This paper is Part One; See also Part Two.
Mackie L. Harper Norris is a registered professional nurse who has a special interest in community health. She holds a Master of Nursing Degree from Emory University, Atlanta, GA and anticipates receiving a PhD degree in May, 1996. Her area of study focuses on the relationship between religion and health. She is interested in the health of African Americans and how the church can be mobilized to meet the increasing needs. Mrs. Norris is the wife of Bishop Alfred L. Norris, Resident Bishop of the North West Texas-New Mexico Area of The United Methodist Church. They reside in Albuquerque, New Mexico.
Introduction
The United Methodist Church, as an institution in the African American community, is unique. While its structure reflects the concept of inclusiveness, some racial separation remains. The denomination and its predecessor denominations had to address and overcome the burden of segregation within the church structure itself. This burden, although remnants do remain, is not the problem that it once was because the structure has been changed. However change of official structure does not automatically guarantee that at the level of everyday life the change will be realized. There remain African American Churches in The United Methodist Church.
To be sure, there are many African American churches in many denominational forms. Although there is no one Black Church as a church, the African American (Black) Church can be addressed as a single institution and will be addressed as such in this writing.
Historical Perspective
Historically, the church in the African American community has been the initiator for activities that benefit the African American community. Many scholars, including Lincoln (The Black Experience in Religion, 1974), Mays (The Negro's Church, 1933), Washington (Black Religion: The Negro and Christianity in the United States, 1964), and DuBois (The Souls of Black Folk, 1907) have affirmed this idea. In the church, educational opportunities were presented and encouraged; in the African American Church educational institutions for African Americans were born. The church was the cradle where voter registration was nurtured and matured. In the church, economic opportunities were conceived for African Americans.
The church was the site of the civil rights movement, based on a theology of liberation. Liberation Theology addresses the concern of freedom of oppression, as do African American Theology and Black Theology. (See below for definitions of these theologies.) Given this history, it could surely be in the African American Church where the major thrust regarding care and nurture for persons with AIDS and the ones that love and support them finds fertility and fruition.
Liberation Theologies and HIV/AIDS
The Black Church, as an institution, came into being following separation from white churches, because the majority church did not confer full status to black people. In the formation of the Black Church, full status to all was conferred. This is significant, especially at a time when other oppressions are keeping people from experiencing the fullness of belonging to the body of Christ. It is incumbent upon the Black Church to remember its own history and, from it, to assure that no group be made to suffer such inhumanities. The function of Liberation Theology is to call people to this remembrance.
Liberation Theology in the African American community was born as a result of the inhumanities black people suffered and are still suffering at the hands of the majority population. The liberation of black people is an ongoing process. It will continue as long as there is real or perceived enslavement. So, too, will Liberation Theology remain.
From the beginning, Black Theology was understood as Christian theology which reflected upon the struggle for justice and liberation. In that light, Liberation Theology was and is not limited to any ethnic group. African American Theology attends to the liberation of African Americans and also brings into sharper focus the contributions of Africans in monotheistic religion.
Liberation Theology can embrace anyone who is struggling under an oppressive state. Such is the case with people who have AIDS or HIV. AIDS in indeed oppressive, not only because of the physical manifestations of the disease but also the social responses to the disease. Within the meaning of liberation stands the inclusion of freedom from all that would impede the strive toward salvation and wholeness.
If the African American Church is to be empowered by a theology of liberation, then persons with AIDS would be included under the umbrella of concern and ministry. Liberation Theology is inclusive, not selective. All persons who are oppressed, for whatever reason, are the concerns of Liberation Theology.
The church must be liberating if it is to live up to the mandate of African American Christianity. African American Christianity should be a tool to direct African American congregations to be particularly mindful of HIV/AIDS because the epidemic is growing most rapidly in the minority population. What was once thought to be a disease of white gay men has become the scourge of minorities, in general, and black women, in particular. Not to be overlooked is the fact that women also make up the majority of church memberships. If so many women are becoming infected by the AIDS virus and women comprise the majority of church membership, then an additional reason for the development of AIDS ministries exists.
In addition, the question of HIV disease presenting a threat to one's civil rights has been addressed by some advocates of AIDS awareness. They postulate that when HIV disease is seen as a threat to the civil rights of the individual, the community, and the nation, then perhaps more attention will be given to limiting its effects and ultimately eradicating it.
That HIV disease is a threat to civil rights leads to the necessity of the Black Church to be a liberating institution for African Americans and for all people. Liberation Theology, as stated before, addresses the concept that oppression, in any form, must be eradicated.
Initiating Action
Liberation Theology, a theology of involvement, includes both proximal and contextual action. Proximal action is person-to-person intervention, including actions that provide for the personal needs of the sufferer. Contextual action addresses the systemic causes of enslavement.
In the case of HIV/AIDS, proximal action includes providing housing, food, transportation, health services, and the like. Provision of resources meets the basic needs of life. This gives a face and name to HIV/AIDS. The people affected, whether directly or indirectly, would become the image, rather than the disease. Contextual action includes addressing the problem of AIDS at the systems level. The federal, state, local governments, school systems, health care systems, religious systems, legal systems, corporate systems, and others have all been influenced by the HIV/AIDS epidemic. Schools have attempted to deny access, courts have battled over rights, health care has been overloaded with needs without available resources to meet them. Contextual action means calling these, and other, systems to the task of providing the resources, means, attitudes, and environment in which the HIV/AIDS epidemic could be addressed and eliminated.
Contextual action includes the church when the church itself is operating under polarizing beliefs about the meaning of HIV/AIDS. Liberation Theology, for the church, means confronting the systems that continue to persuade the general population that the presence of HIV/AIDS is God's way of calling people to repentance for their sinful life styles/behavior choices. It also means confronting issues related to suffering.
In the New Testament, suffering is addressed at three levels, in terms of action responses. For example, suffering may be the result of oppression by one person or group of another person or group. This type of suffering calls for contextual action, to confront the oppression at the systems level. The second type of suffering is related to physical or mental disability or disease. This type of suffering cries out for proximal action, action at the personal level.
Types of suffering and action are not always clear cut and simply defined however. When intervening at either the personal or systems level, one may experience unfavorable reactions and responses. According to the scripture, if persecution or alienation occurs when taking liberating action, then a third type of suffering is experienced. This suffering is the result of attempting to live up to the model of compassion, which is the cornerstone of theology in general and Liberation Theology in particular. One cannot engage in acts of true liberation without compassion.
Contextual and proximal action and compassion are the foundation of African American, Black, or Liberation Theology. Place these within the functions of the larger church relative to AIDS-- service, prophesy, and communion. There you will find the responsibility and the opportunity, for theology in general and Liberation Theology in particular, to respond to the crisis that the presence of HIV/AIDS has created.
A Societal Response to AIDS
In some form or another, all of society has been affected by the HIV/AIDS epidemic. According to Dorothy Nelkin in A Disease Of Society, "AIDS is no ordinary epidemic. More than a devastating disease, it is freighted with social and cultural meaning" (Nelkin 1991, et. al., p. 1). AIDS has become what French anthropologist Marcel Mauss called "a social phenomenon -- one whose transactions are at once economic, juridical, moral, aesthetic, religious, and mythological, and whose meaning cannot, therefore, be adequately described from the point of view of any single discipline" (Bosk and Frader in Nelkin 1991 p. 150).
A social response to AIDS and HIV distinguishes disease from illness. According to Arthur Kleinman, a disease "is an abnormality in the structure and function of the body organs and systems" (Kleinman 1978, p. 252). Illness, on the other hand, refers to "experiences of devalued changes in states of being and in social function; the human experience of sickness" (Ibid).
Kleinman goes further to say that both disease and illness are manifestations of sickness. Sickness must receive attention if the patient, whether individual, group, or society, is to have any hope of complete recovery or peaceful death.
Peter Conrad has also described the difference between disease and illness. He states that "disease is understood best as a biophysiological phenomenon, a process or state that affects the body. Illness, by contrast, has more to do with the social and psychological phenomena that surrounds the disease. The world of illness is the subjective world of meaning and interpretation; how a culture defines an illness and how individuals experience their disorder" (Conrad 1988, p. 52).
In relation to HIV and AIDS, the distinction between disease and illness becomes clear in the public's responses to persons living with AIDS and others with whom they interact. According to Morris Floyd, the "responses of a terrified public, misinformed or inadequately informed about the ways in which AIDS spreads, have caused some observers to suggest that hysteria about the malady may be an even greater threat than the virus itself" (Floyd 1986, p. 19).
AIDS, Health Care, and the Church
C. Eric Lincoln has said of the Black Church: "Beyond its purely religious function, as critical as that function has been, the black church in its historical role as lyceum, conservatory, forum, social service center, political academy and financial institution, has been and is for black Americans the mother of our culture, the champion of our freedom, the hallmark of our civilization" (Lincoln 1974, p. 5). An institution with a strong heritage such as this also has the capability of influencing other institutions through the theology that has directed and fortified it. Therefore today the church can focus on the health care delivery system.
According to Kenneth Vaux, the practice of medicine was, at first, a moral enterprise. As the idolatry of technology gained strength, the profession moved further and further away from the meaning of its inception (Vaux 1985). Currently, the guiding values of health care decisions tend to be based more on economics and technology rather than on compassion, morality, or a holistic understanding of health.
The dynamics of wholeness, or holistic health care, are to work toward unity and integration of the self, others, and the creator. "Whole person care" means the treatment of mind, body, and spirit. Healing means "to touch with love that which we previously touched with fear." It does not mean curing. Necessarily, it means to embrace the situation with an understanding of the finiteness of humankind and the infinite nature of the Creator.
Today's health care delivery system has technology that can perform many feats which were unthinkable just a few years ago. Multiple organ donation and transplantation are an illustration. In addition, in this country, the health care industry has taken on a life of it own. Health care is "driven" by economics. For example, much of our fiscal resources are used to erect larger and larger diagnostic facilities. Often great attention is focused on how to solve health problems but less attention on how to prevent health problems in the first place.
Moreover the focus of medicine as a profession has shifted from the needs of the patient to the rights of the physician. In the case of HIV/AIDS, for example, there is established a policy that the physician has the right to provide the needed care or to refer the patient to another source of treatment. As long as physicians are given this choice of rights in addition to responsibility and as long as our society remains a litigious society, the moral obligations of health care, as defined above in terms of holistic health and compassion, will be secondary.
It is incumbent on another institution to give direction to the health care enterprise. People of faith, especially African Americans, have the opportunity and responsibility to continue to call attention to the liberating effect of focusing on health, not illness; on ethical decision making, not on fiscal or technological decision making; and on obligations that are for the good of the community (the body of Christ), not solely for the individual.
African American and Black Theologies, out of their understanding of the meaning of liberation, can influence the health care delivery system in its attempt to structure a moral enterprise. Liberation Theology equips people with resources necessary for responsible behavior and nurturing care. It calls for individual and corporate examination, education and training, and clarity of purpose. Earlier in the history of health care, many hospitals, schools of nursing and medicine, were initiated by churches or church-related institutions. We are no longer in need of more medical schools and nursing schools, but we are in need of institutions to focus, again, on what health means to the individual, not the institution.
"One basic distinction of Liberation Theology is an unwavering faith in the absolute sovereignty of the supreme, infinite creator," writes Joseph Washington (Washington 1994). The Black Church came into being as a thrust of black people for self-realization, for spiritual creativity, and for worship and celebration. The understanding of spiritual creativity is a significant tool for the Black Church to use as it helps to reformulate the health care industry into a moral enterprise. That there is a power beyond the walls of the hospital is a message that must be repeated and modeled. The church must develop a transcendent vision to guide health care providers.
Liberation Theology has the opportunity to redirect the intention of medicine to a rededication to the high and holy calling of healing as salvation. If African American and Black Theologies are true to the quest for liberation, then their actions and activities will take them into hospital and pharmaceutical board rooms, medical and nursing schools, and biomedical engineering facilities to call to task the ethical and moral obligations of health care delivery.
The day will come when theology, not technology, becomes the frame of reference. The day will also come when the church, in general, and the African American Church in particular, takes the lead in addressing the problem of HIV disease and in developing supportive ministries for the people affected by the disease-- the individual and others that hold the individual in special relationship.
The Price of the Ticket
As we move toward the end of the second decade of the AIDS epidemic, the demographics of AIDS are shifting substantially. AIDS is spreading rapidly in the urban poor. A group extremely familiar with increased vulnerability to health threats is being ravaged yet again- - one that is least capable of handling all of the problems attendant to the presence of the virus.
This fact bodes poorly for the already overburdened systems that support the needs of this population segment. However, this fact offers the strategic opportunity for the Black Church to offer a haven of support and care to the victims of HIV disease and their support network.
Dr. Emilie Townes, a contemporary voice for Womanist Theology, presents a comprehensive challenge to the African American community. In her article, "The Price of the Ticket," she calls us to the task of "doing our first works over again." Dr. Townes believes that the AIDS crisis challenges us to take an inward look at our own racism, sexism, and heterosexism. She articulates several "prices," for adequately addressing the HIV/AIDS crisis. These prices are: justice, grace, truth (Townes in Susan Davies and Eleanor Haney 1991, p. 71). Justice, grace, and truth are also tenets of Liberation Theology, Christianity, and Womanist Theology. What we now need is to reclaim those concepts that were the forces enabling the creation of African American Churches.
By all accounts, HIV/AIDS will continue to present challenges to this society previously unmatched by any other crisis. It is, therefore, in the best interest of all of us to participate in education to limit, and ultimately eliminate, the virus. Society must reconstruct the meaning of HIV/AIDS so that the focus will be on the people affected and not the disease. When this happens, society will be more compassionate and churches will be more responsive to the needs of the people living with AIDS.
In a real sense, all of us are already suffering the effects of the disease, because of the societal changes that have taken place. As responsible citizens of the world community we must use our resources, including our influence, to rid the society of this devastating disease. We must model the examples of Jesus, the Christ, as we minister to the needs of today's lepers.
In the words of Rev. Dr. Zan Wesley Holmes, Senior pastor of St. Luke Community UMC of Dallas, TX, "when we know who we are, we will know what to do" (Holmes 1992). When we come to the total realization of what it means to be a Christian, we will become immersed in the struggle. When we accept, fully, the responsibility of liberators through the theology of liberation we will be clear about our mission in the Black Church to confront the menace of AIDS and its associated effects. We seek the power and presence of the Holy Spirit to make it so.
Definitions of Theological Terms
African American Theology is theology that affirms the understanding of God through experiences of life in the United States of America as African Americans.
Black Theology is a theology driven by political power as understood by and in the African American community. Its birth was a result of the Civil Rights movement, which energized the power of the African American community.
Liberation Theology is the quest for salvation through the eradication of oppression.
Theology is an understanding of a community's belief in the Divine.
Womanist Theology is the voice of Liberation Theology spoken and understood through the experiences of women. It is a theology that calls to task the sexism that has pervaded all forms of theology.
Works Cited
Conrad, Peter. "The Social Meaning of AIDS." Social Policy, Vol 16 (1), 1986, 51-56.
DuBois, W.E.B. The Souls of Black Folk. New York: AC McClurd and Company, 1907.
Floyd, Morris. "The AIDS Hysteria: Threat to Justice, Civil Rights." Engage/Social Action, Vol 14 (2), 1986, 18-23.
Holmes, Zan Wesley. Encountering Jesus. Nashville: Abingdon Press, 1992.
Kleinman, Arthur. "Culture, Illness, and Care: Clinical Lessons Form Anthropology and Cross Cultural Research." Annals of Internal Medicine. Vol. 88 (2), 1978, 251-58.
Lincoln, C. Eric. The Black Experience in Religion. Garden City, NY: Anchor Press, 1974.
Mays, Benjamin E. and Joseph Nicholson. The Negro's Church. New York: Institute for Social Research, 1933.
Nelkin, Dorothy, et. Al. A Disease of Society: Cultural and Institutional Responses to AIDS. Cambridge, Cambridge University Press, 1991.
Townes, Emilie. "The Price of the Ticket" in Redefining Sexual Ethics. Edited by Susan Davies and Eleanor Haney. Cleveland: Pilgrim Press, 1991.
Vaux, Kenneth. "AIDS as Crisis and Opportunity." Christian Century. Vol. 102 (16), 910-911.
Washington, Joseph R. Black Religion: The Negro and Christianity in the United States. Boston: Beacon Press, 1964.
Books on Black and Liberation Theology
Cone, James. A Black Theology of Liberation. 1970.
Jones, Major J. Black Awareness: A Theology of Hope. 1971.
Lincoln, C. Eric. The Black Church in the African American Experience. 1990.
Lincoln, C. Eric. The Black Experience in Religion. 1974.
Mitchell, Henry and Nicholas C. Cooper-Lewter. Soul Theology. 1986.
Paris, Peter. The Social Teachings of the Black Church. 1985.
Roberts, J. Deotis. A Black Political Theology. 1974.
Washington, Joseph R. Black Religion: The Negro and Christianity in the United States. 1964.
Wilmore, Gayraud and James H. Cone. Black Theology: A Documentary History, 1966-1979. 1984.
Books on HIV Disease and AIDS Ministries
Cantwell, Allen. AIDS: The Mystery and the Solution. 1989.
Feldman, Douglas. Cultural Aspects of AIDS. New York: Praeger, 1990.
Hallman, David. AIDS Issues: Confronting the Challenge. 1989.
Russell, Letty M., ed. The Church with AIDS: Renewal in the Midst of Crisis. 1990.
Shelp, Earl and Ronald H. Sunderland. AIDS and the Church: The Second Decade. 1992.
Woodward, James. Embracing the Chaos: Theological Responses to AIDS. 1990.
