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This we teach and do - Volume one policy
Author(s): Kenya Episcopal Conference - Catholic Secretariat, Commission for Health
Language: English
Abstract
Kenya Episcopal Conference
This We Teach
and Do
Volume One – Policy
Catholic Church and AIDS in Kenya
THIS WE TEACH AND DO – VOLUME ONE
© Kenya Episcopal Conference – Catholic Secretariat
Commission for Health
Kenya Catholic Church HIV & AIDS Taskforce
ISBN 9966-08-168-2
Year of publication 2006
PAULINES PUBLICATIONS AFRICA
Daughters of St Paul
P.O. Box 49026
00100 Nairobi GPO (Kenya)
E-mail: publications@paulinesafrica.org
Website: www.paulinesafrica.org
FOREWORD
For over twenty years the Church in Kenya has been engaged in counteracting HIV and AIDS, and only God can know how generously Christians from every walk of life have given of themselves. Through them and in them, our Lord Jesus Christ has been embracing, healing, comforting and reconciling the suffering people of God.
Out of these generous daily responses given in thousands of corners of Kenya, a deeply serious plea has reached the Bishops. Those working ‘on the front lines’ of the Church’s response to HIV and AIDS have been asking us their Pastors:
“Please give us the support of our faith, give us the guidance and orientation of our Church’s teaching, as we deal with the questions, doubts, fears and dilemmas of Kenyans, all of us burdened in one way or another by HIV and AIDS.”
To this solemn request, we Bishops are very happy to respond with an authoritative statement entitled This We Teach and Do: Catholic Church and AIDS in Kenya.
This We Teach and Do presents our Catholic faith in the face of HIV and AIDS, spells out the spiritual principles and moral guidelines, and invites everyone to faithful adherence. With a holistic understanding of Christian life, we affirm both compassion and responsibility. We invite our own people, and anyone else so disposed, to a thoroughly faith-filled involvement in all aspects of the AIDS struggle.
This forthright and vigorous presentation of Catholic faith and teaching is what our people have asked of us, as they labour on the front lines of the AIDS response. The tone may be a bit robust, the clarity a bit shocking, but nothing less will meet the challenge. Today, the Catholic Church in Kenya accepts that AIDS challenges us all and invites everyone to take up the challenge with great courage, energy, faith and hope.
This We Teach and Do is our follow-through on the commitments made by the Catholic Bishops of Kenya in 1987 and 1999, as part of SECAM1 in 2003 and of AMECEA2 in 2005. Having striven to elaborate this policy, we declare ourselves equally ready – both as a national Conference and in our respective Dioceses – to continue to accompany, teach, lead and support this mission which is Christ our Lord’s. Within three years, by the end of 2009, we will review and revise the Policy in the light of the Church’s teaching and of what experience continues to teach us.
With this statement and its accompanying Inventory, the Catholic Church wishes to recognize the ministry of many pastors, priests, religious, men and women and youth who dedicate themselves with the greatest Christian compassion, faith, sensitivity and concern for those infected by HIV and affected by AIDS in Kenya. This Policy, which you have requested, is meant to guide and support you in your AIDS ministry.
We gratefully acknowledge everyone who helped us to give expression to this Policy. At the Kenya Episcopal Conference, the Secretary General, Rev. Fr. Vincent Wambugu, and the National Executive Secretary of the Commission for Health & Family Life, Dr. Margaret Ogola, and her staff tirelessly encouraged the Catholic Church’s HIV & AIDS Taskforce (K-CHAT) in this whole effort.
We are very grateful for the present Volume One in its two parts:
The doctrinal framework, The Church Speaks and Teaches, was directly undertaken by K-CHAT and especially by its convenor, Fr Michael Czerny, S.J., director of the African Jesuit AIDS Network, with excellent editorial assistance of Fr. Damian Howard, S.J., in Britain. Thanks also to theologians Rev. Prof. J. Baitu and Fr. Aquiline Tarimo, S.J., for their helpful critical reading of the draft.
The programmatic framework, The Church Presents its Strategy, was ably drafted by Mrs Ana Maria Ferraz de Campos, Regional Technical Advisor for Health HIV/AIDS (CRS-Eastern Africa), and Mr. Jackson Thoya, HIV/AIDS Unit Manager (CRS Kenya)
We are also very grateful for the accompanying Volume Two. The Inventory was commissioned by K-CHAT and ably produced by KARDS and the Jesuit Hakimani Centre in both 2003 and 2006. For the second edition, we thank Mrs. Agnes W. Njuguna and her colleagues at KARDS for the research, Mrs. Pamela Wamalwa of the KEC Health Commission for the compilation, and Fr. Ludwig Van Heucke, S.J., of the Jesuit Hakimani Centre for his methodological guidance and supervision.
For the funding of the research, compilation, writing and publication, we thank Fr. Michael Czerny, S.J. of the African Jesuit AIDS Network, Mrs. Chiara Cremona of Caritas-Italiana and Mr. Ken MacLean of CRS-Eastern Africa.
For everyone who contributed in any way, may our Heavenly Father, “who sees what is hidden” (Mt 6:4), repay them abundantly.
+ Most Rev. John Njue,
Chairman
Kenya Episcopal Conference (KEC)
Feast of All Saints
1 November 2006
INTRODUCTION
“We urge the members of the Church in our countries, laity and clergy, cooperating where possible with already existing organisations to search for the most effective means of help, and we ask our bishops to give their active support to this work of Christ: for it is His Body which has AIDS.”
The Challenge of AIDS (1987)1
With this dramatic appeal in 1987,2 the Catholic Bishops of Kenya launched a plan of action in our country to fight the AIDS pandemic, one of the decisive battles then – and now – facing the continent of Africa. Involved in this extraordinarily significant effort for some 20 years already, we want to hear the urgent words anew: the most effective means of help ... for the Body of Christ has AIDS.
We want to reassert the ecclesial presence of Christ among us. For during these twenty years we have seen those sufferings, which even then provoked such passion and compassion, not alleviated but intensified. Today, the Body of Christ bears the wounds of huge pain, the burden of unfathomable losses, and lets out “groans that cannot be put into words” (Rom 8:26). But we must never forget that it is the Body of Christ, and of this we can be sure because we have met the Risen Lord many, many times as we have walked with the infected and the affected, as He brings peace and healing, challenges us to new growth and commitment, and proclaims His saving truth which, though not always comfortable to hear, is always the promise of a new start in God, the occasion of forgiveness and hope. These are spiritual gifts we badly need.
So, in the confidence of Christ’s activity among us, we remember the inspiration of the Bishops’ Message in 1987, The Challenge of AIDS. Then in their 1999 pastoral letter, The AIDS Pandemic and Its Impact on our People: Seeking Solutions and Solidarity in These Difficult Times, the Bishops again expressed the Church’s determination to work alongside other agents in Kenya, trusting that “the human spirit will find ways to conquer the ravages of this disease which poses such a challenge to all.”3
At the 15th AMECEA Plenary Assembly in June 2005, all we Catholic Bishops of Eastern Africa committed ourselves4
to formulating new policies in our evangelisation so that the challenge of HIV/AIDS is focused-on and mainstreamed in all activities to enhance the holistic approach
and we mandated
all our departments and commissions at Episcopal Conference level to integrate the challenge of HIV/AIDS in their programmes and activities.
Moreover, we fully adopted
the Plan of Action of the Symposium of Episcopal Conferences of Africa and Madagascar (SECAM), for our AMECEA region, in responding to the HIV/AIDS challenge.
There are four questions which keep getting raised and addressed to us:
• Where does the Church in Kenya stand, what is its position regarding AIDS?
• What is the Church committed to doing from now on?
• What does the Church do, and how, throughout Kenya?
• Who in the Church is doing what?
The purpose of this Policy is to respond authoritatively to all four questions – in a way which, we trust, will encourage and fortify Kenyan Catholics, Christians and Muslims, other believers and people of good will to rally together and confront HIV and AIDS.
The Policy comes in two volumes. The first volume, the present one, answers the first pair of questions by giving a doctrinal and a strategic framework:
• Where does the Church in Kenya stand, what is its position regarding AIDS? The response is entitled The Church Speaks and Teaches. Here the Church is primarily addressing herself to those responsible for the Church’s AIDS ministry and those actively involved in it. This part expresses and affirms the teaching of the universal Catholic Church. These doctrinal, moral and practical points are meant for those on the front lines of the Church’s struggle against HIV and AIDS, and we hope that more popular versions will follow for different sectors: youth, adults, families, caregivers.
• What is the Church committed to doing from now on? The response, entitled The Church Presents her Strategy, presents the strategic framework of what we are doing and hope to do. This section is addressed especially to those who, wishing to partner with Church efforts, need clear information about our plans, procedures, commitments, and will be of great help to administrators and fund-raisers within the Church in drawing up more specific plans of action at the national, regional, diocesan or local levels.
The companion volume is subtitled Inventory, and it answers the remaining pair of questions:
• What does the Church in Kenya do, and how? In response, we present how the Church’s work to address the pandemic is organised and structured in Kenya, giving clear mention to the achievements, strengths, weaknesses and challenges. This Inventory should assist Church people, especially those in positions of responsibility, in their understanding, managing, planning and evaluating of Church initiatives in the AIDS field, and it will also be of great interest for others who wish to understand how the Church actually carries out its AIDS work.
• Who in the Church is doing what? The much expanded and updated Directory lists the programmes, names, addresses and contact-information, in order to facilitate communication, cooperation and networking. It shows that there is less reduplication of efforts than some fear, and offers great potential for the exchange of best practices and resources as well as for mutual support.
Thus This We Teach and Do sets out as clearly as possible the stand of the Church, how we see the present situation, and the role the Church can play in confronting it. We believe that we have a crucial contribution to make in the effort to defeat the pandemic, and this can only be accomplished if we Bishops, together with the clergy, the religious and the faithful, share an articulate Catholic vision of what it means to struggle against AIDS in Kenya. With both conviction and gratitude, therefore, we offer these two volumes to all those with whom we wish to make common cause in this struggle, which is surely Christ the Lord’s.
+ Rt Rev. Philip Sulumeti,
Chairman of the Commission for Health
Feast of All Saints
1 November 2006
Notes
1 Catholic Bishops of Africa and Madagascar, Speak out on HIV & AIDS, Revised Edition, Paulines Publications Africa, 2006, pp. 108-113.
2 Speak out, pp. 137-144.
1 Catholic Bishops of Kenya, “The Challenge of AIDS,” June 1987. See Speak out, pp. 11-12 and Appendix, below, pp 47-48. Henceforth referred to as (87).
2 The words are taken from the first conference on AIDS under Catholic auspices in Britain, November 1986.
3 Speak out, pp. 64-65, or as a pamphlet (16 pages), Paulines Publications Africa, 1999. Henceforth referred to as (99).
4 Speak out, pp. 137-44.
5 Speak out, pp. 111-113.
1. THE CHURCH SPEAKS AND TEACHES
The Situation
We are greatly alarmed by the magnitude of HIV and AIDS, its origin, the conditions of susceptibility to infection and illness, its spread and its consequences. Beginning with devastating statistics, according to UNAIDS,1 24.5 million people out of a total population of 774 million in sub-Saharan Africa are living with HIV and AIDS. This means that sub-Saharan Africans represents almost 64% of the total number of HIV infections worldwide. In Kenya, 1.3 million adults and children out of a national population of about 34 million are living with HIV and AIDS.
A rate of infection above 1% is, by definition, an epidemic. Nearly all the countries of the sub-Saharan region have a rate well above 1%. The average HIV-infection rate among adults aged 15-49 in sub-Saharan Africa is 6.1%. Here in Kenya it is 6.1%. In 2005, about 2 million Africans died of AIDS-related illnesses; in Kenya, there were about 140,000 such deaths in 2005.
Statistics confirm that the AIDS epidemic continues to advance. According to UNAIDS, in spite of the many programmes of prevention and treatment, 55 million Africans are expected to die of AIDS-related illnesses between 2000 and 2020.
What is behind the apparently unassailable onslaught of the disease? We have to highlight a long list of powerful contributing factors which make it very hard to combat the epidemic effectively:
• First of all, and most importantly, grinding poverty throughout Africa, many situations of injustice and, in many places, conflict and involuntary displacement. These adverse conditions may not directly cause HIV, but they do make its spread practically inevitable.
• the collapse of education and healthcare systems
• rampant unemployment
• poor nutrition
• alcohol and drug abuse
• greed and corruption
• ignorance and prejudice
• discrimination and stigma
• lack of respect for children and women
• destructive sexual behaviour
• damaging practices supported by both traditional and modern cultures
The impact of the disease itself compounds these difficulties horribly. AIDS does not just kill huge numbers of people; it is wiping out the young generations, those who are working and raising children and supporting families. Children, many of them infected with the virus themselves, are orphaned. The epidemic is crippling Kenya’s economy and welfare system, devastating the family and overwhelming the extended family that has, until now, been giving nearly everyone the essential economic and social supports. AIDS is also weakening the Church.
The terrible consequences are too plain to see in every Kenyan city, town, village and home, parish and community: untold suffering, worsening misery, early deaths, countless orphans and our up-coming generations decimated.
Here the Church Stands and Serves
“As surely as God is trustworthy, what we say to you is not both Yes and No. The Son of God, Jesus Christ, who was proclaimed to you by us … was never Yes-and-No; his nature is all Yes. For in him is found the Yes to all God’s promises…” (2 Cor 1:18-20).
The divine Yes who is our Lord and Saviour is spoken to all people, no matter their colour, creed, tribe or condition. For us in turn this means saying a deep, affective and effective Yes to everyone touched in any way by the pandemic sweeping through Kenya.
Saying Yes in this context is far from easy. It means, above all, avoiding the simple dualisms into which human beings so easily fall: EITHER moral evaluation OR unconditional acceptance; EITHER prevention OR treatment; EITHER looking after the innocent OR helping people to change. Saying Yes means to proclaim the centrality of each person against a mentality that refuses to recognize the value of every human being. The Church’s contribution to the AIDS crisis in Africa means saying God’s Yes to each and every one in all these situations, leaving nobody outside.
At the same time, that divine Yes which both Jesus and the Church signify at times implies a lesser No, for without boundaries we fail to develop and fall short of that fullness of life, which is God’s desire for His creatures. This is why, alongside pastoral ministry, medical care, and the practice of compassion and advocacy, the Church also keeps a firm place for personal morality, social ethics and education for prevention. It is true that some people cannot see why the Church consistently finds this comprehensive approach necessary. They prefer simple answers and act with uncomplicated activism, perhaps feeling that no-one should “judge” on issues of personal morality or “preach” on how to construct a more just and humane society. Yet to offer compassion while neglecting a serious analysis of the sinful structures at the root of the problem flies in the face of the Church’s tradition and negates her mission to proclaim the Kingdom of God in which sin and death are defeated for ever.
We want never to lose sight of the Kingdom as we confront the daily challenges of helping the people of our nation. This Kingdom is promised, described and imagined in the Bible, in the great doctrines of the Church including her moral and social teaching, and in the exhortations of the Synods and the African Bishops. We turn to these deep wells of wisdom for insight, inspiration and energy on what is a long and tiring journey. Profound faith in God’s love and in the triumph of life over death, sensitivity to people’s genuine needs, desire to be fed by our ancient tradition, and the keen honesty of rigorous analysis are all prerequisites for a response which is authentically Catholic. This is why the same Church which accompanies the infected, cares for the ill and embraces everyone, resolutely fights against the social injustices and miseries which contribute greatly to the spread of HIV and to the suffering of the infected and affected.
Our Full Yes to One Another
While we are proud of the faith we profess and enthusiastic about the mission on which Christ sends us, we are also painfully aware of our difficulties and limitations, our mistakes and failures. If we speak with clarity about sin, it is not with a view to stigmatising people ‘out there,’ still less to finding a scapegoat for the dreadful situation confronting us. We know from our own bitter experience how collusion with sin wreaks havoc in personal and social life.
But at a deeper level, this uncomfortable truth about ourselves, which God’s grace makes available to us if only we can exercise the humility to receive it, is perhaps the greatest single gift we have to offer those suffering from HIV or AIDS. Confessing sin is, for one thing, a vital antidote to hypocrisy. “It would be wrong, theologically unsound, to think that this calamity is the work of an avenging God, punishing mankind for individual and collective sins” (87).
As we know ourselves to be sinners, then we can never stand in judgment on another. From inside we know the experience of wretchedness, the strange lack of freedom, the tortuous lies the sinner tells himself, and we know we deserve condemnation as much as anyone. “Looking at AIDS patients as sinners condemned by God, as if we had a right to judge them, wickedly distorts reality. Only a hypocrite would think that way” (99). Are we going to be like those who once asked Christ, pointing to the man born blind, “Rabbi, who sinned – this man or his parents – for him to have been born blind?” Remember Jesus’ answer, “Neither he nor his parents sinned. He was born blind so that the works of God might be displayed in him” (Jn 9:2-3) (99).
Conditions such as poverty, war and forced displacement, domestic violence and the sex industry make infection much more likely as well as the onset of AIDS. Such sinful structures can weigh heavily, and the Church takes them very seriously. Despite many years of raising awareness, unfortunately, harsh prejudices and cruel discrimination, shame and fear continue to be closely associated with people who are HIV positive. “Then let us no more pass judgment on one another, but rather decide never to put a stumbling block or hindrance in the way of a brother or sister” (Rom 14:13). Once someone is infected, the right question to ask is not “why?” or “how?” but “Can we help?” which is how we say Yes.
Compassion, Forgiveness and Teaching
When Jesus encounters the woman taken in adultery, looking up He asks her, “Woman, has no one condemned you?” She replies, “No one, Lord.” And Jesus says, “Neither do I condemn you; go, and do not sin again” (Jn 8:10-11).
The bright rays of forgiveness have shone in the darkness of our hearts too, and in that wonderful light the clarity of saving truth bids us come out of the shadows and expose the false reasoning and twisted logic of the Father of Lies. “Certain actions will have certain consequences. … When we misuse tobacco, drinks or drugs the consequences are inevitable. So also AIDS is the necessary consequence of certain abuses” (87). Sometimes the ones who suffers the consequences, like orphans, are not the ones who committed the abuses.
Among the many complex factors involved, that of sexuality seems to be the most difficult to talk about. Touching on one of the most delicate nerves in the human person, it can arouse embarrassment, stigma, fear, shame and guilt. How can the Church speak with clarity and compassion in an area which, being so intimate, is fragile before harsh words, and yet which can be lived out with such destructive consequences for self and others? Those who have been sinned-against and are suffering, certainly do not need to be further afflicted, made to feel guilty, punished. But the man or woman, teenager or youth, who more/less wilfully and more/less ignorantly is sinning by fornication or adultery and is putting health, happiness and life at great risk, does need to meet Jesus in the Church and feel His touch, discover the sin, repent and hear His words, “Go in peace and do not sin again!”
This is why the Church’s discourse is not the same in every time and place and circumstance. It is not the same when teaching from the pulpit, or when speaking to the media. When running a programme on sexuality, it is not the same for teenagers, or in marriage preparation, or in marriage renewal. It is not the same in front of a classroom, as in counselling, as in the confessional. The Church’s message has to meet each and every person where they are, has to equip them to live more responsibly and, crucially, has to respect the tension that always exists between the noble ideal which reason and revelation communicate, and the reality of human lives lived by the limited, often broken people we all are. But “respecting the tension” does not mean watering down the message.
At the same time, the Church fights stigma and judgmentalism. “We are particularly distressed by the stigma attached to people living with AIDS and their families. We call upon all Christians to overcome any prejudice they feel towards AIDS victims. Even when contracted through immoral behaviour – and we know it can be contracted through other ways – AIDS as a disease is not different from cancer or malaria” (99), due to genetic or environmental factors rather than behaviour. Fighting stigma and discrimination for so many years, it is disappointing to discover how powerful and destructive they still are throughout Kenyan society and within the Church.
HIV infection can be transmitted by sexual behaviour, or at birth, or during breast-feeding, or by the transfusion of contaminated blood, or through accidents. But the risk of stigmatisation arises out of the possibility that infection was due to behaviour which many see as shameful. From a Christian point of view, this can be overcome, not by minimising responsibility or considering it irrelevant or narrowing the issue to so-called ‘safer sex,’ but only by teaching with warmth, clarity and courage. Catching HIV is sometimes like coming down with cancer or malaria, and sometimes it is not. Only an individual can judge and conclude, “In catching HIV or in passing it on, I have sinned.” No one on earth has access to another’s conscience, and no one can judge whether or not an individual has sinned, only the person in the presence of God.
Perhaps the most distressing situation of all is what the Church can try to say to those who do not want to listen. What are we to say to those who decide to do – or, even if they don’t deliberately decide, are likely to find themselves doing – what the Gospel and the Church forbid? Fornication, adultery, sexual abuse, rape are all far too widespread, and each time they betray the divine gift of sexuality, damaging life if not destroying it. For in the era of HIV, the consequences can be as bitter as murder. Much as Christians want to reach out tolerantly to someone intent on serious sin, we never want to condone, even implicitly, the abuse of a poor youth by an adult or an adulterous man’s forceful sexual advance upon his faithful wife. Some would have the Church offer such people advice on how to minimise the destructive consequences of their behaviour, as if, having rejected the central message of life-giving responsibility, they are likely to heed the call of commonsense decency and choose the lesser evil. In such situations, we find ourselves pushed to the very limits of our capacity as Catholic leaders in a world fractured by sin. But it is a delusion to imagine that ‘compassion’ can ever be invoked to tolerate death-dealing actions as being normal or acceptable.
The Church forms each person to take responsibility for his/her actions and, when appropriate, to seek forgiveness, conversion and change. Men and women, old and young, we all need God’s grace to live our human vocation chastely and faithfully. When we fail, only the individual with the help of God’s wisdom and love can judge his/her own sinfulness. That is why we confess in the first person, “I confess to Almighty God and to you, my brothers and sisters, that I have sinned through my own fault, in my thoughts and in my words, in what I have done and in what I have failed to do” (Confiteor).
Thus it is the same Lord Jesus who teaches, “Anyone who looks at a woman lustfully has already committed adultery with her in his heart” (Mt 5:28), who challenges “Let him who is without sin among you be the first to throw a stone at her” (Jn 8:7), and who condemns the hypocrisy of those whose religious practice serves only to make them feel smug and self-satisfied: “I thank you, God, that I am not grasping, unjust, adulterous like the rest of mankind, and particularly that I am not like this tax collector here” (Lk 18:11).
As Bishops
The pandemic forces us to look at topics traditionally considered taboo, and to have open, honest and respectful discussion about HIV and AIDS at every level of the Church. It demands that we examine and, if necessary, challenge traditional and cultural beliefs, norms, practices, and expectations, in particular about the rights, roles and responsibilities of men and women, youth, adolescents and children. Those beliefs and practices that enhance the transmission of HIV and worsen its effect, need to be challenged and changed. At the same time, it is important to reverence and value our traditions and not condemn those who in the past practiced customs that are now seen as harmful. It is important to be honest and courageous in discussing these issues, so that we can deal with the epidemic in the most effective ways.
We are stewards of God’s greatest gift: life. “Let us make man in our image, after our likeness … and so God created man in his own image, in the image of God he created him; male and female he created them” (Gen 1:26.27). By imprinting His own image and likeness upon every human person, God confers upon each and all an inherent dignity and incomparable worth, including the human body and human sexuality. In their various responses to HIV and AIDS, the Church and those who work with her must respect the absolute sanctity of human life and uphold each person’s dignity at each stage of life. The Church forms us both individually and communally throughout our lives, and this includes situations in which any possibility of real, tangible hope is very hard to see. Those who are afflicted with AIDS encounter so much suffering in their lives which could lead them to despair, yet faith reveals that it is precisely in the darkest places of the human experience that God’s healing and liberating light can shine brightest. We are witnesses to that light, and we try to bring it to others as humble servants of the mystery of love.
The most elementary, but necessary, testimony to this mystery lies in denying a destructive but commonly held belief: that AIDS is a divine castigation. Jesus teaches us that illness is not a punishment from God, nor an indication that someone has sinned, but an opportunity that “the works of God might be revealed” (Jn 9:3). To condemn someone, or speak about someone, or treat someone, as if God is punishing him/her with HIV for having sinned, is very wrong and probably itself sinful. It violates the teaching of Jesus and destroys family and community. To interpret AIDS as God’s punishment for sin is wrong. It is theologically unsustainable, as powerfully demonstrated in the book of Job and in many healing narratives of the Gospels. All such judgemental expressions seriously undermine efforts at care, support and prevention.
Evil is at work in the larger context of structural sin that provides the enabling environment in which individual sin can flourish. These sinful social structures – local and national, Africa-wide and international – constantly cause abuses of human dignity and fuel the spread of HIV, and all these the Church continues to denounce, prophetically, calling for a real change of heart in those who have the power to decide and for greater social justice at every level.
In all Church ministries to prevent HIV from spreading, to heal illness and soothe suffering and to address the painful consequences of the pandemic, the duty of everyone involved – bishops, clergy, religious, faithful – is to spread the Gospel and form consciences in the light of these values. We recommit ourselves to be faithful to Jesus Christ in responding to the challenges posed by both sexuality and stigma. “Be renewed in the spirit of our minds, and put on the new nature, created after the likeness of God in true righteousness and holiness” (Eph 4:23-24). In fidelity to the Gospel, our struggle against AIDS should never erode but always enhance the dignity and worth of each human person, the fundamental and lasting Yes of God. All these things need to be treated, respectfully and often, in Sunday homilies and on other occasions.
Many clergy and followers of Islam as well as Christians of an evangelical persuasion tend to agree with our stance, even if reaching the same conclusions from very different backgrounds, and we need to work together more closely on programmes of both prevention and care. By contrast, many Christian Churches of the reform tradition, with whom we usually dialogue and collaborate on so many issues, do not by and large share our moral convictions regarding sexuality and the condom, and this is a painful division between us.
The shadows which surround us are considerable. They make us even more amazed by the good that God’s grace has helped us to accomplish in Kenya ever since AIDS began, and we give thanks. We commit ourselves afresh to offer support to everyone involved:
To Everyone Affected by AIDS
Jesus loved little children, saying, “In so far as you did this to one of the least of these brothers and sisters of mine, you did it to me” (Mt. 25:40). The Church’s evangelical mission is to do the same: to shed Christ’s love and the light of the Gospel upon the living, suffering and dying, among believers and non-believers, and upon those who care for them and upon those growing up.
Those of us losing a loved one or watching a relative suffer need to be open to conversion, discovering that life is a gift and death not the last word. For some Kenyans, death is the end, and life is lived without goal and purpose. When they see the Church ministering to their sick, this is the most powerful testimony to the Gospel. “For those who have no hope in a future life, AIDS will seem a curse, and a good reason to keep a safe distance from those who have it. For those with Christian faith, it is an encounter with grace, prompting us to be generous and to love others as Christ loves us” (99).
For Kenyans who take life’s end to be communion with the God of Life, the moment called ‘death’ is sad but has great meaning. We therefore exhort you in the words of our Lord Jesus Christ, “Fear not, I am the first and the last; I am the living one! I was dead, but now I am alive forever and ever. I have authority over death and the world of the dead” (Rev 1:17-18) (99). Death is but a temporary passage in the continuum of life, linking those living now to the living dead, linking our earthly home with where the ancestors are already always alive. Death is, therefore, not the end because God is. Hence the power of that Christian hope and experience of being reconciled to one’s creatureliness. “We shall be like him for we shall see him face to face, and not distorted like in a mirror” (1 Cor 13:12).
We speak in the name of the Church as the mother and teacher of all generations. We seek to care preferentially for widows, orphans, vulnerable children and child-headed households, and help them overcome the consequences and grow up healthy and well. We want to offer special support to children and young people and to families, to grow and live AIDS-free and to help those in need. Many Church initiatives endeavour to tackle the inter-related problems of poverty, unemployment, injustice and violence in the communities.
To Those at Risk of Infection
To all, the Church offers moral formation and encouragement. This includes forming moral conscience so that each one, in considering how to behave, can distinguish between what is good and what is sinful. The Church teaches us to be upright, personally and interpersonally, to resist temptation, to respect one another and thus honour God our Creator. “The morality we teach in God’s name seeks to respect and affirm human life which gets its value and dignity from the fact that it is the inviolable gift from our Father who creates every human being and calls everyone to the fullness of life.”2
The teaching of Christ and the Church urges men and women, youth and adults and elders, to treat each other as sons and daughters of God. Even if HIV did not make pre-marital sex, fornication, adultery, abuse of minors and rape so terribly dangerous, they would still be wrong and always have been. It is not the risk of HIV or the sufferings of AIDS, which make sexual licence immoral; these are violations of the Sixth and Ninth Commandments which are sinful, and today in Kenya surely the worst of their many destructive consequences is HIV and AIDS. The Church does not teach a different sexual morality, when or where AIDS poses no danger. But this teaching is not easy for ‘the world’ including the media to understand, much less accept.
We are especially called to witness to Jesus Christ among young people at risk of contracting HIV. But awareness, information or knowledge about HIV and AIDS are not enough; young people hunger for formation for life, and the Church needs both courage and wisdom to form them well in Christian morality and values. Everyone involved in pastoral, educational and care programmes should speak clearly about Christian morality and convey the Christian meanings of sexuality, illness, suffering, hospitality and service, and testify by their own lives to these very truths. Many who are involved in the Church’s AIDS ministries are calling for more solid formation in this regard.
In the area of sexuality, a Catholic ethical approach has concrete ramifications. Some international agencies, national governments and non-governmental organizations advocate the liberal use of condoms. They seem “prompted by the principle of the greatest happiness of the largest number of citizens, guided by the principle of utilitarianism and hedonism. [They] may resort to the unrestricted use of condom (whose efficacy, incidentally, is not infallible) and tacitly encourage promiscuous living. But this is not a question of protective condoms and clean needles only. We have to go to the sources of morality, do a bit of heart-searching, consider our attitude towards human relationships and how sexuality fits into that” (87).
Beginning at baptism, the Church invites and helps us to grow into this integral sexuality, developing throughout our lives, with the help of God’s grace and, when needed, with repentance and Divine forgiveness. “Abstinence and fidelity are not only the best way to avoid becoming infected by HIV or infecting others, but even more are they the best way of ensuring progress towards lifelong happiness and true fulfilment.”3
What happens when someone wakes up to the real dangers? “A moral reaction may set in by the fear induced by AIDS. We must note, however, that a fear-inspired morality is not a truly Christian morality; this must rest on love, not on fear. It is not a bad thing to be startled and shocked into sobriety by the challenge of this terrible epidemic; but from this awakening one must rise to the recognition of the love of God which has dictated the moral law for our happiness” (87).
But aren’t chastity and fidelity unrealistic ideals? “In the past, we, in most ethnic groups, had our own positive values to protect virtue – sometimes protected by very severe measures. If so, why not go back to these positive moral values and authentic Christian ethics? … A virgin bride was much esteemed in almost all African cultures, and her family loaded with gifts; conversely, the husband had the right in some African societies to repudiate a bride found to be non-virgin, or at any rate to reduce the bride-price. So when the Church condemns premarital and extra-marital sex, it is neither asking for the impossible nor proposing something altogether contrary to our traditions” (87).
This is why the Church encourages everyone to live an integral sexuality which means behaving responsibly towards others and oneself. Therefore, the Church does not promote the use of condoms as protection against AIDS because sexual intercourse is for the married alone, and using a condom does not make it right in other situations. All those involved in the Church’s ministry – pastorally, in education and in healthcare – should help people at every stage of life to develop a well-formed conscience. This includes the Church’s moral teaching as well as solid information about HIV and AIDS.
To Those Who Are Unsure of Their Status
The Church encourages all who harbour doubt about their status to get tested. This is always a courageous decision. It means facing the truth about one’s responsibility, one’s past actions and one’s mortality. It is not surprising that so many prefer to remain in the dark. But as well as undermining the joy and gratuity which Christians experience at the free gift of life offered them by the Lord, refusing to face the truth of one’s status can seriously jeopardise the well-being of others too. To help people to take responsibility for their behaviour and its consequences means resolutely refusing to stigmatise them. So we vigorously encourage the use of voluntary counselling and testing and, once one knows the facts, to take the appropriate steps.
To Those Who Are Infected
The Church reaches out to people living with HIV or AIDS (PLWHA), of all faiths or none, in an integral, holistic and evangelical way. The first step is to appreciate their situation and value the potential each one has. Becoming infected or sick in no way reduces anyone’s belonging to the Church, on the contrary. Everyone should know that the Church welcomes them and accompanies them, however broken, guilty or excluded they may feel. PLWHA have a vital role to play in the Church’s life and ministry and must be enabled – and even challenged – to accomplish it.
Life is worth living: “I have come that they may have life, and have it to the full” (Jn 10:10). This life should be characterized as a life of relationship, pride in one’s achievements, a life that builds family and nation, a life worth living. All those who find themselves infected, the Church embraces and welcomes them without hesitation or reservation and does whatever it can to help them to live responsibly and positively and delay the onset of AIDS. “Welcome one another, therefore, as Christ has welcomed you, for the glory of God” (Rm 15:7).
Our heart goes out to those infected and their families, especially to discordant couples (one spouse being HIV+, the other negative) and infected couples (both spouses being HIV+). While constantly renewing the universal teaching of the Church in this time of AIDS, we encourage priests, sisters and other pastoral agents to assist discordant and infected couples to form their consciences with regard to how they will live out their marital relationship, and make decisions that are life-enhancing and faithful. Drawing from the love of Christ that culminates in the Pascal Mystery, such couples may find themselves called to live the challenge of love in relation to sacrifice for the sake of the uninfected spouse and of the children. Even when solutions seem difficult or even non-existent, we want everyone living with HIV and AIDS and their families to experience the motherly care of the Church. It is our Christian responsibility to care for them, it is our Christian vocation to love them. As Church we assure those living with HIV that God and the Church are with them in their suffering. In Christ they have a new life which nothing can take from them,4 not even AIDS.
To Those Who Have Developed AIDS
The Church cares pastorally and often medically for the sick, advocating their access to treatment. A large proportion of healthcare and medical treatment is already offered by Catholic clinics, hospitals, parishes and other institutions, and we renew our commitment to make as many resources available as possible. But let everything be done, not only with efficiency and professional competence, but also with the hands and mind and heart of Jesus – not just excellent, but clearly Christian.
To Everyone Involved in Catholic AIDS Ministry
Catholics working in this urgent and demanding ministry cannot be triumphalist or think of themselves as some kind of moral elite. They need to recognise and remember at a deep level that they are sinners in need of God’s mercy. At the practical level, they must always be aware of the way in which such things as prejudice, fears, obsession and anger seriously compromise the healing and liberating value of the work they have undertaken. So they should not hesitate in having recourse to the appropriate sacramental and other resources which the Church, as a believing and worshipping community, makes available to all Her children.
The main purpose of the preceding pages is to meet the needs of those in the front lines of AIDS ministry. It is the counsellors, the catechists, the nurses and doctors and social workers, the teachers, the preachers, the confessors who guide God’s people, inform them, assist and support them and, most importantly, help each form his/her own conscience. May the Lord reward you for your tireless labours and, in some cases, for the initiatives you have taken in responding to HIV and AIDS even without much official support. In the name of the Church we officially thank you. As Bishops we need to see to it that you have the formation and resources necessary to carry out this Policy, which is itself a re-expression of the Church’s teaching and tradition for Kenyans in the time of AIDS.
Notes
1 UNAIDS is the United Nations Joint Programme to coordinate the global response to HIV and AIDS. All data are from UNAIDS, Report on the global AIDS epidemic, May 2006.
2 Speak out, p. 109.
3 Speak out, p. 109.
4 See Rm 8:38-39.
2.
THE CHURCH PRESENTS
HER STRATEGY
Strategic Objectives
• New HIV infections are averted and lives are preserved through increased awareness on HIV prevention and promotion of positive values and responsible behaviour.
• People living with HIV or AIDS, orphans and vulnerable children (OVC) are provided with holistic and compassionate support, treatment and care.
• Solidarity and responsibility are promoted while addressing societal issues related to HIV and AIDS.
• Church leaders are empowered to advocate for and influence national policies which better protect, serve and support those infected by HIV or affected by AIDS.
Targeting
Population
The Catholic Church in Kenya aims to serve anyone at risk of HIV infection, regardless of their ethnicity, faith and social group. As HIV and especially AIDS eat up the existing and future assets of surviving orphans, their grandparents and other family members, the Church targets the most vulnerable, the poorest and those most at risk of HIV infection,1 promoting justice, solidarity and responsibility to protect and preserve life through informed decisions.
Geography
Kenya has significant differences from the rest of Eastern Africa in HIV infection rates. Nyanza Province has a rate of 15% among adults while the North Eastern Province has less than 1%. The Catholic Church serves people according to the regional needs. Over time, assessments will be conducted and services adjusted to meet the needs better.
Guiding Principles
Building capacity
Capacity building is a key and strategic element. The Church will develop its own institutional capacity to deliver sustainable high-quality aid to PLWHA, OVC and the community at large. This will include strengthening the capacity of families to cope with problems, mobilizing and strengthening community-based responses, increasing the capacity of OVC, children and young adults to meet their own needs, raising awareness within communities to create an environment that supports PLWHA and OVC, setting up community protection mechanisms and safety nets, and forging strong partnerships and networks to improve practices and promote the best ones.
Partnership/Collaboration
This policy framework will be largely achieved through a strategy of partnership. In all the outlined interventions, the Dioceses will work and network closely with each other and collaborate with relevant stakeholders and appropriate government ministries. Church efforts will be implemented in line with government priorities, policies and guidelines. Hence, Church strategies are geared towards complementing the efforts of the Government in providing quality services to the population and generally improving the quality of life for the beneficiaries. Moreover, the Church is already operating a range of community-based or facility-based programmes for youth, PLWHA and OVC. These provide an ideal opportunity to improve linkages between the programmatic areas, establishing a continuum from prevention to care, support, treatment and advocacy.
Mobilization of Resources
To meet the needs generated by the pandemic, the Church will diversify its sources of funding2 and is committed to foster stewardship of resources allocated for the fight against HIV and AIDS.
Involvement of People with HIV or AIDS
The Church in Kenya will actively engage people living with HIV in planning, implementation and advocacy. They will enhance the Church’s pivotal role in the alleviation of stigma.
Fair and Respectful Relationships
Gender inequality is at the centre of gender-based violence3 which is a pervasive public health and human rights issue worldwide. In Kenya, this includes exploitation of child labour where young orphans are employed as domestic workers, are subjected to sexual abuse such as incest, early marriages and prostitution as well as human trafficking whereby orphans are easy targets for the highly lucrative business along the coast, and unfavourable cultural practices such as widow inheritance, polygamy, female genital circumcision and cleansing rituals (which include the sexual violation of girls). All these increase the risk of HIV infection.
The Church in Kenya will promote fairness and respect in relations between women and men, boys and girls, encouraging more equal status, rights, levels of responsibility, access resources and share in decision-making. The Church will promote discussions on cultural or traditional practices which undermine equality and respect, thus increasing the risk of HIV infection, and help vulnerable groups to make well-informed and responsible decisions. The Church will also advocate for the promotion of justice, protection and adherence to human rights standards.
Advocacy
This is a core element of the Church’s strategy aimed at promoting solidarity and averting the spread of HIV. The Church will work to increase its own capacity at the national, regional and local levels to address both the root causes of HIV infection as well as the human, economic and political impact of the pandemic. Education will aim at increasing understanding within ecclesial structures, among clergy and pastoral workers and local communities, so that they can better contribute to HIV prevention, care and mitigation of impact. The Church will advocate for the development of new national policies, and the implementation of existing ones, which protect and support those living with HIV or affected by AIDS.
In line with the above, the Church will actively advocate the provision of basic, affordable and accessible healthcare, both preventive and curative, including access to ARVs, financial and political support, increased funding and reduction of stigma and discrimination.
Interventions
Prevention
In Kenya, HIV prevalence in women, as a consequence of both biological susceptibility and gender inequalities, is almost twice that of men.4 Those living in urban areas have significant higher risk of HIV infection (10%) than rural residents (6%). However, the greatest impact of HIV and AIDS on livelihoods occurs in the rural areas. Prevention of HIV is based on open communication, better understanding, firm values and avoidance of high risk behaviours.
COMMUNICATION ABOUT BEHAVIOUR, VALUES AND CHANGE
The Church in Kenya will strive to increase general capacity for HIV prevention through formation for responsible and respectful behaviour as well education about HIV, AIDS and sexuality, based on full, accurate and scientific information. Information will be tailored to reach and suit different audiences such as children, youth, females and adults in general.
In order to diminish inequalities and abuse which fuel the spread of HIV, the Church will promote the education of women, their empowerment and leadership. Concomitantly, the Church will impart life skills to men, women, children and youth, enabling them to make informed and responsible decisions.
In Kenya, the wealthiest portion of the population has the highest HIV prevalence (10%) while among the poorest it is less than 4%. Among cohabiting couples, 4% are both infected and 7% are discordant (one partner being infected and the other not). Using appropriate media channels, the Church will educate about HIV prevention, exercise its leading role in stigma reduction, and endorse positive, responsible behaviour in line with the Church’s moral values like respect for others, self-respect, the protection of life and the promotion of the family.
PREVENTION OF MOTHER TO CHILD TRANSMISSION
Mother-to-child transmission (PMTCT) of HIV is responsible for the majority of HIV infection in children. The likelihood of a pregnant woman who is HIV-positive transmitting HIV to her newborn ranges from 30% to 40%. The infant may become infected during pregnancy, labour and delivery and through breastfeeding.
The Church will advocate on behalf of those who are infected, and its health facilities will refer clients (both mother and child) for access to anti-retroviral therapy. Health workers will be kept abreast of modified obstetrical practices5 to reduce trauma and exposure of the baby to the HIV virus during labour. The Church is committed to promote follow-up and care with the provision of a full package of services (PMCT-Plus) in line with existing government policies.
COUNSELLING
Counselling is a core activity of the clergy and pastoral workers and it is how the Church promotes values such as family unity, responsibility, solidarity, fidelity and justice. In order better to equip pastoral teams to provide counselling and leadership, the Church will provide training to all pastoral workers and clergy to keep them abreast of the most up-to-date information on HIV and AIDS in order to support those affected or infected to cope better, to sustain their livelihoods and to help communities to maintain social cohesion. Through constant counselling, the Church will promote HIV testing and explain that those who are aware of their HIV status are better able to plan their livelihood and enjoy family values based on trust. Couples with one or both members HIV-positive will be counselled and equipped to make informed decisions on how to live their marital relationship while preserving life and the family.
VOLUNTARY COUNSELLING AND TESTING
An individual aware of his/her HIV status is better equipped to avoid risky behaviour, change behaviour if necessary, and make informed and responsible decisions. Voluntary counselling and testing (VCT) are, for those testing positive, the point of entry into care. Early access to care delays progression to full-blown AIDS and is, therefore, in line with the main strategy of preserving life. The Church in Kenya will motivate people to know their HIV status and offer, when suitable, HIV testing and counselling in compliance with Government policy. Those testing positive will be provided with education on positive living, receive spiritual and psychosocial support and appropriate care or referral. The Church will encourage testing before marriage, while keeping the information confidential within the couple, to promote a relationship based on truth and trust and the ability to make informed decisions.
PREVENTION AND MANAGEMENT OF SEXUALLY-TRANSMITTED INFECTIONS
Both HIV and Sexually Transmitted Infections (STI) are spread through the same high-risk behaviours. Those with STIs are at higher risk of contracting HIV and should be offered counselling and education to enable them to take appropriate decisions. The Church in Kenya will strive to combat such infections through appropriate healthcare, diffusion of moral values, and stigma reduction.
PREVENTION OF TUBERCULOSIS
Since the HIV epidemic began in Kenya, tuberculosis cases have increased tenfold. TB is a major cause of mortality among those who are infected. The Catholic Church will comply with the National Tuberculosis Control Strategy ensuring state-of-the-art services to fight these two epidemics and promote a better quality of life. This will include surveillance support such as active-case search and referral.
UNIVERSAL PRECAUTIONS
Averting risks of HIV transmission during the delivery of healthcare is a matter of ethics, justice, rights and solidarity. Preservation of life is at the core of healthcare services. The Church will promote training of health personnel to avoid nosocomial infections and closely monitor compliance and adherence to Universal Protection6 so as to protect both health workers and service-users including those under home-based care. Pastoral workers and clergy providing home-based care will receive training as well. In addition, Post-Exposure Prophylaxis (PEP) will be available to both health workers and clients.
BLOOD SAFETY
Delivery of curative health care includes the provision of blood as a vital component. However, this life-saving intervention is accompanied by the risk of infection.7 The Church will promote and ensure the delivery of safe blood in its health care services. Health facilities equipped to dispense this service will strictly comply with Kenya’s Policy Guidelines on Blood Transfusion, to guarantee that this life-saving intervention does actually save lives.
HIV IN EMERGENCIES
During crises and social instability, the effects of poverty are intensified, as well as abuse and inequalities which increase vulnerability to acquiring HIV or developing AIDS. Even usually stable relationships such as the family and community leadership might not offer security; social norms break down and, typically, children and women are at increased risk. In emergencies, the Church will aim to protect the most vulnerable, meeting their immediate needs, promoting moral values respect and solidarity, and working for the return of stability.
HIV IN THE WORKPLACE
While increasing levels of poverty in Kenya8 continue to fuel the spread of HIV, the pandemic itself intensifies such poverty in families and households affected by AIDS. Among the 2 million Kenyans infected with HIV, the majority are between 20 and 39 years of age, the most economically productive age-group. This is why the high HIV infection rate has undermined agriculture, industrialization and development, reducing the labour force and the availability of basic services.
Programmes for HIV in the workplace aim to prevent HIV infection through education for employees and their families. In addition they promote early treatment for HIV infection in order to maintain the health of workers and ensure the legal protection of their rights. The Church will implement programmes of HIV in the workplace within its own structures, thus promoting solidarity, justice and a workplace free of stigma.
Care and Support
HOME-BASED CARE
Home-based care (HBC) includes a range of interventions that sustain PLWHA, their families and caregivers throughout the illness, from diagnosis to death and bereavement. The Church will strive to include palliative care in all its HBC programmes. This will include basic medical and nursing care, counselling, and psychological support, spiritual guidance, relief for social needs, prevention of further spread of HIV and promotion of community.
The majority of PLWHA and OVC whom the Church serves live within the community with their families or foster families, and there are also community-based institutions following a family model. The Church will aim to support PLWHA, OVC and their families within their home settings. This option is based on the premise that extended family care systems can continue to function with the support of community-based programs. This provides the most effective way of helping PLWHA, OVC and their families, as well as the caregivers, to live more productively, address the complex needs, and reduce the stigma associated with AIDS within the community.
ANTI-RETROVIRAL THERAPY
To ensure long-term care and support of PLWHA and their caregivers, the Church’s health facilities will offer medical services including anti-retroviral therapy (ART). These services will include diagnosis and treatment of HIV related illnesses. The Church will also continue to advocate that the Government ensure access to anti-retrovirals (ARV) for everyone who needs them.
PREVENTION AND MANAGEMENT OF OPPORTUNISTIC INFECTIONS
To prolong life, those who are HIV-infected should receive preventive and curative treatment of opportunistic infections. Access to treatment will be offered through the Church health facilities, and advocacy for just and sustainable health policies, especially access to affordable healthcare.
MANAGEMENT OF TUBERCULOSIS
More than half of TB patients in Kenya are HIV-positive, and the presence of TB is a criterion for initiating ART. The Church will support the Government of Kenya in implementing the National Tuberculosis Control Strategy.
NUTRITION
Adequate food security is indispensable for basic health, nutrition and better survival. Those infected with HIV have higher nutritional requirements, yet lose their capacity to obtain or produce food. Both HIV and malnutrition compromise the immune system, increasing susceptibility to severe illnesses and reducing quality of life and life expectancy. The Church will promote nutrition education and counselling, water and food safety interventions, in its health facilities and during provision of home-based care. Concomitantly, the Church will campaign for policies assuring access to land and livelihoods, certification of land-ownership, and widows legally securing their family property.
Impact Mitigation
ORPHANS AND VULNERABLE CHILDREN
Since the beginning of the pandemic, the number of children losing one or both parents in Kenya has reached an estimated 1.6 million.9 Between 50% and 60% of these have lost their parents due to AIDS and an estimated 300,000 are double orphans.
Orphans were traditionally adopted by relatives or fostered in homes in their own communities. However, with the increased deaths due to AIDS, the number of OVC has grown beyond the capacity of the community to cater effectively for their basic needs. The Church will provide comprehensive care including access to education, shelter, nutrition and healthcare; psycho-social support, vocational training, access to credit and legal aid. The Church will advocate for national policies to recognize the rights of the orphans and vulnerable children and their legal protection.
GRANDPARENTS AND CAREGIVERS
Most double orphans and many single orphans are cared for by ageing grand parents or sent to other relatives. Many of these households are already living in utter poverty, and the additional burden of more children increases the vulnerability of the entire family10. The Church will facilitate support for these households and will campaign for the effective implementation of the five UNGASS11 targets to be delivered by the Government of Kenya.
ECONOMIC STRENGTHENING
Strengthening the economic capacities of families and targeted communities will be a priority for the Church. Since AIDS has delivered a devastating blow to families and communities, there is a great need to economically empower affected families as a way of enabling them to take care of the increasing needs of their OVC.
HEALTH IMPROVEMENT
OVC and their caregivers need to access medical services, including diagnosis, treatment of HIV-related illnesses, and ART. These can be offered by existing Church health facilities, in partnership with private and Government service providers.
SUPPORT FOR EDUCATION
OVC require educational support including school fees and expenses, uniforms, books and stationery. In partnership with the Ministry of Education, the Church will work for improved quality of education and better rates of school enrolment, retention and completion. For OVC who graduate, vocational training will be provided so that boys and girls can prepare to earn their livelihoods.
PSYCHO-SOCIAL SUPPORT
OVC, their families and caregivers require appropriate psycho-social support and spiritual counselling. These continuous services of counselling and guidance would form a large part of the Church’s HIV control activities.
BUILDING CAPACITY
To ensure long-term support for OVC and their caregivers, the Church will identify and train members of the Small Christian Communities. These resource persons will mainly be volunteers, some of whom are already supporting OVC and their families in their parishes.
FOOD SUPPORT
The majority of OVC and their caregiver households require some food assistance. The Church will provide food assistance and continue urging the Government and other agencies to provide it, too. Parish programmes will train needy households in simple technologies of food production like the trench garden system and corridor gardens.
REDUCTION OF STIGMA
Stigma and discrimination make the general public afraid, with individuals afraid to find out their HIV status, or to seek care and support, or to do anything which might manifest their HIV-positive status. To deal with this cultural problem, the Church will use its well-established structures and systems (including homilies, media and schools) to educate communities about HIV and AIDS and counteract stigma and discrimination.
LIFE SKILLS
Youth are at greater risk of HIV infection if they are out-of-school and lack access to formation and information. Education in life skills helps children and youth to deal with peer pressure and resist negative cultural practices (like early marriage, defilement, incest and sexual cleansing) that increase the risk of HIV infection. Such education conveys self-worth, moral values and self-confidence, helping youth to make informed decisions such as postponing first sexual experience until marriage. The Church will offer life skills education and push for it to be incorporated into curricula throughout the country.
LEGAL ASSISTANCE AND PROTECTION
AIDS continues to impact on the growth of the Kenyan population, and has reduced family income and assets, increasing expenditure on healthcare and funerals. Kenyan agriculture, health, education, commercial and industrial sectors have been severely affected by the loss of skilled adult labour. The Church will advocate for policies to protect the rights of children, orphans, widows and other vulnerable populations affected by HIV.
Monitoring and Evaluation
Many Catholic AIDS projects have their own mechanisms for monitoring and evaluation, but the Church as a whole lacks one. Hence, a framework will be developed to monitor and evaluate the progress of this Kenya Catholic AIDS Policy. This will go hand in hand with building the capacity of Catholic institutions in monitoring and evaluation. A system for the management of information will be established. Skills and tools for supervision, accounting, monitoring, evaluation and reporting will be developed and offered in joint training sessions at all levels of the Church.
Notes
1 Those at most risk include but are not only limited to: discordant and infected couples, people physically challenged, healthcare personnel, heavy drinkers, commercial sex workers, injecting drug users and transportation workers.
2 The Church will look beyond its traditional sources of funding and increase its donor portfolio to include the World Bank, the Global Fund, with participation in the Country Coordination Mechanisms, and private foundations.
3 Gender-based violence (GBV) refers to any harm perpetrated against a person’s will, resulting from power inequalities that are based on gender roles. This harm does not need to be physical; it can be psychological, emotional and a number of coercive/controlling behaviours.
4 HIV prevalence in women age 15-49 is 8.7%, while for men age 15-49 it is 4.6% (National AIDS and STI Control Programme, Ministry of Health, Kenya. AIDS in Kenya, 7th ed., Nairobi: NASCOP, 2005).
5 These practices include avoiding routine episiotomy, avoiding prolonged labour, ensuring that delivery happens within 4 hours after membranes rupture and opting for a Caesarean where feasible.
6 This includes the use of protection equipment such as gloves, goggles and aprons by health care workers, appropriate disposal of sharp used equipment and appropriate management and disposal of medical and health facility solid waste.
7 Malaria, syphilis, hepatitis C, hepatitis B and HIV can be transmitted through unsafe blood transfusion.
8 More than 56% of Kenyans have less than one dollar a day and live below the poverty line (NASCOP, 2005).
9 This includes both single and double orphans. A single orphan is a child who has lost either the mother of father; a double orphan one who has lost both mother and father.
10 Of the Kenya population, 56% lives below the poverty line (UNAIDS/UNICEF/USAID, Children on the brink, 2004).
11 (1) Disseminate and promote the Convention on the Rights of the Child, (2) Combat childhood diseases, strengthen PHC, prioritize prevention of HIV and treatment of AIDS, (3) Overcome malnutrition, (4) Reduce maternal mortality, (5) support parental responsibility and alternative care. United Nations General Assembly Twenty-sixth Special Session Doc: A/s-26/L.2 [27 June 2001, New York]
CONCLUSION
The Catholic Church in Kenya has been responding to HIV and AIDS for over twenty years, and yet This We Teach and Do is a big step and a new beginning.
With our signature as Bishops, the document becomes the impetus for efforts at every level.
Each Diocese will develop its own plan, or share the plan it has already made, in harmony with this national policy. More specific guidelines will be provided. At the same time, the Commission on Health and Family Life will share this policy with the other Commissions and Departments of the Kenya Episcopal Conference so that every aspect of Church life may appropriately take up the challenges.
With the assistance of K-CHAT, planning will begin immediately for a national Catholic AIDS conference to be held in 2007,
• to review and celebrate the twenty years of Catholic AIDS ministry since The Challenge of AIDS of 1987
• to launch This We Teach and Do throughout the Church in this country
• to enhance collaboration and networking amongst everyone involved in the Church’s AIDS ministry
A more popular version of this policy will be produced in English, Swahili and other languages, so that everyone who is contributing to the Church’s effort can benefit from the encouragement, guidance and orientation which we Bishops are giving.
In this age of AIDS, our prayer is for the infected, the affected, those at risk and those involved in care and service.
“In Christ lies the hope of true, full health; the salvation that He brings is the true response to the ultimate questions about man. There is no contradiction between earthly health and eternal salvation, since the Lord died for the integral salvation of the human person and of all humanity.”1
HIV and AIDS deeply challenge us all. We beg our most merciful Father to bestow the twofold grace of health and salvation on everyone in Kenya and beyond.
“May the God of steadfastness and encouragement grant you to live in such harmony with one another, in accord with Christ Jesus, that together you may with one voice glorify the God and Father of our Lord Jesus Christ” (Rom 15:5-6).
Notes
1 Pope John Paul II, Message for the 13th World Day of the Sick, 2005, § 6, referring to 1 Peter 1:2-5; Liturgy of Holy Friday, Adoration of the Cross.
APPENDIX:
THE CHALLENGE OF AIDS
Two disasters struck mankind in the year 1986: Chernobyl and the AIDS epidemic, which sent shock waves throughout the world. Chernobyl was a solemn warning against polluting the stream of human life itself. AIDS has cast a baleful shadow across, what was fancied to be, the beautiful lives of men and women emancipated by the sexual revolution. We, the Bishops of Kenya, would be failing in our pastoral duty if we remained silent in this hour of trial.
It would be wrong, theologically unsound, to think that this calamity is the work of an avenging God, punishing mankind for individual and collective sins. Certain actions will have certain consequences. Nature has its own law of retribution. When we misuse tobacco, drinks or drugs, the consequences are inevitable. So also AIDS is the necessary consequence of certain abuses. Promiscuity, it would seem, is at the bottom of the whole problem, the root-cause of the rapid spread of the disease in epidemic proportions.
What is the remedy? Some governments in the West have been advocating the liberal use of condoms. The governments, prompted by the principle of the greatest happiness of the largest number of citizens, guided by the principle of utilitarianism and hedonism, may resort to the unrestricted use of condoms (whose efficacy, incidentally, is not infallible) and tacitly encourage promiscuous living. But this is not a question of protective condoms and clean needles only. We have to go to the sources of morality, do a bit of heartsearching, consider our attitude towards human relationships and how sexuality fits into that.
Chastity before marriage and fidelity after should not be brushed aside as an impossible ideal. The news from the United States in this connection is encouraging: under shock treatment given by the scare of AIDS, men and women are rediscovering that self-discipline is both possible and necessary. A moral reaction may set in by the fear induced by AIDS. We must note, however, that a fear-inspired morality is not a truly Christian morality; this must rest on love, not on fear. It is not a bad thing to be startled and shocked into sobriety by the challenge of this terrible epidemic; but from this awakening one must rise to the recognition of the love of God which has dictated the moral law for our happiness.
In the past, we, in most ethnic groups, had our own positive values to protect virtue – sometimes protected by very severe measures. If so, why not go back to these positive moral values and authentic Christian ethics? Surely most of these traditional values did not promote the sort of life that is glorified in some sophisticated societies, which celebrate all sex as liberating, enriching, joyous, even if it is not honest, faithful and socially responsible.
A virgin bride was much esteemed in almost all African cultures, and her family loaded with gifts; conversely, the husband had the right in some African societies to repudiate a bride found to be non-virgin, or at any rate to reduce the bride-price. So when the Church condemns premarital and extra-marital sex, it is neither asking for the impossible nor proposing something altogether contrary to our traditions.
Finally, however much we may dread the disease, we must show Christian compassion to the victims. It would be unchristian to treat AIDS victims as outcasts. Besides, medical authorities assure us that one does not catch the infection by caring for and tending AIDS patients. For the victims the greatest pain will be that they are not wanted, shunned even by their near relations. The first conference on AIDS in Britain under Catholic auspices, held in November 1986, issued a noble statement from which we quote:
“Our Lord came to redeem mankind, healing the sick and identifying with the outcast. We, the Church, his disciples who seek to carry on his work and be like him, can only show ourselves his followers if we too share in the love of God for those in need….
“We urge the members of the Church in our countries, laity and clergy, cooperating where possible with already existing organisations, to search for the most effective means of help, and we ask our Bishops to give their active support to this work of Christ: for it is his Body which has AIDS.”
The Catholic Bishops of Kenya, June 1987
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