Mission Issues

Thinking and re-thinking missionary issues

Rethinking Marriage on the eve of World AIDS Day

On the day before World AIDS day, it is appropriate to blog about something related to this topic. UNAIDS recently published their latest epidemiology report on the global HIV/AIDS pandemic. You can download the full report here.
While, for most of the readers of this blog, this report contains statistics, for every person personally involved in the fight against the AIDS pandemic, these numbers and percentages represent people. There are some positive things included in the report. It is clear that ART (anti-retroviral therapy) is helping many people to live longer. According to the report the number of new infections are coming down slightly. But in a country like Swaziland with a population of less than 1 million and with the highest infection rate in the world (according to the report Swaziland had an estimated adult HIV prevalence of 26% in 2007, but antenatal surveillance found an increase in HIV prevalence, from 39.2% in 2006 to 42% in 2008, among female clinic attendees), I wonder if it isn’t a matter of “too little too late.”
In a newspaper in South Africa it was reported that the Dutch Reformed Church (N G Kerk) which is also the church that sent me as missionary to Swaziland in 1985, might be rethinking it’s attitude towards cohabitation as an alternative for marriage. The irony was that the immediate following report told of the alarming increase in HIV infections amongst the white, the rich and students in South Africa (three groups that form a large part of the membership of the Dutch Reformed Church.) In the report it says that the South African Blood Transfusion Service had to reject 25% of blood donated by students at a specific university, due to it being HIV-positive.
One of the reasons, I believe, why Swaziland has such a high rate of HIV infections, is because marriage has to be postponed. Swaziland has a lobola system, where a man who wants to get married, has to discuss a form of bride’s price which needs to be paid before they can get married. One of our church members was involved in such a discussion over the weekend and eventually it was determined that the young man had to give his future father-in-law fourteen head of cattle! Keep in mind that this man and the girl are deeply in love. They are emotionally and physically ready to get married. But they can’t, not unless the man can find a way to pay at least part of the lobola. It is no wonder that very few Swazi girls (or men, for that matter) enter into marriage as virgins.
In 2005 I was in the Netherlands at a meeting of the Reformed Ecumenical Council and was chairperson of a committee that had to write a document on the church’s response to HIV and AIDS. I am extremely proud of the product that we presented to the meeting. (You are welcome to download a copy of this document with the title Towards a Theology of Hope in a Time of HIV/AIDS.) As we worked on the document, thinking and rethinking through every sentence, I was challenged by a young woman from the Netherlands. She asked me whether I wanted the document to be accepted by the Reformed churches all over the world, or only in Swaziland? I had felt for a more conservative approach, but was eventually convinced that this would lead to the document never being acceptable in churches in Europe, where sex before marriage and homosexuality are issues which are totally acceptable in most churches. (Once we had agreed on our approach and reformulated one or two sentences, I came under strong attack, especially from churches in Nigeria, when I had to defend the document.)
But I then wanted to know from some of the people in the Netherlands, why cohabitation was so acceptable to them. The answer I got from some church members, was that people had to wait until they were older before they could get married. Typically, they would wait until they were around thirty before they got married, regardless of when they started dating. And when I asked why they waited so long, the answer was that they had to collect money first before they could get married.
And this is where the link with the lobola system in Swaziland comes in. In South Africa people also tend to get married at an older age. The arguments I hear is that they have to buy a house and furnish the house before they can get married. In other words, the problem in Swaziland and the problem in South Africa (and Europe) boils down to the same thing: a materialistic approach towards life. And this is where I feel that the church is failing it’s young members. Instead of giving the go-ahead for cohabitation, shouldn’t the church rather address the problems that are causing young people to opt for cohabitation instead of getting married? Shouldn’t the church rather speak out against the ridiculous extravagance of wedding ceremonies? (I recently heard of someone we know planning to get married, who’s invitation cards costs more than my son’s entire wedding had cost!) Shouldn’t the church say to young couples that it’s fine to rent a cheap apartment with only the most basic things to survive (which they need in any case, even if they live together). Shouldn’t the church say to young people that it’s really not necessary to buy a five carat diamond ring in order to get engaged?
I remember a story which was once told to me of a town high up in a mountain with an extremely dangerous road leading up to the town which frequently led to accidents and severe injuries. As the authorities debated a solution for the problem, they eventually decided to build a new hospital in the town in order to treat the victims of the accidents.
Is this perhaps what the church is doing?

Monday, November 30, 2009 Posted by | Africa, AIDS, Church, Culture, HIV, HIV & AIDS, HIV/AIDS Documents, Swaziland, Theology | 8 Comments

Reporting about Mission

Yesterday was spent in a meeting with the ten coordinators of the ten different home-based caring projects in the southern region of Swaziland. These meetings can be quite exhausting but at the same time it’s really a joy to be busy with this. When we started with the home-based caring ministry in 2006, the story which you can read in an article I published under the name: “On Becoming the Hands and Feet of Christ in an AIDS-ridden community in Swaziland – A story of hope”, I invested huge amounts of time and energy in the group. I met the entire group at least once a week and during the other days I regularly met the volunteers individually. My aim was to build up this group to become as strong as possible. But the other advantage was that I had my finger on the pulse of the group and I knew fairly well what was going on.
And then, in 2007 we trained five more groups in different areas in the southern region of Swaziland. By the end of that year it felt to me as if things were getting out of control. Eventually, in an attempt to determine where things were and where they were going to, I arranged for the entire group of volunteers to meet at a central place and gave them a chance to tell me what was going on. It was a highly informative meeting and afterwards I felt that I was more or less in control again.
And then we started more groups this year. At present we are standing at ten groups of around 350 volunteers doing home-based caring. And I got that depressing feeling again a few months ago that I’m out of control! And at that point I decided that I will need to implement a reporting system whereby I can at least get an idea whether we are working effectively and where we need to improve. We drew up a reporting form in the simplest way we could think of, translated it into siSwati and then gave the coordinators a brief training session on how the forms should be completed. They then had to train the volunteers for whom they are responsible and once a month the coordinators have to meet at a central place where they bring one consolidated report from their project from which a final report can be made of the previous month’s work. And this is the meeting we had yesterday.
The reports still have many errors, but I prepared myself beforehand that it will take at least three months to get this sorted out. But what amazed me was to see what these people are doing. When I was in the USA recently to receive the Courageous Leadership Award, I told the people there that we are caring for around 1000 sick people. Now that the reports for July have been finalised, I found that the total number of clients is closer to 1500! More than 3800 home visits took place that month, 524 new clients were identified and 80 of our existing clients died. 374 of the clients are terminally ill and 821 are chronically ill.
These figures are mind-boggling. Three more communities in the southern (Shiselweni) region of Swaziland have approached us to train them to start with home-based caring and our first invitation from the northern part of Swaziland (Manzini) have also been received.
And as I keep on thinking about the future, I realise that God may well be preparing us for more work. I’m excited about this. But I also realise that God will have to provide great wisdom if we want to keep on expanding. I have ideas in my mind, some of which I may share in my next post.

Tuesday, September 16, 2008 Posted by | AIDS, Death, HIV, HIV & AIDS, HIV/AIDS Documents, Home-based Caring, Meetings, Mission, 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