m not convinced that people in the USA, Europe and Australia, where the prevalence rate is low, are really living much differently). But the point is, and with this I do agree, if the number of sexual partners could be tuned down, the statistical possibility of someone who is HIV-negative to get the virus, is also lower. How much lower, is anybody’s guess.
One of the key note speakers at the discussion, Ms Lebogang Ramafoko, is a Black South African woman who also spoke about the role of culture. I myself have found that many people in Swaziland have an almost fatalistic attitude towards AIDS, saying that it is part of their culture to have a high number of sexual partners. Even many women seem to accept the fact that their husbands are unfaithful to them and shrug their shoulders when one tries to discuss the issue. “This is our culture,” they say. However, this viewpoint was challenged today by the speaker. She challenged a culture which fails to adapt to circumstances which causes the death of thousands of people every day. In South Africa, about 1000 people are dying daily directly as a result of HIV infection. She was loudly applauded when she demanded that we re-think our attitude towards culture, as if this was some kind of unchangeable monster.
A few other things which came out in some of the other papers today and which I found interesting: When speaking about AIDS in Africa, one of the topics which regularly come up is the problem of child-headed households. I wrote about this, about eighteen months ago, when I reviewed the documentary, Dear Francis. If you are interested in my viewpoint on child-headed households, I suggest that you read this. The point is that I have become convinced that people, working for NGOs, are often using the argument of child-headed households in an attempt to get money. Obviously, one’s heart has to be very hard if you don’t give money to assist children, especially if they are living on their own. But amongst the almost 1600 clients that we are serving in one of the poorest regions in Swaziland through our home-based caring project, we still have not found a child-headed household. Obviously the orphans are facing tough times, but all of them that we know of, are living with other people, mostly family members. Therefore, I’ve been questioning the truth of the alleged large number of child-headed households for a long time and definitely the claim that one out of ten households in the Mbabane area of Swaziland are run by a child is not the truth, as claimed in the documentary.
This was confirmed today when it was said that research has shown that, of the 4.1 million orphans in South Africa (out of a total population of around 44 million!), only approximately 60,000 are living in child-headed households. In no way do I want to suggest that this is acceptable. On the contrary, one child-headed household is one too many. But the point is that we need to be careful not to exaggerate statistics to draw an even bleaker picture, in order to obtain the sympathy (or funds) from others. The picture is dark enough. By being honest we will hopefully still get enough sympathy and assistance to be able to do something to help those in need and people will also accept our integrity.

Thursday, April 2, 2009 Posted by | Africa, AIDS, Cross-cultural experiences, Culture, Death, Giving, Health, HIV, HIV & AIDS, Home-based Caring, Hope, Mission, Movie Review, Poverty, Social issues, Swaziland | 1 Comment

Death – the inevitable result of AIDS

In an attempt to minimise stigma, I find that many people who work with others who are HIV+ or have full-blown AIDS, are reluctant to speak about death. “AIDS is not a death sentence!” we are told and in a certain sense I do agree with this. There are people who have become HIV+ twenty years ago and who are still living productive lives. There has been a great advance in the effectiveness of anti-retroviral therapy (ART) and this medication, linked to a healthy lifestyle could mean that someone who is HIV+ could live a long and healthy life.
Alas, this is not true in countries like Swaziland. ART is available, (unless if the government runs out of medication, which happens every now and then, which means that for a few weeks people have to live without taking the lifesaving medication). Many people starting ART have to stop using the medication when the expense of travelling to a clinic outweighs the advantage of using the medication. And test after test have shown that ART needs to be linked to a healthy diet for it to have a long-term effect on the person with AIDS.
In rural areas in Swaziland this is totally out of the question and with the exception of the few who are earning good salaries, even those who live in one of the larger towns in Swaziland where products such as fresh fruit and vegetables are available, do not have the resources to buy these products. This means that the majority of people who are on ART, have no choice other than to eat maize porridge (the staple food of Swaziland) – which is not unhealthy under normal circumstances, but which does not contain enough vitamins and other micro-nutrients essential to stay healthy while the person carries the HI virus.
Regular readers of this blog will know that we started with a home-based caring project in the southern region of Swaziland in 2005, where volunteers are trained and equipped to take care of the people in their communities who are too sick to look after themselves anymore. For more information on this work, you can go to http://www.swazimission.co.za/English/aids.htm
We have developed a fairly simple report form which each of the 400 volunteer caregivers fill out every month. The 12 groups which we have trained, each have a coordinator who then fill out another form, based on the report forms of the group’s volunteers and then I compile a single report from these 12 forms. I’m not all that interested in reports, but the way in which the form was developed, it is possible to see with a single glance where problems exist, how effectively we are working and also what is happening within the community.
I was wondering today how many of our clients (we prefer to speak of “clients” rather than “patients”) are dying each month. The number of clients are not stable, but on average we have about 1400 people whom we are caring for at this stage (about 3.5 clients per caregiver). To get this number in perspective: A medium to large congregation in South Africa may have around 1400 members. In a normal congregation of this size, there may be one or two funerals per month. But things are totally different in our case. In July 80 of the clients died. In August 54. September 54. October 60. November 29 and December 48. That’s 325 people who died in six months. That’s almost as many people that can travel on an Airbus A300! And this is happening only in 12 small communities in one region of Swaziland. What about all the other communities in the region where we are situated? What about the three other regions in Swaziland?
This is the ugly reality which we need to face. And we can try and be politically correct and tell our clients that AIDS is not a death sentence. Or we can face up to the reality and inform people of the horrible truth and assist them in making vital changes to their lifestyles (being tested, going on ART if they qualify, taking vitamins daily, eating healthy food if available, ensuring that they do not become re-infected with another strand of the HI virus, etc).
Every once in a while we receive reports about breakthroughs which may be coming in the treatment of people who are HIV+. I don’t get excited about these reports anymore. The harsh reality is that I believe that we are losing the battle against AIDS. And the number of people dying is proof to this fact.

Tuesday, February 3, 2009 Posted by | AIDS, Death, Health, HIV, HIV & AIDS, Home-based Caring, Hope, Mission, Poverty, Stigma, Swaziland, Theology | Leave a comment

Facing up to the AIDS situation in Swaziland

I started working again this week, after a few weeks of rest. At a conference hosted by HEARD, which I attended last year at the University of KwaZulu-Natal in Durban, I was privileged to meet Prof Robin Root, associate professor at the Baruch College in New York, in the Department of Sociology and Anthropology. She has been working on the topic of the role of faith-based organisations in the fight against AIDS in Swaziland for some years. After we met in Durban, I invited her to come and visit our home-based care project in Swaziland, which she did, and at the moment she is back in Swaziland to continue her research. Not only has she been interviewing the coordinators of the different home-based care groups (twelve at the moment), but she has also been visiting some of the clients who are being supported by our caregivers.
So this was a long introduction to speak about a situation we came across on Thursday. Before we entered the home, the specific caregiver working at the homestead warned us that the client is in a bad shape. Oh boy! Nothing could have prepared us for what we saw. This man was lying on a very thin mattress on the floor with the most grotesque sores on his feet imaginable. (I’ve seen something similar before and a doctor told me that it was most probably Kaposi’s sarcoma, a type of skin cancer caused by the herpes virus.) What does one say to a person in this situation. He cannot walk, because the huge tumours are covering the soles of both his feet. He has been taken to a rural clinic for blood tests to try and determine the cause of the tumours, but the clinic either lost the blood sample or they lost the report (I’m not sure which). He lives in a house without running water and without electricity. As we sat with him, he was using a rag to try and chase the flies away from his feet! Furthermore, he is living in severe pain, but the local clinic was only able to give him the weakest form of pain killers available in Swaziland.
As we left, I said to Robin that we should try and imagine a similar situation in the USA. Had anything like this happened there, the patient would have been hospitalised. He would have received medication. Most probably the tumours would have been surgically removed. Once he returned home, he would have had access to medication which would at least have kept the symptoms under control. Physiotherapy, occupational therapy and whatever else was prescribed by the doctors would have been available to assist this person to lead as normal a life as possible.
But in Swaziland this will not happen. At the moment he has no other future, except to wait for his inevitable death.

Saturday, January 17, 2009 Posted by | Africa, AIDS, Culture Shock, Health, HIV, HIV & AIDS, Home-based Caring, Mission, Poverty, Social issues, Swaziland | 4 Comments

My World AIDS Day Church Service

Today is (or was, depending on where you live on the time zone) World AIDS Day. Churches are encouraged to devote the Sunday before or after 1 December for this cause. I was preaching yesterday in a church in South Africa and made full use of the opportunity to devote the entire service to the AIDS issue.
I took my Scripture reading from James 1:19-27 with my main focus on the first part of verse 27: “Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress”
I then proceeded to show an AIDS Photo montage which can be downloaded, free of charge from http://www.willowcreek.com/grouplife/aids_day.asp
As introduction to my sermon I used a parable which was once told by the Danish theologian Søren Kierkegaard. There are a number of versions of the parable, but the one I used goes like this:
Imagine that geese could talk, Kierkegaard once said, and that they arranged things so that they too could have their Church services and their worship:
Every Sunday they would assemble together and a gander would preach. The essential content of the sermon was the exalted destiny of the geese, the exalted goal for which the creator had destined geese (and every time his name was named all the geese curtsied and the ganders bowed their heads). With the help of their wings they could fly away to far countries, blessed countries, where they really were at home; for here they were just like exiles. And so every Sunday. Then the gathering broke up, and every goose waddles home.
Then the next Sunday off they went to the service again, then home again. That was all. They throve and grew fat, they became plump and tender… that was all. For while the sermon sounded so exalted on Sundays, on Mondays they would tell one another of the fate of the goose who wanted to take his destiny seriously, with the help of the wings the creator had given it. And they spoke of the horrors it had to endure. But they prudently kept this knowledge among themselves. For, of course, to speak of it on Sundays was most unsuitable, for as they said, in that case it would be obvious that our service would be a mockery both of God and of ourselves.
There were also among the geese some that looked ill and thin. Of them the others said, “You see, that’s what comes from being serious about wanting to fly. It is because they are always thinking of flying that they get thin and do not thrive, and do not have God’s grace as we do. That is why we get plump and fat and tender, for it is by God’s grace that one gets plump and fat and tender.
(This also motivated the theme for my sermon: Do you want to waddle or do you want to fly?)
I then asked someone with whom I had arranged beforehand to give a short testimony of what she had seen and experienced in homes where people are living with AIDS.
In the second part of my sermon I spoke about the widows and the orphans, in Biblical times and then also in modern times. I ended this part of the sermon with something that I realised as I had been reading Jeremiah recently in my personal devotions, that God was angry with the prophets and the priests, some of whom were actively involved in exploiting the widows and orphans, but He was also angry with the “good” prophets and priests, because although they themselves did not exploit the widows and orphans, they refrained from speaking out against it!
I then showed a short clip from the excellent South African movie “Yesterday”. If you haven’t seen it, beg, steal, buy or borrow a copy! It is available on Amazon.com as well as Kalahari.net. I showed the part where Yesterday goes to a clinic to be tested for HIV. Then I asked a Swazi woman to tell the congregation how it feels to live with HIV.
In the next part of my sermon I spoke about the fact that the church in general still seems to live in denial of the enormity of the problem of AIDS and that the situation calls us to act. I also included the words of Helder Camara, a priest in Brazil who once said: “When I feed the poor, they call me a saint. When I ask why the poor have no food, they call me a communist.” We need to address the reasons why AIDS is such a huge problem. Is it just by chance that the countries most affected by AIDS are the poorest countries, the countries in which the greatest discrimination takes place against women, the countries with the lowest education level?
My last video clip was The hidden face of AIDS, which can also be downloaded, free of charge, from Willowcreek’s website. There is a shorter and a longer version. I used the shorter version.
I then ended by asking those who had come to church whether they were going to waddle back home or whether they were going to fly home, because they had decided not only to listen to the Word of God, but to DO what He wants them to do.

Monday, December 1, 2008 Posted by | Africa, AIDS, Church, Cross-cultural experiences, Health, HIV, HIV & AIDS, Home-based Caring, Hope, Mission, Movie Review, Poverty, Social issues, Stigma, Swaziland, Theology, Worship | Leave a comment

Celebrating the gift to serve

In my life, I’ve been involved in a number of discussions on the gifts of the Spirit. Mainline churches are usually accused that they do not give enough attention to the gifts while other churches are accused that they only emphasise a few spectacular gifts, such as the gift of healing, of speaking in tongues and driving out of demons. Usually, somewhere in the discussion I’ll ask why we don’t make much more about the gift of serving. When Paul writes in Romans 12 about the gifts of the Spirit, he says in verse 7: If it is serving, let him serve… (Not surprisingly, that remark usually ends the argument!)

I’m still waiting that one of the well known evangelists stand up one day and inform the audience that he/she has received a gift for serving and that anyone who needs to be served, should come forward!

This past Saturday I experienced something like this. After our church had received the Courageous Leadership Award for our home-based caring project in Swaziland, I had been looking for an opportunity where I could get the entire group of caregivers together to show then the trophy we had received and to honour them for the unselfish work they are doing. At last our opportunity came when we were able to organise a celebration function on Saturday. Of the 380 caregivers presently in the project, 350 arrived by bus, by car and by taxi. We had rented a school hall and by the time everybody had turned up, the hall was packed. A few people were asked to speak and in between the existing eleven groups which are part of the home-based caring project came forward – some to sing and some to do a short drama to demonstrate how they are working in the community.

My wife summed it up very well when she made the remark afterwards that she looked at the group and was absolutely amazed to see how happy they are. At one point I spoke to the headmaster of the school (who is an elder at our church and a close friend of mine) and told him that there is no way that I would do this work, if I had to do it for money. And I thought to myself that maybe these caregivers truly have received the gift of serving. I can give no other logical explanation why they would keep on doing this work, without receiving a salary, often taking the little food they have in their homes (most of the caregivers live in extreme poverty and a number of them are HIV-positive themselves) to share it with their clients, and still be happy to do it.

Swaziland’s Minister of Education also attended the function. He had actually come on behalf of the Minister of Health, (a friend of mine) who was unable to come and then asked his colleague to come on his behalf. The Minister of Health had no idea what the work was all about and while the groups were singing, he kept on asking me questions to get more information, as he was supposed to give a speech and had no idea what to talk about! (I wasn’t really worried – Swazis have a gift to speak!) But as the morning progressed he kept on telling me that he could not believe what he was seeing. He just could not believe that people would volunteer to take care of the sick and the dying, without being paid for the work.

When we were through and we had had lunch, I could barely contain my emotions. I look at the church of today and see how they struggle with deep theological questions. And then I look at these people, content with what they have, with no concern at all about the deep theological questions church leaders are discussing, merely doing what they believe God has called them to do. And, as far as I can see, they are much happier than most Christian leaders I know.

Monday, November 24, 2008 Posted by | AIDS, Celebration, Church, Cross-cultural experiences, Health, HIV, HIV & AIDS, Home-based Caring, Hope, Mission, Poverty, Swaziland, Theology | 3 Comments

Expanding the Ministry

I have always had a policy to “start small and grow big”. Too often I’ve seen people rush into a ministry with great proposals which eventually fail because there was a lack of planning and also possibly because the time was not ripe for such a big ministry. Maybe I’m over-cautious, but I’ve seen better results where the work expands at a slower pace. (I must admit that I was surprised when I recently heard Wendy Kopp speaking at the Leadership Summit at Willow Creek in Chicago who said that she had exactly the opposite viewpoint – to rush in and do what she wanted to do in as big a way possible.)
Starting in 2005 with an AIDS conference in Swaziland, which was followed by the training of our first group of home-based caring volunteers in 2006, this ministry slowly but surely grew until where we are at the moment with ten group scattered around the southern region of Swaziland and 350 volunteers involved in the ministry. We are planning to train three more groups before the end of the year. A great deal of the responsibility for the work lies on my own shoulders (and someone was praying a while back that God would give me broader shoulders!) If we continue with home-based caring only, then we could probably handle ten or even more extra groups without too many problems. Each of these groups work independently to a certain extent and whether we meet once a month with ten coordinators or twenty coordinators, would have little impact on the effort put into the project.
But I’m becoming increasingly convinced that we will have to expand our ministry. Home-based caring is a necessary service within the almost hopeless situation which Swaziland is facing. But if the pandemic is not stopped, the population of Swaziland will be wiped out. Already the population is decreasing at an alarming rate, from around 1.3 million a few years ago to 947,000 according to the latest census. Predictions are that the population will be down to 800,000 by 2015 and that the number of orphans will have risen to 200,000! We therefore need to get involved with am affective prevention program. And for one person to effectively manage home-based caring and prevention is almost entirely impossible, taking into account that I am also a full-time pastor of a congregation.
But there is more to be done. Thousands of people in Swaziland are benefiting from the government’s ART (Anti-retroviral therapy) program. But as long as the patients do not have sufficient nutritious food to eat, the therapy will not be effective. We see people going onto ART, only to die within a few years. In Western countries people on ART are living 10, 15, 20 years or more. If we could find ways of obtaining food supplements to give to people on ART, a significant difference could be made in the lives of those people. But someone will have to take the responsibility to manage a program like this – finding funds, getting the supplements and ensuring that the people get it.
Then we still have to work on a more effective feeding program for orphans. We are already involved with this in one area, but this will also have to be expanded if we really want to be effective. And while we have the orphans gathered in one place after school to get food, why not appoint someone who can assist them with their homework to ensure a better education for them? Lack of education is one of the main causes for the rapid spreading of HIV infections.
It is clear why I said yesterday that we need a lot of wisdom to decide about the things we need to do in the future. At the same time, I’m excited if I think of the possibilities to expand our services to the communities and in such a way bring people to the realisation that we really DO care about them, mainly because we know that God cares about us – and about them.

Wednesday, September 17, 2008 Posted by | AIDS, Health, HIV, HIV & AIDS, Home-based Caring, Mission, Poverty, Social issues, Support teams, Swaziland, Vision | Leave a comment

Hearing the voice of the Holy Spirit

Probably one of the most difficult things in mission is to discern the voice of the Holy Spirit from all other kinds of voices and sounds trying to influence your life. Yesterday I was preaching from Acts 21 where at two stages people claiming to speak in the Name of the Holy Spirit tell Paul not to go to Jerusalem (verses 4 & 11). Paul, however, disregards their advice and proceeds to Jerusalem where he is indeed captured, first by the Jews and then by the Romans. Granted, Paul did not say that the warning did not come from the Spirit. What he did say was that he was more than willing to suffer and even to die while proclaiming the Name of the Lord Jesus (verse 13).
A few days ago I was reading a post from one of the blogs I regularly follow. Josh and Lindsey Parks had received (what they considered to be) a calling from God to move to Ukraine and to become full-time missionaries there. But then they wrote a post in which they admitted that they had not heard God correctly. After only three months in Ukraine they now plan to return to the USA. And this of course brings up the question: When can we be sure that we have heard God correctly. (I’m not blaming Josh & Lindsay for their decision. It may even be that God wanted them in Ukraine for a shorter period of time for a reason which they still do not understand. But their situation just proves how difficult it is to always be 100% sure that we have heard God correctly.)
My dear friend, Tim Deller – who had spent eight months with us in Swaziland – and I often spoke about this issue, specifically regarding his coming to Swaziland. Although he had prayed about going to some area for a longer period of time, Swaziland wasn’t really on his spiritual map. And then this opportunity came along, he felt it was the Spirit leading him to Swaziland, I heard about him and felt at peace that it would be the right thing to do and shortly afterwards we were working together in Swaziland! I believe that this was truly from the Spirit. But what would have happened if we had both heard incorrectly?
I think when it comes to big issues such as going full-time into mission, it would not be inappropriate to ask God to confirm, even more than once, what you believe you hear He is telling you. And even more so when it is a husband and wife team going off to another country. Both of them need to be sure that they have heard God correctly. Invariably there will be challenges which the wife will have to face which may be much more difficult for her to handle than for the man. When we moved to Swaziland, we were both sure that God wanted us to be there. (Today we are more sure than ever before.) But this decision did not come without problems. To name only one: Our eldest son had tremendous health problems as a baby. Much later we found out that he had an allergy for gluten, but this we found out only after he had almost died and was hospitalised for ten days where we literally prayed him through every day. When he came home, we had to keep him off gluten to prevent him from getting sick again. How my wife coped, I still don’t know. In a modern city it would have been difficult enough. In Swaziland it was almost beyond imagination.
Why didn’t we leave? Probably because we had no other realistic option. But I think, somehow, we never doubted that God had indeed called us to Swaziland. God had convinced us that this is where He wanted us to be and up to today I’m still sure that we are where He wants us to be.
To be led by the Holy Spirit is one of the privileges of being a Christian. But then we need to make sure that we hear His voice correctly.

Monday, July 28, 2008 Posted by | Church, Cross-cultural experiences, Health, Mission, Short-term outreaches, Swaziland, Theology | 3 Comments

Dodging the AIDS issue

A number of years ago I published an article with the title: Why are we losing the battle against AIDS? One of things I mentioned in the article was the problem of denial. In a previous post I wrote about a friend of mine who had died of AIDS. When I asked him, shortly before his death, what was wrong with him – hoping that it would create an opportunity for him to speak about his sickness – he answered that the doctor had told him that he had been working too hard in his garden and that he just needed to rest.
This same man had lost many family members: brothers, sisters, in-laws. Every time he lost another family member and we spoke about it, I asked him: “What did they die of?” And then he would answer: “You know. They died of that sickness.” It was always “that sickness” – never AIDS!
Someone published a list of euphemisms by which HIV and AIDS are known in Africa. It’s called: “AFRICA: Mind your language – a short guide to HIV/AIDS slang.” The original article was published in PlusNews but a better formatted article which reads easier was published on CABSA’s website and can be accessed here.
One of our greatest frustrations remain that it may never be said that a person has died of AIDS. I have with me three death certificates of people who had died in Swaziland. Admittedly, not all of them had AIDS, but the reasons for death which were indicated on the death certificates, were as follows:

  • Unknown, suspected swollen feet
  • Unknown, but suspect headache
  • Unknown, but suspect poisoning (this one had committed suicide by eating weevil tablets – an extremely strong poison)

Some people have the worm, others the bug. Some suffer from slim disease and others from “five plus three.” But until we start calling the sickness by its name and until we admit what caused people’s death, we will always be living in denial.
In the article mentioned above, I started by quoting from an article which was once published in a Swaziland newspaper:

Saturday night has become the night of vigils, of traditional Swazi wakes, when friends and relatives gather to feast and to mourn the deaths of young people, the cream of the nation. As the AIDS pandemic gathers pace, Swaziland has entered an endless season of mourning.
The vigils are announced publicly in death notices that fill a page, or often two pages, in the local newspapers every day. Many are accompanied by photographs which show that almost all the victims are in their twenties or early thirties. The language of the announcements is both quaint and evasive: George Shongwe is late; Zodwa Madolo, nee Diamini, died suddenly and is late, Cynthia Zwane is late. Friends and relatives are informed that the vigil will be on Saturday night, the funeral early the next morning.
There is no hint of the cause of these deaths, though everybody knows. The universal human response to AIDS is denial. It is as though nobody can face the awful reality of a calamity that rivals the great plagues of history.

Unfortunately, too many people, both in the affected countries as well as in the West are still in denial – an ideal breeding ground for this virus to grow in.

Friday, July 25, 2008 Posted by | Africa, AIDS, Cross-cultural experiences, Death, Health, HIV, HIV & AIDS, HIV/AIDS Documents, Mission, Stigma, Swaziland, Theology | Leave a comment

Religion and AIDS Symposium

I’ve just returned from Durban (also known as Durban by the Sea or locally lovingly called Durbs) where I attended a symposium about Religion and AIDS. I grew up in Durban. Up to my tenth year we lived five minutes walk from the main beach. So in that sense it was great to be back in Durban for two days.
This morning the symposium started at the University of KwaZulu Natal. It was hosted by an organisation known as HEARD (Health Economis and HIV/AIDS Research Division) with Prof Alan Whiteside chairing the meeting. There’s a lot of this stuff going on and it is impossible to attend every single conference on AIDS. I received the invitation however and because I have met Alan before and know that he has a great heart for Swaziland, clearly seen through his publication called Reviewing Emergencies For Swaziland, I decided to travel the distance to attend. I was also asked to deliver a short paper on the Swaziland Situation, with special reference to the Home-Based Care program which we are running. If you haven’t read it yet, you can download and read my publication: On becoming the Hands and Feet of Christ in an AIDS-ridden community.
One of the advantages of attending specialised conferences such as these, is that one immediately makes contact with people sharing the same vision and the possibility of networking becomes much greater. Once again, I was not disappointed. I met up with Robin Root, Associate professor of Sociology and Anthropology at the Baruch College in New York and we are now trying to set up a meeting with her in Swaziland on 1 August, at which time I want to introduce her to some of our volunteer caregivers and also give them a chance to tell her first-hand what we are doing in Swaziland.
Some of the other papers were also very interesting to listen to, but the one which touched me the most was presented by Marisa Casale. She is a staff member of HEARD and had been responsible for evaluating a church-based AIDS prevention program run in an area in Durban, known as Cato Manor – an extremely poor suburb with a more than 50% unemployment rate. A local church had started visiting a school in that area where they had built relationships with the children, did AIDS awareness programs with the children and eventually also assisted them in making the right choices in an attempt to prevent them from getting infected with HIV. Their main aim was to promote abstinence among the children.
After the program had been running for a number of years they felt that they would like an objective view on the success of the program and approached HEARD to do this research. Marisa was responsible for this. I didn’t bother to write down everything she said (trusting that I will get a copy of her paper), but it was amazing when they found that, after having run this program for a few years, the sexually active number of children in this school was down to around 40%. In a control school which was also examined, but which had not run the prevention program, more than 60% of the children were sexually active.
For many people this 40% sounds extremely high. It is extremely high, even more so when you realise that the possibility of most of these children becoming infected with HIV is an absolute reality. But I know the influence which poverty has on communities. Often moral behaviour becomes deeply affected when money for food does not even exist.
What encouraged me about this was the fact that the church can indeed play a significant role in the prevention of AIDS. In fact, in my own paper, I said the following:

It is unfortunate that the church does not seem to be having a great influence in preventing the spreading of the HI virus. We are all well aware that the propagation through the church of condom usage is a highly controversial topic. While the Roman Catholic Church has decreed that the use of condoms are not approved, most other churches are equally reluctant to advise their church members to use condoms as they feel that this may sanction extra-marital sex. I am of the opinion that there may also be another reason why churches do not feel comfortable in propagating condoms as a way to prevent HIV transmission. Although condoms undoubtedly decrease the risks of transmitting the virus, even a high profile company such as Durex warns us on their website that “no method of contraception can provide 100% protection against pregnancy, HIV (AIDS) and STDS.” The reluctance of many churches to advise people to use condoms may be compared to advising someone who wants to play Russian roulette with five rounds in the cylinder to remove four of the rounds before firing the revolver. Obviously the risks are much smaller, but most churches I know off would rather prefer people to live in such a way that there is no risk at all of getting AIDS.

I don’t think what I said was incorrect. But there is hope that certain Christian programs are starting to have an effect on the way that people, especially the youth, make moral choices. I believe we still have a long way to go, but after today, the tunnel isn’t quite as dark anymore.

Wednesday, July 23, 2008 Posted by | AIDS, Building relations, Church, Cross-cultural experiences, Death, Health, HIV, HIV & AIDS, HIV/AIDS Documents, Home-based Caring, Hope, Meetings, Mission, Poverty, Social issues, Stigma, Swaziland, Theology, Vision | 5 Comments