AIDS and the church in Africa

Practical implications for the church worldwide

Saleem A. Farag, Ph.D., is chair of the Interdenominational AIDS Committee in Harare, Zimbabwe.

Joel N. Musvosvi, Ph.D., is the dean of the seminary at the Adventist International Institute for Advanced Studies, Silang, Cavite, Philippines. 

United States or Uganda. India or Zimbabwe. Taiwan or Argentina. AIDS has become a worldwide scourge. No country is immune to its ravages. No community is free from its devastating effects. Spiritually, emotionally, physically, and medically it is one of the deadliest diseases, if not the deadliest, ever to strike the human race. In Zimbabwe one person dies of AIDS or AIDS-related diseases every half hour. A 1995 World Health Organization survey estimated that HIV infections worldwide stood at 17 million, with approximately 12 million cases located in sub-Saharan Africa, followed by South and Southeast Asia, with about 3 million. Inaccurate diagnoses, along with incomplete and delayed reporting, have kept this figure much lower than it probably is in actuality. Further, in 50 countries outside the sub-Sahara region, the estimated HIV prevalence rate was 5 per 10,000 sexually active adults, while in 15 sub-Saharan countries the rate was 500 per 10,000, or 100 times as many.1

"Ironically this disease [AIDS] is essentially preventable. The abandonment of sexual promiscuity, homosexuality, and drug abuse could eventually stop it in its tracks, though that is hardly likely to prove an acceptable or practical solution."2 If sexual promiscuity was not endemic, AIDS would not be pandemic.

AIDS and the breakdown of society

All over the world AIDS seems to have people in its grasp. It is destroying not only bodies but also the very social structures, such as the family, that have contributed to the maintenance of morality throughout the centuries.

Consider the agony of Africa. Poverty, the economic exploitation of many by few, and political instability have created a social situation in which bare existence has become a debilitating impossibility. In the wake of AIDS millions of children go hungry each night and suffer from severe malnutrition. As a result, numerous women have resorted to prostitution to feed their families. The result? HIV has significantly affected Africa's female population. As Professor McCeen Ankrah of Makerere University, Uganda, says: "The use of sex to generate income places increasing numbers of young women at risk of HIV infection and transmission." "I did not sell my daughter," Ankrah quotes a parent. "She saw me suffering and wanted to help." Such tragic situations are confined not only to the poor and illiterate but to out-of-work graduates as well.

The human tragedy of AIDS

This is not to say that HIV/AIDS is simply a problem of poorer countries. The disease does not recognize political boundaries, economic status, race, or creed. It is a lifestyle malady, and it affects people everywhere, whether they choose such a lifestyle out of economic desperation or sheer abandon.

AIDS presents itself not only as a personal and family tragedy, but also as a national one. The majority of people who die of AIDS are between the ages of 15 and 35. This age group represents the most economically productive sector of a society. These are also the ones in whom educational resources have been invested. Their death leaves a country economically and socially depleted. In the developing countries, where there is a shortage of skilled personnel, this is a particularly devastating phenomenon.

The tragedy is compounded when one considers that most of these developing countries hardly have the resources to care for AIDS-afflicted patients. Economic realities force these countries to cut the "soft" areas of health care and education in favor of defense, agriculture, mining, and business. The health budget of many of the developing countries is about US$3 per person per year. How could such countries afford expensive AIDS treatments?

In the United States the average cost of caring for an AIDS patient is approximately US$32,000 per year, as com pared to less than $400 in sub-Saharan Africa. Even though Africa has approximately 70 percent of the world's HIV infections, it has attracted only 2.8 percent of the US$1.2 billion spent on HIV prevention programs. Ready access to good health care is one of the main factors determining long-term survival for HIV-infected people. While in Western countries people with HIV survive for 10 or more years, the average patient in Africa has only 15 months to live. The difference is the availability and affordability of good health care.3

The human tragedy of AIDS does not end with the death of the patient, but transfers to an entire generation of orphaned children. Zimbabwe alone estimates an orphan population of 50,000 as a direct result of AIDS. Almost overnight these children find themselves on the streets having to fend for themselves. By the year 2000 it is estimated that HIV infections worldwide could be around 40 million, one fourth being children.4

Traditionally African society had no such thing as an orphan. When the social structure was intact, the extended family immediately adopted any child who lost his or her parents.

In many African countries economic turmoil and civil unrest have severely disrupted these structures. The traditional concept of an extended family has come under so much stress that societies have not been able to deal with the problem of orphans, especially in the numbers generated by the multitude of parental deaths caused by AIDS. Thus the thousands of defenseless children who now make the street their home.

Aids: the challenge to the church

The ultimate test of the church is the spiritual maturity of its people. Nowhere is this maturity more tried than in the way the church responds to the cry of suffering human beings in and around it. In today's context, AIDS represents the ultimate cry of suffering. Upsetting as it might be, when it comes to AIDS many church members, ministers, and leaders have chosen to look the other way, as did the priest and the Levite on the Jericho road.

One area in which the church has no excuse is the area of proclamation. The church exists to proclaim. We all know that AIDS can be prevented by living with chastity before marriage and fidelity in marriage. Yet both chastity and fidelity have been largely ignored in the rhetoric of societies as they expound on the AIDS issue. In all of this the church, reflecting societal ambivalence, has generally been almost as tentative. In the United States 74.4 percent of girls and 90 percent of boys have had sex outside of marriage before the age of 18. Instead of upholding the divine principles of morality and relational integrity, the church, in the name of love, has at least tacitly agreed with the customs and values of what societies generally advocate.

The church must see that the story of AIDS is not about epidemiology, economics, or statistics. Rather it is the story of pain, anguish, fear, and neglect.

World culture, the sexual revolution, and AIDS

In the past, African culture and morality sustained itself around two great traditional pillars, both rooted in the family and culture. One was premarital chastity, with no sanction for sexual contact before marriage. The other was marital faithfulness, with no room for extramarital sexual expression. Tribal, cultural, ethical, and religious forces supported these values in much of Africa.

A fourfold fear also supported these values: fear of what the tribe, the family, friends, and relatives might say; fear of God, because religion was still an active force in society; fear of unwanted pregnancy that would bring shame to the family and the tribe; and fear of sexually transmitted diseases.

A sexual revolution has swept Africa. As the many forms of technology have moved rather suddenly onto the African scene, traditional African values have been shaken. Western sexual perspectives, along with movies, pop music, discos, videos, alcohol, free drug use, and the products of the "sexual revolution" have all had their impact. Other causes include the breakdown of parental control and increasing urbanization. The "free love" philosophy has replaced traditional African sexual mores and behavior.

Most African tribal cultures are profertility and prosexuality, but within strictly defined limits. However, with urbanization, technological development, and independence such limits lost their bearings, widening the road for promiscuous sexual behavior and AIDS. Added to the cultural breakdown and the invasion of a morally loose lifestyle came tentative political and governmental action against AIDS. This hesitation, along with economic limitations, exacerbated the AIDS problem in many African countries.

In some Western countries children may be given explicit sex education, and may even be introduced to the use of pills and condoms, but for a multitude of reasons African tradition and culture do not make such sex education and AIDS prevention programs easily available. Materials provided under Western auspices are often so explicit that many African communities consider them pornographic. Bitter protests from families have led to the removal of such sex education from school curricula.

Never before have family values been more seriously challenged. The United Nations Declarations of the Rights of the Child and the Rights of the Adolescent, including the advocacy of highly controversial sexual and reproductive rights, have challenged the foundation of Christian and traditional African homes in which morality, fidelity, and the heterosexual family unit have been so strong, and in which appropriate parental authority and influence have been maintained.

In a rapidly evolving world under a "new moral world order" many in very influential places, such as the United Nations, are attempting a redefinition of family. According to them, family may be defined as two men, two women, a man and a woman, or a man or a. woman. In this family, adolescents and children have "sexual rights" and can make choices including having access to contraceptives and abortion, with or without parental consent, if they so choose. Thus sex is finally separated from the serious business of morality, marriage, reproduction, and family.

The challenge to the church

Against such powerful and world wide trends, the church has the formidable task of championing chastity before marriage and fidelity in marriage. It must find ways of effectively crying aloud and sparing not, particularly when it comes to maintaining high moral and spiritual standards in human sexuality. Pastors, evangelists, teachers, youth leaders, and others must rediscover the positive discipline of life as it is in Christ so that we will not be pressured into embracing destructive "new" morality trends. We need a spiritual awakening that will enlighten us about the forces that exist to squeeze and conform us into destructive philosophies and behaviors.

What should the Seventh-day Adventist Church do to arrest the deteriorating sexual situation? It is not enough to climb Mount Sinai and proclaim the Ten Commandments. We need to do more, particularly in the areas of proclamation, counseling, and support.

Proclamation begins with the church living out God's plan for human sexuality within the bonds of marriage. The immutable standards that govern sexual relationships must be affirmed. Pastors and youth leaders need to find ways of effectively pointing out that sexual relationships are not a question of "free choice" and "safe sex," but part of a great divine moral order. Human behavior cannot be guided by what is available through technology. A technical advance that provides a way of preventing pregnancy or a medical insight that cures disease cannot be consulted as a basis for moral direction. The higher moral standard of who we are, whose we are, and who we are ever called by God to be, is clearly more definitive and compelling. Focusing on God's intention for human sexuality clearly shows that sex is a beautiful experience, a gift from the Creator to be enjoyed within the realm of marriage. Such focus would challenge adolescents to look at sex in a more wholistic way.

Counseling is the second area of opportunity for the church to work with those infected with the HIV virus and AIDS. They and their families are in serious need.

One 24-year-old AIDS patient said, "I wish I could have seen God's plan as clearly before as I do now after I have been infected. Why was my vision so dim and my spiritual perception so dull? Why couldn't I have seen the beauty and reasonableness of God's plan for a happy and healthy family?"

No other disease can subdue the heart and soften the soul to the pleading of the Spirit as does AIDS! It provides an excellent opportunity for the minister to give hope and courage to patients who have lost hope. One young AIDS patient, who had not been a Christian, accepted Jesus as her Saviour in her last few days of life and was baptized into the Seventh-day Adventist Church. She said, "I know that one day soon I will be raised in immortality and will see my Lord face-to-face. I am not afraid of dying. My only concern is for my mother and family members who are not Christians." She asked the minister to tell her mother about Jesus and requested that he preach on the second coming of Christ at her funeral service when all her relatives would be present. Today her mother and a large number of her relatives have joined the church.

The pastor who cared for this person said, "In all of my 20 some years in the ministry, I have never found more fertile ground for the pleadings of the Holy Spirit than among HIV/AIDS patients and their relatives and friends."

Seminars on how to counsel AIDS patients have become a regular feature in Zimbabwe. Hundreds of Seventh-day Adventist pastors and ministers from other denominations have received such training. In counseling the AIDS patient, the attitude of the AIDS counselor can make a significant difference. If counselors have to give real help to AIDS sufferers, they must have a disposition to love, heal, and save. They cannot afford a judgmental attitude.

Counselors are called to listen as patients share what is in their hearts their fear, agony, anger, anxiety, and remorse. More than anything else, the AIDS patient needs compassion along with spiritual and emotional reassurance. If counselors are open, patients will be able to unburden their guilt and pain and find peace. HIV/ AIDS sufferers experience a huge flood of fears when they hear for the first time that they are the victims of the disease. Only the Saviour can calm the raging storm that comes up when such a diagnosis is made.

Support services is the third area in which the church can serve those affected by HIV/AIDS. Because hospital services worldwide are costly, more and more patients are cared for at home. In Africa, home-based care is quite common. It allows for family involvement and provides opportunity to educate the extended family and the immediate neighborhood on the destructiveness of the disease, and what can be done about it.

Zimbabwe has formed an interdenominational AIDS network to enable churches to identify areas of need and mobilize community resources in order to provide HIV/AIDS patients with necessary support and care in their homes. This network gives home-based caregivers training in prevention and counseling.

Such teams are usually composed of a church worker, a nurse's aide, and a driver, all under the supervision of qualified medical personnel. This team along with a pastor is responsible for services such as:

  • Emotional and spiritual support to the patient and the family
  • Nursing services in the home
  • Financial support when possible
  • Health education for family members, schools, parent-teacher associations, and the community
  • Training of care counselors

Orphan care

As an extension of the home-based care services, churches in Zimbabwe have adopted a program to identify and care for orphans left destitute by parents who have died of AIDS-related causes.

Such children are placed in Christian homes rather than being left on the street or being placed in an institution.

The program is a formidable challenge to the church as the number of orphans mushrooms each year and the resources of the church do not. Yet these initiatives cost little and are culturally appropriate in Zimbabwe. The churches have the added responsibility of educating the orphaned children and training them in occupations that can give them a sense of dignity and personal fulfillment. This outreach of the church is worthy of support from people everywhere.

AIDS is heinous and tragic. It kills the patient and leaves the family in bewildering tragedy. Motivated by love the church must seek to minister and bring the power of Christ to the sufferers and their survivors. The responsibility of the church does not end in proclaiming moral standards alone, but in a caring ministry. If Christ were to walk the streets of our cities today, He would be deeply involved in ministry to those who have AIDS, providing physical, emotional, and spiritual support and care. He is present today through His church. This kind of work is the highest work of the church.

1. World Health Organization Global Program on AIDS, December 1995.

2. A. P. Waterson, in British Medical Journal, March 5, 1983.

3. Ibid.

4. S. A. Farag, "Report on the United National Conference on Population and Development" (Cairo: September 1994).

Ministry reserves the right to approve, disapprove, and delete comments at our discretion and will not be able to respond to inquiries about these comments. Please ensure that your words are respectful, courteous, and relevant.

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Saleem A. Farag, Ph.D., is chair of the Interdenominational AIDS Committee in Harare, Zimbabwe.

Joel N. Musvosvi, Ph.D., is the dean of the seminary at the Adventist International Institute for Advanced Studies, Silang, Cavite, Philippines. 

July 1996

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