In the bleakness of Aids there is hope

Aids. Type the word into Google and you’ll find words like “death rate”m “orphans”, “infection rate” and “South Africa”. It’s not a pretty picture. Say the word to someone and the response is likely to be similar.

With 25 million people already dead from the disease, mostly in sub-Saharan Africa, and with South Africa having the world’s largest population living with the disease, the situation may seem utterly hopeless.

And yet, even in the bleakness, there are beacons of hope in the fight against the disease.

Notre Dame Sister Obehi Ogbeide, the HIV/Aids coordinator in the diocese of Kroonstad in the Free State, believes things are “getting better”. In contrast to the past, many people have started to know their HIV status, and take responsibility for their lives.

“Many people living with HIV in the community are on the treatment roll for ART and they are living a positive life. Families and communities are becoming more open to accepting people living with HIV/Aids and extending a hand of love and care to them,” she says.

Sr Ogbeide believes society and its new familiarity with the disease have made it possible for HIV-positive people to live affirming lives. But the number of infections is still very alarming, she added. The Free State province has the third highest number of HIV cases, with 30,1% infected. Only KwaZulu-Natal (39,5%) and Mpumalanga (34,7%) have higher infection-rates.

Sr Ogbeide attributes the high prevalence of the disease to the large number of migrant workers from different parts of the country working in the region’s gold mines. Sick workers become unemployed, communities become affected and the number of orphaned and vulnerable children increases.

The Church, which is so deeply rooted in communities, is aware of the problems and is working accordingly. Bishop José Ponce de León of Ingwavuma, the episcopal vicar for HIV/Aids, says the Southern African bishops continue to be committed to addressing Aids in their dioceses, and in this they draw on the support of the large network of Catholic agencies. From fund-raising to technical support needed for individual projects, there is always a local Catholic agency that can help.

In many places, the local Church is working where government structures are absent. “Many of the Church projects are providing the kind of support that in other circumstances may have come from clinics or hospitals, or other structures that the Church doesn’t have,” Bishop Ponce de León says.

There is cause for hope and joy in the work that has already been done and in the work that people are willing to do to help in the fight against Aids. “In many places, the best infrastructure we have is not the buildings but rather the ordinary people, in our dioceses and parishes, who are rolling up their sleeves, and responding to their neighbours in need,” the bishop says.

Dr Elizabeth Musaba, director of the Catholic Diocese of Port Elizabeth Aids Council, has worked with people with HIV for more than 25 years. In that time she has seen many examples of hope for the future.

“People have come to understand more about the disease and many education programmes have borne fruit,” Dr Musaba says, adding that scientific advances with antiretrovirals (ARVs) are also very encouraging.

But there are still issues to be taken on. While the Church is doing much, Dr Musaba believes there is still room for more. “In some areas there is a lot of work going on, but not many advances.”

She points to individual behaviour modification, poverty and gender equality as just some of the challenges that are not being successfully confronted.

Similarly Sr Alison Munro OP, director of the SACBC Aids Desk, says that if people would take greater responsibility for their personal behaviour, some of these infections could be avoided. But, she adds, “this is indeed a difficult area for moral theology”.

“It is all too easy to blame individuals in these circumstances, and all too often we so easily do so from the comfort of a position where we don’t personally have to deal with a breakdown in family life, unemployment, poor education and lack of formal employment,” the Dominican nun says.

“Prevention of HIV infection remains a deeply challenging issue. Even if the rate of infection is coming down in certain areas, and among certain sectors of the population, the fact remains that too many people continue to be infected on a daily basis in the country.”

Dr Musaba says leadership from government and the local Church needs to be more direct. “Politically, the message has become blunted. There is not much [political] will to combat the disease. Being Catholic, I feel clergy could also take on a greater leadership role. We need them on the frontline of this battle.”

The Catholic Church is known for looking after the poor, sick and marginalised, Dr Musaba notes, but many clergy are not involved in the Aids fight. Perhaps, she suggests, this relates to the complex nature of the prevention methods suggested by medical practitioners and government which are controversial in the Church.

While leadership in the fight against HIV/Aids is sometimes lacking, “the positive part of all this is the community response”, Dr Musaba says.

According to Sr Ogbeide, the Catholic Church in Kroonstad has had a good response through community-based projects. Its home-based care services—an area the Catholic response to the pandemic emphasises—provide nursing care and support to 236 very ill patients. HIV prevention education through awareness campaigns advise and encourage individuals to do HIV counselling and testing. They also promote a delay in sexual initiation among adolescents as well as faithfulness to partners in sexual relationships.

The diocese also operates a programme that provides care and support for 1477 orphaned or vulnerable children (or OVCs) at drop-in-centres and even at their homes.

The nun sees hope in the world of Aids simply because we find “consolation, encouragement, hope, joy and life in abundance. Jesus says, ‘Come to me all ye who are laboured and over-burdened and I will give you rest’. This for us is hope and joy in the world of Aids.”

Tommy Jarvis has been HIV-positive from birth. He is an adult adoptee and an albino. He is proof that living a positive life, even when one is HIV-positive, is entirely possible. He inspires young Catholics on a regular basis through his presentations at St John Bosco Youth Centre in Johannesburg.

Mr Jarvis has also spoken at international Aids conventions and been invited abroad to speak at leading universities. He says he gets a real sense of fulfillment from taking part in the talks. Programmes like those offered at the Bosco centre are “life-changing”. Mr Jarvis’ talks at Bosco offer young people the strength and courage to resist sexual activity or promiscuity before marriage.

Since he has “responded well to antiretroviral therapies and lives a full and happy life”, he teaches others that the virus is not a death sentence.

Success in the battle on Aids will come from government and civil society working towards the same goal. Johan Viljoen of the SACBC Aids Desk’s antiretroviral programme said in his year-end report that sustainability for the country’s various treatment centres is on its way to being planned and achieved through negotiations with the departments of health in each province.

The idea is to get the particular province to supply the SACBC treatment site with, at least, ARV drugs and laboratory tests. “This would ensure sustainability of the programme, as ARV drugs account for at least two thirds of the budget of each site, and laboratory tests account for at least 10% of each site’s budget.” Since March 2011, he says, significant progress has been made.” Agreements have been signed  and SACBC treatment sites are beginning to receive opportunistic-infection drugs, HIV test kits, laboratory tests and nutritional supplements from government.”

The progress has been quick. “In January 2011 only 13% of SACBC patients were receiving ARV drugs from government. By September 2011 this percentage had increased to 43%. With Holy Family (Tzaneen) patients receiving ARV drugs from November 2011, this figure has risen above 50%,” Mr Viljoen said.

Bishop Ponce de León emphasises that the local Church wants to be true to the call of Jesus and the social teaching of the Church, recognising the dignity of people around us and acting in solidarity with them in their very needs. “This is at the heart of who we are called to be as Catholics, showing our love of God in our love for God’s people. As Church we are all in this together, bringing love, healing and hope to those in need, and receiving God’s love and healing and hope in our own lives.”

And according to Mr Viljoen, despite the many challenges, there are in fact milestones to celebrate — and this represents the hope for the future.