Ministry to the Infected and the Affected1

5/26/2018 Ministry to the Infected and the Affected1

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Re-imagining HIV & AIDS Ministry from the perspective of the infected andthe affected

AIDS is a disease and should be treated as such... God, who loves all humanbeings, cares for the well-being and health of every one of his children, and does notinflict disease as a punishment.

Dr Emilio Castro1

Introduction

The HIV/AIDS pandemic has grown in its size. The pandemic has become ahealth, social-economic and development disaster, with far reaching implication forindividuals, communities and countries. No other disease has so dramaticallyhighlighted the current disparities and inequities in the health care access, economicopportunity and the protection of basic human rights. With respect to the people who are

living with HIV/AIDS (PLWHA) we can see that they are marginalised in the carereceiving front because of the threat of infection and the stigma in society regardingHIV/AIDS.

This affects the people who are related to those who are infected. Hence there is aneed to re-imagine a ministry from the perspective of the ones who are infected andaffected by the disease.

HIV/AIDS Global Situation

By the end of 2003, UNAIDS/ WHO estimated 40 million (34-46 million) people tobe living with HIV/AIDS. In the same year, the HIV/AIDS pandemic claimed more than 3million (2.5-3.5 million) lives and 5 million (4.2-5.8 million) people became infected with

HIV. Each day there were 14,000 new HIV infections, and close to a half of these areyoung people under 24 years of age with over 95% occurring in poor and middle-incomecountries. Globally, the major mode of transmission is through unprotected sexualintercourse. Injecting drug use, sexual intercourse between men, mother to childtransmission and contaminated blood in health-care settings are other modes of HIVtransmission.2

Chronic conditions are defined by the World Health Organization (WHO) asrequiring on going management over a period of years or decades and cover a widerange of health problems that go beyond the conventional definition of chronic illness,such as heart disease, diabetes and asthma. They include some communicable diseases,such as the human immunodeficiency virus and the acquired immunodeficiency

syndrome (HIV/AIDS), which has been transformed by advances in medical science fromrapidly progressive fatal conditions into controllable health problems, allowing thoseaffected to live with them for many years.3

Stigma and Discrimination

HIV/AIDS- related stigma and discrimination rank among the biggest and mostpervasive barriers to effective response to the AIDS epidemic. Stigma is a social process

1 World Council of Churches, AIDS and the Church Hearing on AIDS from

http://www.oikoumene.org/en

2Global HIV/AIDS report. A joint WHO/UNIADS report (Geneva: World Health organization,2003), 4

3Ellen Nolte and Martin McKee (Eds.), Caring for people with Chronic Conditions (Berkshire, New

York : Open University Press, 2008), 1
http://www.oikoumene.org/enhttp://www.oikoumene.org/en


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Re-imagining HIV/AIDS ministry from the perspective of the infected & the affected Page 1

that marginalizes and labels those who are different and discrimination is the negativepractice that stems from stigma, or enacted stigma. Stigma and discrimination targetand harm those who are least able to enjoy their human rights. In fact stigma,discrimination and human violation form a vicious circle, generating, reinforcing andperpetuating each other and the outcome, in the World of AIDS is life-threatening.

Stigma increases peoples vulnerability by isolating and depriving them of treatment, careand support and worsens the impact of infection.

The worldwide effort to remove the barrier of stigma and discrimination include:

Encourage leaders at all levels, and in all walks of life to visibly challengeHIV/AIDS-related discrimination, spearhead public action against the many otherforms of discrimination that are faced in relation to HIV/AIDS,

Involving people living with HIV/AIDS in the response to the epidemic, Creating positive legal environment for fighting discrimination, Enabling the challenge against discrimination and receive redress through

national institutions

Ensuring that prevention, treatment care and support services are accessible tothe ill.4

Biblical & Theological Basis for care

In Ephesians 4, Paul speaks of the body of Christ, the true Chruch, as growingaccording to the effective operation of each member. Other portions of Scripture (eg.Rom.12, I Cor.12) teach that every born-again believer is gifted by the Holy Spirit tocontribute to the growth of the Church. God has a definite purpose for each individual, aforeordained program for accomplishing His sovereign purpose through every member ofHis body (Eph. 2:10). In Christ, God has provided every person with significance, ameaningful purpose for living.5

The Lord God is the creator of heaven and earth; the creator of all life forms inthe earth community. He created all life and everything good. In thisHIV/AIDS era, hesees the misery of his people, who are infected and affected by this disease; He hasheardtheir cry on the account of this epidemic. He knowstheir sufferings and he hascome down to deliver themfrom HIV/AIDS. So he calls to send us to the infected andaffected, to bring his people, his creation, out of theHIV/AIDSepidemic.6

Caregivers to PLWHA

Who are the caregivers for people with illnesses related to HIV and AIDS? Thequestion sought to discover who the main care-givers for PLWHA within the family andsociety at large are and why. It is understood that family members or relatives are

providing care for the people who have illnesses related to HIV and AIDS. Two reasonswere given for this. The first one was that it is their responsibility, and the second reasonwas that they are closer to the sick persons. AIDS is a chronic disease so that one personor gender cannot continually carry out the responsibility of caring for PLWHA alone overa period of years, without support from other members within the family. But patriarchal

4 Elizabeth Marton Semguruka, Living with HIV/AIDS; Womens Perspectives RegardingCare/Support Provided in Dar Es Salaam, Tanzania - M.Phil. Dissertation (Norway: University ofOslo, 2004), 23

5 Lawrence J Crabb Jr., Basic Principles of Biblical Counselling (Grand Rapids, Michigan:

Zondervan, 1975), 59

6http://www.oikoumene.org/en


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ideology denies men an opportunity to practice their Christian faith with regard toproviding care for ones neighbour.7

Siwila therefore argues that, there is need for fresh examination of such sociallyand theologically imposed roles particularly as related to the ministry of care-giving andcalling from God. This suggests that care-giving ought to be shared by all members of

the family irrespective of their gender in order to lessen the exhaustion and over-burdening experienced by women and girls.8

Relevance of Pastoral Care for PLWHA

According to Gerkin: Pastoral care involves not only the care of the individualsand families, but also the care of the community itself. Pastoral care also entails thethoughtful reinterpretation of the tradition that shapes Christian identity as thattradition is brought into dialogical relationship with contemporary culture and its impacton the community of Christians as well as its individual members.9

Counselling services are very important for people living with HIV/AIDS andfamily members. Therefore, counselling needs to be seen as more than the pre- and post-test giving of advice. Household members sometimes become hurt and angry as theyundertake care-giving responsibilities. In some homes this can result in violence andabuse. It is important, therefore, that embittered family members be helped to articulateand express their feelings. Counselling services should seek to address important issuessuch as preparation of wills, marriage and adoption, as these have been found to beinfluencing factors for care and support.

In general sense, pastoral care can be understood as the compassionateattending or presence of the community of faith, in the brokenness and sufferings ofpersons and their relationships. The need for care is grounded in the existentialcondition of humanity. To put it in the words of Vankatwyk, care involves our sharedvulnerability and the attendant anxiety about the tenuous nature10of life in the world.In fact, the ministry of pastoral care is guided by the compassionate sensitivity to theexistential concerns of persons and communities. As such, the ministry of pastoral careis to be understood as a countercultural activity that seeks both restoration of wholenessof persons and their relationships and transformation of the world of pain, suffering andnon-care into a more caring, friendlier and safe place to live in.11

People living with HIV and AIDS (PLWHA) networks, organizations and self-help groupssuch as African Network of Religious Leaders Living with or personally affectedby HIV/AIDS (ANERELA+) and the Global Network of People living with HIV/AIDS (GNP+)play important roles.

7 Rose Materu, Martin Luthers teachings on care giving in crisis times: A challenge to mensinvolvement in the context of HIV and AIDS in the Northern Diocese of the Evangelical LutheranChurch in Tanzania.

8 L. Siwila, Care-giving in Times of HIV and AIDS, when Hospitality is a Threat to AfricanWomens Lives: A Gendered Theological Examination of the Theology of Hospitality in Journal ofConstructive Theology, 13/1, (2007), 72

9Charles V. Gerkin, Introduction to Pastoral Care and Counselling, (Nashville: Abingdon, 1997),

118

10 Peter L. Vankatwyk, Spiritual Care and Therapy: Integrative Perspectives (Waterloo: Wilfrid

Laurier University Press, 2003), 11

11

Rev. Abraham Mathew, Paradigm Shifts in Contemporary Pastoral Care: Challenges andProspects for Christian Ministry in In the Masters Service: Reflections on Christian Ministry inhonour of Rev. Dr. M. V. Abraham (Kottayam : M.T.T.S., 2011), 313


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Support from the Circle

While family members may be willing to care for the sick, this changes in asituation where the relative suffers from AIDS. Yet most of the people with AIDS

immediately turn to their families especially their blood relatives and the vast majorityof the care for people with HIV /AIDS is indeed provided by blood relatives.12

Caring for people with HIV/AIDS is hard, physically and psychologically as wellas socially and emotionally. Problems linked up with caring for a family member withHIV/AIDS can disrupt a family. 13

Apart from being a complicated sickness needing complex care (medical,psychosocial, practical and material and spiritual), AIDS is stigmatized. The sickness hasseveral characteristics that make it suspicious. First, it is associated with sexuality,particularly with illegal forms like prostitution. This association is not very simple, butdeserves attention when thinking about how family members deal with HIV/AIDS.

Ideally when the people in the whole circle come around the patient, whichincludes the physicians, surgeons, nurses and the paramedical personnel in thehospital, the patients relatives, visitors and even those who without actual face to facecontact with the patient and often even without the patients knowledge,they function asa community faithfully praying for the healing of the patient.

The attitudes of those in direct contact with the patient, even over phone orthrough other message, are very important, for these can generate healing energy. Butthe faith of a community and its fervent and sustained prayer can definitely exercise hightherapeutic efficacy. The prayer of a single person, in direct contact with the patient orwithout such contact, can also be immensely effective. There are secular substitutes forprayer available to agnostics: like positive imagining, or intensely desiring and willing thehealing of the patient.

Even in these, a fundamental faith in the positive or beneficent aspect of realityis a precondition. The joint effort in prayer of more than two people has always a specialeffectiveness. This is the mystery of community.14

The mission of the Church in the context of HIV/AIDS

Mission refers to: Gods saving work and the churchs participation in thatwork. The mission of the church has its origin in the mission of God, and that thechurch is called to participate in Gods mission by words and deeds.Regardless of thesinful nature of human beings, God uses them to manifest the divine purposes ofcreation, justice and salvation, and display Gods unmerited grace and love among allpeople.The church is involved in missio Dei to bring salvation and justice which revealGods love and grace to his creation. This implies that Gods mission does not encompassonly spiritual affairs but also the social and economic wellbeing of humanity. In otherwords, the missio Dei has to deal with the wholeness of the person.

Nurnberger argues that the mission of the church is not confined to spiritualmatters but rather has to address the contemporary issues that are evident amidst Gods

12Caldwell JK, et al: African Families and AIDS: Context reaction and potential Interventions;Health Transition1993; 3, 1-16

13 Osei Hwedie K., AIDS on Individual, Family and Community: Psychosocial issues. SocialDevelopment in Africa1994: 9/2, 31-43

14Paulos Mar Gregorios, Healing- A Holistic Approach (Kottayam: Orthodox Seminary, 1995), 43


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people such as disease, poverty, violence and illiteracy.15Provision of care to PLWHA isultimately part of Gods mission to his people since pain and suffering are the realities oftheir daily experience. All Christians are called through baptism to participate in Godsmission.

Answering the Call

Churches in many countries with high HIV prevalence, particularly those inAfrica, are already suffering from the onslaught of the HIV pandemic. Members ofchurches have similar rates of HIV infection as the community in which they live.Churches, as living organizations, have much to learn and to give to their members whoare living with HIV and AIDS. Churches must go through a transformation process,become AIDS competent and be a better home for those directly affected by thepandemic. Churches, as living organizations, are inseparable from their members.16

HIV-related stigma is seen to be at the heart of many failed efforts over the years- both church and secular - to respond to HIV, particularly to break the silence anddenial surrounding the existence of HIV in communities.17Many interventions, whether

for HIV prevention, care, support or treatment, have also been less than effective dueto HIV-related stigma.

Churches must go through a transformation process, become AIDS competentand be a better home for those directly affected by the pandemic. Churches, as livingorganizations, are inseparable from their members. The worldwide church is one body ofChrist. Therefore, for churches, whose theology holds that, "For in one Spirit we were allbaptized into one bodyIfone member suffers, all suffer together with it; if one memberis honoured, all rejoice together with it," (1 Corinthians 12:13 and 26), the church isinseparable from the PLWHA. This holds true for churches many members who are livingwith HIV and AIDS and for their sister churches, which may have few members livingwith HIV as they are all part of the one body of Christ.

There is no "us" (the uninfected) and "them" (PLHWA) within the worshippingcommunity of the church. In being followers of Christ, who identify themselves with thesuffering (Matthew 25:31-46), and recognizing that some members of the churchare HIV-positive, the whole body of Christ, the church, is HIV-positive.

Partnership with PLWHA organizations is therefore central to themission, ministry and identity of the church as the body of Christ. As an expression ofits ministry and commitment to identifying with PLWHA and to breaking stigma anddiscrimination18, the church needs to make part of its confessional liturgy, whereverChristians are gathered for fellowship, that "the church is HIV-positive"

Conclusion

True spiritual ministry is the healing of people-body and soul. In our tradition,salvation means healing, giving life where death rules. To save means to make alive. Thatincludes deliverance from not only Hell, but also from the power of death and of evil aswell. But not just from a future Hell where the flame is never quenched and the wormdies not. Salvation means also delivering people, and that not just Christians, from

15 Nurnberger, K., Martin Luthers message for us today: A perspective from the South,

(Pietermaritzburg: Cluster Publications, 2005), 149

16http://www.oikoumene.org/en

17http://www.unaids.org

18http://www.unaids.org
http://www.oikoumene.org/enhttp://www.unaids.org/http://www.unaids.org/http://www.oikoumene.org/en


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present Hell, the hell of stress and anxiety, of guilt and fear of condemnation, of pain andtorment in all forms, from disease and sickness, from evil and fear of death.19

Reflecting on the AIDS pandemic in Africa, the Bishops of Southern Africaproposed in June 1990:

Perhaps theAIDS crisis is God's way of challenging us to care for one another,to support the dying and to appreciate the gift of life. AIDS need not be merely a crisis: itcould also be a God-given opportunity for moral and spiritual growth, a time to reviewour assumptions about sin and morality. The modern epidemic of AIDS calls for apastoral response.20

AIDS often involves alienation and separation between the person with thedisease and every surrounding system. We are challenged to be reconcilers, helping torestore a sense of wholeness to broken relationships between the patient and those nearto him or her. We must build a sense of trust and caring. This requires education, and achange of heart. If the yardstick of our faith is unconditional love, particularly love ofthose whom society regards as outcasts, then our response to people

suffering from AIDS will be a measure of our faith.21

This must be for those infected andaffected by AIDS.

Bibliography

Bishops of Southern Africa, AIDS: A Christian Response, June 1990 fromhttp://www.oikoumene.org/en

Caldwell JK, et al: African Families and AIDS: Context reaction and potentialInterventions;Health Transition1993: 3: 1-16.

Crabb, Lawrence J Jr. Basic Principles of Biblical Counselling. Grand Rapids,Michigan: Zondervan, 1975.

Gerkin, Charles V. Introduction to Pastoral Care and Counselling. Nashville:Abingdon, 1997.

Ghana Bishops' Conference. Pastoral Statement on AIDS, October 1990 fromhttp://www.oikoumene.org/en

Global HIV/AIDS report. A joint WHO/UNIADS report. Geneva: World HealthOrganization, 2003.

Gregorios, Paulos Mar. Healing- A Holistic Approach. Kottayam: Orthodox Seminary,1995.


http://www.unaids.org

Materu, Rose. Martin Luthers teachings on care giving in crisis times: A challengeto mens involvement in the context of HIV and AIDS in the Northern Dioceseof the Evangelical Lutheran Church in Tanzania.

Mathew, Rev. Abraham. Paradigm Shifts in Contemporary Pastoral Care:Challenges and Prospects for Christian Ministry in In the Masters Service:

19Paulos Mar Gregorios, op. cit., 64

20 Bishops of Southern Africa, AIDS: A Christian Response, June 1990 from


21 Ghana Bishops' Conference. Pastoral Statement on AIDS, October 1990 from

http://www.oikoumene.org/enhttp://www.oikoumene.org/enhttp://www.oikoumene.org/enhttp://www.unaids.org/http://www.oikoumene.org/enhttp://www.oikoumene.org/enhttp://www.oikoumene.org/enhttp://www.oikoumene.org/enhttp://www.unaids.org/http://www.oikoumene.org/enhttp://www.oikoumene.org/enhttp://www.oikoumene.org/en


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Reflections on Christian Ministry in honour of Rev. Dr. M. V. Abraham.Kottayam: M.T.T.S., 2011

Nolte, Ellen and Martin McKee Eds. Caring for people with Chronic ConditionsBerkshire, New York: Open University Press, 2008.

Nurnberger, K. Martin Luthers message for us today: A perspective from the South,Pietermaritzburg: Cluster Publications, 2005.

OseiHwedie K., AIDS on Individual, Family and Community: Psychosocial issues.Social Development in Africa1994: 9/2: 31-43.

Semguruka, Elizabeth Marton. Living with HIV/AIDS; Womens PerspectivesRegarding Care/Support Provided in Dar Es Salaam, Tanzania - M.Phil.Dissertation. Norway: University of Oslo, 2004.

Siwila, L. Care-giving in Times of HIV and AIDS, when Hospitality is a Threat toAfrican Womens Lives: A Gendered Theological Examination of the Theology ofHospitality in Journal of Constructive Theology, 13/1, (2007): 69-82.

Vankatwyk, Peter L. Spiritual Care and Therapy: Integrative Perspectives.Waterloo:Wilfrid Laurier University Press, 2003.

World Council of Churches, AIDS and the Church Hearing on AIDS fromhttp://www.oikoumene.org/en

Ministry to the Infected and the Affected1

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