Ethiopia, Zambia, Malawi: Lessons learned
Ethiopia, Malawi, Zambia: Lessons learned from the responses of the Catholic Church
The SACBC AIDS Office was invited to Addis Ababa, Ethiopia in June 2012 to participate in a conference hosted by the German Episcopal Conference to present the findings of research conducted by the Institute for Global Church and Mission of the Graduate School of Philosophy and Theology, Sankt Georgen, Frankfurt, on the commitment of the Catholic Church in Africa in the field of HIV and AIDS. Institutions collaborating in the research were Missio Aachen and the Medical Mission Institute, Wuerzburg, and partners in five dioceses in Zambia, Malawi and Ethiopia. Four bishops, including one from Germany, participated in the proceedings.
The SACBC AIDS Office hosted a visit of German bishops to South Africa in 2006, and an exposure dialogue programme involving German parliamentarians and Church agencies in 2010, and has a long-standing working relationship with the Medical Mission Institute. Sr Alison Munro presented a paper on HIV testing and recommended policies for dioceses and religious congregations , a topic that bore relevance to findings of the research in the three countries.
The Catholic Church forms less than 1% of the estimated 90 million people of Ethiopia, but is a forerunner in health services, many of which were initiated by religious congregations and are now community-supported. Sexual patterns vary in different parts of the country with fewer arranged marriages and less polygamy than in the past, but there are concerns related to military presence in some areas, human trafficking, the transmission of HIV between discordant married/stable couples, and the increased mobility of students. HIV continues to spread, with stigma still an issue though it is decreasing in some areas. The loss of traditional values rather than HIV is sometimes perceived as the problem. Decreased international donor support is a major concern.
Zambia has a population of 13 million, 3 425 000 of them Catholics, and 14,3% of the country is HIV+. Malawi has a population of 13 million, 80% of them Christian, including one million Catholics. While there are home based care structures, administration is decentralised to local structures rather than centralised at Bishops’ Conference level because of funding realities and the increased provision of anti-retroviral therapy . Traditional customary practices, early marriage in some areas and witchcraft are some of the major challenges. People often follow the most convenient message, not necessarily the Church’s teaching. Stigma and late disclosure of HIV status remain problematic. People view an HIV sensitive Church as one in which people talk freely about issues, care for one another, give testimonies and accept HIV + seminarians.
Pastorally in the three countries AIDS has been seen as a challenge to be addressed, with home based care and support groups as among the main successes of the Church, despite their not always being linked to parishes. The Church helps reduce stigma, reaches the needy, serves mostly people not Catholic, sees its mission as one of instilling hope, doesn’t do enough for its own clergy and is slow in accepting its own HIV+ pastoral agents. It faces difficulties of co-ordination between pastoral and health services, struggles with some negative cultural practices in Christian circles, recognises that most people do not follow its teaching (eg on abstinence), acknowledges that AIDS is insufficiently mainstreamed into seminary curricula, and faces stigma within itself (with silence and denial among HIV+ positive clergy and religious). Finding new funding to support its work and increasing creativity rather than discontinuing projects are needed to build self-reliance.
From an ethical perspective caring for the sick and marginalised is a moral duty, with the person at the centre and the protection of life paramount. HIV is not God’s punishment, but a complex reality on various levels, demanding complex answers within different contexts. Some of the questions raised include: How is ethics applied to real life, and how does it learn from life? How can charity be transformed into justice? How can gender roles be transformed? How does the church embrace an African ethics, recognising the principles of life, liberation, inclusion, faith and moral relevance? Can we do a new theological appraisal of human sexuality, giving real guidance to individuals and putting reflection into practical action?
The conference proposed follow up work for the dioceses in the three counties to strengthen the Church’s commitment to its gospel mandate: in capacity building on all levels for pastoral agents; in ongoing development of north-south, and south -south relations; in work on moral and ethical reflection and praxis, and in the pastoral arena. The completed research report is to be published by the end of 2012.