Sub-Saharan Africa is dying, in part, because of a cultural taboo. Cultural and religious traditions make talking to people about the HIV/AIDS epidemic almost impossible because it is a topic so closely associated with sexual behavior. Yet an estimated 28 million people are living with HIV/AIDS in sub-Saharan Africa, and new cases are cropping up at an alarming rate.
"People are no longer dying of ignorance (of the causes of the disease). We are now working on changing behaviors," says Tabitha Manyinyiri, the former community health nurse at United Methodist-related Africa University in Mutare, Zimbabwe.
It is ironic that Africa University is working so hard to produce future leaders when many students have died or will die of the disease before they can make a difference, Manyinyiri says. "If they die five years after graduation or even before they can graduate, where are our future leaders?" she asks. "We have a house on fire, and we need to find a way to put out the flames."
In the face of this pandemic, the United Methodist Church is reaching beyond the walls of its sanctuaries to offer spiritual and material comfort to people who might otherwise suffer and die unattended. The spreading devastation of HIVS/AIDS has given the church's education and relief efforts a new urgency.
World AIDS Day, observed December 1, will focus attention on such efforts by organizations around the globe -- and the dire need that drives them. Countering stigma and discrimination is the theme for World AIDS Day 2002.
The fight to control the spread of the disease and to provide spiritual and material comfort to the afflicted and their families may be the largest battle ever fought door-to-door, family-to-family. Despite the many workshops organized for youth and adults and the training programs to sensitize pastors, the church still is working to break down resistance to talking about HIV/AIDS.
Caroline Njuki, a staff executive with the denomination's Board of Global Ministries, remembers the extreme discomfort of a young United Methodist pastor at a church in a Ugandan village where some 65 percent of the worshipers are young people. Njuki, assigned at the time to the board's HIV/AIDS initiative, explained to him that she had to address the issue and asked if anyone had talked to the youth.
"If the ground could have swallowed him, he would have been so happy to be swallowed. It really mortified him," she says.
After the service, discussing HIV/AIDS with adult members of the church was no less difficult. Njuki says the group looked "very uncomfortable" as she gave them information about the disease. "Usually I say even more, but I knew I shouldn't get carried away. Still, I had to let them know that if we can't talk about this we are dead because first we must change what is necessary and what is possible to change." Njuki also left pamphlets and other information with the congregation and directed members to other ecumenical resources.
During the past two years, the Board of Global Ministries has offered and funded an ambitious ministry of education, health and relief concentrated in Africa, where a full two-thirds of the world's 40 million reported HIV/AIDS-infected people live. Work also is being done by conferences and local churches in the United States and by students from Africa University. The combined efforts are showing signs of success.
The board coordinates several HIV/AIDS initiatives through its Health & Welfare Ministries program department which, along with the United Methodist Committee on Relief, comprises GBGM's health and relief unit. In 2002, the work was supported with $245,000 in World Service funds. The money has helped pay for workshops, health supplies, pamphlets and assistance to United Methodist hospitals, orphanages and families caring for HIV/AIDS patients. Although the board provides resources and support, Cherian Thomas, the agency's staff executive who directs the HIV/AIDS initiative, notes that the actual work is being done at the local level in places like Zimbabwe, Sierra Leone, Uganda and other severely affected countries.
In Zimbabwe alone, at least one-third of the country's 11.3 million people are believed to be HIV-infected. The National AIDS Council in Zimbabwe estimates over 700,000 orphans in the country have lost one or both parents to HIV/AIDS-related deaths.
The congregation of Inner City United Methodist Church in the capital city of Harare is dealing with the human results of those statistics through its ministry with families and children. Much of its work centers on caring for children orphaned by AIDS.
In a voice weighted with sadness, the Rev. Irene Kabete, district superintendent for the Zimbabwe East Conference and pastor of Inner City Church, says her congregation has lost "plenty" of members. "Now, we have more orphans in the church because the father died and then in a few years the mother died."
About 40 young children between the ages of 7 and 16 come to services at the church each Sunday. The children live in institutions and attend church during the week. "We talk to them during lunch hour, and we are trying to put them into homes. We are paying the fees for them to go to school," Kabete says.
Each Sunday, she adds, four or five new children show up needing the help. "We ask our people to help find places for them to go to school, and we pay the fees for them. Every few months, we collect food and clothing from our parishioners, and then we send the clothing to the kids." The congregation also welcomes street kids into its feeding program for soup and bread three times a week.
Some 3,000 children are confined to orphanages in the Zimbabwe countryside. Africa University students assist by helping the orphans plant vegetable gardens for nutritious meals, as well as by constructing housing and teaching the youngsters income-producing skills, such as growing vegetables for sale.
Several other orphanages are being built through a combination of ecumenical church, non-governmental organizations and government efforts, according to Peter O. Fasan, the board's HIV/AIDS consultant in Zimbabwe. He emphasizes, however, that institutions "are really not the best way to look after these children." Ideally, he says, all children should be cared for by relatives and friends in their villages or homesteads.
Some 1,500 Zimbabwe youngsters are cared for through the AIDS Orphan Trust (UMCOR Advance #982842-6), which allows children orphaned by AIDS to stay in their homes and receive regular visits from trained caregivers. About 400 home caregivers in Zimbabwe have been trained to help families caring for HIV/AIDS patients.
The material resources that appear to be having the most immediate effect are the Healthy Homes and Healthy Families kits provided by UMCOR. Local congregations in the United States donate the kits, which are supplemented by medicines provided by Interchurch Medical Assistance. The kits contain clean sheets, rubber gloves and other items to care for patients and to help prevent the spread of the infection to caregivers.
Interchurch Medical Assistance has shipped 250 of the kits to Sierra Leone and 40 to Zimbabwe -- a mere finger in the dike against the tidal wave of the pandemic but one that has been invaluable to volunteer home caregivers. Fasan says one "overjoyed" volunteer compared the kits to "manna from heaven." Before the kits arrived, the volunteers had few or no few items to leave with the families.
Thomas reports that another 135 to 140 kits are in stock at Interchurch Medical Assistance and will be shipped. The doctor urges local congregations to contribute even more of the valuable kits.
The epidemic continues to take its heaviest toll on the continent of Africa, where widespread communications and access to new drugs to treat the virus are nearly non-existent. Through the combined efforts of the non-governmental organizations, ecumenical organizations and governments, at least some relief is increasingly available.
While infection rates remain high, people are responding to those efforts. It may be some time before evidence emerges of widespread changes in the behavior responsible for spreading the disease, but the fear and reluctance to confront it show signs of breaking down, one person at a time.
"Many patients are terminally ill," Fasan says. "Death is inevitable. But there's a general feeling that the care given to patients allows them to die in dignity and with the knowledge that the church cares."
Author: Lesley Crosson is a writer living in New York City. She is a former staff member of the United Methodist Board of Global Ministries. Photo: Tabitha Manyinyiri, the former community health nurse at United Methodist-related Africa University in Mutare, Zimbabwe, says many students have died or will die from AIDS. "If they die five years after graduation or even before they can graduate, where are our future leaders?" she asks. "We have a house on fire, and we need to find a way to put out the flames." A UMNS photo courtesy of the United Methodist Board of Higher Education and Ministry. Chart: Source: UN Department of Economic and Social Affairs, World Populations Prospects, 2000 revision. Photo: Caroline Gwazaza, a surrogate mother from the Fairfiled Orphanage at Old Mutare Mission, Zimbabwe, plays a game with Ashley (left) and Shumirai. An estimated 28 million people are living with HIV/AIDS in sub-Saharan Africa, and new cases are cropping up at an alarming rate. A UMNS photo by David Manyonga.Chart: Orphan Estimates In Zimbabwe. From information provided by Children on the Brink 2002: A Joint Report on Orphan Estimates and Program Strategies, UNICEF, 2002. A UMNS graphic by Laura J. Latham. Photo: Healthy Homes and Healthy Families kit. Click on any chart or photo (except the one of the healthy families kit) to see a larger version.
Please support UMCOR Advance #982345 "United Methodist Global AIDS Fund," Advance #101218, "AIDS Awareness and Children Impacted by HIV/AIDS in Africa," and Advance #982842 "AIDS Orphan Trust." UMCOR encourages you to give through your local United Methodist church. Gifts may also be sent to: UMCOR, PO Box 9068, New York, NY 10087-9068. To make a credit card donation, call (800) 554-8583.